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“Invasive Procedures” 30th-anniversary reflections With the station all but abandoned due to a plasma storm, a skeleton crew of Sisko, Kira, Jadzia, Bashir, Odo, O'Brien, and Quark are easily overpowered by an unjoined Trill hell-bent on sticking the Dax symbiont in his belly. This feeble man named Verad feels that he has been condemned to a life of mediocrity because he wasn't chosen for joining. If he could only have a symbiont of his own, all would be well, and his girlfriend would especially love him. Doing his research, he found that Dax was the ideal match, and so he has come to the station with the help of Klingon mercenaries to take what he thinks is rightfully his. He almost succeeds, but made one fatal mistake: “never call me Benjamin.” In this episode of The Orb, hosts C Bryan Jones and Matthew Rushing continue our 30th-anniversary retrospective that will take you through all of Star Trek: Deep Space Nine, one episode at a time. In this installment, we discuss “Invasive Procedures”how the intimate story sheds light on Trill society and the relationship between symbiont and host. Chapters Intro (00:00:00) A Dark and Stormy Night (00:03:23) An Intimate Story (00:07:13) Verad's Motivations (00:12:18) World-Building Trill Style (00:18:29) Characters On and Off Target (00:28:01) Quark Consequences (00:33:10) Tuvok Alert! (00:36:29) Final Thoughts and Ratings (00:40:28) Closing (00:43:02) Hosts C Bryan Jones and Matthew Rushing Production C Bryan Jones (Editor and Producer) Matthew Rushing (Executive Producer) Norman C. Lao (Associate Producer)
“Invasive Procedures” 30th-anniversary reflections With the station all but abandoned due to a plasma storm, a skeleton crew of Sisko, Kira, Jadzia, Bashir, Odo, O'Brien, and Quark are easily overpowered by an unjoined Trill hell-bent on sticking the Dax symbiont in his belly. This feeble man named Verad feels that he has been condemned to a life of mediocrity because he wasn't chosen for joining. If he could only have a symbiont of his own, all would be well, and his girlfriend would especially love him. Doing his research, he found that Dax was the ideal match, and so he has come to the station with the help of Klingon mercenaries to take what he thinks is rightfully his. He almost succeeds, but made one fatal mistake: “never call me Benjamin.” In this episode of The Orb, hosts C Bryan Jones and Matthew Rushing continue our 30th-anniversary retrospective that will take you through all of Star Trek: Deep Space Nine, one episode at a time. In this installment, we discuss “Invasive Procedures”how the intimate story sheds light on Trill society and the relationship between symbiont and host. Chapters Intro (00:00:00) A Dark and Stormy Night (00:03:23) An Intimate Story (00:07:13) Verad's Motivations (00:12:18) World-Building Trill Style (00:18:29) Characters On and Off Target (00:28:01) Quark Consequences (00:33:10) Tuvok Alert! (00:36:29) Final Thoughts and Ratings (00:40:28) Closing (00:43:02) Hosts C Bryan Jones and Matthew Rushing Production C Bryan Jones (Editor and Producer) Matthew Rushing (Executive Producer) Norman C. Lao (Associate Producer)
Our man Death Row Sisko starts throwing ALL the hands as we enjoy "Invasive Procedures". When nebbish John Glover Trill shows up to claim the Dax symbiote, the most wild throwdown ever seen in Trek pops off. Did Tim Russ get hit so hard it made Tuvok bad at security? You decide!
Are you considering facial rejuvenation for aesthetic reasons? Or do you want to use Botox or filler for anti-aging purposes? Today's episode gives you the ins and outs of facial aesthetics and how to approach them with longevity in mind. Today on the Biohacking Superhuman Performance Podcast, I talk with Dr. Cameron Chesnut, a facial plastic surgeon, about his approach to facial rejuvenation and aesthetics. He emphasizes the importance of artistry and individualized treatment in his practice. Dr. Chesnut also addresses the use of Botox and fillers, highlighting the narrow lane in which they should be applied and the potential risks of overuse. We discuss the advancements in minimally invasive techniques that reduce trauma and improve outcomes. Dr. Chesnut advises individuals to seek reputable practitioners and consider long-term goals when considering facial procedures. In this conversation, Dr. Cameron Chesnut and I discuss various aspects of cosmetic procedures and their impact on longevity and overall well-being. He emphasizes the importance of exploring the spectrum of available procedures and understanding the baseline tissue quality for long-lasting results. Overall, Dr. Chesnut highlights the role of hormone replacement therapy in enhancing the outcomes of procedures and the significance of personalized preoperative protocols. He shares his approach to managing discomfort without the use of painkillers and the importance of realistic expectations and patient education. Dr. Chesnut is the facial plastic surgeon for the world's high-performers. People from all corners of the globe seek his next-level results - with astonishing outcomes from minimally invasive procedures that leave his patients looking natural, rejuvenated, and seemingly untouched. He is renowned for his progressive use of regenerative medicine and postoperative recovery techniques, as well as his dedicated personal preparation for performance readiness. Even Dr. Chesnut's anesthesia protocol is next level - focused on protecting your neurocognitive function with the safest, opioid-free anesthesia. This is NOT general anesthesia, and it even allows Dr. Chesnut to help optimize the sleep cycle after surgery. Thank you to our sponsors for making this episode possible: Berkeley Life: Consumers may register and place an order using my code NIDDBL for 10% off at berkeleylife.com Vitali: Visit: https://www.vitaliskincare.com and use code NAT25 to save on your order. BiOptimizers: For Sleep Breakthrough use code bionat at checkout to save on your order at bioptimizers.com/bionat Find more from Dr. Cameron Chesnut: Website: https://www.clinic5c.com/about/dr-cameron-chesnut/ Instagram: @chesnut.md https://www.instagram.com/clinic5c.functionalmed/ Find more from Nathalie: YouTube: https://www.youtube.com/channel/UCmholC48MqRC50UffIZOMOQ Join Nat's Membership Community: https://www.natniddam.com/bsp-community Sign up for Nats Newsletter: https://landing.mailerlite.com/webforms/landing/i7d5m0 Instagram: https://www.instagram.com/nathalieniddam/ Website: www.NatNiddam.com Facebook Group: https://www.facebook.com/groups/biohackingsuperhumanperformance What We Discuss: 03:02 The Art of Facial Plastic Surgery 07:52 Approach to Medicine and Wellness 12:28 Facial Rejuvenation and Aesthetics 18:13 The Narrow Lane of Botox and Fillers 23:00 Minimally Invasive Techniques and Trauma 26:40 Best Practices for Botox and Fillers 32:44 Preparing for Future Procedures 34:24 Exploring the Spectrum of Procedures 35:10 Baseline Tissue Quality and Longevity of Results 36:23 Recovery in a Functional Medicine Setting 37:40 Hormone Replacement and Procedure Duration 38:25 Customizing Procedures Based on Hormone Status 39:32 Determining When a New Procedure is Needed 40:07 Rejuvenation vs. Transformation in Older Patients 41:30 Treating the Entire Face for Natural Results 41:44 Preoperative Protocol and Individualized Care 44:11 Utilizing Peptides for Preoperative Preparation 46:37 Ideal Patients and the Screening Process 51:24 Managing Discomfort and Pain Medication 54:37 The Impact of Facial Appearance on Health and Communication 58:33 Educating Patients and Realistic Expectations Key Takeaways: Facial plastic surgery requires an artistic approach and individualized treatment. Botox and fillers have a narrow lane of application and should be used judiciously. Advancements in minimally invasive techniques have reduced trauma and improved outcomes. It is important to seek reputable practitioners and consider long-term goals when considering facial procedures. Exploring the spectrum of available procedures can help individuals make informed decisions about their cosmetic goals. Baseline tissue quality and hormone status play a significant role in the longevity of procedure results. Personalized preoperative protocols, including hormone replacement therapy, can enhance the outcomes of procedures. Managing discomfort without painkillers and setting realistic expectations are crucial for a successful recovery and long-term satisfaction.
The gang gets up into the guts of "Invasive Procedures!" Cameron keeps his marriage from falling apart, Rob doesn't drink the Kool-Aid, John tracks O'Brien's family tree, and Bobi wonders what to do with Quark. Engage!Pick up some Green Shirt Merch
Invasive Procedures (DS9 S2 E04) was recommended by Rhaen, who said: "I saw it as a rerun, I had to have been 7-8 years old. As a kid I identified with the Trill since I felt like my consciousness and body are separate things, like my consciousness was some other being living inside me. Anyway the episode has some rando show up and hijack the Dax symbiont for a little while, and there are these kinda weirdly intimate scenes both where the symbiont is taken out of Jadzia and put in the guy who is them briefly imbued with all sorts of memories and knowledge. The theme of the episode is that it's wrong to take something by force rather than earning it (the trill pipeline) I think, but my very young takeaway was different, reflecting more on the intimacy of the symbiotic relationship and vulnerability I guess!"Invasive Procedures first aired on October 17, 1993, written by story by John Whelpley, teleplay by John Whelpley and Robert Hewitt Wolfe, and directed by Les LandauThe Joy of Trek is hosted by Khaki & Kay, with editing & production by Chief Engineer Greg and music by Fox Amoore (Bandcamp | Bluesky)Send us your recommendations, or support us on Patreon.Find us at joyoftrek.com | Bluesky | Instagram
It's All Been Trekked Before #348 Season 12, Episode 9 Star Trek: Deep Space 9 #2.04 "Invasive Procedures" Keith returns to give his thoughts on recent DS9. Stephen is curious about the Trills and geeks out over guest stars. Jimmy-Jerome wonders how Quark can possibly come back from this. It's All Been Trekked Before is produced by IABD Presents entertainment network. http://iabdpresents.com Please support us at http://pateron.com/iabd Follow us on social media @IABDPresents and https://www.facebook.com/ItsAllBeenTrekkedBefore
Happy New Year! This month for the January 2024 episode of the RCEM Learning Podcast Rob and Liz have got a New in EM segment looking at the DAShED study examining the diagnosis and investigation of suspected acute aortic section. Becky and Chris then go over the RCEM Guidelines for Invasive Procedures in the ED. We then go to Andy and Dave again looking at non-invasive airway management of the comatose toxicological patient. We then end with New Online. If you'd like to email us, please feel free to do so here. (02:58) New in EM - Diagnosis of Acute Aortic Syndrome in the Emergency Department New in EM - Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome (McLatchie et al., 2023) RCEMLearning Podcast - Aortic Dissection - Andy Neill, Becky Maxwell et al. (23:43) Guidelines for EM - RCEM - Invasive Procedures in the ED RCEM - Invasive Procedures in the Emergency Department (55:20) New in EM - Noninvasive Airway Management of Comatose Poisoned Patients New in EM - Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning (Freund et al., 2023) (01:11:40) New Online – new articles on RCEMLearning for your CPD Aortic Dissection – Gary Cumberbatch Blood Transfusion Part 1 – Derek Obiri and Charlotte Davies Blood Transfusion Part 2 – Derek Obiri and Charlotte Davies RCEMLearning Podcast - Aortic Dissection - Andy Neill, Becky Maxwell et al.
