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"My sheep hear my voice, and I know them, and they follow me." John 10:27 Submit a Podcast Listener Question HERE! Fr Joseph shares with us about how he got involved in The Catechesis of the Good Shepherd and a few of the parallels he sees between CGS and Ignatian Spirituality. Fr. Joseph Hill, SJ was born in Phoenix, AZ, raised in a Catholic family with his three brothers. At nine years old his family moved to England, where he attended Catholic schools and then the University of Oxford, earning a BA in theology in 2003. In 2004 he entered the Jesuit seminary in south Louisiana. Taking religious vows after two years, he was sent to study philosophy at Fordham University in New York, graduating with an MA in 2009. He then spent three years teaching theology at Jesuit High School, New Orleans. In 2012 he was sent to study theology at FAJE in Belo Horizonte, Brazil, earning a MA in 2014. Then he returned to Boston, earning a MEd at Boston College in 2015. He was ordained a Catholic priest on June 13th, 2015. For one year he worked at Parroquia San Ignacio in San Juan, Puerto Rico, and served as chaplain of Academia San Ignacio parish elementary school. It was in Puerto Rico that he became familiar with the Catechesis of the Good Shepherd. With the help of two excellent catechists and the school leaders, they implemented CGS Level I in the school. In August 2016 he moved to St. Louis, where he taught and worked in campus ministry at St. Louis University High School. During this time Fr. Hill, SJ completed a Doctor of Education degree from Vanderbilt University. Since July, 2021 he has lived in Tampa, FL, working as a Province vocation promoter. Growing Seeds Become a Growing Seed Donor HERE Growing Seed Donor Form. Access will also be granted to all existing recurring donors as of January 15, 2025. The recordings will be available through June 30, 2026. Be sure to click the checkbox: “Show my support by making this a monthly donation.” In 2024, The United States Association of The Catechesis of the Good Shepherd began celebrating 40 years of being an association of catechists who listen to God with children in the United States and around the world. In honor of our 40 years of remaining with children, we are launching a new sustainable giving program at CGSUSA: Growing Seeds. As part of Growing Seeds, your regular, automatic gift is simple and convenient, allowing you to spread your philanthropy over time. It also provides CGSUSA with a more predictable source of income so we can focus on sustaining and supporting the religious life of children and those who serve them. For a minimum gift amount of $15 per month ($180 per year), you will automatically be recognized as a CGSUSA Growing Seeds donor, giving you one year of access to the recordings from Between Memory and Hope: 40th Anniversary Celebration as our way of thanking you for your generosity. Please be sure you are logged in to your CGSUSA Membership account and complete the online giving form. Access to the video recordings is available to Growing Seeds donors until June 2026, at which point we'll have a new gift for you. For less than $5 per week, you will be able to access all the video and audio recordings from the Between Memory and Hope plenary sessions and workshops, including the full recording of Fr. Joseph Hill's presentation, “CGS and Ignatian Spirituality,” as well as “The Metaphysical Child: To Live and Move and Have Their Being,” “Observations Serving Toddlers in the Atrium,” and “Memories of Sofia and Gianna with the Children.” These presentations would make wonderful topics for catechist retreat days, parent education sessions, and other continuing education for those who serve children. Thank you for joining us in sustaining CGSUSA with a recurring gift. Items from the Store You May be Interested In: Purchase the Religious Potential of the Child HERE Preaching with Children Podcast Episodes With Priests: Episode 29 – CGS and Christian Unity with Bishop Talley Episode 32 – A Priest in the Atrium Episode 125. A Priest in CGS with Fr Kevin Douglas BECOME AN ORGANIZATION MEMBER! Organization Members are any entity (church/parish, school, regional group, diocese, etc.) that either offers CGS and/or supports those who serve the children as catechists, aides, or formation leaders) Organization Members also receive the following each month: Bulletin Items - 4 bulletin articles for each month. We have a library of 4 years of bulletin items available on the CGSUSA Website. Catechist In-Services to download TODAY and offer your catechists. We have six in-services available on the website. Assistant Formation - prayer service, agenda, talking points, and handouts. Seed Planting Workshop - prayer service, agenda, and talking points. Family Events: downloadable, 1/2 day events for Advent, Christmas/Epiphany, and Lent. Catechist Prayers and prayer services and so much more! Click Here to create your Organizational Membership! AUDIOBOOK: Audiobook – Now Available on Audible CGSUSA is excited to offer you the audio version of The Religious Potential of the Child – 3rd Edition by Sofia Cavalletti, read by Rebekah Rojcewicz! The Religious Potential of the Child is not a “how-to” book, complete with lesson plans and material ideas. Instead it offers a glimpse into the religious life of the atrium, a specially prepared place for children to live out their silent request: “Help me come closer to God by myself.” Here we can see the child's spiritual capabilities and perhaps even find in our own souls the child long burdened with religious information. This book serves as a companion to the second volume, The Religious Potential of the Child 6 to 12 Years Old. The desire to have this essential text available in audio has been a long-held goal for many. The work of many hands has combined to bring this release to life as an audiobook. Find out more about CGS: Learn more about the Catechesis of the Good Shepherd Follow us on Social Media- Facebook at “The United States Association of the Catechesis of the Good Shepherd” Instagram- cgsusa Twitter- @cgsusa Pinterest- Natl Assoc of Catechesis of the Good Shepherd USA YouTube- catechesisofthegoodshepherd
This week on The Ryan Show FM Hop into the wormhole for another 4 hour presentation where we discuss the inauguration of Donald Trump from all angles. This weeks show includes contributions from guests including: Tasiim Diliza author of @thisplanetwasstolen stopped by to reveal the truth about humanity's little known origins. Ebony Stone joined us to discuss Tasiim's book and the cold hard truth about the whitewashing of global history. #DavidHolt president of @consumerenergyalliance, is on a mission to help solve the impending energy crisis in America. How can we create enough energy to keep up with the growing world of AI? Joseph Hill has put President Trump on full blast, going as far as comparing him to Hitler. We get into the controversial comparisons and differences between these two monumental figures. Dicky Braggs called into discuss the recent statements made by Yankees owner Hal Steinbrenner and we rate the moves made by Brian Cashman in the offseason. Big T stopped by to discuss the greatness of the Kansas City Chiefs, the layers behind sports riggery and his Super Bowl Picks. #TheRyanShowFM #ebonystone #tasiimdiliza #josephhill #bigt #dickybraggs For all video content subscribe to your YouTube @theryanshowfm
American Sign Language is the third-most used language in the U.S. ASL has its own culture and art forms, and for many Deaf folks, ASL is about much more than just communication. Anita talks to Deaf author Sara Nović and Deaf ASL Slam poet Douglas Ridloff about how ASL gave them tools for self-understanding and artistic expression. Then she learns from scholars Carolyn McCaskill and Joseph Hill about Black American Sign Language (BASL), an ASL dialect that emerged because of school segregation.Meet the guests:- Sara Nović, author of "True Biz," outlines the history of ASL and how it has influenced her work as a writer- Douglas Ridloff, visual storyteller, ASL master and executive director of ASL Slam, shares how he learned ASL and became an ASL poet- Carolyn McCaskill, recently retired professor and director of the Center for Black Deaf Studies at Gallaudet University, talks about attending a segregated school for the deaf — and how integration raised her awareness of Black ASL (BASL)- Joseph Hill, associate professor in the department of ASL and Interpreting Education at Rochester Institute of Technology, talks about the impact of the research he, Carolyn and two other colleagues have conducted about BASLRead the transcript | Review the podcast on your preferred platformCheck out the video version of this conversation: part one is here, and part two is here.Follow Embodied on X and Instagram Leave a message for Embodied
Jump into the wormhole for another edition of @theryanshow radio program! Join #ryanverneuille for the best of this week's content hand wrapped and delivered for your radio experience! This weeks special guests include #LostBoyz Spigg Nice, bank robber turned actor Supreme Dolla and historian Joseph Hill! Enjoy the never before told story of the legendary Lost Boyz bank robbery and a history of Israel's beef with Palestine. This week's program is brought to you by The Insurance God Keith Sands. For more info on how to protect yourself and your family from accidents contact him directly! #theryanshow #hamptonsdave #mrcheeks #fmradio #spiggnice #josephhill #theinsurancegod #keithsands #BIVO
Fr. Mitch with Fr. Joseph Hill, SJ, Fr. Michael Wegenka, SJ and Isaac Beck discuss the martyrdom of St. Jean de Brebeuf, his relics, and the ministry of the North American Martyrs.
American Sign Language is the third-most used language in the U.S. ASL has its own culture and art forms, and for many Deaf folks, ASL is about much more than just communication. Anita talks to Deaf author Sara Nović and Deaf ASL Slam poet Douglas Ridloff about how ASL gave them tools for self-understanding and artistic expression. Then she learns from scholars Carolyn McCaskill and Joseph Hill about Black American Sign Language (BASL), an ASL dialect that emerged because of school segregation.Meet the guests:- Sara Nović, author of "True Biz," outlines the history of ASL and how it has influenced her work as a writer- Douglas Ridloff, visual storyteller, ASL master and executive director of ASL Slam, shares how he learned ASL and became an ASL poet- Carolyn McCaskill, recently retired professor and director of the Center for Black Deaf Studies at Gallaudet University, talks about attending a segregated school for the deaf — and how integration raised her awareness of Black ASL (BASL)- Joseph Hill, associate professor in the department of ASL and Interpreting Education at Rochester Institute of Technology, talks about the impact of the research he, Carolyn and two other colleagues have conducted about BASLRead the transcript | Review the podcast on your preferred platformCheck out the video version of this conversation: part one is here, and part two is here.Buy tickets for our live event on 4/20/24!Follow Embodied on X and Instagram Leave a message for Embodied
Episode Description: Hop into the rabbit hole for another powerful rendition of The Ryan Show FM radio program! Join host #ryanverneuille on his endless quest to further his understanding of the #American culture through its great contributors. This week's guests include legendary actor J.D. Williams, behavioral scientist Dr. Natanya Wachtel, and historian Joseph Hill. This week's program is brought to you by Villon! #theryanshow #hamptonsdave #mrcheeks #theryanshowfm #drnatanyawachtel #jdwilliams #thewire #fmradio Episode Playlist: Rick James - Sexy Lady Mary Jane Girls - All Night Long Jim Jones ft Camron - White Powder Uncle Murda ft Jadakiss - Money
Fr. Joseph Hill, SJ, is with us to share an exciting opportunity to venerate the relics of St. Jean de Brebeuf. Learn about the saint and how you can spend time in prayer with his skull on February 25th at the Cathedral Basilica of St. Louis. More information is at https://brebeuftour24.org/ . We're at "H minus 8" in Operation: Ashes to Glory and Adam continues the conversation about Lenten preparations with Fr. Peter Pomposello. Today they dive into the topics of prayer and fasting. Father invites you to pray the novena LIVE nightly at 9:00 pm (eastern) on his Instagram channel (@Fr.UncleSam). For more information on Covenant Network, visit OurCatholicRadio.org
90% of heart problems can be prevented. Cardiologist Dr. Joseph Hill explains on this episode what we should all be doing for our heart health, what numbers to watch, and why losing even a little weight can make a huge difference for our health.
In this episode of ESG in Conversation, we're exploring the question: what does it take to be a sustainability leader in 2023 and beyond? You'll hear from Joseph Hill, London Techstars alumn and CEO of Zephframe, about the sustainability challenges facing start-ups. You'll also hear from Eileen Buckley, VP of Corporate Responsibility at Stryker, about the importance of integrating sustainability across an organization. Gabriel Presler, Global Head for Enterprise Sustainability at Morningstar, also joins in to discuss the role investors play in sustainability leadership.
This week's show starts off with new music from Burning Spear, Hempress Sativa, Stephanie Joseph, Akae Beka with Kabaka Pyramid, Ras Sparrow, and Scientist with Dubiterian. Roots & Culture tunes this week feature Culture, Tony Tuff, Everton Blender, Ziggy Marley & The Melody Makers, Reggae Regular, Prince Far I, Fabian, Peter Tosh, Glasford Manning, Junior Bytes, Earl Zero, Joseph Hill and the Soul Defenders, and The Heptones. New music this week comes from Israel Starr, Keith Poppin, Robert Dallas, Abiyah Yisrael, Ras Jem, Little Roy, Hassanah, Kuzikk, Exco Levi, Bob Marley & The Wailers featuring Stonebwoy, Mikey Dub and Cotilde, Hugh English, Iratio, Samory I, Manudigital with Liam Bailey and Dubtown Abbey with Omar Perry. Enjoy! Burning Spear - Obsession - No Destroyer - Burning Music Hempress Sativa - Time Has Come - Charka - Conquering Lion Records Stephanie Joseph - Prophecy - Blacker Dread Productions/NCMG Akae Beka feat. Kabaka Pyramid - Glory/Glory Dub - Glory - Zion High Productions Scientist & Dubiterian - Style Dub - Free Brazil From The Invading Vampires - Dubiterian Records Ras Sparrow - Seek Jah First/ Seek Jah First Dub - Eloy A Carrero Bob Marley & The Wailers - Zion Tain - Uprising - Tuff Gong Culture - Iron Sharpen Iron - Too Long In Slavery - Virgin/Frontline Tony Tuff - Shouldn't Fuss and Fight - Foundation Compilation: Reggae Series Volume 1 - Music Life Movements Everton Blender - Just Wanna Be - A Piece Of The Blender: The Singles - Heartbeat Records Ziggy Marley & The Melody Makers - Who Will Be There? - One Bright Day - Virgin Reggae Regular - Ghetto Rock/Ghetto Dubbing - Channel One Sound System: Down In The Dub Vaults - VP Records Prince Far I - Heavy Manners/Heavy Disciple - Under Heavy Manners Remastered - VP Records Fabian - Porphecy/Prophecy Version - Tribes Man Records 12” Peter Tosh & The Wailers - Downpresser - Peter Tosh & Friends: Arise Blackman - Trojan Records Glasford Manning - Prophecy Call - Niney The Observer: Roots With Quality - VP Records Junior Byles - Rasta No Pick Pocket - Junior Byles: Beat Down Babylon/Dreader Sounds - Doctor Bird Earl Zero - Never Get Weary - Jammy's 7” Joseph Hill & The Soul Defenders - Behold (take 3) - Studio First: From The Vaults Of Studio One Vol. 2 - Studio One Records The Heptones - Country Boy - Harry J's 7” Burning Spear - Independent - No Destroyer - Burning Music Israel Starr feat. Lomez Brown & Natural Roots - Spiritual Healing - Bless Up Music Keith Poppin - Stand Up - KP Productions Robert Dallas - Bad Mind - Roots Garden Records Dahvid Slur & Jo Mersa Marley - Cyah Kill Rasta - VPal Xana Romeo & Lone Ark Riddim Force - Tafari The Captain/Tafari Version - Reggae Roads Records AbiYah Yisrael - Wake Up - African Renaissance - Cha Yah Studios Akae Beka feat. Reemah - Still Small Voice - Glory - Zion High Productions Ras Jem - Who They Are - Royal Majestic Sound Little Roy - My Friend/My Friend Dub - Woke Up - Zion High Productions Horace Andy - Lets Live In Love w/ version - More Fire! - Reggae Roast Keith & Tex - Stop That Train - Inna De Yard: Family Affair - Chapter Two Records Derrick Harriot - The Loser - A Place Called Jamaica - Makasound Dennis Brown - Should I - Words Of Wisdom - VP Records Hassanah - I Got To Go - The Real Thing - Upstairs Music Freddie McGregor - Danger In Your Eyes - Sings Jamaican Classics: Deluxe Edition - VP Records Scientist & Dubiterian - Dangerous Dub - Free Brazil From The Invading Vampires - Dubiterian Records Kuzikk - Reggae Town - Hot Wata - Boot Camp Records Exco Levi - Feel Like Home - 2023 Jamaica Festival Song Competition - JCDC Bob Marley & The Wailers feat. Stonebwoy - Buffalo Soldier - Africa Unite - Tuff Gong International Burning Spear - On The Inside/I Am In - The Burning Spear Experience - Burning Music Tetrack w Sly & Robbie - Trappers/Trappers Dub - Channel One Sound System: Down In The Dub Vaults - VP Records Prince Far I - Deck Of Cards - Under Heavy Manners Remastered - VP Records Lee Scratch Perry & Subatomic Sound - Zion's Blood - Super Ape Returns To Conquer - Subatomic Sound Dubinator feat. Seanie T - Police In Helicopter - Police In Helicopter - Echo Beach Clive Hylton & Chazbo - All The Best/Melodica Cut - Roots Masala 12” Vibrations Train - Navegan Dub - Spectral Dub & The Galactic Dub Family: Melodicas Dub Shot - Culture Dub Records Mikey Dub feat. Cotilde - Bye Bye/ Bye Bye Dub - Triumphant Riddim - Dubophonic Records JonnyGo Figure Feat. Green & Fresh - No Officer/Stop & Search Dub - Crucial Moods - Bent Back Records Hugh English - Where Do We Go From Here? - Big Feet Records Iratio - Lion Of Judah - No Choice Music Group Yeza - Star Of The East - Rorystonelove Samory I feat. Capleton & Kabaka Pyramid - Wrath - Strength - Overstand Entertainment Manudigital feat. Liam Bailey - Enough - X Ray Productions Dubtown Abbey Meets Omar Perry - Jah Jah Love/Jah Jah Love (dub mix) - Dubtown Abbey Meets Omar Perry - Dubtown Abbey
Actor/Writer/Director and author William Joseph Hill lives in Hollywood where he works in independent features, short films, television, and theater. Notable roles include a heroin addict in Eskimo, a serial killer in Crisis Management, and a mutant who fights with Monkey Kung Fu in the sci-fi action film The Last Girl which won audience favorite at the Action on Film Festival. Other accolades include L.A. Times' Critics' Pick for the Monty-Python inspired The Unsinkable Bismarck, where he played eight different characters onstage.A lifelong martial artist, he began his journey in Okinawan Kenpo Karate and Kobudo while growing up in Hawaii. He has used his skills in several action roles including an episode of The Rolling Soldier and the comedy film Agent Steele where he played opposite rising star Andrew Bachelor. In 2019, William published his first novel, CYBER FIGHTER, based on a feature film screenplay he is developing into a movie. It's a martial arts/sci-fi action adventure with a comedic kick – best described as The Matrix meets John Wick minus Keanu Reeves.The book is available on Amazon. He also narrated the audiobook which you can find on Audible. Currently he is launching a campaign on Indiegogo for a short film proof of concept for CYBER FIGHTER, which will be used to help develop the feature film. This short was also adapted into a comic book which is also on Amazon.OFFICIAL CAMPAIGN LINK: https://igg.me/at/CYBERFIGHTERThe Douglas Coleman Show now offers audio and video promotional packages for music artists as well as video promotional packages for authors. We also offer advertising.Please see our website for complete details.http://douglascolemanshow.comf you have a comment about this episode or any other, please click the link below. https://ratethispodcast.com/douglascolemanshowPlease help The Douglas Coleman Show continue to bring you high quality programs like this. Go to our Fundrazer page.https://fnd.us/e2CLX2?ref=sh_eCTqb8
In this interview from 1992, the late Joseph Hill tells us how his music was influenced by a painting he created and names the legends that are the "crankshaft" of all music. --- Send in a voice message: https://podcasters.spotify.com/pod/show/reggaerootsrockers/message
TIMESTAMPS: Targeting for Paid Social [00:01:13] Joseph discusses the importance of relevancy over audience size when targeting for paid social media, specifically on LinkedIn, and how chasing after funnel or intent audiences can lead to wasted budget. Using Third-Party Data for Facebook Targeting [00:04:47] Joseph explains the limitations of Facebook's native targeting for B2B marketing and recommends using third-party data providers, such as Metadata's product A Match, to ensure relevancy and avoid wasting budget. Lead Generation vs Demand Generation [00:05:48] Joseph discusses the difference between lead generation and demand generation in B2B marketing and emphasizes the importance of focusing on quality over quantity when it comes to leads, as well as pushing pain points and solutions to potential customers as a first point of contact. Targeting for Paid Social Media [00:10:38] Joseph explains the importance of targeting the right audience for paid social media and shares a diagram to illustrate the concept. Creating Effective Ads [00:12:59] Joseph shares his tips for creating effective ads that have clear copy, relevant visuals, and a powerful story. Focusing on the Problem [00:17:18] Joseph emphasizes the importance of focusing on the problem that the product solves rather than just its benefits and shares examples of effective ads that highlight the problem. Using Problems in Advertising [00:20:27] Discussion on how to use problems in advertising and whether to include the product in the ad unit or on the landing page. Demand Generation and Demand Capture [00:22:10] Explanation of the difference between demand generation and demand capture and how they work on different channels. Driving Meetings with Incentives [00:26:35] Ways to drive meetings with incentives such as gift cards, consultations, and company resources, and the importance of promising immediate value to potential customers. Invest in your sales team [00:29:39] Importance of investing in sales team to retain competent personnel and avoid the cost of recruiting and training new salespeople. Building a marketing framework from scratch [00:30:33] Steps to build a marketing framework from scratch, including identifying problems, creating a story, and targeting relevant companies and job titles. Watch the video podcast on YouTube: https://www.youtube.com/watch?v=XxDV6MSr3cA Resources and references: Joseph's LinkedIn https://www.linkedin.com/in/digital-marketing-joe/ The Ultimate LinkedIn Ad Library Driving Meetings From Powerful Creative Webinar MetaMatch Free Trial -- ⚡ Mony's Linkedin -- ❤️ SUPPORT THE PODCAST 1. Subscribe
Heart failure with preserved ejection fraction (HFpEF) is, in many ways, a fascinating tale of modern cardiovascular medicine that, according to lead author Dr. Joshua Hare (University of Miami Miller School of Medicine), has taught cardiovascular researchers and clinicians a lot of humility. Understanding HFpEF in a variety of animal models has led to a paradigm shift away from heart failure linked to low ejection fraction. In this episode Associate Editor Dr. Jonathan Kirk (Loyola University Chicago Stritch School of Medicine) interviews Dr. Hare along with expert Dr. Julie McMullen (Baker Heart and Diabetes Institute, Melbourne, Australia) about the latest study by Kanashiro-Takeuchi et al. The Hare Lab was originally attracted to a cardiometabolic model of HFpEF pioneered by Dr. Joseph Hill, because in a large proportion of human patients, HFpEF is due to metabolic syndrome, which is a combination of obesity, diabetes, and hypertension. Armed with the ability to create this cardiometabolic HFpEF model, Hare and co-authors decided to test growth hormone-releasing hormone-agonist using a powerhouse of methods to determine if exercise intolerance could be improved. Kanashiro-Takeuchi et al. found that diastolic function and exercise performance improved, and myocyte hypertrophy and fibrosis were restored. Essentially all of the features of cardiometabolic HFpEF responded to treatment with GHRH-agonist. The authors did not see a reduction in blood pressure or weight, indicating a direct myocardial effect. In a wide-ranging discussion that touches on skeletal muscle, aging, sarcomeric proteins, and the technical complexities of running titin gels and PV loops, our experts explain why HFpEF is such a challenging syndrome to treat and why this translational research is so important. Listen now. Rosemeire M. Kanashiro-Takeuchi, Lauro M. Takeuchi, Raul A. Dulce, Katarzyna Kazmierczak, Wayne Balkan, Renzhi Cai, Wei Sha, Andrew V. Schally, Joshua M. Hare Efficacy of a Growth Hormone-Releasing Hormone Agonist in a Murine Model of Cardiometabolic Heart Failure with Preserved Ejection Fraction Am J Physiol Heart Circ Physiol, published April 25, 2023. DOI: 10.1152/ajpheart.00601.2022.
