POPULARITY
2 episodes with ipass
4 episodes with ipass
2 episodes with ipass
2 episodes with ipass
3 episodes with ipass
4 episodes with ipass
想要更好地照顧自己的健康？我們為您介紹【海之滴褐藻糖膠】。不論是術前病後保養，還是日常的營養補充，它都是您的最佳選擇。更暢銷多個國家，獲得眾多使用者好評推薦。立即免費索取產品資料和藥丸盒 https://fstry.pse.is/75h5zh —— 以上為 Firstory Podcast 廣告 —— 近期「一卡通公司」動作頻繁，尤其是前年推出自家的點數計劃－「綠點」後，不斷的升級這個點數的應用場景，愈來愈實用了。那，到底什麼是「一卡通綠點」呢？其實跟LINE Pay自家的「LINE Points」的顏色有點類似，都是綠色的，但是一卡通綠點更著重在「環保」與「綠能」，所以只要持「記名一卡通」搭乘捷運等大眾運輸系統，iPASS MONEY APP裡有搭乘記錄，就能把帳上的綠點折抵掉，變成實實在在的回饋金入帳，還可提領至帳戶，算是相對環保的點數。而2025年起，也正式開放大家做「生活繳費」，每一筆帳一卡通帳戶繳費的金額，都可100%用綠點折抵，更好用啦！目前有繳費20%回饋的活動，拿帳戶的現金來繳信用卡帳單，也符合資格，趕快來解任務賺20%回饋吧！ 來寶可孟YouTube頻道上收聽節目：https://pokem.me/PokemYTPodcast -- 一卡通綠點介紹：https://pokem.me/40Fv8dE 一卡通8%綠點支付活動：https://pokem.me/4fJYA6D -- 小額贊助支持本節目： https://open.firstory.me/user/ckdpsqfmxifcf0862q6efk1qa 留言告訴我你對這一集的想法： https://open.firstory.me/user/ckdpsqfmxifcf0862q6efk1qa/comments Powered by Firstory Hosting
蘭佬佬 竹家莊 真川味 請客樓 蜀魚館 松滿樓 廚房客家美食->滿牆壁都是黃仁勳的合照 新華港式菜館 －－－－以下訊息由 SoundOn 動態廣告贊助商提供－－－－ ✨2025「職」求對決－高雄新媒體人才就業媒合會✨
繼陽明第一廳口碑熱銷後，城揚建設集團全新奢綠鉅作，廳綠廳水_廳見正義站: https://sofm.pse.is/74qgcg 2024 全新公園新品，台鐵正義站綠鄰，東高雄首屈一指黃金地段!地點在 2 千坪正義公園前，陽明國中自由學區。精品廳院、飯店奢華，規劃健身房、双 KTV、閱覽室、交誼廳、運動 Bar、多功能教室，奢華貴氣 -- ✨2025「職」求對決－高雄新媒體人才就業媒合會✨
✨2025「職」求對決－高雄新媒體人才就業媒合會✨
✨2025「職」求對決－高雄新媒體人才就業媒合會✨
終於過完年囉 －－－－以下訊息由 SoundOn 動態廣告贊助商提供－－－－ 高雄美術特區2-4房全新落成，《惟美術》輕軌C22站散步即到家，近鄰青海商圈，卡位明星學區，徜徉萬坪綠海。 住近美術館，擁抱優雅日常，盡現驕傲風範！美術東四路X青海路 07-553-3838 -- ✨2025「職」求對決－高雄新媒體人才就業媒合會✨
華麗音樂傳奇《更好的人》給你頂級視聽饗宴 https://fstry.pse.is/6yuyr5 —— 以上為 Firstory Podcast 廣告 —— 原本我就有在用iPASS Money，最近我發現一卡通 iPASS MONEY也推出獨立的APP了，功能不僅獨立出來更好用，值得大家下載來試用看看。除此之外，首度新增「綁定信用卡」付款功能，也太方便了吧！而開通的信用卡為「聯邦信用卡」，之前很夯的聯邦賴點卡也可綁定使用，大人小孩都有的卡片，趕快從卡夾裡抽出來用。那，該如何賺首綁88元刷卡金 + 月月8%綠點回饋呢？首先你得入手兩項產品：一、 iPASS MONEY APP ，二、聯邦信用卡。下載完APP後，只要照流程指示把信用卡綁定上去，就能在四大超商出示QR Code，即可結帳啦！以我這一次在便利超商結帳的任務流程，就是把商品給店員後，報完會員 + 發票存載具後，再點開「iPASS MONEY APP」，選擇左上角的「付款碼」，確定上面預設的是我之前綁定好的聯邦信用卡，即可給店員掃碼結帳，不到3秒就完成，跟其他行動支付的使用方式差不多，一點都不麻煩。 那，8%綠點怎麼賺呢？這檔活動一共有4個月，每月送你200點綠點，每筆消費送你8%綠點，算一下一個月可刷多少： 200 / 8 % = 2,500元！平常有在超商消費習慣的，可以撥2,500元在四大超商 / 各電支品牌之TWQR立牌店家解任務，就可賺到這8%回饋，接下來只要持有記名的一卡通來搭大眾運輸 / 在APP內繳費，就能把綠點抵掉，換成「一卡通儲值金」，即可提領回帳戶變成現金使用囉。 本團感謝大家的支持，決定加碼送10,000元小七商品券回饋粉絲，活動詳情就在下方的連結，有解任務的也歡迎一起來分享心得，再賺200元小七商品卡回家！ 來寶可孟YouTube頻道上收聽節目：https://pokem.me/PokemYTPodcast -- 完整活動解析：https://pokem.me/4fJYA6D iPASA MONEY APP活動官網：https://i-pass.co/6u9649 點我下載iPASS MONEY APP：https://i-pass.co/6u96ny 點我入手聯邦卡：https://i-pass.co/6x77a7 -- 小額贊助支持本節目： https://open.firstory.me/user/ckdpsqfmxifcf0862q6efk1qa 留言告訴我你對這一集的想法： https://open.firstory.me/user/ckdpsqfmxifcf0862q6efk1qa/comments Powered by Firstory Hosting
In this episode, Dr. Seipp discusses how the IPASS initiative at Lincoln Roosevelt School makes it such an amazing place to teach, learn, and grow with Dr. Zegar, Ms. DelRusso, Ms. Urban, and two students. Their positive approach to building school culture and developing amazing students is a definite reflection of many of the most important growth experiences for young people.
“Under normal conditions, EGFR [epidermal growth factor receptor] is in an auto-inhibited state. And it's only when it's needed that it's upregulated. But when you have cancers that there is either a mutation in the EGFR or an overexpression, what you see is a dysregulation of normal cellular processes. So you get overexpression or switching on of prosurvival or antiapoptotic responses,” Rowena “Moe” Schwartz, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about the EGFR inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 8, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to EGFR inhibitor drugs. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast™ episodes: Pharmacology 101 series Episode 250: Cancer Symptom Management Basics: Dermatologic Complications Episode 226: Patient Education for Next-Generation Sequencing to Guide Cancer Therapy Episode 169: How Biomarker Testing Drives the Use of Targeted Therapies Episode 157: Biomarker Testing Improves Outcomes for Patients With Non-Small Cell Lung Cancer ONS Voice articles: Management Strategies for Cutaneous Toxicity From EGFR Inhibitors Oncology Drug Reference Sheet: Amivantamab-Vmjw Oncology Drug Reference Sheet: Osimertinib Oncology Drug Reference Sheet: Panitumumab Targeted Therapies Are Transforming the Treatment of Non-Small Cell Lung Cancer ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (Fourth Edition) ONS courses: ONS Cancer Biology™ ONS/ONCC Chemotherapy Immunotherapy Certificate™ Safe Handling Basics Clinical Journal of Oncology Nursing articles: Afatinib Therapy: Practical Management of Adverse Events With an Oral Agent for Non-Small Cell Lung Cancer Treatment Cutaneous Toxicities With Amivantamab for Non-Small Cell Lung Cancer: A Practical Guide and Best Practices Medication Adherence Barriers: Development and Retrospective Pilot Test of an Evidence-Based Screening Instrument ONS Guidelines™ for Cancer Treatment–Related Skin Toxicity Nursing Management of Skin Toxicities in Diverse Skin Tones ONS Bispecific Antibody Video ONS Learning Libraries: Genomics and Precision Oncology Oral Anticancer Medication Oral Chemotherapy Education Sheets Seminars in Cancer Biology article: EGFR signaling pathway as therapeutic target in human cancers To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “It wasn't until 2004 that the mutations affecting the tyrosine kinase domain of epidermal growth factor receptor was linked to the responses that were seen in gefitinib. And that's when we really started to understand the way that this was targeting certain patients' cancers. So that led to the phase three study. People may remember the IPASS study that demonstrated that when patients had an activating mutation of EGFR, that that was a really good biomarker that selected out patients that would respond to therapy.” TS 2:58 “The new player on the market is the bispecific. … This was a bispecific that was developed to hit two different targets. The one target is EGFR. The second target was MET. And the reason MET was targeted is because when you have patients who are on EGFR tyrosine kinase inhibitors, they do so well. But over time, resistance develops. And one of the mechanisms that are thought to be important for resistance is that MET pathway. So it was a development of a bispecific antibody that hit two different targets, EGFR and MET, hoping that you would get less resistance.” TS 7:12 “The other thing that I see with these agents is seeing them combined with chemotherapy. For a long time, it was these drugs were used as the single approach to someone with non-small cell lung cancer who had an EGFR mutation, and they did well. But I think we're starting to see that because resistance does develop, that there may be roles for combination with chemotherapy, and you're seeing that in terms of drug approval.” TS 19:10 “I think that people that don't work in the clinic, say, with non-small cell lung cancer—they think of these as a group and don't realize the uniqueness of specific agents, what mutations that they hit that affected those that penetrate into the [central nervous system], the drug interactions that are specific for certain agents. So I think that's one of the common misconceptions.” TS 22:02 “The education, because it evolves so rapidly, is to realize that what you know, if it's from a year ago, may not be the full picture. And so again, I'm going to call out ONS for the phenomenal resources on the Genomics and Precision Oncology Learning Library to help providers learn. And that is updated, and it is readily available. I think it is phenomenal, and I think it helps people build on their basic understanding of any of these types of therapy, including EGFR inhibitors.” TS 23:24
In this conversation, Scott Ohsman from Always Off Brand, Brent Peterson from Talk Commerce, and Robert Rand from iPaas.com discuss the future of e-commerce, focusing on the innovative features of Shopware, including AI and spatial commerce. They explore the complexities of integrating various software systems in e-commerce and the importance of seamless data connectivity. The discussion highlights the challenges businesses face with custom integrations and the need for user-friendly platforms like IPass to streamline operations. They also touch on market trends and the competitive landscape in the e-commerce sector.takeawaysShopware is at the forefront of e-commerce innovation.AI and spatial commerce are transforming online shopping experiences.Integration of various software systems is crucial for e-commerce success.Custom integrations can lead to operational nightmares.A user-friendly platform can simplify complex data flows.Data connectivity is essential for real-time insights.Businesses need to evolve with their software solutions.Streamlining operations can significantly reduce costs.The e-commerce landscape is rapidly changing with new technologies.Understanding product data is key to operational efficiency.Sound Bites"Shopware is pioneering the next frontier of online shopping.""You need all that software talking together.""One error, one typo would kill everything."Chapters00:00Introduction to Shoptoberfest and Guests03:38Understanding Integration Needs in E-commerce06:37The Importance of Seamless Data Flow09:27Simplifying Complex Integrations12:37The Future of Product Data Management15:32Competitive Landscape in Integration Solutions
The most enthralling conversation I've ever had with anyone on cancer. It's with Charlie Swanton who is a senior group leader at the Francis Crick Institute, the Royal Society Napier Professor in Cancer and medical oncologist at University College London, co-director of Cancer Research UK.Video snippet from our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The audios are also available on Apple and Spotify.Transcript with audio links and many external linksEric Topol (00:07):Well, hello, this is Eric Topol with Ground Truths, and I am really fortunate today to connect us with Charlie Swanton, who is if not the most prolific researcher in the space of oncology and medicine, and he's right up there. Charlie is a physician scientist who is an oncologist at Francis Crick and he heads up the lung cancer area there. So Charlie, welcome.Charles Swanton (00:40):Thank you, Eric. Nice to meet you.Learning from a FailureEric Topol (00:43):Well, it really is a treat because I've been reading your papers and they're diverse. They're not just on cancer. Could be connecting things like air pollution, it could be Covid, it could be AI, all sorts of things. And it's really quite extraordinary. So I thought I'd start out with a really interesting short paper you wrote towards the end of last year to give a sense about you. It was called Turning a failing PhD around. And that's good because it's kind of historical anchoring. Before we get into some of your latest contributions, maybe can you tell us about that story about what you went through with your PhD?Charles Swanton (01:26):Yeah, well thank you, Eric. I got into research quite early. I did what you in the US would call the MD PhD program. So in my twenties I started a PhD in a molecular biology lab at what was then called the Imperial Cancer Research Fund, which was the sort of the mecca for DNA tumor viruses, if you like. It was really the place to go if you wanted to study how DNA tumor viruses worked, and many of the components of the cell cycle were discovered there in the 80s and 90s. Of course, Paul Nurse was the director of the institute at the time who discovered cdc2, the archetypal regulator of the cell cycle that led to his Nobel Prize. So it was a very exciting place to work, but my PhD wasn't going terribly well. And sort of 18, 19 months into my PhD, I was summoned for my midterm reports and it was not materializing rapidly enough.(02:25):And I sat down with my graduate student supervisors who were very kind, very generous, but basically said, Charlie, this isn't going well, is it? You've got two choices. You can either go back to medical school or change PhD projects. What do you want to do? And I said, well, I can't go back to medical school because I'm now two years behind. So instead I think what I'll do is I'll change PhD projects. And they asked me what I'd like to do. And back then we didn't know how p21, the CDK inhibitor bound to cyclin D, and I said, that's what I want to understand how these proteins interact biochemically. And they said, how are you going to do that? And I said, I'm not too sure, but maybe we'll try yeast two-hybrid screen and a mutagenesis screen. And that didn't work either. And in the end, something remarkable happened.