In this episode, Dr. Will Cole is joined by author and nationally-recognized board-certified plastic surgeon, Dr. Anthony Youn. Known as America's Holistic Plastic Surgeon®, Youn gives us a glimpse into his new book, Younger for Life, and how we can turn back the clock on aging through the process of Autojuvenation®. He also shares with us his favorite non-invasive procedures and skincare and dispels some of the most common myths surrounding plastic surgery (it doesn't always have to look scary!). For all links mentioned in this episode: www.drwillcole.com/podcastPlease note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.Sponsors:Visit drinkAG1.com/willcole to get a FREE 1-year supply of Vitamin D3K2 AND 5 free AG1 Travel Packs with your first purchase.Right now, Mindbloom is offering our listeners $100 off your first six-session program when you sign up at mindbloom.com/willcole and use promo code willcole.Visit Drinkkarma.com/willcole for 15% off and free shipping on your first order.Visit tndickinsons.com/willcole for more information and to purchase!Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this podcast, Julie Ann Justo, PharmD, MS, FIDSA, BCPS, discusses treatment of carbapenem-resistant Enterobacterales (CRE) infections, including:Burden of CRE infections in the United StatesMechanisms of resistanceChanging epidemiologyUse of rapid diagnostic testsIDSA guidance recommendations, including supporting dataApproach to designing treatment regimens, including weighing patient- and infection-related factorsFaculty:Julie Ann Justo, PharmD, MS, FIDSA, BCPSClinical Pharmacist Lead – Infectious DiseasesInpatient PharmacyDartmouth Hitchcock Medical CenterLebanon, New HampshireLink to full program: https://bit.ly/41a8Mj0Link to accompanying ClinicalThought commentary:https://bit.ly/4865T57Link to downloadable infographic: https://bit.ly/3t7NpT2
In this podcast, Julie Ann Justo, PharmD, MS, FIDSA, BCPS, discusses treatment of carbapenem-resistant Enterobacterales (CRE) infections, including:Burden of CRE infections in the United StatesMechanisms of resistanceChanging epidemiologyUse of rapid diagnostic testsIDSA guidance recommendations, including supporting dataApproach to designing treatment regimens, including weighing patient- and infection-related factorsFaculty:Julie Ann Justo, PharmD, MS, FIDSA, BCPSClinical Pharmacist Lead – Infectious DiseasesInpatient PharmacyDartmouth Hitchcock Medical CenterLebanon, New HampshireLink to full program: https://bit.ly/41a8Mj0Link to accompanying ClinicalThought commentary:https://bit.ly/4865T57Link to downloadable infographic: https://bit.ly/3t7NpT2
Welcome to Vanessa Lee's podcast: The Things We Do! Contact us! Email: podcast@thethingswedo.co TWD Instagram: @thethingswedo.co Vanessa's Instagram: @vanessalee_rn Janet's Instagram: @nursejanetg Intro Music: "No Cry" by Faison (found on Epidemic Sound)
In this podcast episode, Lisa interviews Chloe Cole, a detransitioned individual, who shares her personal journey of transitioning as a child and the challenges she faced. Chloe discusses the lack of support during her detransition and the financial motivations behind transgender surgeries. She emphasizes the importance of exploring oneself and not rushing into life-altering decisions at a young age. Chloe also shares her passion for art and her desire to pursue fashion design as a career. The Truth with Lisa Boothe is part of the iHeartRadio Podcast Network - new episodes debut every Monday & Thursday.Follow Clay & Buck on YouTube: https://www.youtube.com/c/clayandbuckSee omnystudio.com/listener for privacy information.
In this podcast episode, Lisa interviews Chloe Cole, a detransitioned individual, who shares her personal journey of transitioning as a child and the challenges she faced. Chloe discusses the lack of support during her detransition and the financial motivations behind transgender surgeries. She emphasizes the importance of exploring oneself and not rushing into life-altering decisions at a young age. Chloe also shares her passion for art and her desire to pursue fashion design as a career. The Truth with Lisa Boothe is part of the iHeartRadio Podcast Network - new episodes debut every Monday & Thursday.See omnystudio.com/listener for privacy information.
Enhancing people's appearance using non-invasive procedures, today we are discussing tweakments with Professor Catriona Ryan, Consultant Dermatologist, Institute of Dermatology.
CHEST August 2023, Volume 164, Issue 2 Anthony J. Gerbino, MD, and Anton Manyak, MD, join CHEST Podcast Moderator, Dominique Pepper MD, to discuss the harm associated with imaging abnormalities related to lung cancer screening (LCS). DOI: https://doi.org/10.1016/j.chest.2023.02.010 Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.
Dax gets into hot water as Odo stands around wishing he had some special ability which would stop intruding criminals, while Matt and Andy play another round of "Is Bashir being a creepo or just a caring friend-doctor?"[Episode discussion begins at a blisteringly fast 39:00 minutes!]Tune into our Patreon for our weekly coverage of STRANGE NEW WORLDS season 3 starting this week, crew! www.patreon.com/startrektnc
Dr. Betsy Grunch is a neuro and spine surgeon based at the Longstreet Clinic in Georgia. She got her M.D. at the Medical College of Georgia and completed both her neurosurgery residency and her spine surgery fellowship at Duke University Medical Center. Her main interests are minimally invasive spine surgeries, artificial disc replacements, and the overall advancement of neurotrauma, which includes acute surgical management of traumatic brain injury and spinal cord injury. She is one of Georgia's top doctors with multiple awards along with placement in the 40 under 40 lists at UGA. During her free time, she goes on family adventures with her husband, two kids, and two dogs. To keep up to date on the life of a neuro-spine surgeon and see interesting cases along with captivating x-rays and visual information, you can follow Dr. Grunch on Instagram or on tiktok @ladyspinedoc. If you want to support Doctor's Inn, here are some easy ways: 1. Leave a rating! We welcome all feedback! 2. Visit our website at www.doctorsinnpodcast.com to gain access to in-depth resources and our YouTube channel at Doctor's Inn Podcast to watch short engaging animated videos 3. Follow our socials @doctorsinnpodcast
Hosted by Sam and Scott. Support the show and find Southpaw: Deep Space Nine season 3 at: https://www.patreon.com/southpawpod Sign up for Liberation Martial Arts Online: https://www.patreon.com/posts/liberation-arts-72505630 We can't continue to produce important episodes like this one without your solidarity. There is no Southpaw network without your financial support. In return, not only do you help produce our shows but you also get access to more great content. It's mutual aid. Find our Patreon, swag, and other ways to support us at: https://www.southpawpod.com You can find Southpaw on Facebook, Twitter, and Instagram: @SouthpawPod
The station is evacuated AGAIN? Is it the looming energy storm, Quark and the Kingons, or possibly a chance to sneak in an episode at a lower budget? WHO KNOWS? Join the Nerds as they theorize on this and more! --- Support this podcast: https://anchor.fm/thenerdtrekpodcast/support
The station is evacuated AGAIN? Is it the looming energy storm, Quark and the Kingons, or possibly a chance to sneak in an episode at a lower budget? WHO KNOWS? Join the Nerds as they theorize on this and more! --- Support this podcast: https://anchor.fm/thenerdtrekpodcast/support
The Centre for Perioperative Care (CPOC) has published new safety standards (NatSSIPs2) to enable all hospitals in the UK to improve patient safety by applying a consistent and proportionate set of safety checks for all invasive procedures.
Data and Fletcher review Star Trek Deep Space Nine Season 2 Episode 4 "Invasive Procedures." In this episode, Quark coldly betrays the station to ruthless mercenaries, for which he suffers no consequences. Some more quality acting by John Glover: https://www.youtube.com/watch?v=qIzYwGZMI_Y The Sanderlanche, Data's podcast where he and other people talk about Brandon Sanderson books: https://www.thesanderlanche.com/
Podcast discute o quarto episódio da segunda temporada de DS9 "Invasive Procedures". O post Balde do Odo #24 Invasive Procedures apareceu primeiro em Trek Brasilis - A fonte definitiva de Star Trek (Jornada nas Estrelas) em português.
17. Oktober 1993: Kaum ist die Belagerung durch die kreistreue Miliz vorüber, ereilt DS9 ein schwerer Plasmasturm und die Station wird erneut evakuiert. Quark will die Gelegenheit für einen dreckigen Deal nutzen, geht diesmal aber zu weit: Dümmliche Klingonen und ein stotternder Trill brechen ein und plötzlich steht Jadzias Leben auf dem Spiel. Doch hat man die Rechnung ohne Benjamins Psychospielchen gemacht. In Deutschland: Der Symbiont, ausgestrahlt am 1. September 1994.