It is said that the two greatest problems of history are: how to account for the rise of Rome, and how to account for her fall. If so, then the volcanic ashes spewed by Mount Vesuvius in 79 AD - which entomb the cities of Pompeii and Herculaneum in South Italy - hold history's greatest prize. For beneath those ashes lies the only salvageable library from the classical world.Nat Friedman was the CEO of Github form 2018 to 2021. Before that, he started and sold two companies - Ximian and Xamarin. He is also the founder of AI Grant and California YIMBY.And most recently, he has created and funded the Vesuvius Challenge - a million dollar prize for reading an unopened Herculaneum scroll for the very first time. If we can decipher these scrolls, we may be able to recover lost gospels, forgotten epics, and even missing works of Aristotle.We also discuss the future of open source and AI, running Github and building Copilot, and why EMH is a lie.Watch on YouTube. Listen on Apple Podcasts, Spotify, or any other podcast platform. Read the full transcript here. Follow me on Twitter for updates on future episodes.As always, the most helpful thing you can do is just to share the podcast - send it to friends, group chats, Twitter, Reddit, forums, and wherever else men and women of fine taste congregate.If you have the means and have enjoyed my podcast, I would appreciate your support via a paid subscriptions on Substack
Welcome to Madang! Madang is the outdoor living room of the world. Here, we invite you to sit and tune into unreserved, remarkable conversations with renown authors, leaders, public figures and scholars on religion, culture and everything in-between. This has been a dream of mine for many years and now it is. reality. Please join me at Madang. This is the 25th episode of Madang where I converse with Rev. Dr. Graham Joseph Hill on his co-written book, "Healing Our Broken Humanity" Rev. Dr. Graham Joseph Hill is State Leader for Baptist Mission Australia (Western Australia). He is a Professor of World Christianity and Mission Studies, and also the Founding Director of The Global Church Project. Graham is the author of thirteen books, including Healing Our Broken Humanity (co-authored with Grace Ji Sun Kim). Conversations about reconciliation, justice, lament, the vision of the Sermon on the Mount for a radical church and restored world and so much more. Please stay tuned. I am thrilled to announce that Madang podcast is hosted by the Christian Century. Please visit their website for the latest Madang podcast as well as current articles on Christianity, culture and society. I have written several pieces for the Christian Century and welcome this new partnership. https://www.christiancentury.org/madang I am grateful to Homebrewed Christianity, PANAAWTM, Society of Pentecostal Studies for their sponsorship of this episode. Please check out their website for their work, events and to donate. Please reach out to me if you would like to sponsor the next episode of Madang podcast. Or simply support me here: https://anchor.fm/grace-ji-sun-kim --- Support this podcast: https://anchor.fm/grace-ji-sun-kim/support
@theryanshow presents a double presentation of @theryanshowfm & @whatsgoingon_foxsports! In part one of this week's program historian Joseph Hill joins us to discuss the legacy of #MartinLutherKingJr Part two sees Sirius XM's own @darealinphamusamadeuz and author #DavidCayJohnston join @natebrownjr & @ryanverneuille to talk politics, Mets free agency and more. #theryanshow #ryanverneuille #mrcheeks #hamptonsdave #theryanshowfm #deejaykhalil #gruntworks #alphacitymetaverse #sagharbor #fmradio Episode Playlist: EPMD ft K Solo & Redman - Headbanger Roberta Flack - Reverend Lee Ghostface Killah - Wildflower Jay Electronica - Exhibit C
Episode 163: Welcome to this Week's episode of PI-Perspectives. We have a 2 for 1 this week as we are joined by Michael Tapling and Joseph Hill from Conflict International. Michael is Vice President of US operations and Joseph is Vice President of Technical operations for this great multinational company. Conflict has expanded its operations in the United States and the guys are here to discuss how they can help your needs. Please welcome Mike Tapling, Joe Hill and your host, Private Investigator, Matt Spaier Links: Matt's email: MatthewS@Satellitepi.com Linkedin: Matthew Spaier www.investigators-toolbox.com Michael on Linkedin : Michael Tapling Joseph on Linkedin: Joseph Hill https://www.conflictinternational.com/ PI-Perspectives Youtube link: https://www.youtube.com/channel/UCYB3MaUg8k5w3k7UuvT6s0g Sponsors: https://investigationeducation.com/ https://www.conflictinternational.com/ https://apps.crosstrax.co/signup/index/refcd/LY3R7VUW69 https://irbfocus.com/Rosa/apply?UTM_SOURCE=PI_Perspectives&UTM_MEDIUM=Podcast&UTM_CAMPAIGN=Investigtive&UTM_CONTENT=Evergreen_Leads https://orep.org/private-investigator-insurance/
Photographer Joseph Hill is known as the “unofficial mayor” of Southern Pines, North Carolina. He's currently the exclusive photographer for the Southern Pines Welcome Center, where many of his pictures are available for purchase as postcards. His work has been featured in PineStraw Magazine and on the front page of The Pilot newspaper. Joseph also has autism, and he's on a mission to spread positivity and encourage other entrepreneurs like himself. (Note: I'm using person-first language like "has autism" for Joseph at his request.) During this episode, you will hear Joseph talk about: What it was like growing up with autism How his parents and family friend have helped him develop his passion and career as a photographer How he finds and captures the beauty of everyday things in his photography The photograph that helped kickstart his photography career His mission to spread positivity and encouragement For more information about Joseph and his photography, you can find him on his official website, Facebook, Twitter, and Instagram. Watch the video of this interview on YouTube! Subscribe to the FREE Beyond 6 Seconds newsletter for early access to new episodes! Click here for the episode transcript. *Disclaimer: The views, guidance, opinions, and thoughts expressed in Beyond 6 Seconds episodes are solely mine and/or those of my guests, and do not necessarily represent those of my employer or other organizations.*
Los Angeles, CA – William Joseph Hill's book CYBER FIGHTER, with its big screen adaptation underway, is a sci-fi/martial arts/action-adventure story that will engage readers in this action-packed “page turner.” Said the author Mr. Hill, “I'm hoping that my CYBER FIGHTER readers have fun with the story and have a few good laughs, along with being thrilled by the action sequences I have in the story. I'd also like them to think about the scientific possibilities that the story explores. As we spend more and more of our lives online, the idea that you could learn skills via Virtual Reality is becoming less science fiction and closer to actuality.”The Story: Cyber Fighter is the story of a clumsy temp Brian Baldwin who takes a job at defense contractor Kirkman Enterprises, where he volunteers to test their latest software program on himself by getting black belt fighting skills downloaded directly to his brain via a Virtual Reality immersive experience, turning him into a human weapon. http://williamjosephhill.comhttp://fourscorpio.comThe Douglas Coleman Show now offers audio and video promotional packages for music artists as well as video promotional packages for authors. We also offer advertising. Please see our website for complete details. http://douglascolemanshow.comIf you have a comment about this episode or any other, please click the link below.https://ratethispodcast.com/douglascolemanshow
This week's episode is special: Circulation is proud to present the 6th annual Go Red for Women issue podcast. Please join Sana Al-Khatib and James de Lemos as they welcome authors Michelle Albert and Sadiya Khan as they discuss their articles "Shining a Light on the Superwoman Schema and Maternal Health" and "Geographic Differences in Prepregnancy Cardiometabolic Health in the United States, 2016 Through 2019." Then Sana presents an overview of the other exciting articles in this important issue. Dr. Sana Al-Khatib: Hello, and welcome to this special Circulation on the Run podcast, focused on the sixth Go Red For Women issue of the journal. I am Dr. Sana Al-Khatib. I'm an electrophysiologist at Duke University Medical Center and a senior associate editor for Circulation. I have the pleasure of co-leading the sixth Go Red for Women issue with, my friend and colleague Dr. Biykem Bozkurt. Very excited to introduce Dr. James de Lemos, the executive editor for Circulation, who will co-host this part of the podcast with me. Welcome, James. Dr. James de Lemos: Well, Thanks. I'm delighted to be here. Dr. Sana Al-Khatib: The theme of our podcast today is social determinants of health. We will discuss a perspective article in the issue, titled The Interplay of Sex with Social Determinants of Health in Cardiovascular Diseases, led by Dr. Michelle Albert, who is a cardiologist at the University of California in San Francisco. We will also discuss a research letter on geographic disparities in pre-pregnancy cardiometabolic health in the United States from 2016 to 2019, led by Dr. Sadiya Khan, a cardiologist at Northwestern Medicine in Chicago. Welcome, Doctors Albert and Khan. Dr. Michelle Albert: So pleased to be here. An honor to be part of the Go Red issue. Dr. Sadiya Khan: Thank you for having us. Dr. Sana Al-Khatib: Wonderful. So we'll start with the discussion and turn it over to you, Dr. de Lemos, to ask the first question. Dr. James de Lemos: Well, thanks, Sana. Michelle, let's start with you. I love the title of your essay. I'd like you to sort of orient our listeners as to why this title, why the topic and what you write about in your piece. Dr. Michelle Albert: Thank you, James. The title of the essay or Perspective is “Shining a Light on the Superwoman Schema and Maternal Health.” We felt, along my coauthors, Dr. Rachel Bond and Dr. Annette Ansong--Dr. Ansong is a pediatrician, actually. Dr. Bond is also a cardiologist. We felt that it was really important to put forward the psychological parts of the maternal health crisis as a major social determinant of health. Most often, the focus is only on the other risk factors that we know of, like hypertension, diabetes and obesity. And while those are also extremely important, it is actually the interplay between those risk factors and social factors, including racism, including access to care, that actually drive the maternal health crisis for women of color. Particularly for black women, who have about three to four times the mortality and pregnancy complications, compared to white women. Dr. James de Lemos: Michelle, one thing that you've really defined your career by is moving to the biology of adversity. I thought the figure in your paper was striking. Can you expand a little bit on what you mean by this, and how these social determinants and the pernicious effects of things like racism and psychological stress, translate into the biology that I think Sadiya will tell us about, even in her research letter? Dr. Michelle Albert: Yes, James. As you know, I've had a longstanding research history and portfolio, looking at the interplay between biology and social factors, coined the biology of adversity. The adversity part of this is something, we often think about the ACEs, adverse childhood experiences, and think about how those relate to health outcomes, including cardiometabolic and cardiovascular health outcomes. But as we think about adults, actually, it's the adult environment that actually defines adversity for children. Certainly, as it pertains to black women and other women of color, there are certain special circumstances that get embedded into the whole framework of the biology of adversity, that lead to poor overall cardiovascular outcomes, but also maternal and non-maternal health outcomes. So conceptually speaking, the framework of the biology of adversity is the incorporation of stressors into the brain. That then results in a hyper inflammatory milieu, combined with dysregulation of the hypothalamic pituitary access, as well as the flight or fright hormones or the up-regulation of the sympathetic nervous system. And actually importantly, the down-regulation of the parasympathetic nervous system, which is an area that is actively under research currently, that then results in the downstream cascade of health effects. For black women, this is characterized by, in part, the Superwoman Schema, which includes several major themes. The first major theme is the history of oppression and racism and sexism. Also, a history of disappointment, the influences of spiritual values and form other influences, interplayed. These are stressors that incorporate with other stressors. And then there's an interplay with subscales, that focus on the ability to succeed, despite limited resources. Putting others ahead of yourself. So less self-care for yourself, but putting self-care of others ahead of your self-care, the lack of showing vulnerability, as well as suppressing one's emotions. So, all of these things interact with behavior and genetics, as well as epigenetics, to flow into that cascade of the biology of adversity. For me, I gave this presentation four years ago now, at American Heart Association, where I sort of reformatted this whole biology of adversity to incorporate the Superwoman Schema, which was first defined or characterized by Cheryl Woods-Giscombé, who is a PhD scientist in the United States. Dr. Sana Al-Khatib: Now, that was very helpful and insightful, Michelle. Could you tell us about, what are the main next steps that need to be done in this area, that you think are going to be important to move this line of research forward, so that we can actually change this situation and really improve healthcare for these women? Dr. Michelle Albert: Well, I like to think of the answers to that question on several levels. So, I think one of the first levels is ensuring that women, especially women of color and specifically black women, are aware of the fact that hypertension, preeclampsia and eclampsia are risk factors, not only for their pregnancy, but also for cardiovascular disease later on, and for their children developing hypertension and cardiovascular disease later on. So, I think education is really important, on one level. On the next level is, actually having a continuum of care, where women are asked to get early prenatal care, even when they're contemplating pregnancy. So that they can be screened for hypertension, diabetes and their stressors, assessed and put in contact with resources. Having doulas, midwives involved in this process, as well as cardiologists who are involved in the pregnancy setting, as well as post-pregnancy for these women. Then, there's an advocacy initiative that has to take place, that focuses on getting aid. Kamala Harris has put forward a bill to actually do just that for maternal health, focusing on racism and bias in healthcare, because black women across the spectrum of socioeconomic status, experience poor maternal health outcomes. So, this is not only an access to care issue. It's not only a socioeconomic status issue. It is an issue that pertains to the women not being listened to, with racism and other stressors. I can't stress those first two things more, the whole discrimination part of it, and dumbing down the concerns of black women. Then, I think on a research perspective, certainly the American Heart Association has got now this HERN Network, which is a network that's going to focus on research around maternal health. So in that context, figuring out the best care models for women. Understanding the biology and how it interplays with poor outcomes later on, is also very important. One point around the biology that I want to point out for, let's say, African American women and actually Asian women as well, is that there's a higher prevalence of fibroids. There's very little research focusing on fibroids and its importance on maternal health outcomes and even the care for those women. Frankly, in my mind, a lot of that has to do with bias and how we value the healthcare of certain groups of women over other groups of women. So, those are some of the things, in terms of the solutions. Dr. Sana Al-Khatib: Absolutely. Before we move on to the presentation by Dr. Khan, are there any final words Michelle, that you'd like to share with the group, in terms of any final wisdom, so to speak, that you want to leave the listeners with? Dr. Michelle Albert: Yeah. I would just say that the maternal health crisis is preventable and it is tied into... Much of our audience are going to be healthcare providers. To the healthcare providers, I'm going to say, you really, really need to listen to these women when they tell you that they're experiencing certain symptoms. You also need to dig deeper to find out about their concerns, especially their stressors, in addition to making sure their blood pressure is controlled and that their weight is managed. Dr. James de Lemos: Well, thank you, Michelle. We'll turn to Sadiya now, and her team's research letter on geographic differences in pre-pregnancy cardiometabolic health in the US. For our listeners, I think what you'll see, if you read this paper, is how remarkable the research letter format is, and how much information Dr. Kahn and her team have conveyed in this really, really powerful letter, that I think has major public health implications. Sadiya, do you mind orienting our listeners to what you studied and how you did it? Dr. Sadiya Khan: Thanks, James. And again, thank you for the opportunity to join you guys in this podcast. I think Michelle very eloquently set up the preface for this research letter, which was understanding that health in pregnancy begins before conception. That was really the reason we wanted to focus on health factors, particularly cardiometabolic health factors, like body mass index, diabetes status and hypertension status in the pregnant individual, prior to pregnancy. The second piece of this that we were really interested in, is that we had observed that there are significant differences across the United States, in maternal morbidity and mortality outcomes. There are much higher rates of pregnancy-related deaths occurring in the South and Midwest, compared with other states in the US. That led us to ask this question, if we're able to better describe or define health prior to pregnancy, will we see similar patterns? We used the Centers for Disease Control Natality database, which includes all live births in the United States. So, the strength of this dataset, is that this is a surveillance system employed by the CDC, to monitor and record health outcomes of the pregnant individual and the newborn in the United States. Using this dataset, we were able to display maps for pre-pregnancy cardiometabolic health and look at changes from 2016 to 2019. Unfortunately, there's not much positive news, in that we've seen continued declines in favorable or optimal pre-pregnancy cardiometabolic health, which we defined as having a normal BMI and the absence of diabetes or hypertension. In addition, we saw that the levels of favorable pre-pregnancy cardiometabolic health were lower in the South and Midwest. It starts to set up some questions about upstream social determinants of health, that may be playing an important role as we start to address this problem at the individual level, but also at the societal and population level. Dr. Sana Al-Khatib: Very interesting and important findings there, Sadiya. Are you planning to work on additional research, to build on the research that you were publishing in this issue? Dr. Sadiya Khan: One of the most important questions that came from this are, what are the potential ways to start to address and support care for pregnant individuals, or as I think is Michelle really nicely put it, is for preconception care. So, thinking more about the reproductive life course before pregnancy, as well as during and after pregnancy. For that, one of the things that seems to be potentially really important, could be how Medicaid expansion has helped in states that have expanded, and differences between states that have or have not expanded Medicaid. Knowing that, that probably isn't sufficient, but it has that been helpful. Dr. James de Lemos: Yeah. I was struck, Sadiya. I mean, Michelle's essay and your research project really shine a bright and distressing light on maternal health in the US, I think and the crisis that we're under, that many of us don't even maybe recognize is happening. The time trends you showed were, to me, striking, giving over such a short period of time, how much maternal cardiovascular health has declined. It seems, indirectly at least maybe, that declining at a higher rate than overall cardiovascular health. I first applaud you for writing on this topic because I think it brings this issue to light, in terms of a public health crisis, frankly. But I wonder if you have any thoughts on why specifically, things are declining at such a higher rate for pregnant women or pre-pregnant women, maybe relative to national trends? Maybe they're not. Maybe this is what's happening across all age and gender demographics. Dr. Sadiya Khan: It's a really important observation. I agree with you. It seems like it's much more striking in this concentrated and focused group of individuals, that are pregnant and giving birth. It's possible because of the age range that we focus on, the 20 to 44 year old age range, that there are potentially more significant declines happening during this time period. We know cardiovascular health in general, appears to have some age-dependent dips, generally around adolescence. That early adulthood, college age period seems to be where a lot of cardiovascular health decline happens. So, I think that's what we're observing, as we're seeing these more striking trends in this age group. But it would be interesting to know, compared to non-pregnant individuals and across the life course, if that is in fact, the case. Dr. Sana Al-Khatib: Then I'll ask you what I asked Michelle, Sadiya. Any final words of wisdom that you'd like to share with our listeners? Dr. Sadiya Khan: I don't know if I'll be able to speak as eloquently as Michelle did. I think her responses really capture both of these papers and thinking about ways forward, about how we can dress the maternal health crisis. But I think that the word that she used, that really sticks with me and is one of the reasons that I'm so passionate about this work, is that this is preventable. That there are so many different things that could be in place, whether it's at the individual clinician and patient level, at the individual health system level, at the state level, as we looked at here, but really at the national level as well. I think we have a lot of work to do, but there's a lot of things that we know can help. Dr. Sana Al-Khatib: Great. Wonderful. James, any final words from you before we wrap up this part of the podcast? Dr. James de Lemos: First, Sana and the rest of the Circulation team, I congratulate you on another spectacular Go Red issue, that really is such an important endeavor. You and Biykem have done an incredible job leading this. I thank Michelle and Sadiya for coming on today, but also for their work. I think raises the stakes here, that we've got a public health crisis affecting women, and disproportionately affecting black women in the United States. It's underappreciated. I think you both point out that it's preventable. So, I think it's a call to action. It's a really well stated and an important topic. Dr. Sana Al-Khatib: Wonderful. Well, thank you so much, James and Sadiya and Michelle. Thank you so much for submitting your excellent work to us. Thank you for being with us today. This concludes this part of the podcast. Thank you. Next, I'm excited to provide you with a brief overview of the issue. We have two original articles. One is on genes that escape X-chromosome inactivation, modulate sex differences in valve myofibroblasts. This one was submitted to us by Dr. Kristi Anseth and her team. The study elucidated sex dependencies in myofibroblasts activation pathways and transcriptome analyses and small molecule interventions, implicating genes that escape X-chromosome inactivation, in regulating sex differences in the progression of aortic valve stenosis. The authors highlight the importance of considering sex as a biological variable, to understand molecular mechanisms underlying aortic valve stenosis and help guide sex-based precision therapies. The second original article is by Dr. Elena Aikawa and her team. It is on Prothymosin Alpha, a novel contributor to estradiol receptor alpha-mediated CD8+ T-cell activation and recognition of collagen cross-reactive epitopes in rheumatic heart valve disease. This paper provides novel findings that will likely have clinical impact down the road. As the authors pointed out, understanding the Prothymosin Alpha and estrogen sensitivity mechanisms to control the CD8 T-cell function may indeed provide insights into treatment for rheumatic heart valve disease. In this issue, we have three research letters. One letter was on the geographic disparities in pre-pregnancy cardiometabolic health in the US. You just heard about this paper in the first part of the podcast. Another letter, by Dr. Pradeep Natarajan and his team, offers information on the microvascular outcomes in women with a history of hypertension in pregnancy. It highlights that hypertensive disorders of pregnancy, especially preeclampsia, are independently associated with reduced microvascular indices. The investigators called for further research, to translate these findings into cardiovascular risk reduction strategies for women with these conditions. The third research letter, by Dr. Androulakis and his team, provides insights from cardiac magnetic resonance and angiography screening on spontaneous coronary artery dissection, also known SCAD. Theirs was the largest cohort of SCAD patients screened for peripheral vascular pathology by magnetic resonance and geography, to date and one of the largest to assess the SCAD-related impact size and relevant associations. They concluded that cardiac magnetic resonance has valuable contribution to the investigation of SCAD patients. In this issue, we have six perspective papers. In addition to the Perspective paper that you heard about from Dr. Michelle Albert, there are five perspective articles that span topics of great clinical and research relevance and importance. One perspective article, led by Dr. Carolyn Lam, tackles incorporating sex and gender into the design of cardiovascular clinical trials, a very important topic. Dr. Lam highlights the importance of sex and gender to the optimal interpretation, validation and generalizability of cardiovascular clinical trial results. Another perspective by Dr. Kathryn Lindley presents a call for action to address increasing maternal cardiovascular mortality in the US. This actually ties in with the initial part of the podcast. Dr. Lindley offers insightful suggestions, regarding strategies that could improve maternal cardiovascular care. Another perspective by Dr. Anne Curtis, addresses sex differences in response to rhythm management devices. Dr. Curtis reminds us that the conclusion that should be drawn from the many studies that have been conducted on cardiac rhythm management devices, is that these devices are indeed effective in both men and women, but they're still significantly underutilized in women eligible for those therapies. Dr. Curtis calls on us to be ever vigilant, to provide sex-neutral medical care to all patients, when clinical trials don't provide a strong rationale to do otherwise. I'm quoting her here. Another perspective paper by Doctors Mauricio and Khera, addresses statin use in pregnancy. They raise the of whether it is indeed time for a paradigm shift. This article was prompted by the FDA's request to remove the pregnancy Category X label for statins that was issued in July of 2021. The authors encouraged clinicians to use shared decision making. They add that those with atherosclerotic cardiovascular disease events, especially recent ones, should be encouraged to continue statins during pregnancy or resume them as soon as possible, if they're withheld. For those with heterozygous familial hypercholesterolemia, previously reasonable LDL control and no manifest vascular disease, there may be more tolerance for statin deferral during pregnancy, but they definitely highlight the need for dedicated research in this area. The last perspective, led by Doctors Okwuosa and Zaha tells clinicians what they should know about sex differences in cardio-oncology. They highlight sex differences in cancer and cancer treatment, cardiovascular diseases and the intersection of these conditions, that are likely to be quite helpful for clinicians taking care of such patients. Don't forget to check out the Pathways to Discovery section, where you will find a very interesting and motivating dialogue between Dr. Maryjane Farr and Dr. Biykem Bozkurt in which Dr. Bozkurt describes her career journey. I personally enjoyed reading that interview and found it quite inspiring. In closing, I want to express my deepest gratitude to my co-editor Dr. Bozkurt, the Editor-in-Chief for Circulation, Dr. Joseph Hill, the Executive Editor for Circulation, who was with us at the beginning of the podcast, Dr. James de Lemos and all the authors who submitted the research for this issue. I also want wholeheartedly thank and acknowledge the Circulation Associate Editors and Staff, who work tirelessly to enable us to produce an excellent Go Red for Women issue. I am very excited about this issue and hope that you will like it as much as I do. This concludes our Go Red for Women issue, Circulation on the Run podcast. Thank you for listening. Dr. Greg Hundley: This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own, and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.
Hop into the rabbithole for another reality bending episode of #TheRyanShowFM. R&B star Natasha Mosley returned to the program to promote her all new single “My Best Year” and announce her first album in nearly 5 years. Long Island rising star Tonee Marino joined us for the first time nearly 3 years after visiting us at the legendary #DefSquadStudios. Tonee has been busy producing, writing and editing all his content including a recent collaboration with DJ Drewski, To celebrate another year of MLK Day we brought in historian and Civil War expert Joseph Hill to teach us some little known yet important history about the land of the free. #theryanshow #theryanshowfm #ryanverneuille #hamptonsdave #mrcheeks #lostboyz #comedyrado #toneemarino #natashamosley #thehamptons
Podcasting 2.0 for December 17th 2021 Episode 66: Drop The Gate Adam & Dave discuss the week's developments on podcastindex.org where Jason and Joseph join us to discuss PodcastGuru Download the mp3 Podcast Feed PodcastIndex.org Preservepodcasting.com Check out the podcasting 2.0 apps and services newpodcastapps.com Support us with your Time Talent and Treasure ShowNotes Positioning Boost Bait Dave on Jupiter Broadcast appearance Mere Mortals Adam begging for money chapter art Link Spanked Todd and Rob Link WeTransfer opportunity Cross Platform Comments Ryan Transcript Service Namespace Roadmap Helipad Update Proud of the App Developers Jason Hudgins & Joseph Hill - Podcast Guru Podcastguru.io Supported features Search, Transcript, Funding, Chapters, Location, Person, Season Seeing press without us being mentioned Medium Tag Perennial Feeds Fast Follow Last Modified 12/17/2021 13:54:23 by Freedom Controller
Glenroy Washington has been a household name since the late nineties but have been a staple in Reggae since the 70's. Singer, songwriter, and drummer who studied under Joseph Hill, Glen has now reached the status of Legend himself and we are happy to have him on B.O.S.S. Radio's Reggae Hourhttps://www.facebook.com/profile.php?id=100057713633507http://www.glenwashington.net/
In this episode of the Active Texan podcast Dr. Brian Watts sits down with fellow triathletes Ted Boone, Joseph Hill, Kyle Bryson, and Karina Wilson, to give a recap of the 2021 Kerrville Triathlon Festival. Hear why they all loved this race and can't wait to go back next year!
Brought To You By: https://www.2linedmusichutstore.com | Enter promo code ERP20 at check out to receive 20% off your first purchase.The legendary, singer, songwriter and drummer GLEN WASHINGTON pulled up to the Entertainment Report Podcast for an EPICCC conversation about his lengthy career in the music business. Glen Washington spoke about meeting Joseph Hill (Culture) and forming the C35 Incorporated Band, Joseph Hill teaching him to play drums, a chance meeting with Stevie Wonder that changed his life, meeting and playing for Leroy Sibbles, touring the world with Shinehead as a drummer, touring with Gregory Isaasc and Tony Screw from Downbeat introducing him to Clement Dodd from Studio 1. Glen Washington also spoke about the Beres Hammond comparison, first time meeting Dennis Brown, Freddie McGregor and Bob Marley. He also gave us some insight to some of his biggest hits and the inspiration behind them. THIS IS A MUST LISTEN!!! Don't Forget To Subscribe! Enjoy!
It's Morphin Time! Join us tonight The Ryan Show FM as we have 2 legendary former Power Rangers turned actresses Catherine Sutherland & Nakia Burrise coming on to discuss their all new show Power Rangers Playback. For the first time ever we are joined by real life historian & journalist Joseph Hill, contrasting what some may call our sometimes misinformative bookings. We delve into Joseph's upcoming documentary about the 200,000 black soldiers that fought for their freedom as Union soldiers during the civil war. We also learn about the Black Seminole Indians detailed in Mr. Hills latest documentary “Black Border Warriors: The Seminole Negro Indian Scouts” All this and MORE on another installment of The Ryan Show FM! #theryanshow #theryanshowfm #ryanverneuille #hamptonsdave #mrcheeks #lostboyz #powerrangers #pinkranger #yellowranger #catherinesutherland #nakiaburrise #historian #civilwar
A sustainable solution that's opening doors. It's projected that air conditioning expended worldwide produces 2 billion tons of carbon emissions annually and uses 30% of the world's total electricity. In this episode of Preview of Tomorrow Mike speaks with Joseph Hill, CEO of Zephrame, a company working to combat the inefficiencies of air conditioning and its environmental implications. Through finetuning pre-existing technology and developing cutting-edge AI, Zephrame has engineered smart doors that use 80% less energy than traditional AC units and are far more powerful. Zephrame doors are the most sustainable alternative to AC units in countries that don't utilize central air.Support the show
Enjoy this mix! And if you want to hear some excellent new roots rock reggae, check out the new album 18 Karat Reggae Gold 2021 : ONENESS on iTunes.