(03:14):My PhD boss, Nic Jones, who's a great guy, still is, retired though now, but a phenomenal scientist. He put me in touch with a colleague who actually works next door to me now at the Francis Crick Institute called Neil McDonald, a structural biologist. And they had just solved, well, the community had just solved the structure. Pavletich just solved the structure of cyclin A CDK2. And so, Neil could show me this beautiful image of the crystal structure in 3D of cyclin A, and we could mirror cyclin D onto it and find the surface residue. So I spent the whole of my summer holiday mutating every surface exposed acid on cyclin D to an alanine until I found one that failed to interact with p21, but could still bind the CDK. And that little breakthrough, very little breakthrough led to this discovery that I had where the viral cyclins encoded by Kaposi sarcoma herpes virus, very similar to cyclin D, except in this one region that I had found interactive with a CDK inhibitor protein p21.(04:17):And so, I asked my boss, what do you think about the possibility this cyclin could have evolved from cyclin D but now mutated its surface residues in a specific area so that it can't be inhibited by any of the control proteins in the mammalian cell cycle? He said, it's a great idea, Charlie, give it a shot. And it worked. And then six months later, we got a Nature paper. And that for me was like, I cannot tell you how exciting, not the Nature paper so much as the discovery that you were the first person in the world to ever see this beautiful aspect of evolutionary biology at play and how this cyclin had adapted to just drive the cell cycle without being inhibited. For me, just, I mean, it was like a dream come true, and I never experienced anything like it before, and I guess it's sizes the equivalent to me of a class A drug. You get such a buzz out of it and over the years you sort of long for that to happen again. And occasionally it does, and it's just a wonderful profession.Eric Topol (05:20):Well, I thought that it was such a great story because here you were about to fail. I mean literally fail, and you really were able to turn it around and it should give hope to everybody working in science out there that they could just be right around the corner from a significant discovery.Charles Swanton (05:36):I think what doesn't break you makes you stronger. You just got to plow on if you love it enough, you'll find a way forward eventually, I hope.Tracing the Evolution of Cancer (TRACERx)Eric Topol (05:44):Yeah, no question about that. Now, some of your recent contributions, I mean, it's just amazing to me. I just try to keep up with the literature just keeping up with you.Charles Swanton (05:58):Eric, it's sweet of you. The first thing to say is it's not just me. This is a big community of lung cancer researchers we have thanks to Cancer Research UK funded around TRACERx and the lung cancer center. Every one of my papers has three corresponding authors, multiple co-first authors that all contribute in this multidisciplinary team to the sort of series of small incremental discoveries. And it's absolutely not just me. I've got an amazing team of scientists who I work with and learn from, so it's sweet to give me the credit.Eric Topol (06:30):I think what you're saying is really important. It is a team, but I think what I see through it all is that you're an inspiration to the team. You pull people together from all over the world on these projects and it's pretty extraordinary, so that's what I would say.Charles Swanton (06:49):The lung community, Eric, the lung cancer community is just unbelievably conducive to collaboration and advancing understanding of the disease together. It's just such a privilege to be working in this field. I know that sounds terribly corny, but it is true. I don't think I recall a single email to anybody where I've asked if we can collaborate where they've said, no, everybody wants to help. Everybody wants to work together on this challenge. It's just such an amazing field to be working in.Eric Topol (07:19):Yeah. Well I was going to ask you about that. And of course you could have restricted your efforts or focused on different cancers. What made you land in lung cancer? Not that that's only part of what you're working on, but that being the main thing, what drew you to that area?Charles Swanton (07:39):So I think the answer to your question is back in 2008 when I was looking for a niche, back then it was lung cancer was just on the brink of becoming an exciting place to work, but back then nobody wanted to work in that field. So there was a chair position in thoracic oncology and precision medicine open at University College London Hospital that had been open, as I understand it for two years. And I don't think anybody had applied. So I applied and because I was the only one, I got it and the rest is history.(08:16):And of course that was right at the time when the IPASS draft from Tony Mok was published and was just a bit after when the poster child of EGFR TKIs and EGFR mutant lung cancer had finally proven that if you segregate that population of patients with EGFR activating mutation, they do incredibly well on an EGFR inhibitor. And that was sort of the solid tumor poster child along with Herceptin of precision medicine, I think. And you saw the data at ASCO this week of Lorlatinib in re-arranged lung cancer. Patients are living way beyond five years now, and people are actually talking about this disease being more like CML. I mean, it's extraordinary the progress that's been made in the last two decades in my short career.Eric Topol (09:02):Actually, I do want to have you put that in perspective because it's really important what you just mentioned. I was going to ask you about this ASCO study with the AKT subgroup. So the cancer landscape of the lung has changed so much from what used to be a disease of cigarette smoking to now one of, I guess adenocarcinoma, non-small cell carcinoma, not related to cigarettes. We're going to talk about air pollution in a minute. This group that had, as you say, 60 month, five year plus survival versus what the standard therapy was a year plus is so extraordinary. But is that just a small subgroup within small cell lung cancer?Charles Swanton (09:48):Yes, it is, unfortunately. It's just a small subgroup. In our practice, probably less than 1% of all presentations often in never smokers, often in female, never smokers. So it is still in the UK at least a minority subset of adenocarcinomas, but it's still, as you rightly say, a minority of patients that we can make a big difference to with a drug that's pretty well tolerated, crosses the blood-brain barrier and prevents central nervous system relapse and progression. It really is an extraordinary breakthrough, I think. But that said, we're also seeing advances in smoking associated lung cancer with a high mutational burden with checkpoint inhibitor therapy, particularly in the neoadjuvant setting now prior to surgery. That's really, really impressive indeed. And adjuvant checkpoint inhibitor therapies as well as in the metastatic setting are absolutely improving survival times and outcomes now in a way that we couldn't have dreamt of 15 years ago. We've got much more than just platinum-based chemo is basically the bottom line now.Revving Up ImmunotherapyEric Topol (10:56):Right, right. Well that actually gets a natural question about immunotherapy also is one of the moving parts actually just amazing to me how that's really, it's almost like we're just scratching the surface of immunotherapy now with checkpoint inhibitors because the more we get the immune system revved up, the more we're seeing results, whether it's with vaccines or CAR-T, I mean it seems like we're just at the early stages of getting the immune system where it needs to be to tackle the cancer. What's your thought about that?Charles Swanton (11:32):I think you're absolutely right. We are, we're at the beginning of a very long journey thanks to Jim Allison and Honjo. We've got CTLA4 and PD-1/PDL-1 axis to target that's made a dramatic difference across multiple solid tumor types including melanoma and lung cancer. But undoubtedly, there are other targets we've seen LAG-3 and melanoma and then we're seeing new ways, as you rightly put it to mobilize the immune system to target cancers. And that can be done through vaccine based approaches where you stimulate the immune system against the patient's specific mutations in their cancer or adoptive T-cell therapies where you take the T-cells out of the tumor, you prime them against the mutations found in the tumor, you expand them and then give them back to the patient. And colleagues in the US, Steve Rosenberg and John Haanen in the Netherlands have done a remarkable job there in the context of melanoma, we're not a million miles away from European approvals and academic initiated manufacturing of T-cells for patients in national health systems like in the Netherlands.(12:50):John Haanen's work is remarkable in that regard. And then there are really spectacular ways of altering T-cells to be able to either migrate to the tumor or to target specific tumor antigens. You mentioned CAR-T cell therapies in the context of acute leukemia, really extraordinary developments there. And myeloma and diffuse large B-cell lymphoma as well as even in solid tumors are showing efficacy. And I really am very excited about the future of what we call biological therapies, be it vaccines, an antibody drug conjugates and T-cell therapies. I think cancer is a constantly adapting evolutionary force to be reckoned with what better system to combat it than our evolving immune system. It strikes me as being a future solution to many of these refractory cancers we still find difficult to treat.Eric Topol (13:48):Yeah, your point is an interesting parallel how the SARS-CoV-2 virus is constantly mutating and becoming more evasive as is the tumor in a person and the fact that we can try to amp up the immune system with these various means that you just were reviewing. You mentioned the other category that's very hot right now, which is the antibody drug conjugates. Could you explain a bit about how they work and why you think this is an important part of the future for cancer?Antibody-Drug ConjugatesCharles Swanton (14:26):That's a great question. So one of the challenges with chemotherapy, as you know, is the normal tissue toxicity. So for instance, neutropenia, hair loss, bowel dysfunction, diarrhea, epithelial damage, essentially as you know, cytotoxics affect rapidly dividing tissues, so bone marrow, epithelial tissues. And because until relatively recently we had no way of targeting chemotherapy patients experienced side effects associated with them. So over the last decade or so, pioneers in this field have brought together this idea of biological therapies linked with chemotherapy through a biological linker. And so one poster chart of that would be the drug T-DXd, which is essentially Herceptin linked to a chemotherapy drug. And this is just the most extraordinary drug that obviously binds the HER2 receptor, but brings the chemotherapy and proximity of the tumor. The idea being the more drug you can get into the tumor and the less you're releasing into normal tissue, the more on tumor cytotoxicity you'll have and the less off tumor on target normal tissue side effects you'll have. And to a large extent, that's being shown to be the case. That doesn't mean they're completely toxicity free, they're not. And one of the side effects associated with these drugs is pneumonitis.