Matthew (he/him) and Jo (they/them) have a weird podcast episode while talking about a weird DS9 episode, they talk about the small, but emotional scale of this episode, debate evacuation procedures on DS9 and they cast Lord of the Rings with old Hollywood stars for some reason. They also spend a little extra time talking about Trill society and the “haves and have nots.” Matthew asks if Bashir is a royalist and Jo rants about how Starfleet doctors know so much medical and anatomy information about so many different speciesAs always, be prepared that spoilers may be lurking around every corner just like Garak on Empok Nor. Follow us online: Twitter - @TerokNoir E-mail questions or comments: teroknoirpod@gmail.com Feel free to rate and review our podcast and thanks for listening!
They've evacuated DS9 for the second time in a row leaving only our heroes to battle Lionel Luthor, Tuvok and Larry Sanders' wife for custody of Dax. Don't let your high school boyfriends play Kenickie in Grease. *This is an audio-only feed of K&M's Video Podcast found here: https://youtube.com/playlist?list=PLidGSKPjKhVLDXW-9SDCdmYZR7rvMCIfp Support K&M's Patron & get lots of bonus content here: https://www.patreon.com/KandM
This week, please join author Jonathan Sterne and Associate Editor Shinya Goto as they discuss the article "Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the Journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Oh, Greg, we've got a special treat for everyone today. We have a third co-host and he is none other than Peder Myhre from Norway! Really adding to the diversity of our podcast: me from Asia, you from the US, and Peder from Europe. Welcome, Peder. Dr. Peder Myhre: Thank you so much, Carolyn. It's truly an honor to be here and I'm looking forward to being part of this podcast today. Dr. Carolyn Lam: Awesome. Well, here we go. Looks like we have a feature paper, Greg? Dr. Greg Hundley: Absolutely, Carolyn. Peder, welcome. So, listeners, our feature today will involve COVID-19 and its association with arterial and venous thrombotic diseases. But before we get to that, we're going to all grab a cup of coffee from all over the world and get into some of the other articles in the issue. Peder, Carolyn, how about I go first? My first study involves a prospective cohort of 94,000 individuals from the UK Biobank, who had device-measured physical activity from 2013 to 2015 and were free from myocardial infarction and heart failure. Now, Peder and Carolyn, the study was performed because although objectively measured physical activity has been found associated with acute cardiovascular outcomes, it has not been found associated with heart failure and, of course, a syndrome that's been expanding worldwide. As such this study led by Carlos Celis-Morales from the University of Glasgow aimed to investigate the dose response relationship between device-measured physical activity and heart failure by intensity of the physical activity. Now physical activity was measured with a wrist-worn accelerometer and time spent on light, moderate, and vigorous intensity physical activity was extracted. Incidental heart failure was ascertained from linked hospital and death records. Dr. Peder Myhre: Wow, Greg. That sounds amazing. Tell us, what did they find? Dr. Greg Hundley: You bet, Peder! These investigators found that, compared with participants who undertook no moderate to vigorous intensity physical activity, those who performed 150 to 300 minutes per week of moderate intensity physical activity or 75 to 150 minutes per week of vigorous intensity physical activity were at lower risk of heart failure. Now, interestingly, the association between vigorous intensity physical activity and heart failure was a reverse J-shaped curve with a potentially lower risk reduction above 150 minutes per week. And so, the take-home message for this first paper is that device-measured physical activity, especially moderate intensity physical activity, was associated with a lower risk of heart failure. Probably current vigorous intensity physical activity recommendations should be encouraged, but not necessarily increased. In contrast, increasing moderate intensity physical activity may be beneficial, even among those meeting current recommendations. Dr. Peder Myhre: Wow, Greg. That was a great summary. And the second original research article today is about high density lipoproteins. As you know, raising HDL cholesterol levels to prevent cardiovascular disease remains a hot topic. HDL plays a key role in reverse cholesterol transport and may be cardioprotective and reduce infarct size in the setting of myocardial injury. Lecithin cholesterol acyl transferase, LCAT, is the rate limiting enzyme in the reverse cholesterol transport and a recombinant human LCAT called MEDI6012 has previously been shown to increase HDL cholesterol. So in this study from the corresponding author, Marc Bonaca from University of Colorado School of Medicine, the investigators in the real team is 63B multicenter placebo control trial investigated whether randomized patients to, MEDI6012 or placebo would reduce the infarct size as measured by cardiac MRI, 10 to 12 weeks after the STEMI. Dr. Greg Hundley: Very interesting, Peder. So, MRI assessments of LV mass after PCI. So, what did they find? Dr. Peder Myhre: So, Greg, the authors successfully enrolled 593 patients with a median age of 62 years and 78% males. And the median time from symptom onset to randomization was 146 minutes and only 13 minutes from hospitalization to randomization. And the index MI was anterior in 70% and 65% had TIMI Flow grade 0-1. And then to the main results at 12 weeks, the infarct size did not defer between the treatment group. So that was a 9.7% infarct size for MEDI6012 versus 10.5% for placebo with a P value of 0.79. And there was also no difference in noncalcified black volume. So the authors conclude that enhanced reverse cholesterol transport with recombinant human LCAT did not reduce infarct size or late regression of noncalcified coronary REPL at 12 weeks. Okay, Greg. So tell me about the 3rd paper you have today? Dr. Greg Hundley: Peder, what a great description on that previous paper, beautiful job there. So Peder, this next article pertains to cardio toxicity related to the administration of anthracycline-based chemotherapy. And an example would be Doxorubicin. And this occurs in patients often with certain types of cancer. As you know, Doxorubicin is still utilized for the treatment of leukemia, lymphoma, soft tissue sarcoma and in the setting of adjuvant breast cancer treatment. And so to this end, the authors, led by Lorrie Kirshenbaum from St. Boniface Hospital abstract research, wanted to assess cytokine mediated inflammation in myocellular injury, as a result of some of the inflammation that's induced by the administration of Doxorubicin. So as a little bit of background, cytokines, such as TNF alpha, have been implicated in cardiac dysfunction and toxicity associated with Doxorubicin. Now, while TNF alpha can elicit different cellular responses, including survival or death, the mechanisms underlying these divergent outcomes in the heart really somewhat remain cryptic. The E3 ubiquitin ligase, TRAF2, provides a critical signaling platform for K63 length poly ubiquitin nation of rip K1, crucial for NF-kB activation by TNF alpha and survival. Whether alterations in TNF alpha, TRAF2, NF-kB activation signaling underlie the cardiotoxic effects of Doxorubicin, remains poorly understood. So herein, these authors investigated TRAF2 signaling in the pathogenesis of Doxorubicin cardio toxicity. Dr. Peder Myhre: Oh wow, Greg. So we're talking mitochondrial dysfunction in Doxorubicin cardiomyopathy. So please tell me, what did they find and what were the clinical implications? Dr. Greg Hundley: Very nice. Peder, you remind me of Carolyn, asking me the clinical implications. Okay, so first, in mouse models and in vitro measures in rats, mouse and human pluripotent stem cell derived cardiomyocytes, these investigators monitored TNF alpha levels, LDH, cardiac ultra structure and function, mitochondrial biogenics, as you just suggested, and cardiac cell viability. They found that a novel signaling axis exists that functionally connects the cardiotoxic effects of Doxorubicin to proteasomal degradation of TRAF2. Disruption of the critical TRAF2 survival pathway by Doxorubicin, sensitizes cardiomyocytes to TNF alpha and BNIP3 mediated necrotic cell death. Perhaps, interventions that stabilize TRAF2, so here's the clinical implication, may prove beneficial in mitigating the cardiotoxic effects in cancer patients undergoing anthracycline-based chemotherapy. Dr. Carolyn Lam: So Greg, he may sound like me, but this is me going what an amazing summary and especially in something that is your specialty cardio-oncology, that's amazing. Thank you. Peder, I assume you've got one more paper? Dr. Peder Myhre: So Greg, now I'm going to sound like you and say that we are going to stay within the world of preclinical science. So genome-wide association studies have identified many genetic loci that are robustly associated with coronary artery disease. However, the underlying biological mechanisms are still unknown for most of these loci, hindering the progress to medical translation. And there is evidence to suggest that the genetic influence of coronary artery disease sociability may partly act through vascular smooth muscle cells. So corresponding author, Shu Ye from University of Leicester, performed genotyping, RNA sequencing and cell behavior assays on the large bank of vascular smooth muscle cells with an N of almost 1500. And through these extensive analysis, they saw to identify genes whose expression was influenced by coronary artery disease associated variants. Dr. Greg Hundley: Very nice, Peder. So, more about cardiac gene expression. So, what did they find? Dr. Peder Myhre: Approximately 60% of the known coronary artery disease associated variants show statistically significant effects in vascular smooth muscle cells and the study identified 84 candidate causal genes whose expression quantitative trait, loci signals in vascular smooth muscle cells, significantly co-localized with reported coronary artery disease association signals, of which 38 of them are potentially druggable, so, that was the clinical implications. The authors conclude that a large percentage of coronary artery disease loci can modulate genes, gene expression in vascular smooth muscle cells and influence these cell behavior. Several candidate causal genes identified are likely to be druggable and thus represent potential therapeutic targets. And Greg, accompanying this paper is a beautiful editorial by doctors O'Donnell and Bradner entitled "Bridging the Gap to Translating Genome-Wide Discoveries into Therapies to Prevent and Treat Atherosclerotic Cardiovascular Disease." Dr. Greg Hundley: Very nicely done Peder, very nicely done. Well, as usual, we have some other items, we call it in the mail bag because we receive these wonderful research letters and also research correspondence. So I'll go first. First, Dr. Al-Khatib has a research letter entitled, "Duration of Anticoagulation Interruption before Invasive Procedures and Outcomes in Patients with Atrial Fibrillation Insights from the Aristotle Trial." And also there's a nice ECG analysis by Dr. Tsai entitled, "A Peculiar Wide-Complex Tachycardia During Flecainide Treatment." Dr. Peder Myhre: Nice, Greg, and there's also an exchange on letters to the editors and the response from Professors Zhao and Ding, and again, a response from Professor Zhang regarding the prior letter by Jin et al. pertaining to the previously published article "Micro RNA, 210 Controls, Mitochondrial Metabolism and Protects Heart Function in Myocardial Infarction." Dr. Greg Hundley: Beautifully done, Peder. Oh, wow. Welcome to this team. We're so excited to have you. And now Carolyn, I think we're going to jump over to that feature discussion and learn a little bit more about COVID-19 and arterial and venous thrombotic disease. Dr. Carolyn Lam: You bet! Let's go, Greg and Peder. Now we all know that infection with COVID 19 induces a pro-thrombotic