The legendary "Keeper of the Zion Gate" Joseph Hill discusses the legend of Columbus discovering the West Indies. You can hear the rest of my conversation with the late Joseph Hill of Culture, along with some conscious Culture music, on Episode #4 of the Reggae Roots Rockers Podcast. https://open.spotify.com/show/4aEBFx02xIGefbyxuI3rKm Check out this great track by Culture called "Christopher Columbus", which is not available on Spotify: https://www.youtube.com/watch?v=Nb0gSJvGKbU Interview was recorded live in 1992 at the WERS Studios in Boston, MA. --- Send in a voice message: https://podcasters.spotify.com/pod/show/reggaerootsrockers/message
Feast your ears on an interview with the late, great JOSEPH HILL, lead singer and songwriter for the legendary Roots Reggae group CULTURE. Joseph Hill, also known by his Rastafari name "Keeper of Zion Gate", founded Culture in 1976 and went on to record 22 albums. He was known as a teacher and scholar of Jamaican history and current political issues. Joseph Hill passed away on August 19, 2006 at the age of 57. Interview was recorded live in 1992 at the WERS Studios in Boston, MA. A version of this Podcast featuring musical selections from Culture is available to Spotify Premium subscribers by clicking here: https://open.spotify.com/show/4aEBFx02xIGefbyxuI3rKm (those without a Spotify Premium subscription are welcome to listen, but will hear only :30-second snippets of music.) --- Send in a voice message: https://podcasters.spotify.com/pod/show/reggaerootsrockers/message
This weeks show starts off with with classics from Peter Tosh, Bob Marley & The Wailers, The Meditations, Dennis Brown, Burning Spear, Ansel Collins, Johnny Osbourne, Joseph Hill, Tony Tuff, Cultural Roots, Well Pleased and Satisfy, Errol Flabba Holt, Sugar Minott, Hugh Mundell, and Frankie Paul. New music this week comes from Akae Beka, Royal Sounds and Macka B's Roots Ragga Band, Jon Moon, Exile Di Brave, AMJ Collective, Glen Washington, Jah Device, Eesah and Kabaka Pyramid, Jahriffe, Jah Lil, Lutan Fyah, King Kong, Chino, and Eek A Mouse. Also this week we present an extended oldies set featuring the sounds of Ska from legends like The Skatalites, Lyn Tait, and Prince Buster. In The Dub Zone this week you will hear dubs from Tommy McCook, King Tubby, Scientist, Roger Rivas, I Tek Paul, Gentleman's Dub Club, and I Roadie. Extended dub mixes feature Black Uhuru, The Chantells, Prince Alla, Linval Thompson, and Donovan Kingjay with Ranking Joe and Jah Schulz. Enjoy! Peter Tosh - Pick Myself Up - Bush Doctor - Rolling Stones Records Bob Marley & The Wailers - Natty Dread - Natty Dread - Tuff Gong The Meditations - Babylon Trap Them - Deeper Roots: The Best Of The Meditations - Heartbeat Records The Congos - At The Feast Of The Passover - Island Records Presents Roots: 37 Essential Roots Anthems - Island Records Dennis Brown - Man Next Door - The Promised Land 1977-1979 - Blood & Fire Burning Spear - Tradition/2000 Years - Marcus Garvey/Garvey’s Ghost: 100th Anniversary Ansel Collins - One Man Stands Alone - The Magnificent - I-Pril Music Johnny Osbourne - Purify Your Heart - Black Joy Joseph Hill & The Soul Defenders - Behold (Tk 3) - Studio First: From The Vaults Vol. 2 - Studio One Tony Tuff - Oppressor - Different Fashion: The High Note Dancehall Collection - Doctor Bird Cultural Roots & The Revolutionaries - Jah No Partial/Partial Dub - Revolutionary Sounds 12” Well Pleased and Satisfy - Sweetie Come From America - High Note Errol Flabba Holt - My Heart Is In Danger - Rastafari Time - OHM Records Sugar Minott - Have You Ever Found A Love - Collectors Collection Vol. 1 - Heartbeat Records Hugh Mundell - Can’t Pop No Style - Blackman’s Foundation - Shanachie Frankie Paul - Worries In The Dance w/ Version - When The Dances Were Changing: Hitbound Selection - Pressure Sounds Akae Beka - Groove Stampede - Righteous Synergy - Fifth Son Records Willie Williams & Lone Ark Riddim Force - Don’t Show Off - Glory To The King - A Lone Productions Royal Sounds feat. Macka B’s Roots Ragga Band - We Got To Be Together - Chinelo Records Jon Moon - Rasta Is - Rasta Riddim Vol. 2 - Yutman Records Exile Di Brave - Sing A Song Rastaman - Rasta Riddim Vol. 1 - Yutman Records AMJ Collective feat. Nai-Jah - Let Go Of Fear (original mix) - Astar Artes Recordings Glen Washington - Without You - Glen Washington Music Rad Dixon - Write Your Name - Tasjay Productions Jah Device - Bye Bye Babylon - Love and Sacrifice - Stingray Records Busy Signal - No Problem - The Ultimate 2021 - Tad’s Records The Ethiopians - Train To Skaville - It’s Ska Time - Charly Records Lyn Tait & The Baba Brooks Band - Magnificent Ska - Treasure Isle Ska After Ska After Ska - Heartbeat Records The Skatalites - Beardsman Ska - Foundation Ska - Heartbeat Records Prince Buster & The All Stars - Rude, Rude, Rudee - Roots Of Reggae: Ska - Rhino Records Roland Alphonso - Nimble Foot Ska - Studio One Scorcher Vol. 2 - Soul Jazz Records Justin Hinds & The Dominoes - Carry Go, Bring Come - Treasure Isle Ska After Ska After Ska - Heartbeat Records Jackie Opel - Push Wood - Ska Bonanza: The Studio One Ska Years - Heartbeat Records Peter Tosh & The Wailers w/The Skatalites - Shame and Scandal - The Toughest - Heartbeat Records The Skatalites - Phoenix City - Studio One Rockers - Soul Jazz Records The Skatalites - Dick Tracy - Foundation Ska - Heartbeat Records Dub Zone featuring Strictly Dubwize & Extended Dub Mixes Tommy McCook - Tommy’s Vibration - When Jah Shall Come - Pressure Sounds King Tubby & The Skatalites - Fugitive Dub - King Tubby & Friends: Motion Dub Special Classic Dubs 1974-1978 - Motion Records Scientist - Round 7 (Bounty Hunter) - Junjo Presents: Big Showdown At King Tubby’s - Greensleeves King Tubby & Roots Radics - Earthquake Shake - Dangerous Dub - Greensleeves Roger Rivas - Brown Star Liner - Happy People Records I-Tek Paul - Sunshine Dub - In Dub Conference - Moodisc Records International Gentleman’s Dub Club - Last Chance - Down To Earth - Easy Star Records I Roadie - Sax Parade - Dub Time - Dubophonic Records Black Uhuru - Chill Out - Liberation: The Island Anthology - Island Records The Chantells - Natty Supper - The Chantells & Friends: Children Of Jah - Blood & Fire Prince Alla - Life Is/Life Is Dub - Stand Firm - Sunvibes Music Linval Thompson & Irie Ites - Ganja Man/Ganja Dub - Cuss Cuss Riddim - Irie Ites Records Jah Schulz feat. Donovan Kingjay & Ranking Joe - Chanting/Stay Far/Stay Dub - Railroad Records ===================================== Chronixx - Safe N Sound - Soul Circle Music Eesah and Kabaka Pyramid - Police & Badboy - King Ivier Music/Loud City Krak in Dub feat. Capleton - Ah No People Dem Love - Raised Riddim - Krak In Dub Jahrife - Champions - The Greater Cause Riddim - Jah N I Roots Movement Records Jah Lil - Human Race - Marching Riddim - Real People Music/Oneness Records Lutan Fyah - Nuh Cross Mi Line - Jamrock 2021 Riddim - Krush Proof Muzik King Kong - Time Is Changing - Brick Wall Riddim - I Love Sound Eek A Mouse & Irie Ites - Put Food On The Ghetto Youth Table/Put Dub On The Turntable - Irie Ites Records Chino - What Goes Around - Di General Records Protoje - Righteous - In Search Of Lost Time Deluxe Edition - Indiggnation Collective/RCA Luciano - Give Us A Chance - Jah Jah Time Riddim - Zed2dizee Music Macka B - Hail Rasta - Jah Jah Time Riddim - Zed2dizee Music Cornell Campbell - Outernational Blues - Time For Peace - Jancro Eddie Skuller - Rock On/Rock On Dub - Eddie Skuller Music White Mice - True Love - Total Reggae Dancehall - VP Records
Season 1: continues with "When the Music Hits" as Henry befriends a reggae super fan and an obsessed caller to the label. He soon learns that this "Brian from Colorado" is an aspiring singer, whose revolutionary spirit may convince Henry to follow his dream to pursue music over law. That dream becomes a reality when Henry is tasked to bring a reggae legend to a recording session. He's not sure what hits him—it could be the contact buzz, it could be the savory smell of brown stew fish -- but when Henry sees Dr. Dread behind the mixing board with a grin ... life begins to make a whole lotta sense. Rootsland is produced by Henry K Productions Inc. in association with Voice Boxx Studios in Kingston, Jamaica. Introduction by: Michelle "Kim" Yamaguchi Guest Vocals by: Patrick "Curly Loxx" Gaynor Jermaine Keys Featured Music: Adam "Teacha" Barnes - "Different" Big Mountain and Uton Green - " I Can See for Miles" Notes: This episode contains excerpts from NPR's All Things Considered (the original story was reported by friend and colleague: the late, great, Tom Terrell; BBC Radio's Interview with Joseph "Culture" Hill Conducted by Mark Lamar; and Joseph Hill performing "2 Sevens Clash" live. Tune into Rootfire's Reggae Podclash and hear the stories of foundational reggae artists, creating a historical record told by the artists themselves, while building bridges to new artists who have followed in their footsteps. Rootfire is the official home to Rootsland on Soundcloud rootfire.net/rootsland-podcast/
Joseph Hill MD is a Professor of Medicine & Molecular Biology, the James Willerson Distinguished Chair in Cardiovascular Diseases, the Frank Ryburn Jr Chair in Heart Research, the Director of the Harry Moss Heart Center and the Chief of Cardiology at UT Southwestern Medical Center. Dr. Hill graduated from Medical school at Duke with an MD-PhD, worked as a postdoctoral fellow at the Institut Pasteur in Paris for 5 years before pursuing residency in Internal medicine from Brigham & Women's Hospital, where he stayed on to pursue a Fellowship in Cardiovascular Disease. Dr. Hill worked at the University of Iowa before joining UT Southwestern in 2002. His Research focuses on remodelling in cardiac hypertrophy & failure and has published over 160 articles and contributed to 14 books. He is the editor-in-chief of Circulation. His many honors include serving as the President of the Association of University Cardiologists, election to the Alpha Omega Alpha Honor Medical Society and the Association of American Physicians, and being named an American Heart Association's Established Investigator. “Being a physician is an incredibly high calling,” says Dr. Joseph Hill, as he reflects on the tremendous privilege we have as physicians to help people who have entrusted their well-being into our hands. Yet, he reminds us all today to not stop there. “You owe it to this profession to give something back.” Whether it be in advancing the body of knowledge through research or mentoring the next generation as an educator or improving healthcare delivery as an administrator, he encourages us to think beyond our clinical encounters and proactively give back to the profession out of gratitude for the privilege it has bestowed upon us. Pearls of Wisdom: 1. Be mentorable. You may not hear what you want to hear from your mentors, but the best mentees keep an open mind and reflect on the advice given to them. 2. True success is holistic : family is just as if not more important than our profession and therefore we need to carve out time for our family. It will only help us in advancing our careers. 3. In the clinical encounter, make sure to acknowledge the patient's family members who accompany them.
This week's episode features author Adnan Kastrati and Associate Editor Dharam Kumbhani as they discuss ticagrelor or prasugrel in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. TRANSCRIPT BELOW: Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your cohosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor and Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature Ticagrelor Prasmul in patients with ST segment elevation myocardial infarction undergoing primary PCI. More on that story later, though. How about we grab a cup of coffee and look at some of the other papers in the issue. Would you like to go first? Dr. Carolyn Lam: I would. And actually, I'm going to talk about two papers and they're all about BET, BET or promo domain, an extra terminal epigenetic reta proteins. And in particular, this one called BRD4. Now these proteins have emerged as potential therapeutic targets in a number of pathological conditions, including cancer and cardiovascular disease. Small molecular BET protein inhibitors, such as JQ1 have demonstrated efficacy in reversing cardiac hypertrophy and heart failure in preclinical models. Yet genetic studies elucidating the biology of BET proteins in the heart have not been conducted. Well, at least until this week's issue where we have not one, but two papers, both elegantly using mouse genetic studies. Dr. Carolyn Lam: In the first from Dr. Srivastava from Gladstone Institute of Cardiovascular Disease in San Francisco and Dr. Jain from Perlman School of Medicine in Philadelphia and their colleagues, they found that BRD4, that particular BET epigenetic reader protein, forms a transcriptional regulatory module with GATA4, a lineage determining transcription factor in cardiomyocytes. This BRD4 GATA4 module was a critical orchestrator of mitochondrial bioenergetics in the adult heart. Dr. Greg Hundley: Well Carolyn, that is a wonderful summary. What are the clinical implications? Dr. Carolyn Lam: Identification of this new BRD4 interaction partner, such as GATA4 could provide new insights into developing epigenetic based therapies for heart failure. And the second paper is from Dr. Joseph Hill and Thomas Gillette from University of Texas Southwestern Medical Center and their colleagues. And what they found was that BRD4 was essential to the maintenance of mitochondrial electron transport chain function via transcriptional regulation of a nuclear mitochondrial gene network. BRD4 heterozygous deletion resulted in delayed heart failure, whereas pharmacological BRD4 inhibition using JQ1 induced modest changes in mitochondrial genes suggesting potential cardiac toxicity in targeting BRD4 at baseline. Dr. Greg Hundley: So what does this mean for us clinically, Carolyn? Dr. Carolyn Lam: As more potent and specific inhibitors are developed targeting BRD4 for clinical settings in oncology and other diseases, we must carefully monitor bezel cardiac performance for functional and mitochondrial deterioration. Important clinical message there. Dr. Greg Hundley: Great job, Carolyn. Well, my first paper is entitled "An Association Between Immune Checkpoint Inhibitors with Cardiovascular Events and Atherosclerotic Plaques" And it comes to us from Dr. Tomas Neilan and his colleagues at the Mass General Hospital. The study was situated in a single academic medical center. And Carolyn in this paper, there are actually three studies described. First, there's a primary analysis that evaluated whether exposure to an immune checkpoint inhibitor during treatment for cancer was associated with atherosclerotic cardiovascular events among 2,842 patients versus 2,842 controls that were matched by age, a history of cardiovascular events and cancer type. Dr. Greg Hundley: In the second study, a case crossover analysis was performed with an at risk period defined as the two year period after, and the control period as the two year prior to treatment. The primary outcome was a composite of atherosclerotic cardiovascular events including myocardial infarction, coronary revascularization, and ischemic stroke. And secondary outcomes included the individual components of that primary outcome. Dr. Greg Hundley: Finally, in the third study in this paper, there's an imaging stub study of 40 individuals, and it looked at the rate of atherosclerotic plaque progression compared from before and after starting the immune checkpoint inhibitor. All study measures and outcomes were blindly adjudicated in this third study. Dr. Carolyn Lam: Wow, a three in one. That really sounds novel. So what did they find, Greg? Dr. Greg Hundley: Right, Carolyn. In the matched cohort study, there was a three-fold higher risk for cardiovascular events after starting an immune checkpoint inhibitor. There was a similar increase in each of the individual components of the primary outcome. In the case crossover study, there was also an increase in cardiovascular events from 1.37 to 6.55 per hundred person years at the two year time point. Dr. Greg Hundley: And then lastly, Carolyn, in the imaging study, the rate of progression of total aortic plaque volume was three fold higher after immune checkpoint inhibitors from 2.1% per year to 6.7% per year after receiving these agents. The association between immune checkpoint inhibitor use and increased atherosclerotic plaque progression was attenuated with the concomitant use of statins or corticosteroids. Dr. Carolyn Lam: Wow, Greg. So I suppose what all this shows is that we need to be aware of the cardiovascular risk prior to, during and after treatment with immune checkpoint inhibitors and perhaps, you know, optimize these cardiovascular risk factors. Thank you, Greg. Dr. Greg Hundley: You bet. Well, Carolyn, my next paper is from Dr. George Vlachojannis from University Medical Center at Utrecht. These authors conducted a randomized control multi-center trial in the Netherlands enrolling STEMI patients planned to undergo primary PCI. Now patients were randomly allocated to receive in the ambulance before transfer a 60 milligram loading dose of Prasugrel, either being crushed or as integral tablets. The independent primary end points were thrombolysis in myocardial infarction, TIMI three flow in the infarct related artery at initial coronary angiography, and complete greater than they go to 70% ST segment resolution one hour post primary PCI. The safety end points were TIMI major and bleeding academic research consortium, or BARC, greater than three bleedings and secondary end points included platelet reactivity and ischemic outcomes. Dr. Carolyn Lam: Nice trial design. So what did they find? Dr. Greg Hundley: Well, Carolyn, a total of 727 patients were assigned to either crushed or integral tablets of Prasugrel. The median time from study treatment to wire crossing during primary PCI was 57 minutes, and the primary end point of TIMI three flow in the infarct related pre primary PCI artery occurred in 31% in the crushed group versus 32.7% in the integral group. No difference, P .064. Complete ST segment resolution one hour post primary PCI was present in 59.9% in the crush group and 57.3% in the integral group. Again, no difference, P equals .055. Platelet reactivity at the beginning of primary PCI measured as the P2Y12 reactivity unit, differed significantly between the groups. Crushed was 192 versus integral was 227 and the P value was less than 0.01. TIMI major and BARC greater than three bleeding occurred in 0% in the crushed group and 0.8% in the integral group and in 0.3% in the crushed group versus 1.1% in the integral group respectively. So there were no differences observed between groups regarding ischemic events at 30 days. Dr. Greg Hundley: So Carolyn, in conclusion, prehospital administration of crushed Prasugrel tablets does not improve TIMI three flow in the infarct related artery, pre primary PCI or complete SD segment resolution one hour post primary PCI in patients presenting with STEMI planned for primary PCI. Dr. Carolyn Lam: Interesting and interesting stuff with platelet reactivity and bleeding. Thank you, Greg. Well, there are other papers in today's issue. There's an in-depth paper by Dr. Katsanos on stroke prevention in atrial fibrillation, looking forward. There's a research letter by Dr. Berger on myocardial injury in adults hospitalized with COVID-19 and another by Dr. Hacker on again, immune checkpoint inhibitor therapy and how that induces inflammatory activity in large arteries. Dr. Greg Hundley: Well, Carolyn, I've got a couple other papers to talk about in this issue. There's a On My Mind piece from Dr. deFilippi entitled "Navigating Testing for COVID-19." There's a Perspective from Dr. Ridker entitled "Equipoise Trust and the Need for Cardiologists to Randomize Patients into Anticoagulation Trials in the Time of COVID." There's an ECG challenge from Dr. Arias entitled, "A Paced Tachycardia." And then finally, there's an exchange of letters from Drs. Liu regarding a prior publication entitled "Branched-Chain Amino Acid Catabolism Promotes Thrombosis Risk by Enhancing Tropomodulin-3 Propionylation in Platelets." Well, Carolyn, how about we get to the world of anti-platelet therapy, ticagrelor prasugrel in patients with ST segment elevation myocardial infarction, shall we? Dr. Carolyn Lam: Yes, let's go Greg. Dr. Greg Hundley: Well welcome, listeners, to our featured discussion today on this December 15, and we are going to learn and discuss a little more, a paper pertaining to ticagrelor versus prasugrel in patients with ST segment elevation myocardial infarction. And our lead author today is Adnan Kastrati from Deutsches Heart center in Munich. And we also have our own Associate Editor, Dr. Dharam Kumbhani from UT Southwestern in Dallas. Welcome, gentlemen. Adnan, maybe I'll start with you. Could you tell us a little bit about the background related to this article and what was the hypothesis that you wanted to address? Dr. Adnan Kastrati: First of all, thank you very much for having me here to share with you some thoughts. Thank you, Dharam, for handling our paper in Circulation. We are very honored to have it published there. About these are the ISAR REACT-5 series of studies dedicated to optimizing the antiplatelet therapy in patients and anticoagulant therapy in patients with acute and chronic coronary syndromes, mostly who are undergoing a PCI procedure. We started to think about that study immediately after the publication of the platelet trial. We showed the superiority of prasugrel in patients with acute coronary syndromes. These were the two new ADP receptor antagonists at the time. And so as a physician, we are interested to know which of them was better because there was no direct comparison. And so that's why we decided to have an open-label trial randomized. Most of the centers were situated in Germany. Two centers were situated in Italy. The private end point was adopted to the private end point of the trials in this skill. Only one difference was there, instead of cardiovascular death, we put all cause death in the primary end point. Why? Because all cause death may also reflect the gradient end bleeding between the two drugs. We wanted to have a more integrative endpoint in this sense. So it was a combination of all cause death, myocardial infarction, and stroke. Dr. Adnan Kastrati: It was a one year followup study. The study had two groups of steady patients, which was about 40% of the patients, included in the multicentral trial. And what we found in this trial, it was the same results as it was found in the whole trial. The advantages seen for prasugrel was present here also. Although we lost the significance in the evaluation of the primary endpoint. It was a 31% increase or 24% decrease with prasugrel in that sense. But otherwise everything was in the same direction as in the whole trial. And if you look also in the components of the primary end point…, you have the chance to see that numerically, it was the same trend for all components. Although the trial was not powered for going to evaluate the component of the prime end point. This was the main result. Dr. Greg Hundley: It sounds like you had 1,653 patients with STEMI randomized to receive ticagrelor or prasugrel and 10% experienced the primary end point in the ticagrelor group, but only 7.9% in the prasugrel group. But the P value was only .10. We saw trends toward favoring prasugrel rather than sort of a definitive difference. Is that a correct summary? Dr. Adnan Kastrati: Yes, it is a correct summary. I would say this group of patients is the most interesting subgroup of patients in ISAR 5 trial. Why? Because the pretreatment strategy is the same. Because there have been a lot of discussions about non-S-segment segment elevation acute myocardial infarction due to the difference in pretreatment. Although it was intentional, some people felt it's different and they said you have two different strategies there. In the STEMI subgroup, the pretreatment strategy was the same, so it was a head to head comparison of two drugs, even according to the same strategy. This is one. Dr. Adnan Kastrati: Second, you have to look back at the trials in the same field…Both these trials, if you look closely to the results of for STEMI patients, both of these trials haven't shown a significant result for the STEMI subgroup. For plateau it was a P value of 007 and for tritan it was a P value of 0014 only. Why? Because in the tritan it was very specific. They included also patients after fever analyzes and the significance came only from the comparison of tritan in this group, not in the primary PCI group. In the plateau and ISAR-5 we excluded these patients. Dr. Greg Hundley: Dharam, we're going to turn to you now. Adnan's really framed this study nicely, but can you help us from your perspective, put this study in perspective with others that have been published in this space? Dr. Dharam Kumbhani: Yeah, thanks, Greg. And I want to congratulate Adnan and his group for providing the field with another really well conducted study in a very important field. The center has done some very, very landmark trials, and I think this is another one of those. It sort of helps us understand potentially the best treatment mechanism or protocol for patients undergoing primary PCI for STEMI in this case. As you nicely outlined sort of the background for this, the only other trial that I'm aware of in this space is directly comparing pasugrel and ticagrelor head to head was the Prague 18 trial, which was smaller. I think it was about under 1100 patients. So even the STEMI cohort here was larger than that trial. But that trial ended up being terribly underpowered and unfortunately, also discontinued prematurely. So there wasn't really any significant difference that was noted in that trial and there was also a high crossover to clopidogrel in that other trials. Dr. Dharam Kumbhani: So I think that trial, in fact, we had published a trial in circulation as well. And I think this study sort of helps to advance the field a little bit by providing a head to head comparison between the two drugs. If I may extend some of the discussion points that were brought up earlier, I think, again, there is a couple of things that jumped out to me. One is, as you mentioned, the semi cohort is very interesting and very important. The p-value for interaction between the STEMI and the non-STEMI population was not significant for the primary end point. So that is certainly important when considering these results. Dr. Dharam Kumbhani: And the second thing is the differences that were noted in the rates of reinfarction, both spontaneous as well as PCI related. And although that is very interesting, we certainly have to keep that first point in mind when considering that. I think it becomes more hypothesis generating that MI rates ended up being higher with ticagrelor compared with prasugrel, and then sort of trying to tease that out in terms of, was that just a play of chance? Do we end up seeing that, is there a real biological reason for that? All of the trials was extremely well done. There were about 29 patients that did not have one-year follow-up and there were about 67 or so MI events. I think it's very interesting, and I think for at least for me, when I review this trial, I think it brings up some very interesting hypotheses that I think we would need to test further. Those anyway, my sort of high-level thoughts on this excellent trial. Dr. Greg Hundley: Very good. Well, I'd like to ask you just in 20 seconds, each of you, what's the next study that needs to be performed in this field? Adnan, start with you. Dr. Adnan Kastrati: I don't expect trials doing the same thing that we have done in ISAR-X5. We are planning now that ISAR-X6 trial. They are finalizing the protocol, and it will be a large trial of 9,000 patients with acute coronary syndromes in which will test the need for aspirin after discharge. That means all the spaces will be with the potent P2I12 inhibitors. And one group, it will be a placebo controlled trial. One group will have aspirin after discharge, the other placebo. And this is now, for us, the most important thing in this area. Dr. Adnan Kastrati: If I have the chance to respond to Dharam about the mechanistic insights of this effect, I would say that we have shown aggressive cardiology, our data about platelet function. It is the biggest platelet function studies in this area, 600 patients. We have tested in patients after PCI. We tested ADP in used aggregation after ticagrelor and prasugrel. And prasugrel was associated with a 30% reduction in platelet aggregation in these patients. And I think that this offers the mechanistic basis also for our results. And the results will be published shortly. Dr. Greg Hundley: Very nice, and Dharam. Dr. Dharam: Thank you for that response, Adnan. And Greg, to your question, I agree. I think it would be hard, although the field would really benefit from having a head to head comparison between these two drugs again in a larger study. I do think a lot of the interest and excitement in the ACS field is on de-escalation strategies as the outline. And so I suppose that that's sort of where we'll see a lot more in terms of clinical trials. Dr. Greg Hundley: Very good. Well listeners, this has been a wonderful discussion and we appreciate the input from the primary author, Dr. Adnan Kastrati, from the Deutsches Heart Center in Munich and our own associate editor, Dr. Dharam Kumbhani from UT Southwestern. Really reviewing prasugrel versus ticagrelor for primary PCI in patients with STEMI only, and showing really no difference in their primary endpoint of death, myocardial infarction, and stroke, with however an increased risk of reinfection in the patients receiving ticagrelor only. Dr. Greg Hundley: So on behalf of Carolyn and myself, we wish you a great week and look forward to catching you next week On the Run. This program is copyright the American Heart Association, 2020.