(16:03):But that said, the efficacy is simply extraordinary. And for example, we're having to rewrite the rule books if you like, I think. I mean I'm not a breast cancer physician, I used to be a long time ago, but back in the past in the early 2000s, there was HER2 positive breast cancer and that's it. Now they're talking about HER2 low, HER2 ultra-low, all of which seem to in their own way be sensitive to T-DXd, albeit to a lower extent than HER2 positive disease. But the point is that there doesn't seem to be HER2 completely zero tumor group in breast cancer. And even the HER2-0 seem to benefit from T-DXd to an extent. And the question is why? And I think what people are thinking now is it's a combination of very low cell service expression of HER2 that's undetectable by conventional methods like immunohistochemistry, but also something exquisitely specific about the way in which HER2 is mobilized on the membrane and taken back into the cell. That seems to be specific to the breast cancer cell but not normal tissue. So in other words, the antibody drug conjugate binds the tumor cell, it's thought the whole receptor's internalized into the endosome, and that's where the toxicity then happens. And it's something to do with the endosomal trafficking with the low level expression and internalization of the receptor. That may well be the reason why these HER2 low tumors are so sensitive to this beautiful technology.Eric Topol (17:38):Now I mean it is an amazing technology in all these years where we just were basically indiscriminately trying to kill cells and hoping that the cancer would succumb. And now you're finding whether you want to call it a carry or vector or Trojan horse, whatever you want to call it, but do you see that analogy of the HER2 receptor that's going to be seen across the board in other cancers?Charles Swanton (18:02):That's the big question, Eric. I think, and have we just lucked out with T-DXd, will we find other T-DXd like ADCs targeting other proteins? I mean there are a lot of ADCs being developed against a lot of different cell surface proteins, and I think the jury's still out. I'm confident we will, but we have to bear in mind that biology is a fickle friend and there may be something here related to the internalization of the receptor in breast cancer that makes this disease so exquisitely sensitive. So I think we just don't know yet. I'm reasonably confident that we will find other targets that are as profoundly sensitive as HER2 positive breast cancer, but time will tell.Cancer, A Systemic DiseaseEric Topol (18:49):Right. Now along these lines, well the recent paper that you had in Cell, called embracing cancer complexity, which we've talking about a bit, in fact it's kind of those two words go together awfully well, but hallmarks of systemic disease, this was a masterful review, as you say with the team that you led. But can you tell us about what's your main perspective about this systemic disease? I mean obviously there's been the cancer is like cardiovascular and cancers like this or that, but here you really brought it together with systemic illness. What can you say about that?Charles Swanton (19:42):Well, thanks for the question first of all, Eric. So a lot of this comes from some of my medical experience of treating cancer and thinking to myself over the years, molecular biology has had a major footprint on advances in treating the disease undoubtedly. But there are still aspects of medicine where molecular biology has had very little impact, and often that is in areas of suffering in patients with advanced disease and cancer related to things like cancer cachexia, thrombophilia. What is the reason why patients die blood clots? What is the reason patients die of cancer at all? Even a simple question like that, we don't always know the answer to, on death certificates, we write metastatic disease as a cause of cancer death, but we have patients who die with often limited disease burden and no obvious proximal cause of death sometimes. And that's very perplexing, and we need to understand that process better.(20:41):And we need to understand aspects like cancer pain, for example, circadian rhythms affect biological sensitivity of cancer cells to drugs and what have you. Thinking about cancer rather than just sort of a single group of chaotically proliferating cells to a vision of cancer interacting both locally within a microenvironment but more distantly across organs and how organs communicate with the cancer through neuronal networks, for example, I think is going to be the next big challenge by setting the field over the next decade or two. And I think then thinking about more broadly what I mean by embracing complexity, I think some of that relates to the limitations of the model systems we use, trying to understand inter-organ crosstalk, some of the things you cover in your beautiful Twitter reviews. (←Ground Truths link) I remember recently you highlighted four publications that looked at central nervous system, immune cell crosstalk or central nervous system microbiome crosstalk. It's this sort of long range interaction between organs, between the central nervous system and the immune system and the cancer that I'm hugely interested in because I really think there are vital clues there that will unlock new targets that will enable us to control cancers more effectively if we just understood these complex networks better and had more sophisticated animal model systems to be able to interpret these interactions.Eric Topol (22:11):No, it's so important what you're bringing out, the mysteries that still we have to deal with cancer, why patients have all these issues or dying without really knowing what's happened no less, as you say, these new connects that are being discovered at a remarkable pace, as you mentioned, that ground truths. And also, for example, when I spoke with Michelle Monje, she's amazing on the cancer, where hijacking the brain cells and just pretty extraordinary things. Now that gets me to another line of work of yours. I mean there are many, but the issue of evolution of the tumor, and if you could put that in context, a hot area that's helping us elucidate these mechanisms is known as spatial omics or spatial biology. This whole idea of being able to get the spatial temporal progression through single cell sequencing and single cell nuclei, all the single cell omics. So if you could kind of take us through what have we learned with this technique and spatial omics that now has changed or illuminated our understanding of how cancer evolves?Charles Swanton (23:37):Yeah, great question. Well, I mean I think it helps us sort of rewind a bit and think about evolution in general. Genetic selection brought about by diverse environments and environmental pressures that force evolution, genetic evolution, and speciation down certain evolutionary roots. And I think one can think about cancers in a similar way. They start from a single cell and we can trace the evolutionary paths of cancers by single cell analysis as well as bulk sequencing of spatially separated tumor regions to be able to reconstruct their subclones. And that's taught us to some extent, what are the early events in tumor evolution? What are the biological mechanisms driving branched evolution? How does genome instability begin in tumors? And we found through TRACERx work, whole genome doubling is a major route through to driving chromosome instability along with mutagenic enzymes like APOBEC that drive both mutations and chromosomal instability.(24:44):And then that leads to a sort of adaptive radiation in a sense, not dissimilar to I guess the Cambrian explosion of evolutionary opportunity upon which natural selection can act. And that's when you start to see the hallmarks of immune evasion like loss of HLA, the immune recognition molecules that bind the neoantigens or even loss of the neoantigens altogether or mutation of beta 2 microglobulin that allow the tumor cells to now evolve below the radar, so to speak. But you allude to the sort of spatial technologies that allow us to start to interpret the microenvironments as well. And that then tells us what the evolutionary pressures are upon the tumor. And we're learning from those spatial technologies that these environments are incredibly diverse, actually interestingly seem to be converging on one important aspect I'd like to talk to you a little bit more about, which is the myeloid axis, which is these neutrophils, macrophages, et cetera, that seem to be associated with poor outcome and that will perhaps talk about pollution in a minute.(25:51):But I think they're creating a sort of chronic inflammatory response that allows these early nascent tumor cells to start to initiate into frankly tumor invasive cells and start to grow. And so, what we're seeing from these spatial technologies in lung cancer is that T-cells, predatory T-cells, force tumors to lose their HLA molecules and what have you to evade the immune system. But for reasons we don't understand, high neutrophil infiltration seems to be associated with poor outcome, poor metastasis free survival. And actually, those same neutrophils we've recently found actually even tracked to the metastasis sites of metastasis. So it's almost like this sort of symbiosis between the myeloid cells and the tumor cells in their biology and growth and progression of the tumor cells.Eric Topol (26:46):Yeah, I mean this white cell story, this seems to be getting legs and is relatively new, was this cracked because of the ability to do this type of work to in the past everything was, oh, it's cancer's heterogeneous and now we're getting pinpoint definition of what's going on.Charles Swanton (27:04):I think it's certainly contributed, but it's like everything in science, Eric, when you look back, there's evidence in the literature for pretty much everything we've ever discovered. You just need to put the pieces together. And I mean one example would be the neutrophil lymphocyte ratio in the blood as a hallmark of outcome in cancers and to checkpoint inhibitor blockade, maybe this begins to explain it, high neutrophils, immune suppressive environment, high neutrophils, high macrophages, high immune suppression, less benefit from checkpoint inhibitor therapy, whereas you want lymphocyte. So I think there are biomedical medical insights that help inform the biology we do in the lab that have been known for decades or more. And certainly the myeloid M2 axis in macrophages and what have you was known about way before these spatial technologies really came to fruition, I think.The Impact of Air PollutionEric Topol (28:01):Yeah. Well you touched on this about air pollution and that's another dimension of the work that you and your team have done. As you well know, there was a recent global burden of disease paper in the Lancet, which has now said that air pollution with particulate matter 2.5 less is the leading cause of the burden of disease in the world now.Charles Swanton (28:32):What did you think of that, Eric?Eric Topol (28:34):I mean, I was blown away. Totally blown away. And this is an era you've really worked on. So can you put it in perspective?Charles Swanton (28:42):Yeah. So we got into this because patients of mine, and many of my colleagues would ask the same question, I've never smoked doctor, I'm healthy. I'm in my mid 50s though they're often female and I've got lung cancer. Why is that doctor? I've had a good diet, I exercise, et cetera. And we didn't really have a very good answer for that, and I don't want to pretend for a minute we solved the whole problem. I think hopefully we've contributed to a little bit of understanding of why this may happen. But that aside, we knew that there were risk factors associated with lung cancer that included air pollution, radon exposure, of course, germline genetics, we mustn't forget very important germline variation. And I think there is evidence that all of them are associated with lung cancer risk in different ways. But we wanted to look at air pollution, particularly because there was an awful lot of evidence, several meta-analysis of over half a million individuals showing very convincingly with highly significant results that increasing PM 2.5 micron particulate levels were associated with increased risk of lung cancer.(29:59):To put that into perspective, where you are on the west coast of the US, it's relatively unpolluted. You would be talking about maybe five micrograms per meter cubed of PM2.5 in a place like San Diego or Western California, assuming there aren't any forest fires of course. And we estimate that that would translate to about, we think it's about one extra case of never smoking lung cancer per hundred thousand of the population per year per one microgram per meter cube rise in the pollution levels. So if you go to Beijing for example, on a bad day, the air pollution levels could be upwards of a hundred micrograms per meter cubed because there are so many coal fired power stations in China partly. And there I think the risk is considerably higher. And that's certainly what we've seen in the meta-analyses in our limited and relatively crude epidemiological analyses to be the case.