state, but the long term effects of COVID-19 on the incidence of vascular disease, both arterial and venous, remain unclear. That is until today's feature paper. We're so grateful to have corresponding author Dr. Jonathan Stern, from the University of Bristol, as well as our associate editor, Dr. Shinya Goto from Tokai University School of Medicine to join us and discuss this very important paper today. Jonathan, could you start us off on telling us why it's so important to look at this? Haven't we always known that infections, COVID or not, are associated with pro-thrombotic state? So what's so different about what you did and what you found this time? Dr. Jonathan Stern: So, yes, I think we already knew that serious infections, in particular infections leading to hospitalization, can result in thrombotic events, either arterial or venous. And it was also clear from January, February, March 2020, that COVID led to very serious infection and therefore was likely to lead to vascular events. The questions that we set out to address, beyond simply establishing that COVID does indeed do this, was to quantify by how much COVID multiplies the rate at which these thrombotic events occurred, to do that separately for different events, such as myocardial infarction, stroke, venous thromboembolism, pulmonary embolism. And then to importantly, because we analyzed a very large dataset, which we might want to talk about, to try to separate out the amount by which the rating events was multiplied over time and in important subgroups, for example, in hospital people who were hospitalized for their COVID, compared with people who weren't hospitalized for their COVID, by age and sex, and by other demographic characteristics. Dr. Carolyn Lam: I love that, you see, that really set out the novel information this added with, may I add, very important clinical implications, which we'll get to them. You've already teed me up to talk about this 48 million adults that you managed to look at. Oh my goodness! Tell us, how in the world did you do that? Dr. Jonathan Stern: Well, I think the first thing to say is that it's my absolute privilege to talk about this paper on behalf of a really incredible team that put the work together. And a lot of that work, or that work started with really unlocking the power of NHS data because of the COVID pandemic. So in the UK, we have a national health service, free at the point of delivery to everybody. The NHS assembled electronic health records, and there's been a long and proud history of research based on electronic health records in the UK. But for the first time, because of the pandemic, a combined data resource for the whole of England, so that's a population of about 58 million people, was established and that linked primary care data - data from family doctors, data on secondary care hospital admissions, data on COVID testing and subsequently, although it's not the subject of this paper, data on vaccination. So those data were all linked and put into one place within what's called a trusted research environment with very strict controls on what can be output from the environment in order to protect patient privacy. And that was really done during 2020. And then the analyses for this paper took place during 2021, and it was an enormous amount of work by a large and absolutely fantastic team of people across multiple UK universities and national health service institutions. Dr. Carolyn Lam: Wow. Bravo! We talk about big data, we talk about using it. I trained in the NHS system. Who knew that this could come out to reveal such important results? So thank you for that as a background, but now, tell us what you found please? Dr. Jonathan Stern: So we found that rates of these conditions, they were primarily acute lymph infarction and ischemic stroke, which we grouped together with other conditions as arterial thrombotic events, and then deep vein thrombosis and pulmonary embolism, which we grouped together with other conditions as venous events. And we found that rates were substantially multiplied immediately after a diagnosis of COVID by up to 748 times, that the amount by which rates were multiplied diminished with time since COVID, but importantly that even six months to a year after that first diagnosis of COVID, rates of venous events were still about double in people who'd had COVID, compared to people who had COVID. And we found, it seemed quite clear that the persistence of the elevated risk was longer for venous events than for arterial events. Dr. Carolyn Lam: Just really fascinating results and Shinya, could I ask, what are your thoughts on this? And as you were managing this paper, the implications? Dr. Shinya Goto: First of all, thank you very much, Jonathan, for choosing saturation for your great paper. I'm handling quite a lot of papers, but your paper was very attractive. As Carolyn mentioned, it's huge data! 48 million, it's surprising, and also you also pick up booster rate of arterial embolism event for years, and you have also shown adjusted rate is initially increased quite a lot and then decreased gradually. And even after two months, three months still, there is a persisted higher risk. And as you mentioned, for the venous thrombo embolism, it's persisted for more than year to year. It's surprising. COVID-19's a different disease. Perhaps COVID-19 infection cuts to the vascular endarterial cell, perhaps, your research raised a lot of research questions, like endarterial damage induced by COVID-19 in the past 6 months; I would say more than half a year to one year. So that mechanistical insight is very important. And you raise a lot of any clinical questions. Dr. Jonathan Stern: Well, thank you very much for your kind words and you are right, I think we are left with questions about maybe in three areas. Firstly, for how long is there an elevation in risk? I should probably say, for those who haven't read the paper, that these results relate to events that occurred in England and Wales during 2020. And so that is in an era before vaccination and when we were dealing with the original variant, and to some extent, the alpha variant. So we are still waiting to see what the implications were over longer periods, and we will be doing that, we will be extending follow up. In fact, we are at the moment extending those results. I think, secondly, we are left with questions about the mechanisms, which you articulated, and thirdly, there's the question about, well, what are the implications for clinical management of patients with COVID-19? And in particular, for patients who've had severe COVID-19, for example, severe enough to be hospitalized for it? Dr. Shinya Goto: Yeah, you have also showed a very important point that even known hospitalization for COVID-19, the risk of thrombosis becomes high. So it's very surprising. And even non-hospitalized patients have a higher risk of thrombosis. That is probably the huge difference between other virus infections and COVID-19. Dr. Jonathan Stern: Yes. The good news, if you weren't hospitalized for your COVID, is that the elevation in risk declines more rapidly for people with less severe COVID who weren't hospitalized than for people with more severe COVID who were hospitalized. But nonetheless, as you say, particularly in the first week, two weeks, three weeks after COVID, there is a clear elevation in the risk of both arterial and venous events, even if you were not hospitalized for your COVID. We should probably also bear in mind that these results for 2020, when there were severe constraints for some of the time on health service resources. So you probably had to be pretty sick to get hospitalized at that time. Dr. Carolyn Lam: That was a very important caveat that you just highlighted. So thank you for contextualizing those findings for us, Jonathan, but then I kind of wish all podcast guests were like you, and you already asked a question, I was going to ask you. Which is, okay, so what's the clinical implication? Should we all be taking some low dose NOAC or aspirin? Whether you're hospitalized or not? Or if you were in 2020? Because, jokes aside, I know that you found some very important risk factors? Or these events which had clinical implications? Could you expand on it? Dr. Jonathan Stern: So maybe I'd start by saying that we didn't find that these patterns varied dramatically either by sex or by age. And in fact, when we were planning the analyses, I was convinced that we would see dramatic differences in these hazard ratios by age. And, broadly speaking, the facts on a multiplicative scale, the amount by which your rate is multiplied, looked similar across age groups and by sex. On the other hand, we did see the amount by rates of arterial and venous events were multiplied, appeared greater in people of Asian ethnicity or Black ethnicity than in people of White ethnicity. A counterintuitive finding was that the amount by which your rate was multiplied is lower, if you've had a prior event than if you hadn't. Those are the sorts of extents to which we can say something about how your own characteristics predict the consequences once you've had COVID. In terms of management, obviously the pandemic has been tumultuous for medicine and for medical research and things have moved on greatly since the pre-vaccination era, 2020 and early 2021, to which these analyses relate. So the first thing to say is, don't get hospitalized with COVID, and the best way to not be hospitalized with COVID, is to be fully vaccinated for COVID. And that's a message that I think the whole of the medical profession has communicated loudly and clearly for a long time now. So the second thing is, well, okay, what about if, nonetheless, you got COVID, particularly severe COVID, and we discussed this in the team extensively, and I particularly want to mention the senior clinical author, Dr. Will Whiteley from the University of Edinburgh in this regard, and I think the main message here is that risk factor management, cardiovascular risk factor management is always important, but it's probably particularly important in people who've had severe COVID to review risk factor management and make sure that existing guidelines in terms of cholesterol lowering, blood pressure lowering and so on, are being adhered to. We don't... So the most important thing is adherence to existing cardiovascular risk management guidelines. I think we don't have evidence that specific additional interventions are indicated in people who've had COVID, and COVID now in the era of Omicron and widespread vaccination is not the same as COVID during 2020. Dr. Shinya Goto: Jonathan, you have raised a very important issue. I strongly recommend all audiences to read this paper. We have to know persistent or higher risk of myocardial infarction, ischemic stroke, may be controlled more regularly controlled. Don't fear the COVID-19 infection to visiting the healthcare professional. In my country, some of the population stopped coming to the healthcare professional because they fear so much about infection from the hospital or clinic. But it's very important to keep that regular control like static and blood pressure control. Maybe we don't have that data about aspiring or not, but strong message your paper gave is that risk factor control after COVID-19 is very important. Dr. Jonathan Stern: I completely agree. Dr. Carolyn Lam: And I would add to that, remember the days when people were stopping their ACE inhibitors and so on for those fear? So what a great message and thank you for giving us a little bit of a peek into the future of what you're planning next with more follow up, in a population that is vaccinated from a different strain perhaps. And I think this still encourages hopefully more trials and research into this whole area of how we should be managing these patients. Well, thank you so much both of you for discussing this very, very current relevant, important paper. Thank you for publishing it in circulation with us. And to the audience, thank you for joining us today. From Greg and I, you've been listening to Circulation on the Run, and don't forget to tune in again next week. Speaker 6: This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.