Holding Up Half the Sky: A Biblical Case for Women Leading and Teaching in the Church. By Rev. Assoc. Professor Graham Joseph Hill.Women have played significant roles in ministry and leadership throughout the history of the church and the pages of the Bible. Today, women make up more than half the church, and do much of the mission, ministry, and discipleship in the life of the church. But women have often been held back from ministry roles. Graham Joseph Hill outlines the biblical vision for women in ministry and leadership. He offers a biblical and passionate call for women to be released to teach, to lead, to preach, to serve, to pastor, and to minister in every area of the church. The Bible paints a radical vision of women, empowered and emboldened for full ministry participation in Christ's church. The biblical vision for women and for their role as teachers, witnesses, disciplers, and leaders transforms not only personal lives, but also the church and the world. This book offers a biblical case for women teaching and leading in the church. Hill then explores practical ways that we can empower and release more female leaders in the church, and ways that we can amplify the voices and honor the gifts of women in the way Jesus intended. Together women and men can revitalize the church and renew the world.
In this week's episode, we are talking to Graham Joseph Hill about his book Holding Up Half The Sky: A Biblical Case For Women Leading And Teaching In The Church. To connect with Graham and learn more about his work, make sure to check out his web site. During the show, Graham mentioned an opportunity to have his book translated into Arabic. If you would like to donate to help make that a reality, you can email Graham at ghill8@icloud.com The Churchology Podcast is all about conversation and we would love to hear what you thought about today's episode. Connect with us on Facebook, Twitter, or Instagram. Next week we are talking to Jay Kim about his book Analog Church: Why We Need Real People, Places, and Things in the Digital Age. Make sure to subscribe wherever you listen to podcasts so you won't miss it!
“Hide This in Your Heart” sermon (Ps.119:11 and 2 Tim.3:14–16) – by Graham Joseph HillHiding God's Word in your heart restores your spiritual passion.Memorizing the Bible has been proven to be an essential, life-giving practice for spiritual growth. Those who memorize passages from the Bible can point to how it’s given them greater assurance of God’s love and a deeper understanding of how to follow Jesus.This sermon goes with the book by Graham Joseph Hill and Michael Frost. “Hide This in Your Heart: Memorizing Scripture for Kingdom Impact.” NavPress, 2020.Buy the book here: https://www.barnesandnoble.com/w/hide-this-in-your-heart-michael-frost/1136591162Or buy the book here: https://www.bookdepository.com/Hide-This-is-Your-Heart-Michael-Frost/9781641582049See a webinar on how to memorize the Bible, here: https://grahamjosephhill.com/bible-memory-challenge/#HideThisInYourHeart #BibleMemoryChallenge
Rowland visits with Mike Frost and Graham Hill about their new book, Hide This In Your Heart.
This weeks show starts off with music from Ras Michael, Hugh Mundell, Al G, The Paragons, Horace Andy, Sly & Robbie Michael Rose, Dennis Brown, Burning Spear, Bob Marley & The Wailers, Junior Byles, Joseph Hill, The Gladiators, The Congos, Barrington Levy, and Al Campbell. New music this week comes from Akae Beka and Chronixx, Sister Carol, Paul Elliott, Dahvid Slur, Junior X, Perfect Giddimani, Blvk H3ro and Wayne J, Inna Vision, Clatta Bumboo, The Midnight Riders and Naram, Abiyah Yisrael, George Palmer, Burning Soundz, Duane Stephenson and Romain Virgo, Runkus, and The Young Israelites. Also this week we ride the Answer Riddim 2020 featuring George Nooks, Admral Tibet, and Pinchers. In The Dub Zone this week you will hear dubs from Bass Lee, Augustus Pablo, The Wailing Souls, Sip A Cup and Negus Roots, Gaudi, and Principal. Extended dub mixes feature B Davis and Boom One Sound, Massaia DubKillah, Amlak Chazbo and Empress Shema, and Judah Eskender Tafari with Mighty Massa. Enjoy! Ras Michael & The Sons Of Negus - None A Jah Jah Children - Island Records Presents: Roots 37 Essential Roots Anthems - Island Records Hugh Mundell - Time Has Come - Blackman’s Foundation - Shanachie Al G - De Train - Conscious - AWG The Paragons - Land Far Away - Sly & Robbie Presents The Mighty Paragons Collection - Jet Star Horace Andy - Government Land/Government Dub - In The Light/In The Light Dub - Blood & Fire Sly & Robbie - Theme From Mission Impossible - Friends - Taxi Records Michael Rose - Guess Who’s Coming To Dinner - Rock On: Greatest Hits From The Observer Label - Heartbeat Records Dennis Brown - I Need Your Love (Rasta Children) - Ultimate Collection - Hip O Records Burning Spear - Rock - Farover - Heartbeat Records Bob Marley & The Wailers - Concrete Jungle - Catch A Fire Deluxe Edition - Tuff Gong Junior Byles - Beat Down Babylon - Beat Down Babylon - Doctor Bird Joseph Hill & The Soul Defenders - Behold (Tk. 3) - Studio First: From The Vaults Vol. 3 - Studio One The Gladiators - Jah Works - Dreadlocks The Time Is Now - Virgin Frontline The Congos - Ark of The Covenant - Heart Of The Congos - Blood & Fire Barrington Levy - Teach Me Culture - Ras Portraits: Live & Learn Presents - Ras Records Akae Beka feat. Chronixx - Black Carbon/Black Carbon Dub - I Grade Records Al Campbell - Bad Boy - Rub A Dubble Reggae Vol. 2 - CSA Neville Brown & John Wayne - The Right Time (Boogie Down) - Rub A Dub Revolution - Pressure Sounds Sister Carol - Wild Thing - Opportunity - Tafari Records Zema - Black Sheep - Black Sheep - Melchizedek Music Paul Elliott - Be Strong - Life Journey Riddim - Stronger Productions Dahvid Slur - Joy - VP Records Luciano - Ah We Dis - The Answer - Oneness Records Jah9 - Heaven (Ready Fi Di Feeling) - Note To Self - VP Records Rudy Mills - Fisherman - Fisher Man - Rebel Sound Records Keith & Tex - Left Behind - Aquagem Records Junior X - Revolt - John John Records Perfect Giddimani & Soulnation - Inna Marcus Name - Dumplin’ Shop - Soulnation Productions Nga Han feat. The Signal One Band - Great Honor - Roots Unity Presents Nga Han: The Living Stream Chapter One - Roots Unity Blvk H3ro & Wayne J - The Ruler - New Millennium - Delicious Vinyl Island Inna Vision feat. Kanakamon - Pay Them No Mind - 2020 Vision - Roots Musician Records Clatta Bumboo - Heartache/Heartache Dub - Future Water - Black River Sonics Dub Zone featuring Strictly Dubwize & Extended Dub Mixes Bass Lee - Inna One Drop Style - Bass Lee Inna One Drop Style - Bass Lee Augustus Pablo - Braces Tower Dub - King Tubby Meets Rockers Uptown - Shanachie Records Wailing Souls - Very Well Dub - Wild Suspence - Mango Sip A Cup Meets Negus Roots - Conductor Of Dub - Firehouse Dub Vol. 1 - Gussie P Gaudi - Theremin In Hand - Dubmission Principal - Dubsteady - Treacherous Dub - Stereo Royal Nat Birchall Meets Al Breadwinner - Struggle Dub - Tradition Disc In Dub - Tradition Disc B Davis & Boom One Sound System - Rise & Shine/Rise & Dub (3000 Worlds Dub Version) - Blood Fire - Boom One Records Massaia DubKilah feat. Lengualerta - Rootikhal/Rootikhal Dub Kutral Dub Remix - Revolutionary Sound Army In Dub - Culture Dub Records Amlak Chazbo Meets Empress Shema - King Selassie I Calling Mix 1 & 2 - Roots Youth Records Judah Eskender Tafari & Mighty Massa - Peace/Peace In Dub - Divine Right - Black Redemption Productions =================================== Midnight Riders & Naram - Sick and Tired Of The Killing - Midnight Riders Meets Naram Rhythm Section - Red Robin Records AbiYah Yisrael - Bloodshed In The City - Cha Yah Studios George Palmer - Africa - Irie Ires Records The Lambsbread feat. Mykal Rose - Nah Stop Chant - Next Generation Productions Arkaingelle feat. Kabaka Pyramid & Pressure Busspipe - Light Tha Torch - Nah Watah Down - Zion High Productions Inna Vision feat. Million Stylez - Waste No Time - 2020 Vision - Roots Musician Records Burning Soundz feat. Naptali & Rob Smith - Pure & Divine/Pure & Divine Dub - Jafa Sound Duane Stephenson & Romain Virgo - Caribbean Girl - Caribbean Soul Riddim - Maximum Sound Young Israelites - Stay By My Side - Stay By My Side - Fyah Ants Records Runkus - Strange - Dancehall Anthems - VP Records George Nooks - Foundation - Answer Riddim 2020 - G Shav Music Admiral Tibet - Not Gonna Wait - Answer Riddim 2020 - G Shav Music Pinchers - Again - Answer Riddim 2020 - G Shav Music Mighty Diamonds - Nutt’n Nah Gwan/Nutt’n Nah Gwan Dub - Boot Camp Records Wailing Souls feat. Alborosie - Shark Attack/Shark Attack Dub - Back A Yard - VP Records
This weeks show starts off with classic selections from Ini Kamoze, Jacob Miller, Cornell Campbell, Ossie Dellimore, Max Romeo, Frankie Paul, Linval Thompson, Eek A Mouse, The Mighty Diamonds, U Roy, Bob Marley & The Wailers, Joseph Hill and The Soul Defenders, Junior Byles, and Burning Spear. New music this week comes from The Wailing Souls, Toots & The Maytals, Keith Poppin, Beres Hammond, Luciano, Nga Han, Danny Kalima, Tarrus Riley, Macka B, Shinehead, Protoje, Fyakin, Super Cat, Laury Webb, and Mungo's Hi Fi with Marina P, Tippa Irie, and Dennis Alcapone. Also this week we feature a Studio One Set with music from Jackie Bernard, Alf & Teep, Freddie McGregor, Ernest Ranglin, Horace Andy, Prince Jazzbo, Dawn Penn and more. In The Dub Zone this week you will hear dubs from Mad Professor, Nat Birchall and Al Breadwinner, Tommy McCook, Principal, Haze St. Dub, and Mafia & Fluxy. Extended dub mixes come from Freddie McKay, Johnny Clarke, Barrington Levy & Ranking Joe, Jah Mel, Tristan Palmer and Roots Radics, and Bunny Wailer. Enjoy! Ini Kamoze - Hail Mi Idren - Ini Kamoze - Taxi Ossie Dellimore - Time Has Come - Freedoms Journal - AB Records Wailing Souls - In The House Of Jah - Back A Yard - VP Records Jacob Miller - I’m A Natty - Reggae Anthology: Joe Gibbs Scorchers From The Mighty Two - VP Records Cornell Campbell - Forward Natty Dread - I Shall Not Remove 1975-1980 - Blood & Fire Max Romeo - Melt Away - Open The Iron Gate 1973-1977 - Blood & Fire Prince Far I - Back Weh - Kingston Shuffle: Funky Sounds & Beats From Kingston Jamaica - Pressure Sounds Frankie Paul - Music Is The Staff Of Life - Pass The Tu Sheng Peng/Tidal Wave - Greensleeves Cocoa Tea - Rocking Dolly - Rocking Dolly - Ras Records Linval Thompson - Long Long Dreadlocks - Ride On Dreadlocks 1975-1977 - Blood & Fire Eek A Mouse - For Hire & Removal 12” Mix - Reggae Anthology: Eek ology - VP Records The Mighty Diamonds - Right Time - Reggae Anthology: Pass The Knowledge - VP Records U Roy - Full Time - The Lost Album: Right Time Rockers - Ras Records Bob Marley & The Wailers - Africa Unite - Survival - Tuff Gong Joseph Hill & The Soul Defenders - Behold (Tk.3) - Studio First: From The Vaults Volume 2 - Studio One Junior Byles - Rasta No Pick Pocket - Beat Down Babylon - Doctor Bird Toots & The Maytals - Got To Be Tough - Got To Be Tough - Trojan Jamaica Keith Poppin - One More River To Cross - One More River To Cross - Keith Poppin Music Burning Spear - As it Is - Calling Rastafari - Heartbeat Records Burning Spear - Hit Dub - Living Dub Vol.5 - Burning Music Beres Hammond - Call To Duty - VP Records Luciano - Take Me To The Place - The Answer - Oneness Records Nga Han & Roots Unity - The Living Stream - Roots Unity Presents The Living Stream Chapter 1 - Roots Unity Danny Kalima feat. The Raw Rhythm Section - London Bridge - Roots Unity Productions Wailing Souls - Down In Trenchtown - Back A Yard - VP Records Buju Banton - Rising Up - Upside Down 2020 - Gargamel Music/ Roc Nation Tarrus Riley feat. Teejay & Dean Fraser - Babylon Warfare - Healing - Juke Boxx Productions Macka B & Ted Ganung - Stop It Idiot Ting - Deeper Vision Recordings Sound Dimension - Real Rock - Studio One Rockers - Soul Jazz Records Jackie Bernard - Torture & Flames - Studio First: From The Vaults Vol. 2 - Studio One Alf & Teep - Freedom, Justice Equality - Studio First: From The Vaults Vol. 2 - Studio One Freddie McGregor - Bobby Babylon - Studio One Rockers - Soul Jazz Records Ernest Ranglin - Surfin - Studio One Rockers - Soul Jazz Records Horace Andy - Skylarking - Studio One Rockers - Soul Jazz Records Prince Jazzbo - Crabwalking - Studio One Rockers - Soul Jazz Records Lennie Hibbert - Village Soul - Studio One Rockers - Soul Jazz Records Dawn Penn - No, No, No - Studio One Rockers - Soul Jazz Records Larry Marshall - I Need You Girl - Studio First: From The Vaults Vol. 2 - Studio One The Soul Vendors - Darker Shade Of Black - Studio First: From The Vaults Vol. 2 - Studio One Marcia Griffiths - Feel Like Jumping - Studio One Rockers - Soul Jazz Records Sound Dimension - Full Up - Full Up The Best Of Studio One Vol. 2 - Heartbeat Records Dub Zone featuring Strictly Dubwize & Extended Dub Mixes Mad Professor - Kunte Kinte The African Warrior - Beyond The Realms Of Dub: Dub Me Crazy The Second Chater - Ariwa Nat Birchall Meets Al Breadwinner - Tribute to the Great Tommy McCook - Upright Living - Tradition Disc Tommy McCook - Grass Roots - Kingston Shuffle: Funky Sounds & Beats From Kingston Jamaica - Pressure Sounds Principal - Dubsteady - Treacherous Dub - Stereo Royal Haze St. Dub - Supernova - A New Beginning - Haze St. Studios Mafia & Fluxy feat. The Pharmacist - King Nah Bow - Mafia & Fluxy Remembers King Tubby: King Of Dub - Mafia and Fluxy Freddie McKay - Guide Us Jah Jah - Thompson Sound All Stars: Linval Thompson & Friends Vol. 1 - Thompson Sound Johnny Clarke - Roots Natty Congo - Creation Rebel - VP Records Johnny Clarke - Congo Natty Roots Dub - Dancehall Selection With Deejays & Dubs - Attack Barrington Levy & Ranking Joe- River Jordan (crucifixtion) /River Jordan - The Biggest Dancehall Anthems 1979-1982 - Greensleeves Jah Mel - Sinking Sand - Iroko Records 12” Tristan Palmer & Roots Radics - Time So Hard/Dubbing Time - Showcase: In a Roots Radics Drum & Bass - Abraham Bunny Wailer - Rule Dancehall/Rule Dancehall Version - Solomonic Singles 2: Rise & Shine 1977-1986 - Dub Store Records/Solomonic ======================================== Shinehead - Tribulation - Golden Cartel Protoje - Self Defense - In Search Of Lost Time - Indiggnation Collective/RCA Kumar feat. Agent Sasco - Grain of Sand - Kulture Walk - Kulture Walk Music Shabba Ranks - Heart Of A Lion - Reggae Anthology: Serious Times Bobby Digital - VP Records Arkaingelle feat. Kabaka Pyramid & Pressure Busspipe - Light Tha Torch - Zion High Productions Eljai - War - High Rise Riddim - Synthedicate Music Eesah - Kingston Town - Caribic Night Records Skip Marley - My World - Higher Place - Tuff Gong International Protoje - Same So - In Search Of Lost Time - Indiggnation Collective/RCA Anthony B - Easy Rocking - Juicy Empire Records Fyakin - Reggae Vibes - Real Don Dada Riddim - Nyle Banks Music Super Cat & Salaam Remi - Push Time - Louder Than Life Records Kabaka Pyramid - Nice Up The Dance - Dancehall Anthems - VP Records Pad Anthony - Shake Dem Down - Digital B -80’s Vol.1 - VP Records Toots & The Maytals - Struggle - Got To Be Tough - Trojan Jamaica Laury Webb - Gone Up - Lynsam Entertainment Mungo’s Hi Fi feat. Marina P, Tippa Irie & Dennis Alcapone - The Beat Goes Ska/Ivory Coast - Scotch Bonnet Records Luciano & Runkus - Use Jah Words - The Answer - Oneness Records
Lead Stories went global last September when recording this Lead Voices episode featuring a conversation with Grace Ji-Sun and Graham Joseph Hill, co-writers of the book "Healing Our Broken Humanity" named 2019 resource of the year by Outreach Magazine. Graham and Grace are both part of The Global Church Project which exists to help local Christians and churches learn from diverse, multiethnic, and global voices and trends. Listen as they share their stories and encourage us to listen to what is God is doing globally and learn about how we as individuals as well as the Church can experience renewed mission and revitalized churches. Book: "Healing Our Broken Humanity" Website: The Global Church Project Grace Ji-Sun Kim website - https://gracejisunkim.wordpress.com/about/ ConNext Summit October 13-15, 2019 - http://connextsummit.org/ Facebook - https://www.facebook.com/gracejisunkim/ Twitter - https://twitter.com/gracejisunkim Graham Joseph Hill Facebook -https://www.facebook.com/grahamjosephhill Twitter - https://twitter.com/grahamjghill?lang=en Instagram - https://www.instagram.com/grahamjosephhill/?hl=en website - https://theglobalchurchproject.com/ Connect with Lead Stories and Jo and Steph: Twitter: @LeadStoriesVox Instagram: @LeadStoriesPodcast Facebook: LeadStoriesPodcast Connect with Jo at www.josaxton.com @josaxton Connect with Steph at www.pastorsteph.com @pastorsteph Subscribe on iTunes to have the podcast automatically download to your device every week or listen at www.leadstoriespodcast.com www.leadstoriesmedia.com Don’t forget to check out Lead Stories Community at www.leadstoriesmedia.com/community Lead Stories resources at: www.leadstoriesmedia.com/resources
Welcome to the seventeenth episode of “Check- in with SomeAnswers”. Due to COVID-19 I can’t interview people in person, so I’ve had to pivot and change the way SomeAnswers looks during this season. I am going back and “checking in” with people that I have already interviewed and ask them how they are doing in […]
This week’s episode is special: we have the former and current Editors-in-Chief of Circulation on Circulation on the Run. Join Dr Amit Khera, Digital Strategies Editor of Circulation, as he speaks with Dr James T. Willerson, Editor-in-Chief from 1993 to 2004; Dr Joseph Loscalzo, Editor-in-Chief from 2004 to 2016; and Dr Joseph A. Hill, the current Editor-in-Chief. They will discuss the history of Circulation and how it continues to evolve. TRANSCRIPT Dr Amit Khera: Hi, this is Amit Khera. I'm digital strategies editor for Circulation from UT Southwestern Medical Center in Dallas. Today we have a very special Circulation on the Run. We have three Editors-in-Chief from Circulation. First, we have Dr James Willerson, who was the Editor-in-Chief from 1993 to 2004. He's a President Emeritus at the Texas Heart Institute. We also have Dr Joseph Loscalzo, who was Editor-in-Chief from 2004 to 2016, the Chairman of Department of Medicine from Brigham and Women's Hospital. And finally, Dr Joseph Hill, the current Editor-in-Chief, the Chief of Cardiology at UT Southwestern Medical Center. Welcome, gentlemen. Dr Joseph Hill: Thank you. Dr James Willerson: Thank you. Dr Joseph Loscalzo: Thank you. Dr Amit Khera: Dr Willerson, I must say, looking over the tenure prior to Dr Loscalzo, you had one of the longest tenures ever as Editor-in-Chief of Circulation, and certainly a lot happened in the practice of cardiology during that period. It was a really formative period in cardiology. As you think back, what were some of the most important topics that you covered during that time as Editor-in-Chief, thinking about the evolution of cardiovascular care and science at that time? Dr James Willerson: You have to remember, there have been many editors at Circulation. We all build on the shoulders of others, certainly I did. I really wanted Circulation to be the premier cardiovascular journal in the world. I wanted it to be much like the New England Journal of Medicine, but the New England Journal of Medicine Circulation of Cardiology. I wanted to publish it every week. We got permission to do that. That wasn't easy, but we were fortunate. I've been accused of wanting to publish it every day. There's actually some truth to that. I didn't make that. I didn't try very hard. I wanted to be able to present the information, important information, to everybody who cared about cardiovascular medicine: physicians, scientists, students, nurses, those who cared for people, and I wanted to do it frequently. I wanted to publish it quickly. So, we had some success with that. There are many other things that are well-known to the other editors, all of whom have built before me and after me, and I'm very proud of them. Dr Amit Khera: Well, thanks for that. And certainly, as you pointed out, this has been an evolution where you took the gauntlet, if you will, from the people before you, and then built on that and had many advances. I guess after you, Dr Loscalzo, you I think did have the longest tenure if I saw of any of the editors and similarly, a lot of evolutions in cardiovascular care and a lot in science, particularly during your time. Tell us a little bit about any particular papers or topics that you focused on, or that really were revolutionary in the cardiovascular space during your tenure. Dr Joseph Loscalzo: I'll pick up where Jim left off and just make the case that as you're suggesting, I mean, there's sort of been a natural transition of the kind of science that Circulation has been publishing over the tenure of the three editors here today. Before Dr Willerson, it was largely physiology and excellent clinical science. Jim really expanded the scope of what Circulation published to begin to put in press in its pages, fairly basic and translational science as well. I picked up from what he'd laid the groundwork for to expand the scope of that science. And as you know, expand it to the point that we had to develop daughter journals that would pick up the mantle in each of these increasingly subspecialized areas. So, it's hard to think about those papers that I found have the greatest impact because every field had several of them in my several years as editor. As you know, the subspecialty journals that we established, which remain active to the current time, are also broad in their scope from outcomes based research to genomics and proteomics insistence, cardiovascular medicine, to everything in between, imaging, intervention, heart failure, and electrophysiology to arrhythmias. Each of these was led, and continues to be led, by outstanding leaders in their subspecialty fields. I think the beauty of Circulation in contrast to even fine journals like the New England Journal of Medicine, is that Circulation has been able to put on its pages those studies that really do span quite a spectrum. We don't shy away from very basic studies. That actually began with Jim, I must say, because that wasn't the case previously. And of course, we move right through to epidemiology and outcomes based research. And the impacts have been broad in each of those fields, as witnessed by the excitement and uptake of the journal, measured however you wish, by impact factor, or citations, or the frequency with which it's referred to in the lay press. So, I think that tradition certainly continues under the current editor with papers of extraordinary impact. Dr Amit Khera: Thanks for that. I think your point about the evolution of science over time from Dr Willerson and certainly during your tenure and beyond to the breadth of Circulation currently. You also touched on the subspecialty journals. That happened in your watch and that was quite a marked change in cardiovascular medicine to have that explosion of new journals, if you will. What do you think the impact of those subspecialty journals has been for the cardiovascular field? Dr Joseph Loscalzo: We struggled with the idea about whether or not we should pursue that kind of fragmentation. What really pushed us was the fact that the acceptance rate remains quite low, in those days, probably eight or so percent range at its nadir. So, we were rejecting a lot of really excellent papers which wound up in competitor journal pages, that we would like to have accepted and been given the scrutiny of the careful reviews and editorials that accompany papers accepted by Circulation. We felt the best way to do that under the circumstances was to create these daughter journals. They succeeded, in many respects, beyond our wildest imagination. The numbers of papers that were published in the family increased, I think in the first two or three years, by at least 2-to 3000. So, that really speaks to the fact that we kept the best papers in the family. We gave them the right kind of audience. Some of these would have been too technical or too highly specialized to have been published in Circulation proper, but certainly of the highest quality and of significant relevance to the subspecialist. So, we think that it was a successful experiment. Now it's sort of become tradition. I think that the question that will always come up, of course, is can we fragment things more? I would say one of the best reasons to make the case that this was a successful experiment is that if imitation's the sincerest form of flattery, the New England Journal is now going to start three subspecialty journals. In fact, in my role now as an editor of the New England Journal, editor-at-large, they asked my input in how to design those daughter journals and what to expect from them. Dr Amit Khera: Well, I think that's a great point. It certainly has been a resounding success and as you pointed out, imitation is the best form of flattery. I'm going to pivot now to Joe Hill. Dr Hill, you have certainly been the beneficiary of all the great work that these two editors have done in the past. You've inherited a very successful journal and also have crafted your own vision for where you want Circulation to go in your mark. Tell us a little bit about some of the new initiatives you've tried to implement, leveraging on these past successes. Dr Joseph Hill: Thank you, Amit, it's an honor and a privilege to be in this conversation, frankly. I mean, Dr Willerson made this a weekly journal. That was back in the day when FedExes were flying around. Everything was paper. That kind of volume with that technology is impressive. And Dr Loscalzo, who has been a friend and mentor for many, many years, spearheaded the subspecialty journals, as we just heard, and took the journal to yet new heights. Each of you has been a pioneer and we've been fortunate to put together a team that I think has moved in exciting directions. We've leveraged technology now, such that we have our video conference meetings. We meet in a video conference with editors from 17 different countries. We have a third of our editors in Dallas, where I live, a third in the US outside of Dallas, and another third in 16 other countries. It turns out we alternate the time of that meeting each week because there's no single hour of the day that works around the globe, so we move it around to capture Asia or to capture California in alternating weeks. That has been a thrill and, honestly, I believe a robust success. We have leaders on the ground in all these different countries. We have a highly diverse team across the different subspecialty domains of cardiology, across different geographic regions, across race and sex and gender lines. It is an amazing team. And Amit, who leads our robust digital efforts, including this podcast and our efforts on social media, again, the opportunity now in the 21st century to take these initiatives forward has been a real privilege. Dr Amit Khera: It's ironic that Circulation was doing Zoom before everybody else was in the modern era. I'm going to pivot back to Dr Willerson. As Dr Hill just mentioned during your tenure how the volume of papers was handled, FedEx and sort of the nature of the journal publishing process. And now in the modern era, we have so much different information. We have a huge volume of journals. We have online, we have Twitter, we have podcasts. We have people that are consuming information in so many different ways. Tell us from your perspective, what's the role of the scientific journal currently and how has it changed at all in the last few decades? Dr James Willerson: It's always going to continue to evolve. It's about as good as it can be right now with Dr Loscalzo and Dr Hill's leadership, and I'm really proud of them. There'll be more. We can't even imagine what it will be in two or three years. Of course, it'll be better and better, faster, almost momentary. Thank you, Dr Hill. Dr Amit Khera: Thank you for that. I think we all look forward to seeing how this evolves more rapid information, rapid turnaround. I'm certain that will change. Dr Hill, you had a comment on that? Dr Joseph Hill: We live in an era now where peer review is under attack in many ways and pre-print journals, blogs and so forth. And one of the things that I've really seen, and we've all seen, is how the peer review process, and we're all authors, right, we live on the other end of that stick, but it really is important. It makes a big difference. And people who are anxious to accelerate that process, I totally get it. We work very hard to do that. At the same time we, following the traditions here, have an intentionally redundant review process where every paper is evaluated by multiple editors and multiple peer reviewers. On a number of occasions, we've avoided a pothole, or we've improved a paper many, many times. And that is something that has really been impressed on me that I think people who aren't on this side of the editorial fence might not appreciate as much. Dr Amit Khera: I think that's an important point about sort of the rigor about the way that articles come out in Circulation. And Dr Loscalzo, maybe as an extension of the last question, what do you see as some of the challenges going forward or opportunities for Circulation? You think about where it's been, but what are some of the things that you look forward to for Circulation in the future and what are some of the things you're concerned about? Dr Joseph Loscalzo: Well, I too am concerned about this issue of peer review being under attack, and I'm particularly concerned about it for papers that have direct clinical impact. A good example of that concern, of course, are papers published, or at least publicly released, on non-peer reviewed websites like the archive sites because of their importance in the COVID epidemic, potentially. We all know of cases of drugs, at least in test tubes, with cultured cells and viruses appear to be effective that have adverse clinical consequences. So that, and more than in any other sphere of science, ensuring that proper peer review from as many perspectives as possible is always a part of the process is absolutely critical for clinical medicine. And to me, the threat that this need for acceleration and rapid peer review poses and the sort of socialization of the transmission of scientific information that we're all interested in doing really has to have the brakes put on it a bit for the clinical science that the journal represents for this very important reason. Not to say we want to slow things down, we want to make sure that the best possible reviews are performed before we release it to the public. I know that, as Joe was pointing out, one of the most exciting parts of the role of when I led the journal was the weekly meeting. We had a face-to-face meeting because all of our associate editors, save one, was actually physically proximate and they could travel to our conference room. But it's a wonderful exercise to have people of very different perspectives, from basic scientists, to clinical electrophysiologists, to outcomes researchers, make comments on papers that were completely outside their sphere. The argument, of course, is if one can write and transmit a thought with the clear intent in a way that's rigorous and logical, that any reasonably bright person with reasonable scientific background should be able to understand it. And often these folks with very different scientific backgrounds have perspectives that very clearly improved the paper when they were acted upon. That's a process that doesn't exist in many other journals, I have to say. And I would encourage Joe, which I know, well, he's doing this because he enjoys it and he recognizes its importance, and Joe's successors continue to do that as well because that will ensure the value of the journal through all of the challenges that it is going to have to face in the next decade or two. Dr Amit Khera: I think that was a great point. We're certainly seeing candy bowl examples of the importance of this rigorous process of the editors looking through it carefully and, as you both mentioned, peer review. Joe Hill, I'm going to let you maybe have the last word. I know how hard the three of you have historically worked on your craft for the journal, how much effort you've put in, but I also know it's quite a rewarding job. What would you see as the best part of being Editor-in-Chief of Circulation? Dr Joseph Hill: Oh my, I'm learning something every day. I've been on about a steep a learning curve as when I was an intern at Dr Loscalzo's hospital long ago. Under Dr Willerson's term, I imagine many, many studies came in on acute coronary syndromes and thrombolytic therapy, primary PCI, antiarrhythmic drugs. We haven't seen an antiarrhythmic drug paper except for a recent review we did, but for quite a long time. It's artificial intelligence, it's big data, it's the UK Biobank, it's Omix, it's incredibly sophisticated genetics and genomics and basic science with genetic manipulations, IPS cells. It's a very different world now than it was 10 years ago, 20 years ago and it certainly will be again, 10 and 20 years down the road. We are now approaching, I will say, 600 COVID related papers, and they're still coming in at a record pace. The world has changed. As I said before, this is the 70th anniversary of this storied journal. And it is truly my honor to be able to stand on the shoulders of Doctors Loscalzo and Willerson. Dr Amit Khera: Thank you. I think that's a great way to end this podcast and congratulations on the 70th anniversary. It truly has been a privilege to chat with the three of you today. I want to thank you not only for what you've done for Circulation, but for the field of cardiovascular medicine. This is Amit Khera, digital strategies editor for Circulation. Next week we're back to our usual podcast with Carolyn Lam and Greg Hundley. Take care. Dr Greg Hundley: This program is copyright the American Heart Association, 2020.