(30:59):So I think the association was pretty certain, we were very confident from people's prior publications this was important. But of course, association is not causation. So we took a number of animal models and showed that you could promote lung cancer formation in four different oncogene driven lung cancer models. And then the question is how, does air pollution stimulate mutations, which is what I initially thought it would do or something else. It turns out we don't see a significant increase in exogenous like C to A carcinogenic mutations. So that made us put our thinking caps on. And I said to you earlier, often all these discoveries have been made before. Well, Berenblum in 1947, first postulated that actually tumors are initiated through a two-step process, which we now know involves a sort of pre initiated cell with a mutation in that in itself is not sufficient to cause cancer.(31:58):But on top of that you need an inflammatory stimulus. So the question was then, well, okay, is inflammation working here? And we found that there was an interleukin-1 beta axis. And what happens is that the macrophages come into the lung on pollution exposure, engulf phagocytose the air pollutants, and we think what's happening is the air pollutants are puncturing membranes in the lung. That's what we think is happening. And interleukin-1 beta preformed IL-1 beta is being released into the extracellular matrix and then stimulating pre-initiated cells stem cells like the AT2 cells with an activating EGFR mutation to form a tumor. But the EGFR mutation alone is not sufficient to form tumors. It's only when you have the interleukin-1 beta and the activated mutation that a tumor can start.(32:49):And we found that if we sequence normal lung tissue in a healthy adult 60-year-old adult, we will find about half of biopsies will have an activating KRAS mutation in normal tissue, and about 15% will have an activating mutation in EGFR in histologically normal tissue with nerve and of cancer. In fact, my friend and colleague who's a co-author on the paper, James DeGregori, who you should speak to in Colorado, fascinating evolutionary cancer biologists estimates that in a healthy 60-year-old, there are a hundred billion cells in your body that harbor an oncogenic mutation. So that tells you that at the cellular level, cancer is an incredibly rare event and almost never happens. I mean, our lifetime risk of cancer is perhaps one in two. You covered that beautiful pancreas paper recently where they estimated that there may be 80 to 100 KRAS mutations in a normal adult pancreas, and yet our lifetime risk of pancreas cancer is one in 70. So this tells you that oncogenic mutations are rarely sufficient to drive cancer, so something else must be happening. And in the context of air pollution associated lung cancer, we think that's inflammation driven by these white cells, these myeloid cells, the macrophages.Cancer BiomarkersEric Topol (34:06):No, it makes a lot of sense. And this, you mentioned the pancreas paper and also what's going in the lung, and it seems like we have this burden of all you need is a tipping point and air pollution seems to qualify, and you seem to be really in the process of icing the mechanism. And like I would've thought it was just mutagenic and it's not so simple, right? But that gets me to this is such an important aspect of cancer, the fact that we harbor these kind of preconditions. And would you think that cancer takes decades to actually manifest most cancers, or do we really have an opportunity here to be able to track whether it's through blood or other biomarkers? Another area you've worked on a lot whereby let's say you could define people at risk for polygenic risk scores or various cancers or genome sequencing for predisposition genes, whatever, and you could monitor in the future over the course of those high-risk people, whether they were starting to manifest microscopic malignancy. Do you have any thoughts about how long it takes for the average person to actually manifest a typical cancer?Charles Swanton (35:28):That's a cracking question, and the answer is we've got some clues in various cancers. Peter Campbell would be a good person to speak to. He estimates that some of the earliest steps in renal cancer can occur in adolescence. We've had patients who gave up smoking 30 or so years ago where we can still see the clonal smoking mutations in the trunk of the tumor's evolutionary tree. So the initial footprints of the cancer are made 30 years before the cancer presents. That driver mutation itself may also be a KRAS mutation in a smoking cigarette context, G12C mutation. And those mutations can precede the diagnosis of the disease by decades. So the earliest steps in cancer evolution can occur, we think can precede diagnoses by a long time. So to your point, your question which is, is there an opportunity to intervene? I'm hugely optimistic about this actually, this idea of molecular cancer prevention.An Anti-Inflammatory Drug Reduces Fatal Cancer and Lung Cancer(36:41):How can we use data coming out of various studies in the pancreas, mesothelioma, lung, et cetera to understand the inflammatory responses? I don't think we can do very much about the mutations. The mutations unfortunately are a natural consequence of aging. You and I just sitting here talking for an hour will have accumulated multiple mutations in our bodies over that period, I'm afraid and there's no escaping it. And right now there's not much we can do to eradicate those mutant clones. So if we take that as almost an intractable problem, measuring them is hard enough, eradicating them is even harder. And then we go back to Berenblum in 1947 who said, you need an inflammatory stimulus. Well, could we do something about the inflammation and dampen down the inflammation? And of course, this is why we got so excited about IL-1 beta because of the CANTOS trial, which you may remember in 2017 from Ridker and colleagues showed that anti IL-1 beta used as a mechanism of preventing cardiovascular events was associated with a really impressive dose dependent reduction in new lung cancer primaries.(37:49):Really a beautiful example of cancer prevention in action. And that data weren't just a coincidence. The FDA mandated Novartis to collect the solid tumor data and the P-values are 0.001. I mean it's very highly significant dose dependent reduction in lung cancer incidents associated with anti IL-1 beta. So I think that's really the first clue in my mind that something can be done about this problem. And actually they had five years of follow-up, Eric. So that's something about that intervening period where you can treat and then over time see a reduction in new lung cancers forming. So I definitely think there's a window of opportunity here.Eric Topol (38:31):Well, what you're bringing up is fascinating here because this trial, which was a cardiology trial to try to reduce heart attacks, finds a reduction in cancer, and it's been lost. It's been buried. I mean, no one's using this therapy to prevent cancer between ratcheting up the immune system or decreasing inflammation. We have opportunities that we're not even attempting. Are there any trials that are trying to do this sort of thing?Charles Swanton (39:02):So this is the fundamental problem. Nobody wants to invest in prevention because essentially you are dealing with well individuals. It's like the vaccine challenge all over again. And the problem is you never know who you are benefiting. There's no economic model for it. So pharma just won't touch prevention with a barge pole right now. And that's the problem. There's no economic model for it. And yet the community, all my academic colleagues are crying out saying, this has got to be possible. This has got to be possible. So CRUK are putting together a group of like-minded individuals to see if we can do something here and we're gradually making progress, but it is tough.Eric Topol (39:43):And it's interesting that you bring that up because for GRAIL, one of the multicenter cancer early detection companies, they raised billions of dollars. And in fact, their largest trial is ongoing in the UK, but they haven't really focused on high-risk people. They just took anybody over age 50 or that sort of thing. But that's the only foray to try to reboot how we or make an early microscopic diagnosis of cancer and track people differently. And there's an opportunity there. You've written quite a bit on you and colleagues of the blood markers being able to find a cancer where well before, in fact, I was going to ask you about that is, do you think there's people that are not just having all these mutations every minute, every hour, but that are starting to have the early seeds of cancer, but because their immune system then subsequently kicks in that they basically kind of quash it for that period of time?Charles Swanton (40:47):Yeah, I do think that, I mean, the very fact that we see these sort of footprints in the tumor genome of immune evasion tells you that the immune system's having a very profound predatory effect on evolving tumors. So I do think it's very likely that there are tumors occurring that are suppressed by the immune system. There is a clear signature, a signal of negative selection in tumors where clones have been purified during their evolution by the immune system. So I think there's pretty strong evidence for that now. Obviously, it's very difficult to prove something existed when it doesn't now exist, but there absolutely is evidence for that. I think it raises the interesting question of immune system recognizes mutations and our bodies are replete with mutations as we were just discussing. Why is it that we're not just a sort of epithelial lining of autoimmunity with T-cells and immune cells everywhere? And I think what the clever thing about the immune system is it's evolved to target antigens only when they get above a certain burden. Otherwise, I think our epithelial lining, our skin, our guts, all of our tissues will be just full of T-cells eating away our normal clones.(42:09):These have to get to a certain size for antigen to be presented at a certain level for the immune system to recognize it. And it's only then that you get the immune predation occurring.Forever Chemicals and Microplastics Eric Topol (42:20):Yeah, well, I mean this is opportunities galore here. I also wanted to extend the air pollution story a bit. Obviously, we talked about particulate matter and there's ozone and nitric NO2, and there's all sorts of other air pollutants, but then there's also in the air and water these forever chemicals PFAS for abbreviation, and they seem to be incriminated like air pollution. Can you comment about that?Charles Swanton (42:55):Well, I can comment only insofar as to say I'm worried about the situation. Indeed, I'm worried about microplastics actually, and you actually cover that story as well in the New England Journal, the association of microplastics with plaque rupture and atheroma. And indeed, just as in parenthesis, I wanted to just quickly say we currently think the same mechanisms that are driving lung cancer are probably responsible for atheroma and possibly even neurodegenerative disease. And essentially it all comes down to the macrophages and the microglia becoming clogged up with these pollutants or environmental particulars and releasing chronic inflammatory mediators that ultimately lead to disease. And IL-1 beta being one of those in atheroma and probably IL-6 and TNF in neurodegenerative disease and what have you. But I think this issue that you rightly bring up of what is in our environment and how does it cause pathology is really something that epidemiologists have spent a lot of time focusing on.