We beam down highlights from last week's Star Trek Day, while also giving the new Star Trek: The Motion Picture - Collector's Edition 4K a spin. And that's just for starters, gang — we also revisit an underrated Deep Space Nine episode, "Invasive Procedures." So scrub in for some symbiont surgery and listen now!
Preoperative site marking for minimally invasive procedures by AORNJournal
We continue The 7th Rule journey without our friend, out brother, Aron Eisenberg. He is still with us in spirit, in stories, in laughter, and in memories, and the show must go on. Exactly how the show will develop still isn't completely certain, but the show does go on, and here is the next episode of this new journey. Today, Cirroc Lofton (Jake Sisko in Star Trek Deep Space Nine) and Ryan T. Husk review season 2, episode 4 of DS9's, "Invasive Procedures."Hosted & Produced by Ryan T. Husk.Audio Remastered by Scott Jensen. Every week, we rewatch an episode of Deep Space Nine and relive/review it, starting with episode 1, "Emissary."Join us! Rewatch DS9 every week and join in the discussion - we'd love to have you!If you enjoy our content please leave us a five star rating and comment/review.Support and join the community here: https://www.patreon.com/The7thRuleWatch the episodes with full video here: https://www.youtube.com/c/The7thRuleSocial media:https://twitter.com/7thRulehttps://www.facebook.com/The7thRule/https://www.facebook.com/groups/The7thRuleGet cool T7R merchandise here: https://the-7th-rule.creator-spring.com/Cirroc's sister, Merone, makes amazing East-African inspired clothing and items for sale at:https://www.abyssiniankiosk.com/Malissa Longo creates fun and functional Star Trek art at:https://www.walkingartmadebymalissa.com/
It's time to stand tall and shake the heavens - our boys will show you how! Mike, Peter and Jon indulge their egos reaching into the mailbag, active time babble about a controversial limb lengthening procedure, and gear up to discuss a lowering (!) Japanese age of consent for video "performers". Also, Peter is TIRED of all the unwanted attention for his unfortunate affliction. Get on our wave (existence) - it's a new Red Channel Condition, and it's coming at you now!It's time to stand tall and shake the heavens - our boys will show you how! Mike, Peter and Jon indulge their egos reaching into the mailbag, active time babble about a controversial limb lengthening procedure, and gear up to discuss a lowering (!) Japanese age of consent for video "performers". Also, Peter is TIRED of all the unwanted attention for his unfortunate affliction. Get on our wave (existence) - it's a new Red Channel Condition, and it's coming at you now!
The Station is evacuated. Again. Quarks greed run afoul the senior officers and Jadzia may pay the ultimate price. Sisko shows why he is awesome. What to expect from episode 24: Invasive Procedures? Briefing Invasive Procedures…what does that mean? Our…
Heute geht es bei "Planet Trek fm" weiter mit der Episode "Invasive Procedures" in der Reihe "The DS9-ReExperience". Darin lassen Björn Sülter & Claudia Kern die Serie Revue passieren und ganz neu erleben.
This week on Deep Space Nine, a desperate Trill tries to steal the Dax symbiont. Follow the show on Twitter and Instagram: @podwraiths We wanna hear from you! Email us at podwraiths@gmail.com Please remember to rate and review the show! thank you to dj empirical for our theme
Patricia Tallman, Actress & Stunt Performer on Star Trek TNG, DS9 & VOY Patricia Tallman has done it all in her career as an actress and a stunt performer, but all of her accolades came with a hefty price. In this episode of "Trek Untold," we have a candid conversation with the spectacular Patricia Tallman, who performed stunts on TNG, DS9, Voyager, and the "Generations" film. She's also served as a double for Gates McFadden, Nana Visitor, Gwynyth Walsh, Daphne Ashbrook, and many others. She has also been a Starfleet officer, a Romulan, a Bajoran, a Klingon, and even her own new race in the TNG episode "Starship Mine." Through all of her successes and accomplishments, Patricia struggled with being an actress in Hollywood that greatly affected her mental and physical health. Years later, she came to terms with everything she had been through and ultimately discovered her true passion. Patricia started in a small town playing Star Trek with her barbie dolls, which led her into the art of storytelling and the different ways she could express her feelings. We discussed her education in Carnegie Mellon, working with Tom Savini and George A. Romero through her career, memories of Tony Todd and the pranks she played on him during "Night of The Living Dead," learning to perform stunts, and her first role as a stunt performer in "Road House" under instruction from Rowdy Harrington and Charlie Picerni (and the injury she had that made her first stunt even more difficult), doubling for Molly Ringwald in "The Stand" and that explosive stunt that went deadly wrong, and working with Steven Spielberg as Laura Dern's double in "Jurassic Park." From there, we discuss her Star Trek work, including fights with Nana Visitor, taking falls for Gates McFadden on generations, her first Trek stunt gig, Patricia's full role on "Starship Mine," a fight scene with Tim Russ on "Invasive Procedures" that busted her wide open and left her with a crimson mask, doubling for Melinda Culea in The Outcast," a repetitive stunt for Michelle Forbes that left Patricia badly bruised, and a whole lot more! Order Patricia's autobiography "Pleasured Thresholds" here - https://b5events.com/store/ Check out Patricia's travel agency - QuestRetreats.com Support the Penny Lane charity through Patricia's "Be A Santa" program - https://beasanta.orgInside NY Comic Con During COVID-19: https://youtu.be/kQSxXhjBV78Visit Pancan.org to support the Trek against Pancreatic Cancer Please subscribe to our YouTube channel and hit the notifications button to be updated when we go live or upload our next video! Support Trek Untold by checking out our merchandise at https://teespring.com/stores/trekuntold or become a Patreon at Patreon.com/TrekUntold. Trek Untold is sponsored by Triple-Fiction Productions, a US-based company that 3-D prints Trek-inspired prop replicas for fan films and cosplayers, as well as accessories and playsets for all iterations of Trek figures through the years. Visit them at Triple-Fictionproductions.net. Don't forget to subscribe to the show and leave a rating if you like us! The views expressed on air during Trek Untold do not represent the views of the RAGE Works staff, partners, or affiliates. Follow Trek Untold on Social Media Instagram: http://www.instagram.com/trekuntoldTwitter: https://www.twitter.com/trekuntoldFacebook: https://www.facebook.com/trekuntold Follow Nerd News Today on Social Media Twitter: Twitter.com/NerdNews2Day Instagram: Instagram.com/NerdNewsToday Facebook: Facebook.com/NerdNewsToday Trek Untold is sponsored by Treksphere.com, powered by the RAGE Works Podcast Network, and affiliated with Nerd News Today.
Trek Untold: The Star Trek Podcast That Goes Beyond The Stars!
Patricia Tallman has done it all in her career as an actress and stunt performer, but all of her accolades came with a hefty price. In this episode of "Trek Untold," we have a candid conversation with the spectacular Patricia Tallman, who performed stunts on TNG, DS9, Voyager, and the "Generations" film. She's also served as a double for Gates McFadden, Nana Visitor, Gwynyth Walsh, Daphne Ashbrook, and many others. She has also been a Starfleet officer, a Romulan, a Bajoran, a Klingon, and even her own new race in the TNG episode "Starship Mine." Through all of her successes and accomplishments, Patricia struggled with being an actress in Hollywood that greatly affected her mental and physical health. Years later, she came to terms with everything she had been through and ultimately discovered her true passion. Patricia started in a small town playing Star Trek with her barbie dolls, which led her into the art of storytelling and the different ways she could express her feelings. We discussed her education in Carnegie Mellon, working with Tom Savini and George A. Romero through her career, memories of Tony Todd and the pranks she played on him during "Night of The Living Dead," learning to perform stunts, and her first role as a stunt performer in "Road House" under instruction from Rowdy Harrington and Charlie Picerni (and the injury she had that made her first stunt even more difficult), doubling for Molly Ringwald in "The Stand" and that explosive stunt that went deadly wrong, and working with Steven Spielberg as Laura Dern's double in "Jurassic Park." From there, we discuss her Star Trek work, including fights with Nana Visitor, taking falls for Gates McFadden on generations, her first Trek stunt gig, Patricia's full role on "Starship Mine," a fight scene with Tim Russ on "Invasive Procedures" that busted her wide open and left her with a crimson mask, doubling for Melinda Culea in The Outcast," a repetitive stunt for Michelle Forbes that left Patricia badly bruised, and a whole lot more! Order Patricia's autobiography "Pleasured Thresholds" here - https://b5events.com/store/Check out Patricia's travel agency - QuestRetreats.com Support the Penny Lane charity through Patricia's "Be A Santa" program - https://beasanta.org Visit https://www.drivebydogooders.org/ to donate to the cause, and if you donate $35 or more, Lycia will send you an autographed picture. In the comments section where you donate, include your name and address and what pic you would like, and Lycia will send it on your way! Visit Pancan.org to support the Trek against Pancreatic Cancer Please subscribe to our YouTube channel at youtube.com/nerdnewstoday and hit the notifications button to be updated when we go live or upload our next video! Support Trek Untold by checking out our merchandise at https://teespring.com/stores/trekuntold or become a Patreon at Patreon.com/TrekUntold. Trek Untold is sponsored by Triple-Fiction Productions, a US-based company that 3-D prints Trek-inspired prop replicas for fan films and cosplayers, as well as accessories and playsets for all iterations of Trek figures through the years. Visit them at Triple-Fictionproductions.net. Don't forget to subscribe to the show and leave a rating if you like us! Follow Trek Untold on Social Media Instagram: http://www.instagram.com/trekuntoldTwitter: https://www.twitter.com/trekuntoldFacebook: https://www.facebook.com/trekuntold Follow Nerd News Today on Social Media Twitter: Twitter.com/NerdNews2DayInstagram: Instagram.com/NerdNewsTodayFacebook: Facebook.com/NerdNewsToday Trek Untold is sponsored by Treksphere.com, powered by the RAGE Works Podcast Network, and affiliated with Nerd News Today.
A Bone to Fix-From The Orthopaedic Associates Of Central Maryland Division
Dr. Oren Blam leads a discussion on when it is appropriate to consider minimally invasive procedures for the spine, and what are the potential benefits are.