In this episode of The Active Texan Podcast I sit down with my friend and training partner Joseph Hill of College Station, Texas. He is an all around great guy and has a lot of experience in the world of triathlon. We discuss why and how he got into triathlon and what keeps him coming back for more. Enjoy! IG @josephdanielhill Give him a follow on Strava Board member of the BCS Triathlon Club (Facebook)
William Joseph Hill is a martial artist, actor, producer, and the author of the new sci-fi, martial arts novel, Cyber Fighter. Hill talks to Marc Zirogiannis about his new release, the first book in an exciting trilogy. He is a multi-talented and driven individual that grew up in Hawaii and whose life journey in the martial arts and entertainment have converged in the development of this exciting project. Find out about how The Karate Kid and Enter The Dragon influenced his martial arts journey, as well as how he nearly became a Taekwondo practitioner. He also discusses his comedic YouTube series, That Darn Girlfriend.To Purchase Cyber Fighter: Cyber FighterTo Follow William Joseph Hill:http://williamjosephhill.comSupport the show (https://squareup.com/store/tae-kwon-do-life-magazine/item/podcast-support-donation)
Dr Amit Khera: I'm Amit Khera, I'm digital strategies editor for Circulation and I'm standing in this week for Carolyn Lam and Greg Hunley. And I'm also doing the Circulation on the Run podcast, as well as Discover CircRes podcast with our two editors in chief. This is Jane Freedman, who recently took over as editor-in-chief of Circulation Research, and Joseph Hill, who is the editor-in-chief of Circulation. So, welcome you both. We're excited to do this. Dr Joseph Hill: Thank you. Dr Jane Freedman: Thank you. Dr Amit Khera: The idea behind this, there's this session here at sessions where we're learning a little bit about Circulation Research and Circulation, pulling back the cover, if you will, and seeing behind the cloak, as what happens in the Journal. So, Dr Freedman, I'll start with you. Tell me a little bit about, as the incoming editor of Circulation Research, some of your vision for the Journal, which you're excited about. Dr Jane Freedman: Mm-hmm (affirmative). Well, I'm thrilled to be the new editor of Circulation Research. And I've assembled a fabulous team of associate editors, deputy editors and other staff and support, that are going to continue to grow what's already a wonderful journal, to be the preeminent and primary journal for basic and translational cardiovascular sciences. And also support and interact with the other HA family of Journals. Dr Amit Khera: So obviously that starts with a great team. And it sounds like you've assembled that. Anything new that you're thinking about, and sort of the redesign of Circ Research in your term? Dr Jane Freedman: Sure. So, we're hoping to expand the original scientific content, so we can have a larger number of articles in original science. And we can have the pages to be able to handle other areas of basic cardiovascular science to include new areas, emerging areas, things like that. We're also increasing some of our early career initiatives, so that's very important to us as well. Dr Amit Khera: Fantastic. Fantastic. Can you talk about expanding for science? And Joe, that leads to you. I'm going to, in this session tomorrow, one of the goals is when people submit their science, it really goes into a black box and people don't know what happens on the editorial level. Can you maybe enlighten us a little, what happened? Dr Joseph Hill: Jane and I have been friends for 20 or more years and we now have established a bi-directional, mutually synergistic collaboration where we send papers each way. We have distinct missions, but yet with significant overlap. And I think it's an incredibly exciting time for the entire portfolio of AHA Journals. So as you say, most people that you hit send and you wait four to six weeks, and you either get a happy note or an unhappy note. And, what happens at both our Journals is we have a strategy of multiple touches on every paper. The paper that first comes in, is first touched by a senior editor, either myself or James de Lemos, and two or three others. And we will reject without review, about 50% of the papers at that point. We publish six papers a week, but we get 110 a week. So we don't need to review 50 of them to pick the top six. Out of respect to our authors to save them time, out of respect to our reviewers who devote tremendous effort to reviewing papers, we don't send them papers that we don't think have a shot. That said, if a paper makes it past that first stage, there's about a 50% chance it'll get published either in our Journal, or in one of the subspecialty journals. Probably a 50-50 chance it'll be published somewhere in an AHA family Journal. So if it makes it past that stage, we send it to an associate editor, of which you are one. And we have about 50 of them. A third are in Dallas, another third are in the U.S. outside of Dallas, and another third are in countries around the world, 17 different countries. And that person will probably reject without review, another five or 10% maybe. But he or she will dig into that paper, and in parallel send it out to two or sometimes three reviewers, who are trusted and valued advisors. They help that associate editor make a strong recommendation. He or she makes a decision to bring to the larger group, that is informed by those reviewers. So already that paper has been touched by five different investigators. Typically, that associate editor will reach out electronically within his or her affinity group. We have an affinity group in epidemiology, heart failure, intervention, basic science. Asking other AEs, "Could you take a look at this paper? One reviewer said this, one said that, I'm sort of thinking this." And then we'll have a conversation on our weekly video conference, and then a decision goes out to the authors. So every paper is touched by at least five, and sometimes 10 different editors and reviewers, which we have found has been a powerful way to really dig into and identify things that one or two people might have missed. Dr Amit Khera: One thing I note here is, if you realize how many people touch these articles, yet how efficient and how fast this process is, then that's a testament to sort of, the goals of the Journal, to be really responsive and rapid for our authors. One big part of that, and come back to Dr Freedman is peer review, right? So, associate editors have a lot of work, and were affinity groups and so forth, but really critical are these peer reviewers. And in the modern era, we're all so busy. Tell us a little bit about the value of peer review, and how we enhance the value to the peer reviewers themselves. Dr Jane Freedman: Mm-hmm (affirmative). Well, just as you said, the peer reviewers are absolutely central, valued and vital parts of making the Journal run correctly. And we, like Circulation, our associate editors send them out to three different peer reviewers, and they have a very fixed amount of time to review the articles, and they provide these wonderful comments. We also very heavily rely on our editorial board. They know the drill, that it needs to be back within a fixed amount of time. And for the most part, they do it. It's an interesting question, "What's the value to them?" I've been a reviewer too. It's part of your pay back. It's part of educating yourself about what's new and interesting. There's a lot of reasons for doing it. People enjoy being on the editorial board and interacting with the Journal. But fundamentally, as an editor, you're incredibly grateful to your reviewers. They are the unsung heroes of making a Journal work. Dr Amit Khera: You mentioned sending out to three, when you have sort of disparate reviews. It's amazing when some people love it and some people hate it. Dr Jane Freedman: Yeah. Dr Amit Khera: How do you handle that? Dr Jane Freedman: Yeah, well, sometimes it's apparent from the reviews why that happened. Someone may have focused on something, that the editorial group thinks is less important. Or they have focused on something that's addressable. The other thing we do, similar to Joe, is we have a video conference call every single week on Wednesdays, and that's a period where people can vet any concerns or questions. And then my editors, my associate and deputy editors know we have an open communication at all times. So I very frequently, when they have questions about reviews and how to reconcile disparate reviews, we'll have an ongoing conversation about that. Dr Amit Khera: It sounds like, of course you're actively engaged in how this is a dynamic process. I'll mention one thing, is digital strategies editor and I know both at Circ Research and Circulation. We're always thinking, "How do we bring these articles to life? How do we have the most people read them or engage with them?" And one is traditional social media. So Twitter and Facebook, which is incredibly important. Podcast, you have a monthly podcast. Dr Jane Freedman: Mm-hmm (affirmative). Dr Amit Khera: We have a weekly podcast and really hope that people listen to them because they're really full of important information. And finally, I think what people don't appreciate is the media. So we work with the AHA media. Some of our top stories get over a million media impressions, go all around the world and there's Professional Heart Daily. So, there's so many ways that we're bringing articles to life. Joe, I'm going to finish with you. This is a Circ family. The value of having a family of Journals and how we keep cohesion, and for authors when they're submitting to sort of a family of Journals, what's the value and how does that add? Dr Joseph Hill: Well, there has been complete turnover of all the editors in chief in the entire family of Journals, of which there are 12. And we are all quite similar in our personalities, and in our perspectives on the importance, the ultimate importance of validity. The first question we ask, "Is this true?" If it's not, it's gone. It doesn't get referred. We reject it. Even if it's going to be on the front page of the New York Times and cited 10,000 times. And all of us hold ourselves to that same standard. So our vectors are all pointed in the same direction. We also care about impact, not impact factor. But does it change the way you think? Does it matter? Is it incremental, or does it really move the needle? So we are now in a situation, I think a wonderful situation where we all sink or swim together. We send papers all around, as you know very well. We send papers to the subspecialty journals. We send 20 or 30 a week, on an extraordinarily regular basis. And we send papers horizontally to Circ Research, or Hypertension, or Stroke and so forth. So, it is a syncytium now I would say, of a family of journals where we are all looking out for each other. Jane cares about our Journal and we care about her Journal. And that's really a wonderful situation to be in. Dr Amit Khera: Well thanks. That family and how this fluidity of articles and thought and exchanges, is really part of the value. And ultimately the goal is for a great paper to find a great home. And I think in this Circ family we do that. Thank you very much. It's been a wonderful podcast. Again, I'm Amit Khera, digital strategies editor sitting in for Carolyn Lam and Greg Hundley for Circulation on the Run, as well as for Discover CircRes. Thank you. Dr Carolyn Lam: This program is copyright American Heart Association 2019.
This month on Episode 7 of the Discover CircRes podcast, host Cindy St. Hilaire highlights two featured articles from the December 6, 2019 issue of Circulation Research and talks with Roy Silverstein and Yiliang Chen about their article, Mitochondrial Metabolic Reprogramming by CD36 Signaling Drives Macrophage Inflammatory Responses. Article highlights: McArdle, et al, et al. Migratory and Dancing Atherosclerotic Macrophages Skaria, et al. Cardioprotection with Endogenous αCGRP Transcript Dr Cindy St. Hilaire: Hi, welcome to Discover CircRes the monthly podcast of the American Heart Association journal, Circulation Research. I'm your host, Dr Cindy St. Hilaire, and I'm an Assistant Professor at the University of Pittsburgh. In this episode I'm going to share with you highlights from recent articles published in the December 6 issue of Circulation Research. We're also going to have an in-depth conversation with Drs Roy Silverstein and Yiliang Chen about their recent article on how macrophage CD36 modulates immunometabolism. Also, the American Heart Association Scientific Sessions were recently held in Philadelphia, PA and in this edition of Discover CircRes, we're going to feature a conversation with the editors in chief of Circulation Research and Circulation, Drs Jane Friedman and Joe Hill. The first article I'd like to highlight is titled Migratory Dancing Atherosclerotic Macrophages. The first author is Sarah McCardell and the corresponding author is Klaus Ley and the work was conducted at the La Jolla Institute of Immunology in La Jolla, California. A major component of atherosclerosis is the inflammatory response and atherosclerotic plaques contain a mix of macrophages. Some macrophages arise from proliferation of resident cells, while other macrophages can infiltrate in from the blood. And a few studies have shown that smooth muscle cells can acquire some macrophage-like markers. Some macrophages are anti-inflammatory while others are more pro-inflammatory. These variations have largely been determined using techniques that examine the cell surface marker expression, the transcription profiles, or by mass spectrometry. But how all these different types of macrophagia cells look and function in vivo has not been clearly defined nor visualized. McCardell and colleagues have now observed fluorescently-labeled macrophages in the atherosclerotic plaques of live mice. First, using single cell RNA sequencing, they identified key markers of macrophage subsets. These markers are Cx3cr1 and CD11c. They then generated Apoe knockout mice that could then express green fluorescent protein under the direction of the Cx3cr1 promoter and yellow fluorescent protein under the direction of CD11c. These fluorescent proteins could be expressed individually, they could be expressed together, or they could be expressed not at all. And then in these mice they used intravital microscopy to look at the carotid artery plaques and they found while green cells and double positive cells, so that is, cells expressing Cx3cr1or both Cx3cr1 and CD11c--these cells tended to stay in one place, but they could extrude these protrusions akin to dancing, while the yellow cells or the cells that were expressing CD11c alone were more spherical and migratory. RNA analysis revealed that migratory genes were indeed upregulated in the yellow cells as compared to the green cells. The work provides preliminary insights into plaque macrophage dynamics and presents a technical resource for investigating how such behaviors may influence disease progression and I highly recommend you check this article out online. They have included several videos in the supplementary data and they're really beautiful. You can actually see the macrophages moving around and dancing and moving through the tissue and it's really neat to think about maybe how people are going to use this in the future to study the role of macrophages and maybe even other inflammatory cells in atherosclerotic disease progression. The next paper I want to highlight is titled Blood Pressure Normalization-Independent Cardioprotective Effects of Endogenous, Physical Activity-Induced Alpha Calcitonin Gene-Related Peptide (αCGRP) in Chronic Hypertensive Mice. The first author is Tom Skaria and the corresponding author is Johannes Vogel and they are from the University of Zurich in Zurich, Switzerland. So chronic hypertension affects a ton of people, over a billion worldwide, and it is a main driver of cardiovascular mortality and morbidity and it's a leading risk for heart failure. The way chronic hypertension can contribute to heart failure is by increasing the sarcomere gene expression in cardiomyocytes. And this gene expression helps to promote cellular hypertrophy or the swelling of cells, the enlarging of cells. High blood pressure can also promote interstitial fibrosis. And this fibrosis, which is happening in between the cardiomyocytes, impairs the contractile function of those cardiomyocytes. And while there are some medications available to help treat hypertension, many patients are unresponsive to these anti-hypertensive therapies. Interestingly, we all know exercise is good for us, and we all know exercise is good for specifically our heart, but exercise itself also induces cardiac hypertrophy, but it does so without impairing cardiac contractility. So how does this do this? How does exercise cause hypertrophy, but do it without impairing contractility? One of the proteins thought to be involved is called alpha calcitonin gene related peptide or alpha CGRP and mice that have been deleted of alpha CGRP, when they exercise, they exhibit hearts that look like hypertensive hearts. So this group hypothesized that exercise-induced endogenous alpha CGRP suppresses hypertension induced pathological cardiac remodeling and they tested this hypothesis in a murine model of chronic hypertension. What they found was interesting--they found that endogenous alpha CGRP suppresses pathological cardiac remodeling and it helps to preserve the heart function and it also mediates the cardioprotective effects of regular exercise in the setting of chronic hypertension. A really interesting thing that this article highlights is that alpha CGRP is currently approved for the treatment of migraines. So what might that mean? That might mean that someone who is taking this long-term for migraines may actually carry the risk of cardiac impairment if they have chronic hypertension. Mid-November is when the annual American Heart Association Scientific Sessions are held. This year's scientific sessions were in Philadelphia, PA and the Editors-In-Chief of Circulation and Circulation Research, Drs Joe Hill and Jane Friedman, had the chance to sit down for a chat and I'm going to share with you what they discussed, and I hope you enjoy it. Here they are. Amit Khera: I'm Amit Khera. I'm Digital Strategies Editor for Circulation and I'm standing in this week for Carolyn Lam and Greg Hunley. And I'm also doing the Circ on the Run Podcast as well as Discover CircRes podcast with our two Editors-In-Chief. This is Jane Friedman, who recently took over as editor-in-chief of Circulation Research and Joseph Hill, who is the editor-in-chief of Circulation. So welcome to you both. We’re excited to do this. Dr Joseph Hill:Thank you. Dr Jane Freedman: Thank you. Amit Khera: The idea behind this, there's a session here at Sessions where we're running a little bit about Circulation Research and Circulation, pulling back the cover, if you will, and seeing behind the cloak as to what happens in the journal. So Dr Freedman, I'll start with you. Tell me a little bit about as the incoming editor of Circulation Research, some of your vision for the journal, what you're excited about. Dr Jane Freedman: Well, I'm thrilled to be the new editor of Circulation Research and I've assembled a fabulous team of associate editors, deputy editors and other staff and support that are going to continue to grow what's already a wonderful journal, to be the preeminent and primary journal for basic and translational cardiovascular sciences and also support and interact with the other AHA family of journals. Amit Khera: So obviously that starts with a great team and it sounds like you've assembled that. Anything new that you're thinking about and the redesign of Circ Research in your term? Dr Jane Freedman: So we're hoping to expand the original scientific content, so we can have a larger number of articles in original science and we can have the pages to be able to handle other areas of basic cardiovascular science to include new areas, emerging areas, things like that. We're also increasing some of our early career initiatives, so that's very important to us as well. Amit Khera: Fantastic. And you talk about expanding for science and Joe, that that leads to you. In the session tomorrow, one of the goals is when people submit their science, it really goes into a black box and people don't know what happens on the Editorial level. Can you maybe enlighten us a little what happens? Dr Joseph Hill: Jane and I had been friends for 20 or more years and we now have established a bidirectional mutually synergistic collaboration where we send papers each way. We have distinct missions but yet with significant overlap, and I think it's an incredibly exciting time for the entire portfolio of AHA journals. So as you say, most people that you hit send and you wait four to six weeks and either get a happy note or an unhappy note. And what happens at both our journals is we have a strategy of multiple touches on every paper. The paper that first comes in is first touched by a senior editor, either myself or James de Lemos and two or three others. And we will reject without review about 50% of the papers at that point. We publish six papers a week, but we get 110 a week, so we don't need to review 50 of them to pick the top six. Out of respect to our authors to save them time, out of respect to our reviewers who devote tremendous effort to reviewing papers, we don't send them papers that we don't think have a shot. That said, if a paper makes it past that first stage, there's about a 50% chance it'll get published either in our journal or in one of the subspecialty journals. Probably a 50/50 chance it'll be published somewhere in an AHA family journal. So if it makes it past that stage, we send it to an Associate Editor, of which you are one, and we have about 50 of them. A third are in Dallas, another third is in the US outside of Dallas, and another third are in countries around the world, 17 different countries. And that person will probably reject without review another 5% or 10% maybe, but he or she will dig into that paper and, in parallel send it out to two or sometimes three reviewers, who are trusted and valued advisors. They help that associate editor make a strong recommendation. He or she makes a decision to bring to the larger group that is informed by those reviewers. So already that paper has been touched by five different investigators. Typically, that associate editor will reach out electronically within his or her affinity group. We have an affinity group in epidemiology, heart failure intervention, basic science… asking other AEs, "Could you take a look at this paper? One reviewer said this, one said that, I'm sort of thinking this…" And then we'll have a conversation on our weekly video conference and then a decision goes out to the authors. So every paper is touched by at least five and sometimes 10 different editors and reviewers, which we have found has been a powerful way to really dig into and identify things that one or two people might've missed. Amit Khera: You know, one thing I note here is how many people touch these articles, yet how efficient and how fast this process is. And that's a testament to the goals of the journal to be really responsive and rapid for our authors. One big part of that, and I'll come back to Dr Freedman, is peer review, right? So associate editors have a lot of work and we're affinity groups and so forth, but really critical is these peer reviewers, and in the modern era we're all so busy. Tell us a little bit about the value of peer review and how we enhance the value to the peer reviewers themselves. Dr Jane Freedman: Just as you said, the peer reviewers are absolutely central, valued, and vital parts of making the journal run correctly and we, like Circulation, our associate editors send them out to three different peer reviewers and they have a very fixed amount of time to review the articles and they provide these wonderful comments. We also very heavily rely on our Editorial Board. They know the drill that it needs to be back within a fixed amount of time and for the most part they do it. It's an interesting question. What's the value to them? I've been a reviewer too. It's part of your payback. It's part of educating yourself about what's new and interesting. There's a lot of reasons for doing it. People enjoy being on the Editorial Board and interacting with the journal. But fundamentally, as an editor, you're incredibly grateful to your reviewers. They are the unsung heroes of making a journal work. Amit Khera: And you mentioned sending out to three. When you have disparate reviews, it's amazing when some people love it and some people hate it. Dr Jane Freedman: Yeah. Amit Khera: How do you handle that? Dr Jane Freedman: Yeah. Well, sometimes it's apparent from the reviews why that happened. Someone may have focused on something that the editorial group thinks is less important or they focused on something that's addressable. The other thing we do similar to Joe, is we have a video conference call every single week on Wednesdays, and that's a period where people can vet any concerns or questions. And