(43:56):But actually in terms of trying to move from association to causation, we've been, I would argue a little bit slow biologically in trying to understand these issues. And I think that is a concern. I mean, to give you an example, Allan Balmain, who works at UCSF quite close to you, published a paper in 2020 showing that 17 out of 20 environmental carcinogens IARC carcinogens class one carcinogens cause tumors in rodent models without driving mutations. So if you take that to a logical conclusion, in my mind, what worries me is that many of the sort of carcinogen assays are based on driving mutagenesis genome instability. But if many carcinogen aren't driving DNA mutagenesis but are still driving cancer, how are they doing it? And do we actually have the right assays to interpret safety of new chemical matter that's being introduced into our environment, these long-lived particles that we're breathing in plastics, pollutants, you name it, until we have the right biological assays, deeming something to be safe I think is tricky.Eric Topol (45:11):Absolutely. And I share your concerns on the nanoplastic microplastic story, as you well know, not only have they been seen in arteries that are inflamed and in blood clots and in various tissues, have they been seen so far or even looked for within tumor tissue?Charles Swanton (45:33):Good question. I'm not sure they have. I need to check. What I can tell you is we've been doing some experiments in the lab with fluorescent microplastics, 2.5 micron microplastics given inhaled microplastics. We find them in every mouse organ a week after. And these pollutants even get through into the brain through the olfactory bulb we think.Charles Swanton (45:57):Permeate every tissue, Eric.Eric Topol (45:59):Yeah, no, this is scary because here we are, we have these potentially ingenious ways to prevent cancer in the future, but we're chasing our tails by not doing anything to deal with our environment.Charles Swanton (46:11):I think that's right. I totally agree. Yeah.Eric Topol (46:15):So I mean, I can talk to you for the rest of the day, but I do want to end up with a topic that we have mutual interest in, which is AI. And also along with that, when you mentioned about aging, I'd like to get your views on these two, how do you see AI fitting into the future of cancer? And then the more general topic is, can we actually at some point modulate the biologic aging process with or without help with from AI? So those are two very dense questions, but maybe you can take us through them.Charles Swanton (46:57):How long have we got?Eric Topol (46:59):Just however long you have.A.I. and CancerCharles Swanton (47:02):AI and cancer. Well, AI and medicine actually in general, whether it's biomedical research or medical care, has just infinite potential. And I'm very, very excited about it. I think what excites me about AI is it's almost the infinite possibilities to work across scale. Some of the challenges we raised in the Cell review that you mentioned, tackling, embracing complexity are perfectly suited for an AI problem. Nonlinear data working, for instance in our fields with CT imaging, MRI imaging, clinical outcome data, blood parameters, genomics, transcriptomes and proteomes and trying to relate this all into something that's understandable that relates to risk of disease or potential identification of a new drug target, for example. There are numerous publications that you and others have covered that allude to the incredible possibilities there that are leading to, for instance, the new identification of drug targets. I mean, Eli Van Allen's published some beautiful work here and in the context of prostate cancer with MDM4 and FGF receptor molecules being intimately related to disease biology.(48:18):But then it's not just that, not just drug target identification, it's also going all the way through to the clinic through drug discovery. It's how you get these small molecules to interact with oncogenic proteins and to inhibit them. And there are some really spectacular developments going on in, for instance, time resolved cryo-electron microscopy, where in combination with modeling and quantum computing and what have you, you can start to find pockets emerging in mutant proteins, but not the wild type ones that are druggable. And then you can use sort of synthetic AI driven libraries to find small molecules that will be predicted to bind these transiently emerging pockets. So it's almost like AI is primed to help at every stage in scientific investigation from the bench all the way through to the bedside. And there are examples all the way through there in the literature that you and others have covered in the last few years. So I could not be more excited about that.Eric Topol (49:29):I couldn't agree with you more. And I think when we get to multimodal AI at the individual level across all their risks for conditions in their future, I hope someday will fulfill that fantasy of primary prevention. And that is getting me to this point that I touched on because I do think they interact to some degree AI and then will we ever be able to have an impact on aging? Most people conflate this because what we've been talking about throughout the hour has been age-related diseases, that is cancer, for example, and cardiovascular and neurodegenerative, which is different than changing aging per se, body wide aging. Do you think we'll ever changed body wide aging?Charles Swanton (50:18):Wow, what a question. Well, if you'd asked me 10 years ago, 15 years ago, do you think we'll ever cure melanoma in my lifetime, I'd have said definitely not. And now look where we are. Half of patients with melanoma, advanced melanoma, even with brain metastasis curd with combination checkpoint therapy. So I never say never in biology anymore. It always comes back to bite you and prove you wrong. So I think it's perfectly possible.Charles Swanton (50:49):We have ways to slow down the aging process. I guess the question is what will be the consequences of that?Eric Topol (50:55):That's what I was going to ask you, because all these things like epigenetic reprogramming and senolytic drugs, and they seem to at least pose some risk for cancer.Charles Swanton (51:09):That's the problem. This is an evolutionary phenomenon. It's a sort of biological response to the onslaught of these malignant cells that are potentially occurring every day in our normal tissue. And so, by tackling one problem, do we create another? And I think that's going to be the big challenge over the next 50 years.Eric Topol (51:31):Yeah, and I think your point about the multi-decade challenge, because if you can promote healthy aging without any risk of cancer, that would be great. But if the tradeoff is close, it's not going to be very favorable. That seems to be the main liability of modulation aging through many of the, there's many shots on goal here, of course, as you well know. But they do seem to pose that risk in general.Charles Swanton (51:58):I think that's right. I think the other thing is, I still find, I don't know if you agree with me, but it is an immense conundrum. What is the underlying molecular basis for somatic aging, for aging of normal tissues? And it may be multifactorial, it may not be just one answer to that question. And different tissues may age in different ways. I don't know. It's a fascinating area of biology, but I think it really needs to be studied more because as you say, it underpins all of these diseases we've been talking about today, cardiovascular, neurodegeneration, cancer, you name it. We absolutely have to understand this. And actually, the more I work in cancer, the more I feel like actually what I'm working on is aging.(52:48):And this is something that James DeGregori and I have discussed a lot. There's an observation that in medicine around patients with alpha-1 antitrypsin deficiency who are at higher risk of lung cancer, but they're also at high risk of COPD, and we know the associations of chronic obstructive pulmonary disease with lung cancer risk. And one of the theories that James had, and I think this is a beautiful idea, actually, is as our tissues age, and COPD is a reflection of aging, to some extent gone wrong. And as our tissues age, they become less good at controlling the expansion of these premalignant clones, harboring, harboring oncogenic mutations in normal tissue. And as those premalignant clones expand, the substrate for evolution also expands. So there's more likely to be a second and third hit genetically. So it may be by disrupting the extracellular matrices through inflammation that triggers COPD through alpha-1 antitrypsin deficiency or smoking, et cetera, you are less effectively controlling these emergent clones that just expand with age, which I think is a fascinating idea actually.Eric Topol (54:01):It really is. Well, I want to tell you, Charlie, this has been the most fascinating, exhilarating discussion I've ever had on cancer. I mean, really, I am indebted to you because not just all the work you've done, but your ability to really express it, articulate it in a way that hopefully everyone can understand who's listening or reading the transcript. So we'll keep following what you're doing because you're doing a lot of stuff. I can't thank you enough for joining me today, and you've given me lots of things to think about. I hope the people that are listening or reading feel the same way. I mean, this has been so mind bending in many respects. We're indebted to you.Charles Swanton (54:49):Well, we all love reading your Twitter feeds. Keep them coming. It helps us keep a broader view of medicine and biological research, not just cancer, which is why I love it so much.******************************************The Ground Truths newsletters and podcasts are all free, open-access, without ads.Please share this post/podcast with your friends and network if you found it informativeVoluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly helped fund our summer internship programs for 2023 and 2024.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff tor audio and video support at Scripps Research.Note: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in. Get full access to Ground Truths at erictopol.substack.com/subscribe
最後登機廣播，2023長榮航空線上旅展將於11/26結束，尚未購買機票的旅客請盡速前往長榮航空官網購買。除享有全航線最低72折起優惠外，還可再抽一年全球飛到飽機票！https://go.fstry.me/46mGW4h —— 以上為 Firstory DAI 動態廣告 —— 俗話說得好：「有競爭，才有油水」，這句話具體而微的展現在一卡通這檔600萬元的抽獎活動上。為何要灑幣辦活動呢？原因很簡單，就是要從其他電子支付業者手上搶下更多用戶數啦！iPASS MONEY真的是殺紅眼，這一次只要持一卡通記名卡，或是聯名信用卡之一卡通功能，或iPASS MONEY APP裡面的繳費/乘車碼，每完成一筆就享有一次抽獎會，總計高達2萬5千組好禮送大家，有點佛心啊！雖然它不保證100%人人有獎，但只要年底前，把日常生活會做的消費/繳費都換過來，改用iPASS MONEY APP / 一卡通聯名卡支付，筆筆都能累積抽獎機會，倒也不太困難，說不定你就是那個萬中選一的幸運兒，把最新的iPhone 15 128G帶回家！這一回，總共要抽出50支，數量不是普通的少，真的很多！還沒有卡片的小財神們，趕快入手一張一卡通聯名卡，解任務去囉~ 活動詳情：https://i-pass.co/5d7368 下載iPASS MONEY APP：https://i-pass.co/5dcapp -- 「【iPASS MONEY】歡慶突破600萬用戶，總價逾600萬好禮獎不停！」文字解析：https://bit.ly/3Rb6IUA 「2023 一卡通聯名卡感恩回饋雙重送，活動最高回饋 600 元！」文字解析：https://bit.ly/3s0xGVj 立即入手星展eco一卡通聯名卡：https://lihi1.com/UC0ce -- 小額贊助支持本節目： https://open.firstory.me/user/ckdpsqfmxifcf0862q6efk1qa 留言告訴我你對這一集的想法： https://open.firstory.me/user/ckdpsqfmxifcf0862q6efk1qa/comments Powered by Firstory Hosting
In this episode, Dr. Seipp discussed the Lincoln Roosevelt School IPASS initiative with Ms. Folkers, Ms. Davenport, Ms. DelRusso, and two students. IPASS is not just Lincoln Roosevelt's core values, it means much more to the school community and is celebrated through IPASS Day and throughout the school year.
Current Methods of Measuring Intracranial Pressure are Invasive, Expensive, and Risky. The current method for measuring intracranial pressure involves drilling a hole in the skull and physically inserting a sensor into the brain.Because this procedure is invasive and introduces additional risk factors, it is only used for patients in critical condition, typically in a coma. In 98% of traumatic brain injuries, the intracranial pressure is never tested. This leaves patients vulnerable to brain damage, seizure, coma, stroke, or even death.CranioSense has developed IPASS, a technology that measures intracranial pressure in seconds, without the need to drill a hole in the skull or insert a sensor into the brain. IPASS measures intracranial pressure (ICP) with an easy-to-use system that only requires a patch on the forehead, two clip-on sensors, and a handheld device the size of an iPad.In this episode, we discuss how Ryan Myers of CranioSense is discovering what their beachhead market should be, how to build the right team, and navigate between grant and venture funding to co-develop a winning medical product.