Believers S1E10 (27 Apr 94) vs. Invasive Procedures S2E4 (17 Oct 93)-We were happy to recognize John Glover who played Lionel Luthor & voiced the Riddler on Batman: The Animated Series & Tim Russ who played Tuvok on Star Trek: Voyager-The Trill issues raised in this episode callback to our prior discussion: https://rss.com/podcasts/b5ds9/174686/-Some of the implications about the Trill symbiote selection process being suspect are also present in Star Trek: Discovery Season 3--For a recent critique of meritocracy, see Daniel Markovits Meritocracy Trap: How America's Foundational Myth Feeds Inequality, Dismantles the Middle Class, & Devours the Elite (2019) & a critical interview with the author on The Genn [Loury] Show
"Invasive Procedures" from Invasive Procedures by Pelgrane Press using the Fear Itself 2nd Edition System. A MythosCon 2020 Event! In 2020, a group of hospital patients are transferred to the old Our Lady's Hospital, where they find their ailments are the least of their troubles.
"Invasive Procedures" from Invasive Procedures by Pelgrane Press using the Fear Itself 2nd Edition System. A MythosCon 2020 Event! In 2020, a group of hospital patients are transferred to the old Our Lady's Hospital, where they find their ailments are the least of their troubles.
"Invasive Procedures" from Invasive Procedures by Pelgrane Press using the Fear Itself 2nd Edition System. A MythosCon 2020 Event! In 2020, a group of hospital patients are transferred to the old Our Lady's Hospital, where they find their ailments are the least of their troubles.
"Invasive Procedures" from Invasive Procedures by Pelgrane Press using the Fear Itself 2nd Edition System. A MythosCon 2020 Event! In 2020, a group of hospital patients are transferred to the old Our Lady's Hospital, where they find their ailments are the least of their troubles.
"Invasive Procedures" from Invasive Procedures by Pelgrane Press using the Fear Itself 2nd Edition System. A MythosCon 2020 Event! In 2020, a group of hospital patients are transferred to the old Our Lady's Hospital, where they find their ailments are the least of their troubles.
Rebinging Star Trek DS9: Invasive Procedures Hello everyone! Welcome to Season 2 episode 4: Invasive Procedures! Hot off the 3-part season opener, we slide into a standalone episode starring none other than Lionel Luthor...well actually it's John Glover who is well known for playing Lionel Luthor on Smallville and most importantly LA slimeball Brice Cummings in Scrooged (his most important role). Because the station has been evacuated (so we ARE capable of evacuating!!) , DS9 is being run by a skeleton crew leaving it vulnerable to an attack. And Lionel attacks! And as always, the crew is unprepared and cannot come up with a useful plan! Argh!!! What Invasive Procedures? Lionel Luthor (also known as Verad in this episode) has come to kidnap a member of the crew...well part of a member of the crew. He wants Dax, not Jadzia, just Dax. He's a trill without a symbiont and he's come to rectify that. And let's just say...this does not go well for anyone. The usual and not so usual We cover the usual (bad hair) and the not so usual (Kira getting beat up by someone). Something has gone wrong with the hair in season 2 except for some killer bangs back in episode 2. But we are all a bit frizzy or in Lionel Luther's case we've had a very unflattering bowl cut. Questionable hair is a common thing on this show, what's not common is someone getting the better of Kira in a fight! She takes out a big Cardassian in episode 1 of this season, but here she gets taken out by Verad's tough as nails girlfriend. It is alarming! What's this rebinge thing? It's a re-watch of a thing you've already seen but love to watch and talk about. We go deep with every episode, walking you through every scene and analyzing all of the characters and story lines. Please listen to season 1 and some of our favorite episodes like In the Hands of the Prophets and Duet. Or you can also listen to our previous episode (a really good one): The Siege. Next time... We dive into Season 2 Episode 5 of DS9: Cardassians. Be sure and join our Facebook group and Follow Rebinge It on Twitter!
When is a heart attack not a heart attack? Current diagnostic tools are surprisingly inaccurate. 2020 Cade Prize finalist Dr. Russell Medford and his team have developed a “virtual cardiac catheterization” that takes existing CAT scan images and analyzes them using advanced mathematics and computational fluid dynamics. Heart doctors can quickly run this analysis on a desktop and determine whether someone has a blockage and how serious it is. This could eliminate up to 1.5 million unnecessary invasive procedures annually in the United States and Europe. TRANSCRIPT: Intro: 0:01 Inventors and they’re inventions. Welcome to Radio Cade a podcast from the Cade Museum for Creativity and Invention in Gainesville, Florida. The museum is named after James Robert Cade , who invented Gatorade in 1965. My name is Richard Miles. We’ll introduce you to inventors and the things that motivate them, we’ll learn about their personal stories, how their inventions work, and how their ideas get from the laboratory to the marketplace. Richard Miles: 0:37 When is a heart attack, not a heart attack, and how do we know? Welcome to Radio Cade, I’m your host Richard Miles. Today my guest is Dr. Russell Medford, CEO of Covanos, a company that is working on solutions to the diagnosis and treatment of cardiac and vascular disease. Dr. Medford is also a finalist for the 2020 Cade Prize for Innovation. Congratulations and welcome to Radio Cade Russell . Dr. Russell Medford: 1:00 Thank you, Richard. It’s a pleasure being here. Richard Miles: 1:02 So I should note from the beginning that you are one of our first Cade Prize finalists from outside the state of Florida, specifically from Emory University in Atlanta, and now normally Floridians don’t congratulate Georgians for anything, but today is a new day. So Russell, tell us a little bit about yourself. You’re originally from Brooklyn. How did you end up in Georgia? Dr. Russell Medford: 1:21 Well, first of all, thank you for having me on your show Richard and we at Covanos are honored to be a Cade Fibonacci finalist . We understand this is the first year that the award is now outside of Florida and I’ll speak for many Georgians, if not all, that we view our Floridian brothers and sisters with a great deal of affection and we’re part of a Southeast region that has a great deal to be proud of in many areas. So we love Florida. I love Florida. My background, I’m a Brooklyn born son of Brooklyn, but was raised in Northern New Jersey, went to Cornell University for my undergraduate training and then to the Albert Einstein College of Medicine in the Bronx, in New York City for both my medical degree training and I also have a PhD in molecular and cellular biology. I then traveled as a professional student as one to do, to Harvard and became a resident in medicine and a fellow in cardiology. And my first faculty position at the Harvard hospitals, the Beth Israel and the Brigham and Women’s hospitals. My career has been characterized by basic science research on the basis for heart disease and vascular diseases and was recruited in 1989 from Boston to head up the molecular cardiology group at Emory University School of Medicine in 1989, where we began to apply new fields in our understanding of genes and molecular biology to the treatment and understanding of heart disease and other vascular diseases such as stroke. In the course of that work, I became introduced to the process by which we take ideas in the laboratory, as a basic scientist, and translate those ideas eventually into therapies that we, as doctors can use at the bedside to treat patients with disease. And in my laboratory, we had come up back in the nineties with a hypothesis that heart disease, the disease that leads to blockages and the vessels that feed the heart with blood, the coronary arteries, a process called atherosclerosis was an inflammatory disease. Any irritation, shall we say that the immune system never quite resolves and chronically manifests itself, kind of like a cut the redness and swelling that you see on your skin when you get a cut is an inflammatory response designed to resolve the infection and the irritation. Well in heart disease that irritation never goes away, it is chronic. And instead of protecting the blood vessel, it contributes to damage to the blood vessel. And that’s how we began a journey of looking at heart disease and applying advanced technologies and science to the most common killer in the United States and the rest of the world, which is cardiovascular disease and coronary artery disease. So this is a journey, shall we say of innovation, of using science and technology and medicine together, which I began throughout my training, and this will be a theme as we go through our discussion today of how did we get to Covanos in which we’re using a combination of advanced technologies that haven’t been put together before to really change the way in which we view heart disease, it’s diagnosis and it’s therapy. Richard Miles: 4:29 So let’s go right into that. And as you said, heart disease and vascular disease remains one of the leading killers of Americans . So it’s one of those studies, actually that your average American has a fair amount about simply because almost everyone has had some sort of experience with it either personally or a family member. So a lot of the terminology and a lot of the treatments are fairly well known to Americans. But if you could just give us a little bit of context in terms of maybe some statistics, how many people for instance, need to go in for some sort of intervention or testing. And then what is the standard of care now, if you present at a hospital and you think you may be undergoing a heart attack or symptoms of that, what happens now today, if I were to go to the emergency room an hour from now, what would happen? And then again, give us that context. How often is this happening across, let’s just take the United States as an example. Dr. Russell Medford: 5:18 Well, Richard, I’m glad you asked that. Heart disease is the leading cause of death and disability in the United States and throughout the world. Cancer is actually number two and my wife is a molecular oncologist so sometimes we have this argument as to which is the more important disease on the human condition. But for us, for your listeners, a coronary disease is by far the most important issue that we’ll be dealing with. Certainly as we age and in your listeners that are over the age of 55, for example, the statistics in the United States are daunting for heart disease. Over 18 million Americans have blockages in their coronary arteries already, walking around. And these blockages are what to the heart attack that destroys heart muscle and causes cell death, death of the heart muscle and kills people on a regular basis. I think the heart attack rate is enormous. We have over 360,000 deaths from heart attacks every year in the United States, alone, 360,000, which means every 40 seconds during this interview, an American will have a heart attack. So just add up those minutes as we go forward in this conversation. Importantly, along those 18 million Americans, with heart disease , almost half of us, half of all, adult Americans, 120 million of us walk around with risk factors that lead to coronary artery disease. We have some combination of high blood pressure, high cholesterol, diabetes, all of which are important risk factors that predispose us to heart disease. So, this is a huge problem that is on a daily basis. Your question was, well, what do we do with this? How does it manifest itself? Well, not infrequently. You develop what’s called chest pain. When the blockage in the coronary arteries reaches a certain point, the blood flow to the distal part of the heart muscle, that’s fed by that coronary isn’t sufficient for the activity. You climb a flight of stairs and your heart starts to be quicker. Well, that means the muscle is working harder and it needs more blood and more oxygen to continue beating the faster. If the blockage prevents that increased blood flow from occurring, the heart begins to develop. What’s called aschemia . It sends out pain signals that are saying, I need more blood. I need more blood. And therefore you wind up with what’s called angina. Well, this is a very common diagnosis. This is probably the most common presenting symptom to