then my editors, my associate and deputy editors, know we have an open communication at all times. So I very frequently, when they have questions about reviews and how to reconcile disparate reviews, we'll have an ongoing conversation about that. Amit Khera: It sounds like of course you're actively engaged in how this is a dynamic process. I mentioned one thing as digital strategies editor, and I know both at Circ Research and Circulation, I was thinking how do we bring these articles to life? How do we have the most people read them or engage with them? And one is traditional social media, so Twitter and Facebook, which is incredibly important. Podcast, we have a monthly podcast, we have a weekly podcast, and really hope that people listen to them because they're really full of important information. And finally, I think what people don't appreciate is the media. So we work with AHA media. Some of our top stories get over a million media impressions, go all around the world and there's Professional Heart Daily. So there's so many ways that we're bringing articles to life. Joe, I'm going to finish with you. This is a Circ family. The value of having a family of journals and how we keep cohesion and for authors when they're submitting to serve a family of journals. What's the value and how does that add? Dr Joseph Hill: Well, there has been complete turnover of all the Editors-In-Chief in the entire family of journals, of which there are 12. And we are all quite similar in our personalities, in our perspectives on the importance, the ultimate importance of validity. The first question we ask is this true? If it's not, it's gone. It doesn't get referred. We reject it. Even if it's going to be on the front page of the New York Times and cited 10,000 times. And all of us hold ourselves to that same standard. So our vectors are all pointed in the same direction. We also care about impact, not impact factor, but does it change the way you think? Does it matter? Is it incremental or does it really move the needle? So we are now in a situation, I think, a wonderful situation where we all sink or swim together. We send papers all around, as you know very well. We send papers to the sub-specialty journals, we send 20 or 30 a week on an extraordinarily regular basis, and we send papers horizontally to Circ Research or Hypertension or Stroke and so forth. So it is a syncytium now I would say of a family of journals where we are all looking out for each other. Jane cares about our journal and we care about her journal and that's a really a wonderful situation to be in. Amit Khera: Well thanks. That family and how this fluidity of articles and thought and exchanges is really part of the value and ultimately the goal is for a great paper to find a great home and I think in the Circ family we do that. Dr Cindy St. Hilaire: Great. So I'm here with Drs Roy Silverstein and Yiliang Chen and today we're going to be discussing their paper titled Mitochondrial Metabolic Reprogramming by CD36 Signaling Drives Macrophage Inflammatory Responses. And this article is in the December 6th, 2019 edition of Circulation Research. So thank you both for joining me today. I'm really looking forward to learning more about the study, but before we really dig into it, could you please introduce yourselves and maybe give us a little bit about your background? Dr Roy Silverstein: Hi, I'm Roy Silverstein. I am a physician scientist, chair of the department of medicine at Medical College of Wisconsin in Milwaukee and also a senior investigator at the Blood Research Institute, which is part of what is now called Versiti Blood Center of Wisconsin. I'm a hematologist. Dr Yiliang Chen: Hi, my name is a Yiliang Chen. I graduate a PhD from University of Toledo, Ohio State. Then I chose to join Roy Silverstein's lab because I'm fascinated with this macrophage biology and immune functions in a disease called atherosclerosis, which is well-known inflammatory diseases. Dr Roy Silverstein: Can I make a little note that Dr Chen is currently supported by a scientist development grant from the American Heart Association, which is I think a nice tie-in? Dr Cindy St. Hilaire: Yeah. Dr Yiliang Chen: Yeah. I want to take this opportunity really saying American Heart Association to support our research. Dr Cindy St. Hilaire: Well that's wonderful. And now we get to publish this beautiful story. So it's come full circle. So you stated the objective of this paper was to investigate the mechanisms by which dyslipidemia, oxidative stress, and macrophage activation are linked in athero. And you focused on immunometabolism and you also focused on a protein called CD36. So before we get too deep in the weeds, can you give us a short little primer on what is immunometabolism in the context of athero, and also maybe a little bit about the molecule CD36? Dr Roy Silverstein: Well let me take the CD36 piece and then I'll let Dr Chen take the immunometabolism piece. So CD36 is a protein that's expressed on quite a few different cell types. We think that on muscle and fat its main purpose is to translocate free fatty acids from the external environment into the cell. In the case of fat, for storage, and in the case of muscle, for beta oxidation and energy, but in macrophages and immune cells and platelets, it has a different role. It serves as a scavenger receptor, part of the innate immune system, and it recognizes structures that we call DAMPs-danger associated molecular patterns. And the specific DAMPs that are recognized include oxidized low-density lipoprotein or what we call Ox-LDL. Dr Cindy St. Hilaire: Okay, so now could you give us a little bit about immunometabolism? Dr Yiliang Chen: Sure. So for metabolism, especially the process related to ATP or energy production, normally we call it bioenergetics and it is import. For so many years, people understand for the immune cell to get activated, they may produce proteins or somehow sometimes they need to proliferate. So there's a lot of energy is required during this whole process, right? But the old dogma is that the metabolism is only activated just to support the production of energy, especially the ATP. Right. But the emerging evidence has shown that, actually it's not that simple. For example, if you use LPS or bacterial product to activate to M1 status, the cells mainly use the glycolysis. They don't use the mitochondria Ox-LDL so TCA cycle to produce ADP. While the M2 activation is total different story. They switch it to the mitochondria ATP production and not using the glycolysis and it seems the metabolism is the underlying mechanism that driving these immune activations of the macrophages. So we want to ask, what kind of metabolism is going on in those ox-LDL-stimulated macrophages and is it related to atherosclerosis? So finally we figured out, okay, everything is focusing on a mitochondria function, which is interesting. But in our situation, very interesting, we find when the cells treat with oxidized LDL, actually they largely shut down the mitochondria OXPHOS. Then the Mito can switch ROS production of reactive oxygen species in shall we call it ROS. So that makes things quite interesting because it is well known oxidative stress is commonly observed during atherosclerosis. And also the mitochondria dysfunction actually, they are also commonly observed in the human patients with cardiovascular diseases. That kind of thing, everything together. Dr Cindy St. Hilaire: So you found that fatty acid metabolism, which is induced by this oxidized LDL, leads to the metabolic shift in the mitochondria, this switch you just described. And that shift leads to an accumulation of long chain fatty acids, but you also noticed independent of the metabolism in the mitochondria, you notice dysfunctions in what you call the mitochondrial network, and I'm wondering is it the accumulation of these long chain fatty acids that drives alterations in the mitochondrial network, or is it the other way around? I guess what I'm curious about is the interplay between that metabolic shift and just the baseline function of the mitochondria. Is one causing the other? Is it bi-directional? Dr Yiliang Chen: It sounds like a chicken and egg question. Dr Cindy St. Hilaire: Exactly. Dr Yiliang Chen: I think it's not that simple. For me, I was saying initially the cell try to adapt to this oxo LDL microenvironment. They try to stimulate the fatty acid trafficking into the mitochondria. But a side effect, what we think is, when you shut down a fatty acid oxidation while you're trafficking them there, that naturally will lead to accumulation of fatty acid. Those lipids may very well insert into the inner membrane of mitochondria then leads to the defects and that pretty much explained the EN images we show in our paper. Yeah. Exactly. Dr Cindy St. Hilaire: So the fact that the cell can't break down these long chain fatty acids, they're accumulating and potentially disrupting the mitochondrial membrane integrity. Dr Roy Silverstein: It's a form of lipodystrophy, not lipodystrophy, but lipotoxicity. Dr Yiliang Chen: Essentially, I think this is a defect in metabolism that leads to chronic inflammation. Dr Cindy St. Hilaire: Yeah. So your study focused on macrophages and atherosclerotic plaques and there's a huge body of evidence that shows inflammation and macrophage contribute to atherosclerotic disease progression pretty much throughout the whole plaque development. But there's also a body of evidence that shows smooth muscle cells can transdifferentiate and acquire macrophage-like phenotypes and they can also express CD36. It's one of the markers that people look for in that. And so I'm wondering, do you think this metabolic shift is operative in the smooth muscle or the macrophage-like smooth muscle cells? I guess that's the better thing to call them. Do you think that metabolic shift is operative and is contributing more so to the plaque or do you think this is innate to the macrophage from the immune system? Dr Roy Silverstein: I think that's a very provocative question. Thank you for it. Our in vitro experiments would not answer that question yet. We'd start with macrophages in those experiments, but it would be very interesting to look at smooth muscle cells that have been pushed towards that phenotype. We do, however, have some in vivo data that suggests that the cells that we call macrophages are behaving this way. And we can't say for certain that those are haematopoietically-derived cells versus smooth muscle derived cells. Dr Cindy St. Hilaire: So your study focused on the role of CD36 on macrophages, however, you mentioned in your introduction at the beginning that CD36 has also, it's in the GI track, it's on the muscle cells, it's on adipose tissue. It's also on the skin. And I'm wondering if you think these findings are specific only to the resident macrophages in the plaques or is this a broader function in macrophages? And I guess I'm thinking of this in the context of your study because it used the Apoe CD36 double knockout. So these are full body knockouts missing Apoe and functional CD36. And so I'm wondering, I guess, what would happen if CD36 was only removed from the macrophage cells itself? And I guess I'm thinking about this in context of something like metabolic syndrome. Could this be operative in adipose cells expressing CD36 or muscle cells or something like that? Kind of a more speculative question. Dr Roy Silverstein: That's great. You're helping us write our next grant. Dr Yiliang Chen: Yeah. Great question. Dr Cindy St. Hilaire: Give me 10%. Give me a little bit. Dr Roy Silverstein: I think one of the things that we've found over the years is that CD36 signaling in response to DAMPs, and even in response to fatty acid, involves a generalizable pattern that involves recruitment of what you might call a signalosome inside the cell. That signalosome typically would include members of the SARC family kinases, specific map kinases, a guanine nucleotide exchange factor called VAV, and other downstream signaling complexes. So we believe that that creates some opportunity for context specific signaling, but it does seem that a common theme is the generation of intracellular reactive oxygen species. Dr Cindy St. Hilaire: So I guess the bigger question after all of this, after your great findings, is what is the potential to leverage these findings in terms of developing therapies? Is there a novel pathway we can start to target or to think about targeting and how would you kind of go about that? Dr Yiliang Chen: Yeah. For that, that is our ongoing investigation. So based on the story in this paper, we are saying the mitochondria dysfunction and ROS production will activate and be pathway and drive this chronic inflammation, right? So if this is true, the particular question we are asking now is can we find a way to suppress mitochondrial ROS production or find a way to correct this fatty acid defect? Dr Cindy St. Hilaire: Do you think your findings on the metabolic shift of macrophage and how those contribute to atherosclerosis, how do you think those findings inform what the Cantos trial showed and the Cantos trial, which people may not be familiar with, used immunomodulation. Essentially, it was an antibody to block IO1 beta signaling and it had mediocre affects. The MI numbers were down, but the death rates were the same. Do you think that targeting the metabolism of the immune cells specifically as opposed to targeting the inflammation pathway outside of the cells is a more targeted and therefore maybe more precise approach? Dr Roy Silverstein: Yeah. I think that's a good observation. In my mind, what the Cantos study really showed us is that blocking inflammation in the broad sense, in a very upstream sense, can have an impact on human atherosclerotic heart disease. And I think that's really important observation and it validates the concept of inflammation as a target for atherosclerosis. Dr Cindy St. Hilaire: All of us breathed a sigh of relief once we're okay. It is an inflammation disease. Dr Roy Silverstein: Yeah. And it also decreased cancer, right? So it's double victory. Dr Cindy St. Hilaire: Yes. It did. Exactly. Yeah. Dr Roy Silverstein: But my thought is that we could maybe get a little bit upstream of that in a specific way. And perhaps the most translatable discovery here is the importance of mitochondrial reactive oxygen species as the source. Most people have looked at the NOX pathways, the NADP H oxidase pathways or broad spectrum. Dr Cindy St. Hilaire: I looked at that in my graduate studies. Dr Roy Silverstein: Yeah. So, you know that literature, and using broad heavy-handed approaches to create a “antioxidant effect” and most of those clinical trials have been extremely disappointing. But they haven't really targeted specific reactive oxygen species or specific sources. And we have this inhibitor that Dr Chen used in his experiment called mito-TEMPO which targets the mitochondria through a molecular mechanism and had a significant impact on the downstream production of pro-inflammatory product. So we think, or I think at least, that that is potentially an interesting target to basically prevent that reversal of mitochondrial function. Dr Cindy St. Hilaire: Thank you so much for taking the time to speak with me today. It's been wonderful, and I look forward to reading more of your papers in the future. Dr Roy Silverstein: Thanks. Dr Yiliang Chen: Thank you. Dr Cindy St. Hilaire: That's it for highlights from the December 6th issue of Circulation Research. Thank you so much for listening. This podcast is produced by Rebecca McTavish, edited by Melissa Stoner, and supported by the editorial team of Circulation Research. Some of the copy text for the highlighted articles is provided by Ruth Williams. Thank you to our guests, Dr Roy Silverstein and Dr Yiliang Chen and Drs Jane Friedman and Joe Hill for sharing their discussion with us. I'm your host, Dr Cindy St Hilaire, and this is Discover CircRes, your source for the most up-to-date and exciting discoveries in basic cardiovascular research.
Davant dels fets que han succeït aquesta setmana, ens veiem obligats a dedicar el programa a la llibertat d’expressió i la lluita anti-repressiva. No ens callaran! Tracklist: -The Penguins “Cent Mil Barrots” -Joseph Hill & Culture “Police Man” -TosTones “Poli … Continua llegint →
This interview is with Graham Joseph Hill. Listen as we talk about abuse, alcoholism, depression, ministry and his new book “HEALING OUR BROKEN HUMANITY” with co- author Grace Ji-Sun Kim.
Lead Stories goes global today in this Lead Voices episode featuring a conversation with Grace Ji-Sun and Graham Joseph Hill, co-writers of the book "Healing Our Broken Humanity" named 2019 resource of the year by Outreach Magazine. Graham and Grace are both part of The Global Church Project which exists to help local Christians and churches learn from diverse, multiethnic, and global voices and trends. Listen as they share their stories and encourage us to listen to what is God is doing globally and learn about how we as individuals as well as the Church can experience renewed mission and revitalized churches. Book: "Healing Our Broken Humanity" Website: The Global Church Project Grace Ji-Sun Kim website - https://gracejisunkim.wordpress.com/about/ ConNext Summit October 13-15, 2019 - http://connextsummit.org/ Facebook - https://www.facebook.com/gracejisunkim/ Twitter - https://twitter.com/gracejisunkim Graham Joseph Hill Facebook -https://www.facebook.com/grahamjosephhill Twitter - https://twitter.com/grahamjghill?lang=en Instagram - https://www.instagram.com/grahamjosephhill/?hl=en website - https://theglobalchurchproject.com/ Connect with Lead Stories and Jo and Steph: Twitter: @LeadStoriesVox Instagram: @LeadStoriesPodcast Facebook: LeadStoriesPodcast Connect with Jo at www.josaxton.com @josaxton Connect with Steph at www.pastorsteph.com @pastorsteph Subscribe on iTunes to have the podcast automatically download to your device every week or listen at www.leadstoriespodcast.com www.leadstoriesmedia.com Don’t forget to check out Lead Stories Community at www.leadstoriesmedia.com/community Lead Stories resources at: www.leadstoriesmedia.com/resources
Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your cohosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center, and Duke National University of Singapore. Dr. Greg Hundley: And I'm Greg Hundley, associate editor from the Poly Heart Center at VCU health in Richmond, Virginia. Dr. Carolyn Lam: Greg, I'm so excited about the feature paper this week. You know it deals with machine learning. It's such a hot topic now, and this one particularly deals with machine learning and the prediction of the likelihood of an acute myocardial infarction. So everyone's going to want to listen to it. Let's discuss a couple of papers and get to it, shall we? Dr. Greg Hundley: Absolutely Carolyn, would you like to go first? Dr. Carolyn Lam: I sure would. So my first pick is the first study to investigate the overall importance of translational regulatory networks in myocardial fibrosis. This is the study from doctors Rackham and Cook from Duke NUS Medical School here in Singapore. Dr. Carolyn Lam: What they did is they generated nucleotide resolution translatome data during transforming growth factor beta one, or TGF beta one-driven cellular transition of human cardiac fibroblasts to myofibroblasts. So this technique identified the dynamic changes of RNA transcription and translation at several time points during the fibrotic response, revealing transient and early responder genes. Dr. Carolyn Lam: Now, very remarkably about one third of all the changes in gene expression in activated fibroblasts was subject to translational regulation and dynamic variation in the ribosome occupancy, affected protein abundance independent of RNA levels. Ribosome occupancy in the hearts of patients with dilated cardiomyopathy suggest that the same post-transcriptional regulatory network, which was underlying cardiac fibrosis. Now key network hubs included RNA binding proteins such as PUM2 and QKI that worked in concert to regulate the translation of target transcripts in the human disease hearts. Dr. Carolyn Lam: Furthermore, the authors showed that silencing of both PUM2 and QKI inhibited the transition of fibroblasts towards profibrotic myofibroblast in response to TGF beta one. Dr. Greg Hundley: You know, Carolyn, this whole aspect of fibroblasts and how they turn on and turn off, become myofibroblasts, such a hot topic in heart failure. What are the clinical implications of this work? Dr. Carolyn Lam: Yes, I agree. Well, threefold. First, these authors identified previously unappreciated genes under translational control, which could be novel candidates for disease biology and therapeutic targets. Dr. Carolyn Lam: Number two, they found that critical fibrosis factors impacted cellular phenotypes at a protein level only, and hence these cannot be appreciated using single cell, or bulk RNA sequencing approaches. So that was significant. Finally, RNA binding proteins was shown to be central to the fibrotic response and represent unexplored gene expression regulators, and of course potential diagnostic or therapeutic targets. Dr. Greg Hundley: Very nice Carolyn. Well, my next paper is also from the world of basic science, and it comes from Dr. Joseph Hill. Have we ever heard of him? Well of course, he's our Editor in Chief. He's going to discuss, he and his team investigated Polycycstin-1. Well, what is Polycycstin-1? It's a trans membrane protein, originally identified in autosomal dominant polycystic kidney disease, where it regulates the calcium permeate cation channel polycystin-2. So autosomal dominant, polycystic kidney disease patients develop renal failure, hypertension, left ventricular hypertrophy, atrial fibrillation and other cardiovascular disorders. These individuals harbor PC1 loss of function mutations in their cardiomyocytes, but the functional consequences of this are relatively unknown. Dr. Greg Hundley: Now PC1 is ubiquitously expressed in its experimental ablation in cardiomyocyte specific knockout mice reduces contractile function, and in this paper the authors set out to determine the pathophysiologic role of PC1 in these cardiomyocytes. Dr. Carolyn Lam: Huh--very interesting. I liked the way you laid that out. So what did they find? Dr. Greg Hundley: What the investigators identified is that PC1 ablation reduced action potential duration in cardiomyocytes. They decreased calcium transients and therefore myocyte contractility. PC1 deficient cardiomyocytes manifested a reduction in sarcoplasmic reticulum calcium stores due to reduced action potential duration and circa activity, an increase in outward potassium currents decreased action potential durations in cardiomyocytes lacking PC1. PC1 coimmunoprecipitated with a potassium 4.3 channel and modeled PC1 C terminal structure suggested the existence of two docking sites for PC1 within the end terminus of K4.3. Supporting a physical interaction between the cells. Finally, a naturally occurring human mutant PC1 manifested no suppressive effects on this potassium channel activity. Thus, Carolyn, Dr Hill and colleagues' results help uncover a role for PC1 in regulating multiple potassium channels, governing membrane repolarization and alterations in circa that reduce cardiomyocyte contractility. Dr. Carolyn Lam: Oh wow. What a bonanza of really interesting papers in this week. Now my next pick is a secondary analysis of the reveal trial. It hinges on the hypothesis that was generated from prior trials that the clinical response to cholesterol ester transfer protein or CETP inhibitor therapy may differ by ADCY9 genotype. So in the current study, authors Dr. Hopewell and colleagues from Nuffield Department of Population Health, University of Oxford examine the impact of ADCY9 genotype on the response to the CETP inhibitor Anacetrapib within the reveal trial. Dr. Greg Hundley: Tell me, I've forgotten a little bit, but can you remind me a little about what was the reveal trial? Dr. Carolyn Lam: Yes, of course. So the randomized placebo controlled reveal trial actually demonstrated the clinical efficacy of the CETP inhibitor Anacetrapib among more than 30,000 patients with preexisting atherosclerotic vascular disease. Now, in the current study, among more than 19,000 genotyped individuals with European ancestry, 13% had a first major vascular event during four years median follow up. The proportional reductions in the risk of major vascular events did not differ significantly by ADCY9 genotype. Furthermore, the authors showed that there were no associations between the ADCY9 genotype and the proportional reductions in the separate components of major vascular events, or any meaningful differences in lipid response to Anacetrapib. Dr. Carolyn Lam: So in conclusion, the reveal trial being the single largest study to date to evaluate the ADCY9 pharmacogenetic interaction provided no support for the hypothesis that ADCY9 genotype is materially relevant to the clinical effects of the CETP inhibitor Anacetrapib. The ongoing dal-GenE study, however, will provide direct evidence as to whether there's any specific pharmacogenetic interaction with dalcetrapib. Dr. Greg Hundley: Oh, very good. So we've got some results coming from dal-GenE. Dr. Carolyn Lam: Mm. Dr. Greg Hundley: Well, Carolyn, my last selection relates to a paper regarding the incidence of atrial fibrillation among those that exercise, and I mean really exercise. Dr. Carolyn Lam: Ooh. Dr. Greg Hundley: So the paper comes from Dr Nicholas Svedberg from Uppsala University, and studies have revealed a higher incidence of atrial fibrillation among well trained athletes. The authors in this study aim to investigate associations of endurance training with the incidents of atrial fibrillation and stroke, and to establish potential sex differences of such associations in this cohort of endurance trained athletes. They studied all Swedish skiers, so 208,654 that completed one or more races of the 30 to 90 kilometer cross country skiing event called the Vasaloppet from 1989 through 2011, and they had a matched sample of 527,448 non-skiers, and all of the individuals were followed until their first event of either atrial fibrillation or stroke. Dr. Carolyn Lam: Wow. What an interesting and what a big study. So tell us, what are the results and especially were there any sex differences? Dr. Greg Hundley: Well, interesting that you ask about those sex and gender differences. So female skiers had a lower incidence of atrial fibrillation than female non-skiers, independent of their finishing time and the number of races, whereas male skiers had a similar incidence to that of non-skiers. Second, skiers with the highest number of races or fastest finishing times had the highest incidents of the AFib, but skiers of either sex had a lower incidence of stroke than non-skiers independent of the number of races and finishing time. Third, skiers with atrial fibrillation had a higher incidence of stroke than skiers and non-skiers without atrial fibrillation. That's true for both men and women. We would think that. Finally after one had been diagnosed with atrial fibrillation, skiers with atrial fibrillation had a lower incidence of stroke and a lower mortality compared to non-skiers with atrial fibrillation. Dr. Carolyn Lam: Very interesting. Could you sum it up for us? What's the take home? Dr. Greg Hundley: Couple things. One, female endurance athletes appear to be less susceptible to atrial fibrillation than male endurance athletes. Second, both male and female endurance athletes have a lower risk of stroke independent of their fitness level. Third, after the diagnosis of atrial fibrillation, participants in a long distance skiing event with atrial fibrillation had a 27% lower risk of stroke and a 43% lower risk of dying compared to individuals from the general population with the diagnosis of atrial fibrillation. Dr. Greg Hundley: So there's some clinical implications. Although very well trained men have a higher incidence of atrial fibrillation than less trained men, the incidence is on par with that of the general population and not related to a higher incidence of stroke at that group level. This indicates that exercise has very beneficial effects on other risk factors for stroke. Then lastly, atrial fibrillation in well trained individuals should be treated according to our other usual guidelines for the population at whole. Dr. Carolyn Lam: Wow. What a fantastic study to end our little coffee chat on, but it's time to move on to our feature discussion. Dr. Carolyn Lam: Today's feature discussion touches on super-hot topics. First of all, the perennially interesting and hot topic of the prediction of acute myocardial infarction, or should I say the more precise predictions that we can do these days. The second part of the hot topic is machine learning. Oh my goodness. This is creeping into cardiovascular medicine like never before. So I'm so glad to welcome to this discussion corresponding author of the featured paper Professor Nicholas Mills from the University of Edinburgh, as well as our Associate Editor Doctor Deborah Diercks from UT Southwestern. So welcome both, and Nick, if I could start with you, tell us about MI Cubed. Prof Nicholas Mills: First thing to say, it was a major international collaboration, involved researchers from over nine different countries and we got together to develop and test an innovative algorithm that estimates for individual patients the probability when they attend the emergency department with acute