Barbara Nelson, VP of Engineering @ InfluxData, joins us to share her eng leadership philosophies on career adaptation and helping teams adapt to meet both business needs & individual interests / strengths. We cover how her leadership journey has shaped her perspective on adapting to new career opportunities, implementing boundaries within eng teams to foster creativity, approaching problem sets with eng teams, and building a healthy relationship between product & eng orgs. Additionally, Barbara shares strategies for adapting a team based on personality dynamics, meeting developers where they are, and why she's built her career on building products with purpose.ABOUT BARBARA NELSONBarbara leads the engineering team at InfluxData. She has extensive experience leading globally distributed teams in designing, developing, deploying, and supporting products and services that are delivered on a cloud-based service platform and on a range of client platforms. Prior to InfluxData, Barbara had a variety of engineering and technical leadership roles, including VP of Engineering at iPass, CTO at Cirrent, and Principal Architect at eBay. Barbara has a Bachelor's degree in Computer Science from University College Dublin, Ireland."There was an assumption that we had more shared context than we really had. So the engineers kind of thought, 'Well, it'll be obvious to the operations folks that this thing is deployed correctly or incorrectly.' There was no reason for it to be obvious to the operation folks. What would've made it obvious to the operations folks?”- Barbara Nelson Join us at ELC Annual 2023!ELC Annual is our flagship conference for engineering leaders. You'll learn from experts in engineering and leadership, gain mentorship and support from like-minded professionals, expand your perspectives, build relationships across the tech industry, and leave with practical prove strategies.Join us this August 30-31 at the Fort Mason Center in San FranciscoFor tickets, head to https://sfelc.com/annual2023SHOW NOTES:Barbara's favorite leadership dilemma – job efficiency vs. enjoyment (1:57)How Barbara has adapted to various roles throughout her leadership journey (3:42)Lessons learned from diving into the role of Interim VP of Operations (6:19)Formal & informal frameworks for making / communicating adjustments (9:03)Barbara's perspective on pursuing new opportunities & the “career ladder” (11:33)Advice for those who feel stuck on that ladder (13:25)How Barbara's experience at General Magic impacted her leadership philosophy (15:07)Why boundaries help foster creativity (17:30)Barbara's approach to introducing problem sets to eng teams (19:14)Strategies for aligning eng teams to reach an intended output (21:55)Driving a healthy relationship between product & eng teams (23:58)Recommendations for bridging the gap between product & engineering (26:02)Adapt a team based on personality dynamics & what gets them excited (28:49)The power of building a product with purpose (36:31)How AI trends will impact eng team adaptation & alignment (38:12)Rapid fire questions (39:45)LINKS AND RESOURCESBuild: An Unorthodox Guide to Making Things Worth Making - Written for anyone who wants to grow at work—from young grads navigating their first jobs to CEOs deciding whether to sell their company—Tony Fadell's Build is full of personal stories, practical advice, and fascinating insights into some of the most impactful products and people of the 20th century.This episode wouldn't have been possible without the help of our incredible production team:Patrick Gallagher - Producer & Co-HostJerry Li - Co-HostNoah Olberding - Associate Producer, Audio & Video Editor https://www.linkedin.com/in/noah-olberding/Dan Overheim - Audio Engineer, Dan's also an avid 3D printer - https://www.bnd3d.com/Ellie Coggins Angus - Copywriter, Check out her other work at https://elliecoggins.com/about/
Александър Петров. Двукратeн световен и европейски шампион по кикбокс в стил К1 със статистика от 31 победи, 17 от тях постигнати с нокаут. Носител на шампионските титли на MAX FIGHT в стил К1 и MAX1. Ден преди мача му на #MaxFight 53 с опитния боксьор от далечен Кот д'Ивоар - Улрих Аксел Тиебе, който ще се проведе във формат К1, в категория до 85 кг. Разговор за физическата и психическата подготовка на един шампион, както и за Александър Петров извън ринга. Приятно гледане и слушане! Билети за 53-тото издание на MAX FIGHT можете да закупите в мрежата на IPASS, на касата на Арена Армеец, или на всички каси на EasyPay в страната. Приятно гледане и слушане! MAX FIGHT: https://max-fight.com/ https://www.facebook.com/MAX-FIGHT-171555649638269/ https://www.instagram.com/maxfight/ Последвай ни в: / Follow us in: YouTube: bit.ly/3jFjmXS Facebook: bit.ly/2FJlMHl Instagram: bit.ly/3jl8L4h Twitter: twitter.com/LegendiLegends Apple Podcasts: https://podcasts.apple.com/bg/podcast/legendi-legends/id1538275381 GooglePodcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zb3VuZGNsb3VkLmNvbS91c2Vycy9zb3VuZGNsb3VkOnVzZXJzOjg5NjIxNTM0OC9zb3VuZHMucnNz?sa=X&ved=2ahUKEwjg6eXspYXtAhUI9hoKHVTgAw4Q9sEGegQIARAC Spotify: spoti.fi/2TeTM1p SoundCloud: https://soundcloud.com/cfcjgwgp3shy Deezer: https://www.deezer.com/us/show/2067872?deferredFl=1 - Георги Харизанов Веселин Вълчев Легенди / Legends Българският подкаст / The Bulgarian podcast
S1E3: Join host Jared Johnson and his guest Rajesh Voddiraju, Founder and President of Health iPass, as they discuss how an educated patient pays better, price transparency, and other aspects of the patient payment journey. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio.” Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
In this special episode of Lung Cancer Considered, hosts Dr. Stephen Liu and Dr. Narjust Florez discuss the seminal IPASS trial with its principal investigator, Dr. Tony Mok. IPASS was a randomized phase III trial that compared the EGFR TKI gefitinib to carboplatin plus paclitaxel and showed, for the first time, that in a selected population, targeted therapy was superior to chemotherapy. The initial results were published in the New England Journal of Medicine in 2009 and helped usher in the era of precision oncology. Dr. Tony Mok is the Li Shu Fan Medical Foundation endowed Professor and Chairman of the Department of Clinical Oncology at the Chinese University of Hong Kong. He cofounded the Lung Cancer Research Group, Chinese Thoracic Oncology Research Group and Asia Thoracic Oncology Research Group.
America will not be able to sign a trade deal for agricultural goods with the UK, unless the agreement includes 'no tariffs, and no barriers' according to a senior US Dept Agriculture representative. Jason Hafemesiter Acting Deputy Under Secretary for Trade and Foreign Agricultural Affairs says the US wants to embrace new technologies such as gene editing to reduce its reliance on fertilizers and pesticides, creating a more sustainable farming system. So, if a trade deal is signed between the UK and the USA, it would have to include crops produced in this way. He was also keen to point out that America would not want to see barriers to exports of hormone-treated beef or chorine-washed chicken. Meat production and alternative protein sources were up for debate at the Oxford REAL Farming Conference, as part of a wider discussion throughout the conference on sustainable food production. Nourish Scotland - a charity which focuses on food policy and practice - brought together farmers, academics, producers and consumers from all over the country for a workshop to explore some of the problems and solutions. We dropped in on a session entitled "What's at Steak?". A farmer with a passion for engineering and the environment will be unveiling a seed drill he's designed at Lamma - the agricultural machinery show at the NEC in Birmingham. Martin Lole, whose company Mzuri is based in Worcestershire, calls his new machine the Ipass. It's been set up to be used in a strip tillage system to minimise disruption to the soil and promises to deliver higher crop yields. Presenter = Anna Hill Producer = Rebecca Rooney
Imran Ahmad tells us what it's like to go from successful investor to successful operator. His skill set is rare, and this episode is full of gems you can incorporate into your business.
Matthew Owen has been solving problems as a Fractional Chief Technology Officer for 25+ years and is a Digital transformation leader, specifically with disruptive innovation of facial recognition. He is also a Twitter enthusiast, using it to ensure success at large scale events to gain valuable real-time consumer service feedback on new technology being implemented while it's being experienced by the consumers. Key Takeaways The main ingredient for disruption is extreme customer focus, taking into account the customer experience and their journey. Twitter could be a major feedback tool, where customer voices their opinion and experience about your product & services. Facial recognition technology is controversial but when used correctly can be incredibly useful. Facial recognition technology can help solve certain types of problems. Example: A Football stadium or a concert – 60 odd thousand people are trying to get in with an even smaller army of people helping them to get in, creating a bottleneck. Adding COVID to this mix makes it more challenging. Implementing Facial Recognition based express access or iPass allows fans and staff workers touchless access. Status Quo with Events and what consumers expect after COVID – Change is constant, with COVID regulations easing out consumers are confused with overlapping rules thrown by the authorities. Each event has its own set of rules & regulations, making it challenging for fans and employees alike. User education plays a pivotal role in making this technology scalable. The problem with educating the masses is that they are desensitized to marketing emails and half a short attention span. A proper protocol is followed with multiple layers of screening and judgment to ensure peace of mind and public safety. The challenge with this technology in the States is the regulatory environment. With privacy advocates for the consumers, the country is governed by laws making it difficult to navigate around them and still make sure the technology works for the consumers. The future of Facial recognition technology is going to be ubiquitous, inevitable and can be deployed at every location for the good of the customer. Part of the challenge is the myths surrounding the privacy and security of the technology – Consumers don't really care as long as it's convenient and saves them the Hassel. The real bottleneck it educating the end-users and making them aware of such technology. The major challenge is budgeting – who pays for such a tech? Because it's a cross-functional tech, getting all departments to agree to possess a greater challenge, which slows down the process. It's all about the consumer experience. When it comes down to it, any technology which is developed whether B2B or B2C, ultimately affects the end consumer. In the case of Facial recognition, it affects directly. Quote of the show: 6:43 “The technology can it used for good or evil, just like any other technology we've invited as mankind. It's incredibly useful if used correctly, there are things you can only do using facial recognition, like scanning a crowd of 66,000 people and picking out 3 people that shouldn't be there” Links: LinkedIn: https://www.linkedin.com/in/mowenranger/ Company Website: http://6bpartners.com Ways to Tune In: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Google Play - https://podcasts.google.com/feed/aHR0cHM6Ly93d3cuZGlzcnVwdGlvbmludGVycnVwdGlvbi5jb20vZmVlZC54bWw Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlD Stitcher - https://www.stitcher.com/show/disruption-interruption YouTube - https://youtu.be/WAPMxIZmNJs Links LinkedIn: https://www.linkedin.com/feed/update/urn:li:activity:6923281101763268608 YT snippet: https://youtube.com/shorts/ADMv9X0IysE?feature=share YT episode: https://youtu.be/5TadziWMP84 Podbean: https://www.disruptioninterruption.com/?s=%23+029 Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Google Play - https://podcasts.google.com/feed/aHR0cHM6Ly93d3cub21ueWNvbnRlbnQuY29tL2QvcGxheWxpc3QvODE5NjRmY2EtYTQ5OC00NTAyLThjZjktYWI3YzAwMmRiZTM2LzNiZTZiNzJhLWEzODItNDhhNS04MDc5LWFmYTAwMTI2M2FiNi9kZDYzMGE4Mi04ZGI4LTQyMGUtOGNmYi1hZmEwMDEyNjNhZDkvcG9kY2FzdC5yc3M= Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlD Stitcher - https://www.stitcher.com/show/disruption-interruption See omnystudio.com/listener for privacy information.
How can using 3D model technology improve workflows of drone manufactures? Patricia Hume is CEO of Canvas GFX, a company that develops visual communication and collaboration solutions. Canvas GFX is trusted by leading brands from verticals in aerospace and defense, automotive, commercial and domestic appliance, energy, and education. The company's solutions bridge the divide between technical and graphics applications, empowering everyone to communicate and understand complex information with absolute clarity. Pat's career in software and high tech spans four decades. At Canvas GFX, she is responsible for creating and executing the company's strategic vision. With a wealth of cross-functional experience and deep operational expertise across large companies and microcaps, she specializes in driving sustained growth and high-impact turnarounds. Prior to joining Canvas, Patricia was chief operations officer at iPass, Inc., where she led global customer-facing activities until the company's acquisition in February 2019. She has also served as chief revenue officer at Convio, senior vice president of Global Indirect Channels at SAP AG, group vice president of Avaya's SMB Division, and CEO and president of VerticalNet Markets. She held numerous senior management positions during her 18-year service with IBM and Lotus. In 2021, Canvas was selected by Zipline to optimize a range of visual documentation workflows. Launched in 2016 to deliver critical medical supplies, Zipline designs, manufactures and operates the world's largest automated on-demand delivery service, which to date has made more than 200,000 commercial deliveries and has delivered millions of units of blood, vaccines and other critical medical products. Using the Canvas Envision platform, Zipline employees will have the ability to create rich, dynamic visual assets leveraging real 3D CAD data. In this edition o f the Drone Radio Show, Patricia talks about Canvas GFX, the partnership with Zipline to create interactive 3D product models and the benefits of using new technologies to streamline workflows and communicate ideas.