an emergency room, for example. And if any of your listeners develop that kind of pain, especially on exertion or even at rest, they should go see a doctor. And what does the doctor do at that point? Well, whether it’s an internist, an emergency room physician, or a cardiologist, we would be asking questions first. Have you ever had a heart attack in the past? Are you predisposed to this disease? Has anybody in your family ever had a heart attack? Do you smoke cigarettes? Do you have diabetes? Do you have high blood pressure? Do you have high cholesterol? What we’re trying to do is ascertain now by history, what is your likelihood that the chest pain that you’re presenting with may be due to blockages in your coronary artery? We’re also very concerned under the circumstances, is that chest pain, a heart attack and evolution. Are you actually having a heart attack right now? Or is this just angina in which there’s no permanent damage? Our tools available to us though, as physicians are indirect and not very accurate unfortunately, assuming that you’re coming in with what’s called stable angina, stable angina means, doc, I’m not having any, Hey now, but when I climb a flight of stairs, I develop this heaviness in my chest and it goes away when I sit down and rest. Well, that is exertional angina, which could be chronic, may not represent a medical emergency, but our challenge is, is that due to blockages in your coronary artery? And what do we do about that? Well, what your doctor currently does is they say, you know, I’ll examine you, I’ll take an EKG, do the history and do some blood tests. But what I’m going to do next is what’s called an exercise tolerance test. I’m going to try to repeat the symptoms that you had on the outside, under controlled circumstances. And I’m going to hook up an EKG to you, or I’m going to do a nuclear medicine scan or look at your heart’s ability to pump using an echocardiogram and try to get a sense of whether or not when you develop those symptoms that I can see objectively that the heart muscle is not functioning properly because of a lack of blood flow. Well, we performed 16 million of those tests every year in this country. And our goal is if it’s positive, if it turns out to be some abnormality, the next step is I’m going to take you to a cardiac catheterization laboratory. An operating room like Sweden, which under sterile conditions, a team of doctors and nurses and technicians thread, a catheter into the coronary blood vessels, themselves inject dye, and in an X-ray, we can visualize whether or not you have blockages in your heart. And if those are significant blockages, then we can correct that by putting in a stent, which is a metal lattice that opens up the coronary artery permanently, or if it’s too complex to send you to bypass surgery. The problem with our technology Richard now, and this is where Covanos comes in is this industry of diagnostic exercise tests and nuclear medicine test is old technology. I was trained on this when I was a cardiology fellow at the Brigham and Women’s Hospital. And we know that the diagnostic accuracy of these tests are about 50%. It’s a coin toss, whether or not you actually have disease that when I take you to the cath lab, which is the gold standard that the interventional cardiologist and the cath lab said, well, we had a positive stress test. Something is wrong based on that test, but I don’t see anything here. Well, over 50% of the time, that’s the answer. I don’t see anything, that I’m going to do anything about, so over half of these invasive very expensive procedures are unnecessary. What we need is a tool that allows us to diagnose rapidly and definitively whether the chest pain that you’re presenting to your doctor is due to blockages in your heart and whether or not those blockages are functionally significant so that you can justify going into an invasive procedure to have a stent put in or to go to bypass surgery. So this is where Covanos comes in. The technology for imaging. The heart has advanced so dramatically that we can take very accurate pictures of blockages in the heart, in your street clothes, get a CAT scan. You’ve heard of cat scans in which you lie down in your street clothes, and you go through a donut-like device. And we take concentric pictures of slices through the heart, and we can reconstruct the entire heart and look at the coronary arteries. It’s a coronary CT angiography. It’s outpatient. It’s done quickly, it’s in your street clothes and you get the results quickly. What we need is one more element on top of that, just seeing blockages in the cath lab or by CAT scan is not enough. If we see the picture and we often say a picture’s worth a thousand words, that’s not the case in cardiology or medical imaging, simply seeing a blockage doesn’t tell us how serious it is. There’s a huge number of patients that I can see some blockage there, but I don’t know if it’s significant or not. This is where Covanos comes in. We take that image on a PC workstation, that’s attached to the CAT scanner and we use advanced mathematics, our technology and our scientific founders are leaders in the world in an area called bioengineering and computational fluid dynamics. And through that single picture, that picture of the coronary artery from the CAT scan, we can compute and reconstruct the blood flow through the coronary artery to determine if that blockage that we see on the picture is impeding or blocking 70% of blood flow or 80% of blood flow. This is what your cardiologist does in the cath lab itself. The gold standard. When they see a blockage they’ll thread, a catheter, pressure catheter, across that blockage physically, and measure the pressure drop across that blockage. And then we’ll get the same answer they’ll saying , well , those pressure drops calculate to be an 80% reduction in blood flow. Why is that important? Because if you just use your eye, you over-diagnosed disease tremendously. It becomes cost prohibited. We get too many false positives by knowing the physiology. We eliminate the false positives and the false negatives for that matter and create a definitive diagnosis, noninvasively that tells your cardiologist or internist in their office whether I have disease, here’s a picture. You can actually put it up on your refrigerator wall if you want next to the ultrasound of your new child. But also I can overlay this mathematical analysis that says, well, in fact, that lesion, which looks pretty bad actually by eye, really isn’t blocking blood flow significantly. And we know through extensive clinical trials, that there is a cutoff on the reduction in blood flow that tells us whether we should take you to the cath lab and do a procedure and put a stent in, or do bypass surgery, or we’ll just increase your medication. We’ll increase your lipid lowering therapies, antihypertensives and control your diabetes better. This is where Covanos comes in. It provides for the first time a definitive tool that within minutes of that CAT scan, we now know not just the structure of the lesion a picture, but the significance of it, functional significance. And it allows the doctor to use an evidence based approach to effectively determine what the next course of action is and tell you what your diagnosis is. So, if it’s significant and I tell you, you have to go to a catheterization ] procedure, Richard, you know that you’re going for a definitive procedure, not for a diagnosis. We have the diagnosis you’re going in, your doctors preparing to put a stent in, and we’re going to fix the problem instead of taking you to a cath lab in invasive procedure, not knowing over 50% of the time, that there was no reason for you to go to the cath lab in the first place. Richard Miles: 15:03 So I just want to underscore for our listeners , what you all have done is not developing a new piece of hardware or a new machine that gets wheeled into the room. And somebody gets hooked up. You’re really using existing machines, existing scanning technologies, right? Primarily CAT scan. But I imagine other scanners like MRIs, or I don’t know if the other scan technologies would help, but then you’re taking that data that it already exists. Or there are machines already for that. You’re taking that. You’re running that through what some sort of algorithm, right? You can see, we know exactly where it is. So I’m guessing then that the cost factor must be a lot lower than if you’d come up with a brand new machine for instance. Dr. Russell Medford: 15:39 Exactly. We’re adding a dramatic extension of the capability of already a , uh , installed base of CAT scanning machines that are all over this country, whether it’s Atlanta, Georgia, Macon, Georgia, a rural hospital, anywhere in the country. In Florida, for example, all of these hospitals have CAT scanners. It is a basic tool now of American medicine. What we’ve done is taken that install base, and now magnified its capability, extended its capability, using very sophisticated advances in mathematics and engineering principles to draw new information from those images to help make definitive diagnosis and the treatment of heart disease. So what we’re doing is adding on a cost. That is true. There is a bit of a cost to add that on that’s the business model, but it has such a dramatic impact on patient outcomes. You do better when you make a decision. Based on that data, we have extensive what are called outcome and pharmaco economic studies that look at patients who underwent traditional methodologies for intervention versus this new approach. They do better. They have less events, it is less expensive, and we can cost justify this extremely well. So our job is to improve clinical outcomes for patients. That’s what Covanos is in the business for . We want to make the diagnosis and treatment of cardiac disease, much more efficient and effective. And we reduce costs to the patient and to the medical system by billions of dollars by eliminating unnecessary invasive, cardiac catheterizations. So, in an era we’re facing now, in which we have to re-evaluate our priorities in terms of medical expenses and expenses in the healthcare , each of us as consumers and as patients and our doctors want the most efficient, effective way of advancing of diagnosing and treating the most common cause of death and disability in the United States, heart disease. Richard Miles: 17:31 So just to clarify, Russell , it sounds like the two major benefits or outcomes for the health care system is one, you’re identifying people who really don’t need invasive procedures to determine whether they have a serious problem or not. And you can confidently look at those people who look you’re okay, you know, we can send you home. And it sounds you can take people who are at high risk and take some of the guests where it can maybe speed them into treatment that they might’ve not had before. Is that an accurate way of looking at it? Dr. Russell Medford: 17:58 It works both ways. Exactly. We’re giving a powerful new tool to the noninvasive cardiologist , to the internist, potentially even the family practitioner. So in the community they have now we call it a virtual cardiac catheterization lab . So they don’t have to send their patients to a specialized center. One of our scientific founders is Dr. Habib Samady. He’s the head of interventional cardiology at Emory University School of Medicine at Emory Hospital. He’s thrilled by this saying, if we can diffuse decentralize the decision making, patients will only come to me as the head of the cath lab when they need a procedure done, and we can make these sophisticated diagnoses in the community, locally. We don’t have to send patients into Atlanta or central facilities in New York City for example, all this becomes all the more important Richard in a post Covid environment, in which we only want essential travel to medical centers, sophisticated medical centers for definitive procedures. If we can make those diagnoses out in the community, then the costs go down. The clinical outcomes go up for the individual and the risk of centralizing diagnosis in very crowded and stress hospital facilities goes down dramatically. Richard Miles: 19:11 So we are going to switch now and talk on the business end of this now Russell , an entrepreneurial side of it and great ideas don’t sell themselves. They have to make it to market. And sometimes particularly in the health field, that includes a lot of different obstacles and capital regulation, et cetera, et cetera. So, two