chest pain that they may or may not have had a myocardial infarction. Prof Nicholas Mills: Machine learning is a really new area in cardiovascular medicine as you say. Our algorithm called MI Cubed uses a fairly simple algorithm which is a decision tree. It takes into consideration really important patient factors such as age, sex, troponin concentration at presentation, and troponin concentration on subsequent testing, and the change in troponin in between those two tests in order to estimate or calculate the probability of the diagnosis. One of the really interesting aspects of this is it's not just an algorithm for research, it's a clinical decision support tool as well. So what we've done is taken the output from that algorithm and translated it into something that is meaningful for clinicians. We've kept it quite simple. It gives an output between zero and a hundred, which is directly proportional to the likelihood of the patient having a myocardial infarct. We also provide estimated diagnostic metrics. So sensitivities and specificities that relate to that individual patient. It's really going to change the way we think about the interpretation of cardiac troponin in clinical practice. Dr. Carolyn Lam: Indeed, and first audience please, please look up the beautiful figures of this paper. I think it summarizes it all. The algorithm shows you what MI Cubed is and then compares it to the ESC three hour algorithm, one hour algorithm. Then I love the last figure, where you actually show us that very important component that you just said. As a clinical support tool, how it's going to work. So we actually have pictures of your cell phone and showing you the pictures that you're going to get from it. So super cool. Beautiful paper. Dr. Carolyn Lam: Now I just have so much to talk about, first the machine learning bit, always sexy sounding, but a bit scary for clinicians. So I really like the fact that you broke it down to actually say what components go in so that people aren't afraid of this black box. We don't know what's going on. Is there like a set time between samples, or how does this work? Do you need to have it within a certain timing? How does that fall in? Is it a particular type of troponin, what are some of the specs of the model that a practicing clinician needs to know? Prof Nicholas Mills: Well, in order to answer that question, I might explain to you the rationale for developing it. So when you're assessing a patient in the emergency department, we all recognize in our daily practice that patients differ. So interpreting troponin has been challenging. One threshold for all may not be the right way to approach this really important clinical diagnosis. Troponin concentrations differ in men and women. They differ by age, and as a surrogate of the presence of comorbidities. They differ depending on the timing of when you take that sample and when you repeat that measurement, and that has introduced some complexity. So many interesting pathways have been developed for guidelines which try and apply fixed thresholds and fixed time points, and it's pretty tough to deliver in the real world setting of a super busy emergency department. So the premise for developing this algorithm was we wanted something that was really flexible, that recognized that patients are different, they're not all the same. Prof Nicholas Mills: That's why we went for a machine learned approach rather than a more conventional statistical model. So you asked about the specification. You can do your two troponin tests whenever you like. So I had across the 11,000 patients huge variation in the timing of samples, but that is okay for MI Cubed. If you repeat the test within an hour, two hours, three hours, six hours, it still provides the same diagnostic performance. I think that's really important. Prof Nicholas Mills: You also mentioned specification about the assay. This algorithm has been developed using a particular high sensitivity cardiac troponin assay developed by Abbott Diagnostics. It will be effective for other high sensitive troponin assays, but it's unlikely to be as effective using a contemporary assay. So if your hospital uses a contemporary or conventional cardiac troponin assay, this might not be the right algorithm for you. Dr. Carolyn Lam: Great. Thank you for breaking down the issue so beautifully and practically. It really makes me think, oh my goodness, this paper's just far more than about MI. Because you know, natriuretic peptides, you could say the same thing. A prediction of heart failure is the same thing, you know? So the whole approach is novel. Deb, could you please share your thoughts and perspectives on where this is going perhaps? Dr. Deborah Diercks: I think this study is terrific because I think it does, as Dr. Mills stated, reflect reality. We don't draw measures at zero, exactly at zero, and exactly at one and exactly at three, especially in a busy emergency department. So I think it provides flexibility to the physician and provider in using it to be able to interpret values in a world that doesn't fit complete structure like the guidelines are written out. What I find really interesting about this study, and I'd love to hear more about, is how you decided the thresholds of where low risk and high risk were cut at. It mentions by consensus, and I guess I would have loved to have been a fly on the wall to hear how those discussions went, and would love to hear more from you Dr. Mills about that. Prof Nicholas Mills: Fascinating discussions amongst all the investigators on this project as to how we would define that. The first point I would make though is we designed the algorithm to provide a continuous output, a continuous measure of risk. So your MI Cubed score is between zero and a hundred. You don't have to apply a threshold, but we are used to in clinical practice having processes that support our triage of patients, and identifying people as low risk and high risk. Therefore we felt upfront that we should evaluate specific low risk and high risk thresholds. Prof Nicholas Mills: So low-risk, we were completely unanimous on how to define that, and it was based on some really nice work done by emergency physicians in New Zealand. Martin Fan, who's the first author on this paper, surveyed many emergency physicians and asked about their acceptance of risk. They came up with the concept that an algorithm to be considered safe in emergency medicine would be acceptable if the sensitivity was greater than 99% or the negative predictive value was greater than 99.5%. Prof Nicholas Mills: So we agreed up front that we would hold our low risk thresholds to those bars. Those metrics. Where there was less agreement was how you defined high risk. That didn't surprise me hugely. The positive predictive value of troponin is one of the most controversial topics around. Most cardiologists [crosstalk 00:20:52] of troponin has been difficult for them in clinical practice because with the improvements in sensitivity we are seeing lower specificity and lower causative link to value. If I put it into context, just measuring troponin and using the 99 percentile in consecutive patients gives you a positive predictive value of around about 45 to 50% in most healthcare systems for the diagnosis of type one myocardial infarction. Therein lies the problem. So one in every two patients has an abnormal troponin result but doesn't have the condition that we have evidence based treatments for, and whom cardiologists who are often quite simplistic in their approach to the assessment of these patients know how to manage. Prof Nicholas Mills: Every second patient we don't know how to manage, and therefore we wanted an algorithm that would help us identify those patients who can go through our often guideline-based pathways and treatment pathways for acute coronary syndromes more effectively. We eventually agreed that a positive predictive value of 75% would be ideal. So three out of every four patients would have the diagnosis that we knew how to manage and treat. That was our target. We got pretty close to it in our test set. I think the actual positive predictive value at the threshold of around an MI Cubed value of 50 was 72%, so pretty effective. Certainly a lot better than relying on a kind of binary threshold such as the 99 percentile to identify high risk patients. Dr. Deborah Diercks.: Thanks for that great answer. My next question is how do you think MI Cubed is going to integrate, or will it even replace the need for other risk stratification tools that we often use the emergency departments such as TIMI or the heart score? Prof Nicholas Mills: Fabulous question. In this analysis, we haven't specifically compared the performance of MI Cubed with TIMI or heart, so my answer is going to be a little speculative. You can forgive me hopefully. Both those scores were developed prior to the widespread use of high sensitive cardiac troponin tests. I think what we've learned since the introduction of high sensitive cardiac troponin is that we're using this test as a risk stratification tool, and a lot of the power of the MI Cubed algorithm comes from the way that it identifies extremely low risk patients with very low and unchanging cardiac troponin concentrations way below the diagnostic threshold. Prof Nicholas Mills: TIMI and heart simply consider troponin as a binary test, a positive or negative test, and do not take advantage of the real power of the test to restratify patients. All the evidence to date that has compared TIMI and heart with pathways that use high sensitive troponin in this way, both to restratify and diagnose patients show that these risk tools add very little in terms of safety, but do make pathways more conservative. So they identify fewer patients that are lower risk and permit discharge of those patients. Prof Nicholas Mills: So my concern about using an algorithm like MI Cubed with an existing tool like heart is that it will undermine much of the effectiveness of this tool which identifies around about two thirds of patients as low risk. If you were to combine that with a heart score, you would reduce the effectiveness. I don't think you get a gain in performance, but further research is required to do a head to head comparison with these sorts of traditional restratification tools. Dr. Carolyn Lam: I'm so grateful for this discussion, both Nick and Deb. In fact, I was about to ask what are the next steps and I think Nick you just articulated it. Deb, I want to leave the final words to you. Do you have anything else to add? Dr. Deborah Diercks: I think this study represents a real change in how we can practice medicine, where we can actually take our biomarkers that actually have really strong value and utilize them in a manner that is pragmatic. It can actually introduce and take full advantage of them, and so I think this is a great opportunity for us to rethink our usual approach, which frankly, especially for troponin has really been very binary and very static. Thank you so much Dr Mills for the innovation and the willingness to look into this area. Dr. Carolyn Lam: Thank you so much. This paper is like a sneak peak into the future of what we'll be practicing medicine like. Well, audience, you heard it right here on Circulation on the Run. Don't forget to tune in again next week. This program is copyright American Heart Association 2019.
I sat down (in person!) with Grace Ji-Sun Kim and Graham Joseph Hill to talk about their new book, Healing Our Broken Humanity: Practices for Revitalising the Church and Renewing the World. We talk about the process of co-authoring, why they focused on practices, justice, lament, race, beauty, hospitality, and how writing the book has shaped their experience with The Sermon on the Mount.Grace Ji-Sun Kim received her M.Div. from Knox College (University of Toronto) and her Ph.D. from the University of Toronto. She is an Associate Professor of Theology at Earlham School of Religion. She is the author or editor of 16 books, Intersectional Theology: An Introductory Guide (Fortress Press) cowritten with Dr. Susan Shaw; Healing Our Broken Humanity, co-written with Graham Hill, The Homebrewed Christianity Guide to the Holy Spirit, Mother Daughter Speak, co-written with Elisabeth Sophia Lee; Planetary Solidarity (Fortress Press) co-edited with Hilda Koster; Intercultural Ministry co-edited with Jann Aldredge-Clanton (Judson Press); Making Peace with the Earth (WCC); Embracing the Other (Eerdmans); Here I Am(Judson Press); Christian Doctrines for Global Gender Justice (Palgrave) co-edited with Jenny Daggers; Theological Reflections on “Gangnam Style” (Palgrave Macmillan) co-written with Joseph Cheah; Contemplations from the Heart (Wipf & Stock); Reimagining with Christian Doctrines co-edited with Jenny Daggers (Palgrave Macmillan); Colonialism, Han and the Transformative Power (Palgrave Macmillan); The Holy Spirit, Chi and the Other (Palgrave Macmillan); and The Grace of Sophia (Pilgrim Press). Follow Grace on Twitter: @GracejisunkimGraham Joseph Hill (PhD, Flinders University) is Research Coordinator at Stirling Theological College (University of Divinity) in Melbourne, Australia. Graham has planted and pastored churches, and been in theological education for twenty years. He is the author or editor of 6 books (with 5 more coming in 2019) including Global Church (IVP, 2016), Healing Our Broken Humanity, (IVP, 2018), and Salt, Light and a City (Cascade, 2017). Graham also directs The Global Church Project. Follow Graham on Twitter: @GrahamJGHillBuy the Book Follow the Show: @RinseRepeatPod // Follow me: @liammiller87Music by Fyzex
Erin Martine Sessions interviews Grace Ji-Sun Kim and Graham Joseph Hill on their book "Healing Our Broken Humanity." The Global Church Project podcast episode #144. On https://www.theglobalchurchproject.comHealing Our Broken Humanity is about things disciples can do together and in their neighborhoods to bring change, hope, love, and healing. We offer 9 ways to transform society, from lament and repentance to seeking justice, being reconcilers, and more. Doing these things enables God's people to make a difference and see justice restored. Jesus calls us to be a peacemaking and reconciling people.Here's what's in the book:Foreword by Willie James JenningsIntroduction: Nine Practices That Heal Our Broken Humanity1. Reimagine Church2. Renew Lament3. Repent Together4. Relinquish Power5. Restore Justice6. Reactivate Hospitality7. Reinforce Agency8. Reconcile Relationships9. Recover Life TogetherEpilogue: A Benediction and PrayerAppendix One: Questions for Small Group Discussion and EngagementAppendix Two: The Nine Transforming Practices Accountability FormAppendix Three: Resources for Healing Our Broken HumanityTo help churches do these things, our book includes small group activities, discussion questions, and exercises in each chapter. Our hope is that Christians would do these 9 practices together in community, and also in their cities and neighborhoods.Discover here how to bring real change to a dehumanized world: https://amzn.to/2NqFScy Motion Graphic Title by Jack Galbraith, Digital Media Specialist at InterVarsity Press
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen's University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen’s University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen’s University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen’s University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen’s University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen’s University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Joseph Hill's new book Wrapping Authority: Women Islamic Leaders in a Sufi Movement in Dakar, Senegal (University of Toronto Press, 2018), is an ethnographic study of women Sufi leaders in the Taalibe Baay or Fayda branch of the Tijaniyya. Hill provides life stories of various fascinating and powerful female muqaddamas (or Sufi leaders) in Dakar and explores how they navigate the complexity of their gendered authority in religious, familial, and public domains. The book examines the ambiguity of female religious leadership and its manifestation through piety and performance, be it through cooking, motherhood, and/or the use of a female voice. Hill frames these pious actions through the semiotic acts of “wrapping” (as opposed to “veiling”), as it provides a more expansive analytical framework for his project. The book will be of interest to those who work on gender and women in Islam, as well as those who engage contemporary Sufism, West African Islam, and anthropology of Islam. Shobhana Xavier is an Assistant Professor of Religion at Queen’s University. Her research areas are on contemporary Sufism in North America and South Asia. She is the author of Sacred Spaces and Transnational Networks in American Sufism (Bloombsury Press, 2018) and a co-author of Contemporary Sufism: Piety, Politics, and Popular Culture (Routledge, 2017). More details about her research and scholarship may be found here and here. She may be reached at shobhana.xavier@queensu.ca Learn more about your ad choices. Visit megaphone.fm/adchoices
Crucial Reggae Time #72 02062019 Radio Canut Selecta Zayann'ay et Reprezi Tracklist : Eric Donaldson - Cherry oh baby ???? ??? Carl Malcom - No jestering Big Youth - Knotty No Jester Big Youth - Natty dread she want ? Culture - Jah rastafari Mighty Diamonds - Have mercy DJ version U Roy - Have mercy Tony Tuff - Operator mix me down Leroy Sibbles - Rock and come on Michael Prophet - Boom him up now Frankie Paul - Dancehall style Frankie Paul - Give thanx and praises Frankie Paul - Strictly reggae music Joseph Hill & Culture - Policeman – ??? Freddie McGregor - I was born a winner Montez Holy Mount Zion Reprezi : Chimin la vie Pardonne-moi Fire a go bun Black and proud
Jane Ferguson: Hi everybody. Welcome to Episode 25. I'm Jane Ferguson. This is Getting Personal: Omics of the Heart, the podcast from Circulation: Genomic and Precision Medicine, and it is February 2019. Let's get started. The first paper this issue is a concurrent publication and comes to us from 29 different editors-in-chief of 27 major cardiovascular journals, led by Joseph Hill, editor-in-chief of Circulation. This editorial, entitled Medical Misinformation: Vet the Message! gives a pointed reminder of the real life risks of misinformation that spreads rapidly through social media and influences people who are making crucial decisions about healthcare for themselves and their families. Quoting directly from the paper they say, "We, the editors-in-chief of the major cardiovascular scientific journals around the globe, sound the alarm that human lives are at stake. People who decline to use a statin when recommended by their doctor, or parents who withhold vaccines from their children, put lives in harm’s way." In this editorial they call on those in the media to do a better job of taking responsibility for the information they disseminate. In particular, in evaluating content before disseminating it, and avoiding false equivalencies where overwhelming scientific evidence favors one side of the so called "debate." I'll add to that that those of us who are medical or scientific professionals need to do our best to take the time to explain our science to those around us. The science underlying most of medicine is complex and hard to explain and sometimes incomplete, but we do a disservice to people if we don't at least try. Let's all join the editors in calling everyone to vet information and hold those with power in the media accountable for the spread of misinformation they enable. Next up this issue, a paper from Jody Ingles, Birgit Funke, and co-authors from the University of Sydney, Harvard Medical School and others, entitled Evaluating the Clinical Validity of Hypertrophic Cardiomyopathy Genes. As panels for clinical genetic testing expands to include more genes, there are more and more variants that are detected and reported to patients, but do not necessarily have underlying evidence to support or disprove pathogenicity. This group aimed to systematically assess the validity of potential gene disease associations with hypertrophic cardiomyopathy and left ventricular hypertrophy by curating variants based on multiple lines of genetic and experimental evidence. They categorized genes based on the strength of evidence of disease causation and reviewed HCM variant classification in the ClinVar variant and phenotype repository. They selected 57 genes to study based on those which were frequently included on test panels or had previous reports of association with HCM. Of HCM genes, only 24% were characterized as having definitive evidence for disease causation, 10% of the genes had moderate evidence, while 66% had limited or no evidence for disease causation. Of syndromic genes, 50% were definitively associated with left ventricular hypertrophy. Of over 4,000 HCM variants in ClinVar, 31% were in genes that, on review, had limited or no evidence for association with disease. What this study shows is that many genes that are included on panels for diagnostic testing for HCM actually have little evidence for any relationship to disease. Systematic curation is required to improve the accuracy of information being acquired and reported to patients and families with HCM. Moving on to the next paper. This manuscript describes the international Triadin Knockout Syndrome Registry: The Clinical Phenotype and Treatment Outcomes of Patients with Triadin Knockout Syndrome. It comes from Daniel Clemens, Michael Ackerman and colleagues from the Mayo Clinic. So, Triadin Knockout Syndrome is a rare inherited arrhythmia syndrome and it is caused by recessive null mutations in the cardiac triadin gene. To improve the ability to study this rare syndrome, this group established the International Triadin Knockout Syndrome Registry, with the goal of including patients across the world with homozygous or compound heterozygous triadin null mutations. The registry currently includes 21 patients from 16 families who have been carefully phenotyped and many of whom exhibit T wave inversions and have transient QTC prolongation. The average age for first presentation with cardiac arrest or syncope was three years of age. Despite a variety of treatments, the majority still have recurrent breakthrough cardiac events. These data highlight the importance of conducting testing for triadin mutations in patients, particularly young children presenting with cardiac arrest, and as this registry grows it will enable a better understanding of the disease and hopefully pave the way for future triadin gene therapy trials. The next paper comes from Daiane Hemerich, Folkert Asselbergs and colleagues from Utrecht University, and is entitled Integrative Functional Annotation of 52 Genetic Loci Influencing Myocardial Mass Identifies Candidate Regulatory Variants and Target Genes. They were interested in whether variants that have been associated with myocardial mass may exert their influence through regulatory elements. They analyze the hearts of hypertrophic cardiomyopathy patients and non-disease controls and ran ChIP-seq in 14 patients and 4 controls and RNA-seq in 11 patients and 11 controls. They selected 52 loci that have been associated with electric cardiogram defined abnormalities in amplitude and duration of the QRS complex and looked specifically at these gene regions. They found differential expression of over 2,700 different genes between HCM and control. They further found differential acetylation over 7,000 regions. They identified over 1000 super enhancers that were unique to the HCM samples. They found significant enrichment for differential regulation between disease and control hearts within the loci previously associated with HCM, compared with loci not associated with HCM. They analyzed regions where putative causal SNPs overlapped regulatory regions, and identified 74 co-localized variants within 20 loci, with particular enrichment for SNPs in differentially expressed promoters. They confirmed associations with 18 previously implicated genes, as well as identifying 14 new genes. Overall, what this study demonstrates is that by looking at regulatory features that differ in affected tissues between disease and healthy individuals, we can learn more about the underlying mechanisms of disease. Moving on, we have a paper entitled Interleukin-6 Receptor Signalling and Abdominal Aortic Aneurysm Growth Rates from Ellie Paige, Marc Clément, Daniel Freitag, Dirk Paul, Ziad Mallatt and colleagues from the University of Cambridge. They aimed to investigate a specific SNP in the Interleukin-6 receptor rs2228145, which has been associated with abdominal aortic aneurysms. Inflammation is thought to be a contributor to aneurism progression. The authors hypothesized that the IL-6 receptor's SNP may affect aneurysm growth. They use data from over 2,800 subjects from nine different prospective cohorts and examine the effect of genotype on annual change in aneurysm diameter. Although there was a significant association between genotype and baseline aneurysm size, there was no statistically significant association with growth over time. It appeared that growth was less in minor allele carriers, but the effect if true, was small and the analyses were not powered for small effect sizes. Sample sizes are limited for cohorts with abdominal aortic aneurysms and the authors already used all available worldwide data. In complimentary experiments in mice, they examined the effect of blocking the IL-6 receptor pathway. They found that selective blockage of the IL-6 trans-signaling pathway mediated by soluble IL-6 receptor was associated with improved survival in two different mouse models. However, blocking the classical membrane-bound IL-6 signaling pathway in addition to the trans-signaling pathway did not lead to improved survival. Although the severe lack of enough subjects for well powered genetic analyses is a major limitation for the study of abdominal aortic aneurism and humans, this paper demonstrates the potential relevance of the IL-6 trans-signaling pathway and aneurysm growth, and suggests that further interrogation of this pathway may be informative in figuring out new ways to prevent aneurysm progression and rupture. Next, we have the first of two research letters this issue. The letter on Common Genetic Variation in Relation to Brachial Vascular Dimensions and Flow-Mediated Vasodilation comes to us from Marcus Dorr, Renate Schnabel and co-authors from several institutions including University Heart Center in Hamburg. They were interested in gaining a better understanding of the genetics underlying vascular function. They ran a meta-analysis of brachial artery diameter, maximum brachial artery diameter adjusted for baseline diameter, and flow-mediated dilation in over 17,000 individuals of European ancestry from six different GWA studies. They sought to replicate findings in over 9,500 newly genotyped individuals. They identified two novel SNPs for baseline brachial artery diameter, but no SNPs reached significance or replication from maximum brachial artery diameter or flow-mediated dilation. One of the significant SNPs was located in the insulin-like growth factor binding protein 3, or IGFBP-3 gene. They analyzed plasma IGFBP-3 protein levels in 1,400 individuals and found a significant association with brachial artery diameter. The second SNP they identified is located within the AS3MT gene for arsenite methyltransferase, and this SNP appears to be an eQTL for AS3MT expression in monocytes and arterial tissue. Along with identifying these two genes with potential involvement in baseline brachial artery diameter, this study also supports a low genetic component to flow-mediated dilation, indicating that environmental factors may be or more influential in FMD. The final research letter comes from Alexis Williams, Craig Lee and colleagues from the University of North Carolina and is entitled CYP2C19 Genotype-Guided Antiplatelet Therapy and 30-Day Outcomes After Percutaneous Coronary Intervention. It is known that loss of function variants in CYP2C19 effect bioactivation of clopidogrel, and CYP2C19 genotyping is increasingly used to guide antiplatelet therapies. The authors were interested in whether genotype-guided therapy is effective in reducing major adverse cardiovascular events in the short term, specifically in the 30 days following percutaneous coronary intervention, when most MACE occurs. They followed over a thousand individuals undergoing PCI and CYP2C19 testing and looked at atherothrombotic and bleeding outcomes. Consistent with implementation of genotype-guided therapy, individuals carrying loss of function alleles were less likely to be prescribed clopidogrel. However, out of loss of function carriers, those who did take clopidogrel had significantly higher risk of MACE with no difference in bleeding risk. There was no difference by therapy in individuals without a loss of function allele. What this study shows us is that even in the 30 days following PCI, genotype-guided therapy can be effective in protecting individuals carrying loss of function CYP2C19 variants. And that's it from us for February. Go online to ahajournals.org/journal/circgen to read the full papers, access videos and more, and of course to delve into the podcast archives. Thank you for listening and I look forward to bringing you more next month. This podcast was brought to you by Circulation: Genomic and Precision Medicine and the American Heart Association Council on Genomic and Precision Medicine. This program is copyright American Heart Association 2019.