上一次的節目有聊到LINE Pay 跟LINE Pay Money的分家前兆，結果沒多久就有媒體揭露兩家分開的詳細故事，還有四大階段都寫出來了！今天，我們就來跟大家聊聊電子支付業者的興衰，還有若是iPass 一卡通退居老二，將來會是誰坐大？會是悠遊付嗎？還是街口支付呢？LINE Pay的電子支付這塊空缺，又有可能讓誰進駐？iCash Pay？還是扶不起的阿抖Happy Go Pay？一起來收聽本集節目吧！ -- 小額贊助支持本節目： https://pay.firstory.me/user/pokemcard 留言告訴我你對這一集的想法： https://open.firstory.me/story/ckwtie8be5oyt08955jhk16h0?m=comment Powered by Firstory Hosting
In this episode of SaaS Connect from the Cloud Software Association, Fraser Davidson, CEO of Cyclr, is joined by Daniel Twigg, Cyclr's Marketing Manager. They speak about the complexities of seamless connections, scarce resources, and the different approaches to getting things done. Join us as we discuss the options and challenges, what's been done in the past, what's been the status quo, and the new schools of thought. Discussion points include: Becoming more agile and adding extra value when you don't have deep pockets and you have other priorities. Integrations: monetizing vs. adding value vs. cost. Dealing with friction between commercial and development departments. Building an integration yourself as opposed to iPass. What a day in the life of an iPass integration looks like. Dependencies and why they need to be thought through carefully. The upside and downside to owning everything. Not all integrations are templateable or standardised. When you share integrations, who provides end user customer support for the integration? (Answer = the vendor). Bear in mind that if you hand over the responsibility, you're sending your customer away. How Cyclr helps with the maintenance cycle and resources that iPass teams have as opposed to vendors; iPass is able to pick up on these things more rapidly than any vendor in isolation might necessarily be able to do. What good iPass vendors look like and how they're on the leading edge of how people are tackling integrations. A hybrid model of a SaaS company growing and building out, and the 80/20 rule. Resources Mentioned: Salesforce AWS Salestech Oracle Slack Azure Netsuite Thank you to our amazing podcast team at Content Allies! Want to launch your own B2B revenue-generating podcasts? Contact them at https://ContentAllies.com
Dr. Deepak Ravindran has over 20 years of experience in Pain Medicine and is Clinical Lead in Pain Medicine at the Royal Berkshire Hospital, one of the busiest General Hospitals in the UK. He is one of the very few consultants in the UK who holds triple certification in musculoskeletal, pain medicine and lifestyle medicine. He also is an honorary consultant to the award-winning community Pain service, IPASS, for the county of Berkshire. Recently, he helped set up and leads the Berkshire Longcovid Integrated service. Dr. Deepak Ravindran is a speaker, podcaster and author of the Best Selling book “The Pain-Free Mindset” – a book aimed at patients suffering from pain but also immensely useful for all healthcare professionals in understanding all the recent advances around pain management and a scientific evidence based way of managing and overcoming pain. Dr. Deepak Ravindran is a self-confessed ‘upstreamist' with a trauma-informed approach to pain practice. He has recently become a podcaster with his new podcast “PainSpeak” available to listen and download from iTunes and Spotify. Find him and follow him atTwitter: @deepakravindra5Linktree: https://linktr.ee/DrDeepakRavindranInstagram: @drdeepakravindran
In Ep.59 of the Sports Therapy Association Podcast, we are honoured to be joined by special guest Dr Deepak Ravindran, a consultant in pain medicine at the Royal Berkshire NHS Foundation Trust and clinical lead for specialist pain services for all of West Berkshire since 2015. Dr Ravindran has been one of the main consultants in setting up the award winning NHS community service IPASS (2015) and the Circle Fibromyalgia Rehabilitation Clinic (2017). In this episode he discusses his recent book 'The Pain-Free Mindset: 7 Steps to Taking Control and Overcoming Chronic Pain', an integrated approach that enables patients to evaluate the importance of each aspect of the pain-free MINDSET: Medication, Interventions, Neuroscience, Diet, Sleep, Exercise and Therapies for mind and body. A fantastic episode of huge value to both therapists and patients. We sincerely thank Dr Ravindran for giving up his time to speak to us. Useful Links: The Pain-Free Mindset on Amazon UK Twitter: @DeepakRavindra5 Facebook: DrDeepakRavindran Join us for Ep.60 - July 20th at 8pm (UK): 'Are We Human Or Are We Dancer' with special guest Liz Bayley Enjoyed the episode? Please take a couple of minutes to leave us a rating & review on Apple Podcasts. It really does make all the difference in helping us reach out to a larger audience. iPhone users you can do this from your phone, Android users you will need to do it from iTunes. All episodes are streamed live to our YouTube channel and remember all soft tissue therapists (non members included) are welcome to join us for the LIVE recording on Tuesdays at 8pm (UK time) on the Sports Therapy Association Facebook Page Questions? Email: matt@thesta.co.uk
In a lawsuit naming four physicians, the patient’s estate alleged negligent failure to restart anticoagulation after surgery, resulting in a stroke and ultimately, her death.
The Center for Medical Simulation Presents: DJ Simulationistas... 'Sup?
Hospital environments and clinical care has become complex. Managing interfaces across different aspects of the health system is critical, for example, patient flow across departments in a hospital. There has been a call for addressing these and other human factors in healthcare, but it is not clear what interventions are supported by data. Dr. Saša Sopka, anesthesiologist and medical education researcher, and the Medical Director of AIXTRA – Aachen Interdisciplinary Competency Center for Training and Patient Safety has been working to systematically review this topic. During this presentation, Dr. Sopka will review major problems in healthcare and human factors, explore solutions implemented in aviation and other related fields, and describe the published experience in healthcare highlighting several unexpected outcomes and examples. Two focus areas will be the Safe Surgery Checklist and IPASS for handovers.
Transitions of care are one of the most dangerous activities in medicine. Numerous studies highlight the rates of medical errors which occur at the time of sign-outs. Formalized sign-out processes have been shown to significantly decrease breakdowns in communication and reduce adverse events. In this episode, Dr. Kaminsky sits down with residents from across the country to dissect and discuss different sign-out styles and share some insights regarding bias and areas for improvement. Host: Alex Kaminsky, MD -- UCSF, Fresno Guests: Rosemarie Diaz, MD – University of Michigan Mary McLean, MD – St. John's Riverside Hospital Nicholas Robbins, MD – John Peter Smith Hospital Key Resources: Safer Sign Out Protocol: Available at ACEP. EMRA: Transitions of Care https://www.emra.org/students/advising-resources/transitions-of-care/#:~:text=Improving%20transitions%20of%20care%20%E2%80%93%20also,transfer%20of%20patient%20care%20information Key Points: In a prospective multi-center study (>10,000 patients) communication error occurred at a rate pf 24.5 per 100 admissions. Preventable errors were found to be 4.7 per 100 admissions. Effective sign-out strategies have been shown to reduce overall medical errors by ~23% and preventable adverse events by ~30%. Hand-Off Tools: Remember CODE STATUS! IPASS: Illness severity: Stable, “watcher,” unstable Patient Summary: HPI, ED course/Ongoing assessment, Plan Action List: “To-do” Situation Awareness and Contingency Planning: “If this, then do that.” Give your colleagues an idea of what to do if an event occurs. Synthesis by Receiver: Person taking the sign out does a “readback” of what they heard. Restate key actions. Also, the time to ask questions. SBAR Situation: Clearly and briefly define the situation Background: Provide clear, relevant background information that relates to the situation. Assessment: A statement of your professional conclusion. Recommendation: What do you need from this individual? What to do and contingencies. SHOUT S: Sick or not Sick H: History and Hospital Course O: Objective Data U: Upcoming plan, disposition T: To do (note: This is by no means a comprehensive list) References: Brady P, Gorham J, Kosti A, et al "SHOUT" to improve the quality of care delivered to patients with acute kidney injury at Great Western Hospital. BMJ Open Quality 2015;4:u207938.w3198. doi: 10.1136/bmjquality.u207938.w3198 “SBAR a Powerful Tool to Help Improve Communication.” The Joint Commission, www.jointcommission.org/resources/news-and-multimedia/blogs/at-home-with-the-joint-commission/2013/11/sbar--a-powerful-tool-to-help-improve-communication/?_ga=2.175033826.1924301882.1600033523-2075193987.1600033523. Starmer AJ, Spector ND, Srivastava R, West DC, Rosenbluth G, Allen AD, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803-12. Heilman JA, Flanigan M, Nelson A, Johnson T, Yarris LM. Adapting the I-PASS Handoff Program for Emergency Department Inter-Shift Handoffs. West J Emerg Med. 2016;17(6):756-61. Cheung DS, Kelly JJ, Beach C, Berkeley RP, Bitterman RA, Broida RI, et al. Improving handoffs in the emergency department. Ann Emerg Med. 2010;55(2):171-80.
Hey Lakers! We’re going to talk more about procrastination again, but this time we’re going to talk more about how we can add and subtract our way to productivity! We’re going to look at a couple tools from Dr. Peirs Steel and his book The Procrastination Equation: How to Stop Putting Things Off and Start Getting Stuff Done and talkRead More
Hey Lakers! We’re in uncharted waters here. Beth did a no fuss Be the Burrito take over to talk about productivity and how to kick procrastination to the curb, mostly. Beth gets real about why procrastination happens, how to fight it, and how she almost fell victim to it today. We can’t be together right now, but we are notRead More
Tutors, SIs, and midterms– all of our least favorite things! This week we bring on Connor Sands to talk about how to get a tutor, be a tutor and overcome the nightmare of midterms! So sit back and take a break from your studies and tune in!
Hey Lakers! This episode is going to be the saddest one so far because we must say goodbye to our host Beth Brandon. You all must put the sadness behind you and get pumped for the new hosts! We are excited to announce that Michael Gills and Lyndsey Murdock will be taking over Be the Burrito. If you have anyRead More
Sierra wants to save the Chicago coyote - Mancow thinks shes crazy! We hear what all of our listeners think and they side with Mancow. PLUS, opera star Lucas Meachem stops back in studio to sing some more for Mancow, there is a new proposed bill that would stop stalkers and divorce attorneys from getting your iPass data, Pete the Movie Manatee has a surprising good movie for you to see this weekend, and we play more Mancow Family Fued.