part question here. One is what are the origin stories of the idea itself? Did somebody come up with this and a flash of insight, or was this something that got iterated to a solution where people sort of tinkered and then tell us a little bit about the road that Covanos faces in terms of getting, not just regulatory approval, but convincing, I presume doctors and hospitals that they should use this because a lot of people in this field report that it’s not enough to say it works. You’ve got to prove that it works by a factor of two or three in order for hospitals and doctors say, okay, fine, I’ll go ahead and add this to my arsenal of tests. And so on that I use, it’s not good enough to be just 5% better, 10% better in most cases. So tell us a little bit first origin story of the idea and then path to market. What has it been like so far and what do you face ? Dr. Russell Medford: 20:12 Well, I think Richard, you put your finger on it. You made several good points. Let’s take them one at a time. Outstanding science and outstanding technology is absolutely necessary, but absolutely not sufficient to translate new discoveries into products and services that will have an impact on people’s lives. I’ve been in the biotech industry for 25 years. I’ve had the privilege of bringing two major clinical trials, drugs that are new ways of treating heart disease and infectious disease. It is not sufficient to be able to have a new approach or outstanding science, the steps that we to take from a financing regulatory clinical standpoint, and to address a true need that’s in the marketplace all have to be addressed on top of outstanding science that’s extremely exciting. So there are four founders of Covanos. I have the privilege of being one of those four, but the three core scientific founders, Dr. Habib Samady at Emory University, Dr. Don Giddens, who was the former Dean of the School of Engineering at the Georgia Institute of Technology and Dr. Alessandro Veneziani is a professor of mathematics at Emory University, have worked together for the last 15 years in this interface of mathematics and engineering and coranary physiology and medicine, to understand the details of how blood flows through obstructed coranaries, the physiology of it, doing careful measurements with advanced technologies and with an eye towards taking images that are easily derived and creating this type of computational solution that creates the virtual cardiac cath lab. So this is something 10 years in the making of collaborative research and $6 million in research funding even before they came to me and said, this sounds like a pretty good idea. What do you think? And this was only three years ago, they’ve been working on this and , and put this idea together. So it didn’t come over a weekend or a cup of coffee. This is years of work together in publications. What I brought to the table was as a cardiologist and as a molecular biologist, but more importantly, with 25 years experience in the biotech industry, as a CEOs of public and private biotech companies, what is the business model? The regulatory pathway are we addressing the proper clinical marketplace here? How do we align multiple interest groups together to move this forward from a legal and regulatory and financial standpoint? And do we have a technology with a series of clear milestone accomplishments that reduce the risks that we all know are inherent in any new science or technology as you advance it towards the marketplace, there are new requirements on that science and technology at each step, a significant fraction of ideas fail. They can’t be advanced. So how do we plan that out, bringing all these interest groups together and skill sets to create basically a product that we are now within one year of launching for Covanos the C-HEART program. That’s what got me excited about the science and technology that had been developed as interdisciplinary, multidisciplinary effort with people who I had known by reputation for many years, I was on the faculty at Emory as well, but an opportunity to work with people that have broken down barriers, broken down silos that I think are critical for us to advance science in general, but medicine in particular, to bring engineers and mathematicians and clinicians together in one room is something that we do on a routine basis in industry. But in academia, that’s not so common necessarily. So it was my privilege to say, well, I’ve been there, done that. I understand what the problem is. I think you have a major solution. Let’s put our work together and see, what are we going to try to address? It’s not enough Richard to solve a technical problem in medicine. It has to be a solution that will be used by physicians, be used by hospitals so that patients can have access to them. And it has to be in such a way that we have universal access. There has to be broad access. It can’t be something specific for a unique group. How can we make sure that everyone who needs a C-HEART gets a C-HEART analysis and so pricing and access to care. And these are the issues that we had to bring on, not just outstanding scientists and mathematicians and engineers, but business people, our head of commercial development and Brian Walsh , somebody who may be well known to some of your listeners is a Senior Medical Technology Industry Executive with vast experience in major and large and small companies and bringing medical technologies into the workplace, through the regulatory pathways. And by putting that package together, you then have to engage with the financial communities which we’re doing now to say, well, you know, this costs a fair amount of money to get into the marketplace. What is in your best interest as investors? How do we reconcile the return on investment requirements for different groups, financial returns, the societal returns technology returns. And when you create that mix and solve that you’re able to pull it all together and you can see that the science is a big part, but it’s only the first part of the journey. Then we’ve got many other steps that we have to succeed and to get here. And it’s exciting for me to relate to that through this journey, we are very close to launching this product and making a difference. Now, the last point that I’d like to say is this has to be used by doctors. If we have a technological solution, as great as it may be, if it’s never used by doctors, it means you’ve got patients that won’t benefit from it. So we’ve been very careful that we’ve advanced our technology in a way that enables us to be used easily and readily in the workflow and decision making process for cardiologists and radiologists and hospitals so that they can order this, get the result quickly and in their workflow, be able to make decisions and then move on to the next patient. All of this requires in depth analysis and integration, but it’s more than just the science. And I think that’s what the Cade Prize is all about, actually. It’s how do you bring these elements together? What type of people with backgrounds, diverse backgrounds can come together in some sort of effective collaboration to create a company and a company being probably a group of people with very different backgrounds and skillsets that somehow now share a common vision, even though their backgrounds are different and their skill sets are different. Well, that’s what Covanos says. And every company that I’ve been involved with and helped start in advance has had that same mix of diversity and a common purpose among people with very different backgrounds, but essential skill sets to make a difference in people’s lives. Richard Miles: 26:55 Hey Russell, one more question you, usually we ask almost every interview, a version of what do you wish you knew then that you know now, or ask people to think of your 25 or 30 year old self? What advice would you give now? And a lot of times people say something like, well, you know, work hard, don’t give up. And I want to know, are there things that aren’t as obvious? Are there insights that you gained say 10, 20 years into your career as a doctor and the medical industry that you didn’t really figure out until later and go like, wow, that would’ve been really useful to know 20 years ago, but I had to figure out, is there anything that falls in that category, nuggative wisdom? If you think of somebody wanting to emulate something that you’ve done, start companies, take ideas to market, lot of pitfalls in there. What are some of the do’s and don’ts that you would give to somebody wanting to do that? Dr. Russell Medford: 27:40 So, Richard, thank you for asking that question. That’s a good question. And there are some takeaways that putting myself as a 30 year old, you have to build trusted relationships with people of diverse backgrounds. You cannot accomplish any of these things on your own. You build it through teams. It doesn’t mean that there aren’t leaders. It doesn’t mean that there are inspirational components to this, that people bring unique skills and capabilities, but unless you can build a team around you, of people who are experts beyond your expertise, a multidisciplinary approach like changing the face of cardiology is impossible for the individual. So I think one thing I learned that I guess I evolved that over time was you need to recognize that you are building a group to share a common vision and you need multiple skill sets to move forward on that. So I think that’s the first thing nothing is done in isolation, no matter how talented you are. And the last point is you have to have the confidence in your own abilities to work with people who are much smarter than you, hopefully in the areas, in which you lack expertise. And if you’re prepared to do that, then I think your chances of advancing are dramatic. If you, as most of us are concerned and perhaps intimidated by very smart people, especially in different fields, we tend to shy away from that and try to protect ourselves. I think that’s the advice I would give. You have to have confidence in your own capabilities to work with and potentially lead a group of people who are much smarter than you. And if you can do that, the sky’s the limit. I think. Richard Miles: 29:12 One of the best things I ever heard early on is, you know, you never ever want to be the smartest guy in the room. And fortunately, that was never a problem for me. Thank you for being on the show. I want to congratulate you again and you and your team for making the finals of the Cade Prize wish you the best of luck. And I hope at some point when your book comes out, Russell, we’ll have you back on the show. Dr. Russell Medford: 29:30 Richard, it was a pleasure call on me anytime. Richard Miles: 29:33 Thank you. Outro: 29:35 Radio Cade is produced by the Cade Museum for Creativity and Invention located in Gainesville, Florida . Richard Miles is the podcast host and Ellie Thom coordinates, inventor interviews, podcasts are recorded at Heartwood, Soundstage and edited and mixed by Bob McPeak . The Radio Cade theme song was produced and performed by Tracy Collins and features violinist, Jacob Lawson.
In this episode, VICE Podcast Producer Sophie Kazis talks with Broadly reporter Jessica Furseth about how women are often denied pain management during invasive medical procedures - and how this is all too common. See acast.com/privacy for privacy and opt-out information.
Verad is one of the 9-in-10 Trill who doesn't have a symbiont living inside him. He can't seem to get over it, though, and he's got his eyes on what Jadzia has... Dax. Can he steal the symbiont from her and escape to the Gamma Quadrant? If he does, what becomes of Jadzia? Find out when we put Invasive Procedures into the Mission Log. Get in touch with us! On Facebook: On Twitter: On Skype: missionlogpod On the phone: (323) 522-5641 Online: We may use your comments on a future episode of Mission Log.
A meek Trill stages an attack on DS9, with the ultimate goal of stealing the Dax symbiont. We've been complaining that the Trill have been underdeveloped since they originally appeared in TNG, so Invasive Procedures seeks to flesh out this mysterious species. Does it work? Amy joins me to discuss scowling at the television, Quark as a bad guy, and what it means to be "joined". Are you looking for older episodes? Find this and every other episode at The Pensky Podcast! Thanks for listening. Stay connected: • https://thepenskyfile.com/links/ • e-mail: thepenskyfilevideo(at)gmail.com
Covering “The Siege” and “Invasive Procedures.”