Episode link: https://www.sabmgroup.com/gary-griffiths/ Gary Griffiths (USNA '72) is the co-founder and managing director of Wisdom LLP. A 35-year veteran of the high-tech industry, Griffiths has led some of the web’s most innovative companies. Prior to co-founding Wisdom LLP, Griffiths was CEO of iPass (NASDAQ: IPAS), a leader in global Wi-Fi technology and services, which was acquired by Pareteum, Inc (NASDAQ: TEUM) in February 2019. He was also president of products and operations at WebEx, acquired for $3B by Cisco Systems, Inc. Griffiths was also co-founder and CEO of Everdream Corporation, a SaaS company, from 1999 to 2005, acquired by Dell, and co-founder/CEO at HEAT.net from 1996 until its acquisition by Sega, Inc. in 1999. Patricia Hume is a co-founder and managing partner at Wisdom LLP and has been named CEO of Canvas GFX. Wisdom LLP has invested in Canvas to fuel its growth strategy. Prior to Canvas, Patricia was chief operations officer of iPass, Inc., which was acquired in February 2019. In this episode, we discuss: Their exciting new opportunity with Canvas GFX, an all-in-one software to create digital illustrations and images How Gary and Patricia will work as a team to maximize this opportunity in a $75B market Gary’s favorite investments over the years which include and angel investment in Zoom.us which went public in April 2019 and is currently valued at $25B Connect with Gary and Patricia: Gary on LinkedIn Patricia on LinkedIn Canvas GFX If you found this episode valuable, please share it with a friend or colleague. If you are a Service Academy graduate and want to take your business to the next level, you can join our supportive community and get started today. Subscribe and help out the show: Subscribe on Apple Podcasts Also available on Google Play, Spotify & Stitcher Leave us a 5-star review! Special thanks to Gary and Patricia for joining me this week. Until next time! -Scott Mackes, USNA ’01
Scaling a hypergrowth Silicon Valley is a once-in-a-lifetime experience. Or in Evan Kaplan’s case, 3 times in a lifetime. And I was curious to learn how he does it. Evan is a Silicon Valley legend. A three-time CEO, who’s currently leading Influx Data. With 130 employees, Influx Data has created a platform for handling the massive amounts of data that are created by the IOT internet of things. (Think about your self-driving Tesla that throws off hundreds of millions of points of data per second. Someone has to process all that data!) That’s where Influx Data comes in. Evan previously served as CEO of iPass and Aventail. And if that’s not enough, he climbed the Himalayas. Whew. In this 20-minute conversation, Evan reveals how to create an amazing culture, how to hire the best, and how to build a remote-first organization.
Radiology Fall Risk
EPA Podcast Series: Giving First!- An Interview with Baruch Kim, MD -Networking -Bestdocz -Eastern Pain Association Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others. Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU. Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety. At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019. Baruch
Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others. Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU. Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety. At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019.
EPA Podcast Series: Giving First!- An Interview with Physiatrist Baruch Kim, MD -Networking -Bestdocz -Eastern Pain Association Dr. Baruch Kim obtained his undergraduate degree in Psychology at Stony Brook University with a simple desire to study the "human mind." At Stony Brook University, he participated in conducting a research study in human memory. He has extensive experiences in teaching his peers and students including a self-developed course in Rapid Reading, Optimization of Human Memory, Mid Mapping, as well as his online Chemistry Series and many others. Dr. Kim finished his medical school in New York, completed his internship in Michigan. He then moved back to New York to join his residency program at the Rusk Rehabilitation of NYU Langone Health, where he has been serving as an administrative chief resident. Dr. Kim will soon begin his journey in pain medicine at the ACGME-Accredited Pain Management Fellowship Program at NYU. Dr. Kim has featured in the newsletter at NYU on multiple occasions with his institutionwide projects in patient safety. Has contributed to improving the interpretation service at NYU Tisch, NYU Langone Orthopedic Hospital and NYU Brooklyn Hospital for all physicians. He also made official institutional guides (tutorial animations) on how to report patient safety events at three hospital sites, and how to perform the IPASS (handoff). He has also created tutorial animations on High Reliability Organization for all house staff at NYU with his sincere dedication to supporting "the culture change" in patient safety. At the beginning of his PGY 4 year, he was nominated by NYU residency program and the Association of Academic Physiatrists as an ACGME Review Committee member of his field. Dr. Kim has numerous leadership positions on a regional, and national level. He is currently serving as the secretary of the executive committee of Eastern Pain Association, co-chair of the Korean American Medical Residents and Fellows, national chapter, resident chair of social communication committee of the New York Society of Physical Medicine and Rehabilitation, and quite a few other positions. He manages multiple websites and many social media accounts for medical organizations and national leaders/physicians. He is a founder of BestDocz.com and also a brand strategist for Samuel Shem for his new book, Man's 4th Best Hospital (sequela to the House of God) which is to be released in November 2019. Baruch
With 25+ years in the tech industry, it’s pretty safe to say Doug is a technology veteran. A graduate of Central Michigan University, he started his career at Hewlett-Packard as a Software Engineer and left after 4 years to become a Director at Symantec (Semantic). It was shortly after that when he started Mobile Automation, developing enterprise system management solutions for tech companies and service providers. After selling Mobile Automation to iPass for $20M in 2004, he wouldn’t get back to life as an entrepreneur until 2007 with Boomdash. Fast forward to 2012, he started eLab ventures in Ann Arbor and at the same time served as Executive Director of the Center for Entrepreneurship at the University of Michigan. Currently, he serves full-time as Co-Founder and Managing Director at eLab and as a board member for several tech startups in the area. This episode is part of Capital Appreciation Month. We’re interviewing Michigan’s venture capitalists and angel investors in an effort
On May 11 of 2011, Timmothy Pitzen’s mother Amy picked him up early from school unexpectedly. In the following days, the two of them went on what appeared to be a fun-filled road trip…right up until Amy was found dead in a hotel room with a suicide note by her side. Did Amy take Timmothy somewhere safe before killing herself, or could she have hurt him as well before taking her own life? Listen in as John and Jamie share the details of the case and discuss popular theories about Timothy's disappearance.
https://www.patreon.com/FarEastAdventureTravel Get access to exclusive content and insider info on my travels! Become a patron now! Visit my Patreon page and check out the offers! I was so glad to see the Taoyuan International Airport MRT line open earlier this year. This finally brings Taipei in line as far as convenience and access goes, to it’s international airport, with other major cities in East Asia including Seoul, Tokyo, Hong Kong, Shanghai and Southeast Asian centers like Singapore and Kuala Lumpur. Like most airport trains across Asia they do not operate 24 hours a day so if your flight arrives outside of the 6am to 23:00 train schedule then you’ll have to use a bus, still fairly convenient or catch a taxi. At NT$160 for a one way ticket the Taoyuan Airport MRT is the bargain of East Asia for airport rail fares. As I mentioned in the video Taipei Metro offers a number of unlimited passes ranging from 24 hours to 72 hours. These passes are not valid for the airport MRT. If you’d like an unlimited pass that includes a return trip on the airport MRT then purchase the “Joint Ticket” at the airport MRT counter. At the airport and at Taipei Main Station you can purchase an Easy Card or iPass which you can load up and use on the airport MRT, Taipei Metro, many bus lines and convenience stores. This video should cover most of your questions regarding travel between the international airport and Taipei Main Station. For more information visit their website:https://www.tymetro.com.tw/eng/index.php
Wi - Fi Now - Episode 9: iPass’ 50 million hotspots & the future of Carrier Wi-Fi with Aptilo by RCR Wireless News
Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, reviews lung cancer highlights in 2011, focusing here on treatments focusing on the EGFR axis.
Dr. Jared Weiss, Medical Oncologist at UNC-Chapel Hill, reviews lung cancer highlights in 2011, focusing here on treatments focusing on the EGFR axis.
In this week's podcast: In the week Apple announced its third-generation iPad, we look at how tablets are making real inroads in business – but are causing problems as well as solving them. We hear from the CTO of iPass, Barbara Nelson, and the CEO of Netgear, Patrick Lo. Plus, has the supply chain become more dangerous? We ask Stanford University expert Kevin O'Marah why he thinks so. Presented and produced by Stephen Pritchard See acast.com/privacy for privacy and opt-out information.
This podcast describes the analysis of the IPASS study population by EGFR mutation and EGFR FISH biomarker status, and also discusses the results and controversial analysis of overall survival from this trial.
Lung cancer experts Janessa Laskin and Alan Sandler sit down with medical oncologist Jack West to discuss complex cases. Focus on first line chemo standards and the transition to maintenance therapy.
Lung cancer experts Janessa Laskin and Alan Sandler sit down with medical oncologist Jack West to discuss complex cases. Focus on first line chemo standards and the transition to maintenance therapy.
Lung cancer experts Janessa Laskin and Alan Sandler sit down with medical oncologist Jack West to discuss complex cases. Focus on never-smokers and EGFR mutation testing.
Lung cancer experts Janessa Laskin and Alan Sandler sit down with medical oncologist Jack West to discuss complex cases. Focus on never-smokers and EGFR mutation testing.
This interview by medical oncologist Dr. Jack West of Dr. Suresh Ramalingam, medical oncologist at Emory University in Atlanta, covers the evolving first line treatment standards of chemotherapy and targeted therapy for the first line treatment, as well as the emerging issue of maintenance therapy after initial treatment of advanced NSCLC.
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
Croncast - 2006-10-11.mp3 Show: #283 Length: 43:13 Size: 29.6 mb Format: mp3 Betsy and her husband Kris October 11, 2006 We recorded this late last night and the energy levels in some parts are pretty low. I think the prime time for us to record is around 9 p.m. Show notes: Intro numero dos thanks to that low energy Turn the dial? Betsy has been sitting in the house for a couple days Even though she went to Goodwill it was a bad day People were packed in wall to wall Wednesday will be worse cause it is old person day (Kris day) Vickie was rockin' her bag that Betsy missed out on Picking up the sister Resale shop at 11:35 . . . and suddenly the rest of my day is gone Betsy has been really grumpy last three days She wants to push off a pier with cement shoes The honest answer is she upset about parenting issues When will you not be too busy . . . 2008? That doesn't count as parenting Aren't we paying off the final credit card next week? There is always another bill, Mr. B. Rick keeps finding ways to get on the show Documentary about Betsy's uncle, Randy Shilts - Reporter Zero We have to find a way to see this movie Life is show prep holmes "I can't believe that I have to look at your mother at Thanksgiving" Flying back to the midwest and seeing the people at the airport You know your terminal by your people The new vast collection of checked shirts Betsy gets to the punch line before me "I don't belong with you people." Betsy says they are 'Puffy Cuffs' The nosey neighbor Nobody will even know when you are dead without nosey neighbors What would Kris be like as a native american? Shirt, pants and accessories from a single hanger on QVC "Fashion Day" Designed to minimize lumpiness Heart shaped mommy pants in the rear Why try to talk with the other mommies? They are not our people . . . they are 10-15 years older than we are Getting an iPass for the tolls as a birthday gift Oh, that was casual clothing 1) Fill out the appropriate form for you - *New* Listener or Get a Handle (current listener) 2) Verify your email address (Activates and qualifies those with a "Handle") 3) *New* listeners get activated and qualified by using their special RSS feed 4) 300th new listener and the person whose Handle they use win iPods AND 5) A drawing for 2 more iPods from everyone who entered!
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