Dr Joseph Hill: My name is Joe Hill. I'm the Editor-in-Chief of Circulation and I'm very pleased today to be here today with Professor Daida from Juntendo University in Tokyo, Japan, as well as one of our associate editors, Professor Shinya Goto from Tokai University in Kanagawa, Japan. Dr. Daida is one of the senior authors on a very exciting clinical trial that we're publishing in Circulation. The first and largest trial comparing high-dose versus low-dose statins in Asia. Dr. Daida, would you please tell us more about the study? Dr Hiroyuki Daida: Yes. Thank you. The trial, called REAL-CAD, is a randomized trial. We compare high-dose statins with low-dose statins in Japanese patients with stable coronary artery disease. The number of the patients is 13,000. It's the largest trial ever comparing high-dose and low-dose statins. We found that with that reduction of the primary end point, which is a composite end point, including cardiovascular death, non-fatal MI, non-fatal stroke, and unstable angina requiring hospitalization. That is very exciting result because it is the largest trial ever and also the very first trial in Asia. Professor Shinya Goto: Congratulations, Professor Daida, for that great achievement, in the REAL-CAD trial. Could you explain a little bit about the background and that the dose of statins in Japan is generally low, and what was the reason why we kept using low-dose statins, and is care to try change the standard of care in Japan and also East Asia? Could you give a comment on those two topics? Dr Hiroyuki Daida: Our trial is quite similar to that of PNP trial of comparing Western extensive statin treatment and the Asia statin treatment. However, that extensive statin treatment, intensive statin treatment, is not popular in Asia, so we did that maximum clinical dose of statin, we use this dose in Japan. It is the maximum dose of statin approved in Japan. Dr Joseph Hill: So as I understand it, the rationale was the thinking that Asians, East Asians, are unable to tolerate high-dose statin therapy. In this case you used pitavastatin. And, in fact, what you found was there were no increase in serious adversive events in high dose patients. And, just like Caucasians, they derived considerable benefit at multiple points in atherosclerotic cardiovascular disease metrics. Dr Hiroyuki Daida: Actually, they didn't experience a really high-dose of statin in Japan so government approval is up to 4 mg of pitavastatin, a dose of that about 20. Dr Joseph Hill: So, this is not what we would call high-intensity statin therapy but nonetheless, there was a dramatic benefit including an all-cause mortality, irrespective of the starting LDL level at the beginning of the trial? Dr Hiroyuki Daida: That is right. We found that the effect is similar that the patient, the LDL is greater than 95 or less than 95. So, the effect is independent of the basal based on LDL level. Professor Shinya Goto: The one thing, very exciting just like Joe mentioned, all cause of mortality, especially known cardiovascular caused mortality reduced with the use of high-intensive care of the statin. If any kind of speculation, what is the cause, reduce the inflammation or maybe reduce cancer, something like that. They have any kind of advance to an analysis? Dr Hiroyuki Daida: We didn't have further analysis but we are not so keen to emphasis the total mortality because maybe that is a chance of the effect but this is the largest trial, so the result is really exciting in this kind of aspect. Dr Joseph Hill: So, I would reiterate Shinya's congratulations. This is a monumental piece of work. The largest clinical trial comparing high dose versus low dose statin. The largest ever. The first in Asia. You found a benefit that makes total sense across what we know from other trials and this will change practice. Your work, I believe, will change the way patients with atherosclerotic cardiovascular disease is handled in Japan. Dr Hiroyuki Daida: Yes, actually the current guideline in Japan for the secondary condition. The condition is LDL less than 100 and for the really high-risk secondary condition listed seventh. We didn't recommend high-dose statin initially, so, this trial result is kind of like this, changing. Dr Joseph Hill: I can't resist asking, what comes next? What's your next project? Dr Hiroyuki Daida: Maybe we need to have a further reduction of LDL. We have another drug, other potent drug recently. We need to investigate all of the new drug such as PCSK9 inhibitor in secondary prevention. Professor Shinya Goto: That's wonderful. Do you have any time to extend observation of the trial? I think the trial is relatively still superior as compared to the global long-standing trial. Really, that's fine, that effect of statin on the cholesterol and even it's different from Japan and other regions of the world. There ought to be intriguing thing, I would like to know, what are you waiting to extend that observation now? Dr Hiroyuki Daida: Fortunately, we do not intend to extend the follow-up. The whole thing is about four years but we do not plan to extend. We will further analyze the data for some group and our kind of CRP and effect of the baseline. Dr Joseph Hill: Lots of secondary analysis underway, undoubtedly. Let me thank both of you for being here, Professor Daida and Professor Goto, I congratulate you again. It's not often that you make a practice-changing intervention in modern-day medicine. I salute you and we are honored and thrilled to publish your outstanding work in Circulation. Thank you both. Dr Hiroyuki Daida: Thank you very much. Professor Shinya Goto: Thank you very much.
Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and it's editors. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Centre and Duke National University of Singapore. This week's issue is the Go Red for Women issue, my favorite discussions of the year happened during this podcast. Today, I am so delighted to have with me, our Editor-in-Chief himself, Dr. Joe Hill, from UT Southwestern, as well as, of course, the editor that made this issue possible, Dr. Sharon Reimold, also from UT Southwestern. Joe, would you like to tell us a little bit about this year's Go Red issue? From the birds eye view. Dr. Joseph Hill: Well Carolyn, I share your enthusiasm. This is our second annual Go Red for Women issue and it is fantastic. It has generated great interest in the community. We had a number of papers coming in, unsolicited. Our frame of reference-type content. Original research articles. State of the art. We clearly touched a nerve with this issue. As we will discuss further, we shine a bright light here on some of the very best science, focusing on sex-based differences in the biology of heart disease, the presentation of heart disease, how women function, and are treated in the academic environment. The ways in which they are impacted by psychological stress. It's an absolute bonanza of science, in this issue. Dr. Carolyn Lam: You took the words out of my mouth. It is a bonanza issue. I mean, we had seven original articles. Lots of new stuff, but lots of good, important papers on plain old ischemic heart disease. What I really liked was that, three of these original papers focused on myocardial infractions, in the young, and their risk factors, prevention, and so on. Sharon, shall we go through those? I mean, there was the one on genetics, lifestyle, and LDL in young women. Dr. Sharon Reimold: That would be great. That manuscript looked at, sort of, a distribution of lipids, in women, that would have otherwise expect to be healthy. They sorted them out by individuals that had extremely low LDL levels and those that had high LDL levels. They pointed out that the individuals with high LDL levels. Ended up having hypercholesterolemia heritable, but they also found genetic variance of related to those with low LDL levels. I think this manuscript points out the importance of screening younger women for lipid disorders and incorporating those data into their clinical management. Dr. Carolyn Lam: Absolutely. Then, there was that paper that, again, talked about young women experiencing myocardial infarction, and the sex differences in their presentation, and perception. That was super cool. From the Virgo trial. Dr. Sharon Reimold: There are several other papers, that are published, demonstrating that women tend to have multiple symptoms when they present with symptoms of ischemia. That's true for both myocardial infarction, as well as for other unstable syndromes. They certainly have more symptoms than men. But what was very interesting about this particular paper, is that when women presented with multiple symptoms, providers were less likely to think that the symptoms were due to a cardiac etiology. So even when women are trying to tell their providers what is going on, sometimes, they're not taken seriously, because they have multiple symptoms. So I'm hoping that this resonates with our providers, clinical providers, and we think about this. Whether we're cardiologist, or emergency room providers, or even EMTs. Dr. Carolyn Lam: Exactly. Then, the third original paper in these young women, kind of scary, mental stress induced myocardial ischemia. Dr. Sharon Reimold: Right. So there's been a lot of interest in the myocardial infarction without obstructive coronary disease, in the last year or two. Because a lot of those individuals, even thought, they don't have typical atherosclerotic pathologies, they don't have good outcomes. So this article looks at the role that mental stress plays in inducing ischemia, by EKG, in these individuals. I think we still need to understand more about how this contributes to the biology, and outcomes, in these individuals. Also, get a better understanding if this is also true in older women, who have ischemic heart disease. Dr. Carolyn Lam: Exactly. You know, but speaking of the older women, it's not like the issue left out the older women this time either. I did think that the study on the metabolic predictors of incident ischemic events, in postmenopausal women, was really interesting, as well. Basically, the authors identified a cluster of novel metabolites, that were related to oxidative stress, that added to. you know? They weren't correlated with the traditional biomarkers. Really suggesting that there may be a whole area of metabolites, and other biomarkers, that we may be needing to check, and to understand better, for risk prediction. At least, in older women. But, of course, in men as well. Then, finally, there was the data on sex differences from the STICH trial, on surgical revascularization. What did you think of that one? Dr. Sharon Reimold: Well, I thought that this was a very important addition to the cardiology literature. Because we are accustomed to thinking of women as having poor outcomes, after they have cabbage revascularization surgery. Certainly, the STICH trial enrolled patients who were more sick than the average patient, with their underline LV dysfunction. They found that sex did not influence the outcomes in this trial. So the importance of that, for the medical community, is obviously we should not consider sex as a barrier to sending women to surgery, even if they're at high risk, because they can have equally good outcomes. Dr. Carolyn Lam: Exactly. Important message. Important paper. Then, moving from ischemic heart disease. We also had a paper focusing on stroke, which I thought was a really intriguing one, talking about atrial fibrillation, and questioning if being a woman is a risk modifier, or a risk factor. Do you want to elaborate on that one? Dr. Sharon Reimold: So instead of the using the CHA2DS2–VASc algorithm they use the CHADS2-VA program and then looked to see how well that predicted risk, and how much the S and C, the gender actually influenced outcome. I think this is an important issue. I'll say it's for women, perhaps. because as a woman, you know, without doing anything, you start out with a risk factor of one. Then, once you get to a certain age you have a risk factor of two. That's even for somebody who has no other disease processes. Dr. Carolyn Lam: Yeah. Dr. Sharon Reimold: So I think it's a little different way to look at how the risk is modified. They propose that if your CHADS2-VA score is two, or greater, certainly, your risk goes up if you're also female. They propose, then, that you would treat those patients more intensively. It's just a little twist on the CHA2DS2–VASc and maybe will provide us different ways to refine our knowledge about outcomes in atrial fibrillation. Dr. Carolyn Lam: Yeah. I love that paper, too, because it's quite different from the papers that we had in the first Go Red issue. Isn't it? But in the first Go Red issue, we had lots of papers on pregnancy. The current issue certainly has those papers as well. Dr. Sharon Reimold: Yes. There are increasing number of pregnancy related complications. Both maternal, and offspring, complications that predict increased cardiac risk, down the line. This issue has a series of women who had, had preeclampsia during pregnancy, and found that 17% of their women had a coronary artery calcium score of greater than 95th percentile. While that doesn't entirely get you from the biology, in between those two, it at least gives you an idea of where to start going back, and taking a look at what's going on. Dr. Carolyn Lam: What about the one in rheumatic mitral valve disease? Pregnancy outcomes in women with those? Dr. Sharon Reimold: So rheumatic heart disease and pregnancy outcomes, you know, we don't see much written about it anymore. because most of the active disease is in certain areas, in the world. But obviously, these women can have symptoms related to their mitral stenosis and/or their regurgitation during their pregnancy, with heart failure being the most common presenting cardiovascular complication. While some of that is much more quantitative, than perhaps, it was in the past, which is useful. I think that the take-home message from this particular trial is that you need to talk to these patients, and screen them, prior to pregnancy, if possible, to help achieve the best possible outcome. I think that the risk of heart failure was a little bit less than 2% during the trial, which is obviously much higher than the average woman's cardiovascular risk during pregnancy. Dr. Carolyn Lam: this is still definitely an important issue, in many other parts of the world. I really appreciate that you invited this editorial, that gave that global perspective. The editorial, by Athena Poppas and Katharine French, really beautiful work there. You know, I have to say that one of my favorite papers, in this issue, was that in depth paper, regarding gender versus sex, as a social determinant of cardiovascular risk. I found that so intriguing, the first time I read it, and just love it. Dr. Sharon Reimold: Social determinants of health is a hot topic, in a lot of different areas of medicine these days. But they point out some really interesting things, that I don't think I had thought about. One is the fact that, when you are a child, you know maybe 10 or 12, that boys are encouraged more to be physically active. Athletics and other sorts of activities. Whereas many girls, don't have the opportunity or are not as interested. Perhaps we set up an abnormal social situation very early in most people's lives. Dr. Carolyn Lam: Yeah, that represents cardiovascular risk. I know. That stuck out to me too. Dr. Sharon Reimold: Obviously, how and where people live, as children, can influence outcome. That can be influential for both boys and girls. But I think bringing the idea back to cardiovascular diseases, and risk, are really long term, lifelong processes, that we can make changes in, from a preventative standpoint, even in young people. Dr. Carolyn Lam: Something we don't usually think about and I just love the way it was presented, so clearly, and I just love it. Now, to an area that really cuts close to the heart. Pun intended. That is the bias in research grants, bias in manuscript authorship. Joe you mentioned that, right from the introduction, I would love your comments on those papers. Dr. Joseph Hill: The reality, that we all are aware of, is, in many countries, including the United States, 50% of medical students now are female. But as we move through the ranks, into the different subspecialties, and up the career ladder of academic cardiology, we see a thinning of female representation. Arguably, it's been improving, over the last number of years. But the reality is, that there remains a bias against representation of women, in terms of extra mural grant funding, authorship on high-profile papers. This article digs into that, and analyzes those numbers, takes a snapshot of what it looks like at the present time. In some ways, I believe it's a call to arms on how we must do a better job of recognizing this and rectifying it, going forward. Dr. Carolyn Lam: Sharon, did you have comments to add? Dr. Sharon Reimold: Yeah. I mean, I think, I wholeheartedly agree with Joe about those sorts of things. I mean, we see the same types of issues in clinical cardiology as well as in the research components of what we do. we need to figure out how to do this better, so that we all can be productive, going forward. Dr. Carolyn Lam: You know it's just such a beautiful issue. So rich, in so many ways. Was there anything else you might want to highlight to our listeners? Dr. Joseph Hill: I might add that Sharon and I kicked off the issue with a brief introduction. Pointing out that the reality is, that one and four women will die of heart disease. Most women don't know that. Most healthcare providers don't know that. Many Cardiologist don't know that. When you compare that to the realities of breast cancer, it's 1 in 40. It's 10 times different. Now, that community has done a fantastic job. The Susan G. Komen program, in the United States. The pink ribbons, that we see all around the world. That community has done a fabulous job of getting the message out about that grievous disorder. We have to do better. We have to do better educating ourselves, educating the lay public, about the realities of heart disease in women. 1 in 4, around the world. We also have to do a better job of digging into the science. That's where this issue does an especially good job. That the reality is that heart disease is different in men and women. It presents differently. It presents at a different age. The way in which women respond to therapies, can differ from men. So there's work to be done, in terms of awareness. There's work to be done, in terms of the underline biology. This is an especially exciting time in this arena. Dr. Carolyn Lam: I couldn't agree more. I'd add to it, even sex differences and the perceptions about own symptoms, and that of women versus men with chest pain. Then, the whole gender, social element to it. Oh, just so much to discuss, so much to learn from. Well, listeners you heard it right here. I want you to please send this episode, share it with as many other women as you can think of. Do help us to spread this message, it's such an important one. Thank you so much, Joe and Sharon, for joining me today. Thank you, listeners, as well. Tune in again next week.
Dr. Carolyn Lam: Hello from the American Heart Association meeting in Anaheim. I'm Dr. Carolyn Lam, associate editor from Circulation at National Heart Centre in Duke National University of Singapore and I'm so pleased to be here with the Circulation team led by editor in chief Dr. Joe Hill, as well as with Dr. Laura Mauri, senior editor from Brigham and Women's Hospital, and Dr. Dharam Kumbhani, associate editor from UT Southwestern. Boy, we've got lots to discuss. I mean, I want to just first start with congratulating you, Joe. We have got quite a number of simultaneous publications here at the AHA. Dr. Joseph Hill: I appreciate that, Carolyn. Don't congratulate me. We have a team that is a privilege to work with. One of the initiatives that we launched right from the start was a desire to foster and shine a bright light on emerging science at the major meetings around the world. Often, that involves simultaneous publication. I'm proud to say that we have 11 simultaneous publications, a record for us here at AHA. Most of them are clinical trials. A few are clinical science, and two of them are young investigators who are competing in the various different competitions. We reached out to them a few weeks ago and offered them the opportunity to submit to us, of course with no guarantees, and our standard remains the same, but we promised that we would provide them with an external peer review. Two of them made it through the process and they will be simultaneously published with their presentations here in Anaheim. Dr. Carolyn Lam: Wow, well you heard it. A record 11 simultaneous publications. We've got a lot to talk about. Let me just maybe group the topics a little bit. Let's start with talking about peripheral artery disease. I think there are at least three papers around that area, and then we'll talk about coronary artery disease, and almost focusing more on implementation science, papers, there are two there, and then of course we have to talk about heart failure. Dharam, could you start? Tell us about the FOURIER PAD trial. Dr. Dharam Kumbhani: Yeah. It's very exciting to have clinical trials in the PAD realm. FOURIER PAD is certainly really well done sub-study of the FOURIER trial. As you remember, this was a landmark trial, which compared a PCSK9 inhibitor Evolocumab in two doses, two placebo. The overall trial was done in about 27,000 patients who were followed for a median of 2.2 years. In this trial, Marc Bonaca and investigators, they looked at the PAD subset, which were about 13% of the total cohort. Now, they specifically set out to look at how patients with PAD, during this trial and very gratifyingly, they also specifically assessed how patients with PAD did as far as limb events, not just cardiovascular events. At the outset, not surprisingly, patients with PAD had a higher risk of cardiovascular events by, I think it was about 60% higher for the primary end point compared with patients who did not have PAD. There was really no, in fact, modification by PAD in that the benefit of Evolocumab that we saw in the overall trial was preserved among the patients with PAD as well as those without PAD. However, because patients with PAD had higher event rates, the absolute risk reductions were higher in patients with PAD. Then, these investigators looked specifically at the incidents of major adverse limb events, which is a composite of acute limb ischemia, urgent revasc, and major amputations. What they show is that in the overall cohort, there is a 42% reduction in the risk of these major adverse limb events with Evolocumab compared with placebo. Obviously, the effect is significantly higher in patients with PAD. Although the benefit wasn't noted in the PAD subset specifically, the overall p-value for interaction was negative. One of the really exciting things about this paper is that just like investigators have shown a monotonic reduction in cardiovascular event rates with LDL reduction, similarly, the investigators show a reduction in limb events, which is dose related and the same way in a monotonic fashion with Evolocumab. I think this is really exciting and I think this will be a very important paper for the field. Dr. Carolyn Lam: Yeah. Dharam, that was beautifully summarized but once you start talking about the peripheral artery disease and this lack of interaction on effects and so on, I think of the CANVAS trial results that were reported at this meeting too. If I could maybe briefly summarize what the authors did in this circumstance, they looked at the more than 10,000 patients in the CANVAS trial who were randomized into Canagliflozin versus placebo in diabetic patients but this time they looked at whether or not there was a difference in effect with the primary prevention cohort versus the secondary prevention. Primary prevention meaning those adults who had diabetes and risk factors but no established cardiovascular disease and the secondary prevention were those with peripheral artery disease, for example, and other established cardiovascular disease. The same thing, a lack of interaction, which I think is really important because it was the same sort of idea that the overall risk of cardiovascular events was lower in the primary prevention group. Looking at them as a subgroup alone, you didn't get the p-value that crossed the limit because the power was less in a lower risk group, but the lack of statistical interaction really gives us additional information, I think, that Canagliflozin and maybe the SGLT2s in general may be effective for primary prevention in diabetic patients. What do you think? Dr. Dharam Kumbhani: Yeah. I mean, I think certainly, very interesting findings along those lines. As you pointed out, the event rates are much lower in the primary prevention cohort. All the confidence intervals overlap one, but because all the p-values for interaction for the three-point maze, the four-point maze, et cetera, one would say that there really isn't a difference between the primary and the secondary prevention subgroups. You would potentially have the same benefit in that subgroup as well. Dr. Carolyn Lam: Fortunately or unfortunately, in that same study, they looked at the risk of amputations and there was a lack of interaction too for that meaning there was a higher risk of amputations with Canagliflozin versus placebo. That of course is a really hot topic now, isn't it? I just wanted to point out though, when you look at it in the primary prevention group, there are only 33 events. What do you think? It spells caution but further look needs to be done? Yeah. Contrast that with the EMPA-REG outcome PAD analysis. You want to tell us about it? Dr. Dharam Kumbhani: Yeah. Once the Canagliflozin CANVAS findings came out showing a high rate of amputations with Canagliflozin, the Empagliflozin, the EMPA-REG outcome's investigators went back and looked at the PAD subset in EMPA-REG outcomes. This was about 20% of the total cohort. I will say that unlike FOURIER, which we just discussed, the ascertainment of amputations was not prospectively defined for this trial and it was really obtained from the CRF forms. However, having said that, it did not appear that amputation rates were higher with Empagliflozin. They did not break it down by the different doses but one assumes that the benefit is consistent between the two doses that they study. One would imagine the PAD patients would have a higher rate overall, which it was, but even in that group, it was about 6% over three years and there was really no difference between the patients who received Empagliflozin versus those who got placebo. Dr. Carolyn Lam: That EMPA-REG outcome paper, I mean, interestingly, it was a research letter. Joe, you've been watching this whole field unfold right now and our journal has published so many good papers, including CVD REAL, all in this space. Could you comment on that a little bit and the research letter concept and the fact that we're publishing so many of these interesting papers in this topic? Dr. Joseph Hill: Well, Carolyn, as you inferred, this field is evolving very rapidly. Now, the interface between metabolic disease and diabetes and heart disease is blurring. Some of these diabetic drugs are really emerging as heart failure drugs, it looks like and so there's a great deal of interest in exploring that and trying to find underlying mechanisms. It's an incredibly exciting time. In parallel with that, we are publishing research letters now for papers where, again, our bar starts with validity. Our bar doesn't change but if it's a story that can be communicated with really one multi-paneled figure and an 800word text, then that is a nice bite-size piece of information that we can get out to our readership. We're publishing one or two a week now. Overall, it appears to be well received and I think it's an effective vehicle for conveying certain types of our content. Dr. Carolyn Lam: Frankly, it's such a delight to read, isn't it? It's hard to write. I think the shorter, the harder to write but this just goes to show how equally important they are. Dr. Joseph Hill: Absolutely. Dr. Carolyn Lam: That we're discussing it here. Well, let's go on to the next topic then, coronary artery disease. Regionalization of the care. I'll say that again, regionalization of the care. Would you like to comment on the two papers that are simultaneously being published? One would be the ACCELERATOR-2 trial. That's in the U.S. Then, a second from New Zealand, the ICare-ACS trial. Slightly different but- Dr. Joseph Hill: Well, that's exactly right. Often, we know what to do but we don't do what we know we need to do in medicine. The implementation of what we already know is an area of hot research and is an area that's evolving rapidly. These two studies, ACCELERATOR-2 here in the United States, focused on regionalization of the interface between EMS systems and EDs, how to get patients identified in the hospital to their device, whether it's a stent or a balloon pump or whatever it is. The first medical contact to device was the metric and by implementing what we already know, the AHA mission lifeline principles, these investigators were able to optimize this regionalization, so there wasn't so much variability across these 12 metropolitan regions. As a consequence, the time to first medical contact to device was shortened, and there was in fact a striking, maybe even surprising, mortality benefit. Dr. Carolyn Lam: Exactly. That was striking to me too. Dr. Joseph Hill: From the street to the lab, another paper from New Zealand that you referred to called ICare-ACS focused on doing a better job in the emergency department with serial ECGs and serial high sensitivity troponins, risk stratification algorithms and they found that, again, by developing these clinical pathways within the ED, they were able to shorten the length of stay in the ED and the length of stay in the hospital. Dr. Carolyn Lam: Yeah. I thought those were amazing and then also from different parts of the world, really strong public health messages as well. Laura, you take care of these ACS patients right on there. What did you think of these papers? Dr. Laura Mauri: No, I agree. I think that we've, in the past, focused on science and focused on clinical trials but ultimately, none of that matters if we don't deliver the healthcare to the patient. I think this is just a growing field and I'm glad that we're emphasizing it in circulation. Dr. Carolyn Lam: Absolutely. If we would now go to another area that is really increasing in prevalence throughout the world. Heart failure, and of course, heart failure with preserved ejection fraction. Dr. Joseph Hill: Your favorite topic. Dr. Carolyn Lam: Congratulations, Laura on the paper that you're presenting, that is being presented at this meeting, the REDUCE LAP trial. Could you tell us a little bit more about that? Dr. Laura Mauri: Sure. Yes, as you know, it's a really challenging field, heart failure with preserved ejection fraction. There aren't a lot of therapies that we have. We really don't have great medical therapy. This study actually looks at a medical device to treat patients. It really is a feasibility study, so it's a relatively small trial, just over 90 patients but it's randomized. We know in the device arena, as in all trials, how important randomization is but also blinding. This was actually a sham-controlled blinded trial really designed to look at this interatrial shunt device in patients who have an elevated wedge pressure. The REDUCE LAP stands for reduce left atrial pressure. That was the primary endpoint, was pulmonary capillary wedge pressure. This was not only looked at the safety, which showed that the device placement was very safe, but at the same time also looked at the proof of concept that by placing the shunt device, there was actually a reduction in wedge pressure over a period of exercise. It needs to be followed on. It's certainly just the first phase of trials but a pretty good standard with the sham control. Dr. Carolyn Lam: Yeah, well, congratulations again. I mean, this follows … There was a previous publication of the single arm trial and now, this is the first randomized sham-controlled, and the results are consistent. It's a very difficult trial to carry out. HFpEF patients are notoriously difficult to recruit. Could you tell us a little bit about what it was like successfully completing this trial? Dr. Laura Mauri: Yeah. Well, we had very enthusiastic centers and principal investigators, Ted Feldman and Sanjiv Shah. I think what it really required in this early phase was sites that were committed to characterizing the exercise physiology. The next stage of rolling this out to a broader number of sites and a larger number of patients to see if there's a clinical effect will really be more focused on the clinical endpoints and quality of life because ultimately that's the goal, is to improve symptoms in these patients. Dr. Carolyn Lam: What I love about the design and the whole concept, it's so simple and elegant. We almost sometimes forget that HFpEF is heart failure, which means that by definition, there's raised filling pressures. It's hemodynamic at the end and this is just a simple concept of offloading the left atrium. That's so beautiful but it does come with some questions. Every time you mention this to someone, they go, “What about, I don't know, Eisenmenger's syndrome developing later?” The right side, volume overload, pulmonary hypertension, what about atrial fibrillation down the line? How about the safety parts of it? Dr. Laura Mauri: Right, so the procedural safety was excellent but then I think you raise really important questions and these patients are still in follow-up but looking at the report here at this meeting, there was no pulmonary hypertension in excess in the shunt treated arm. The patient selection was towards patients who had higher wedge compared with right atrial pressure and among those patients, there was no evidence of RV overload. At least at this stage things look good to go on to the next step. Dr. Carolyn Lam: That's wonderful and exciting. We definitely need a therapy for HFpEF. Joe, would you like to highlight any other trial? We have 11. We've discussed six. Dr. Joseph Hill: Tonight at the editorial board meeting, we will be saluting these two young investigators who are presenting their work in this competition and simultaneously publishing their work. We've invited these young investigators and their mentor and they will present a short talk to the editorial board dinner. It's an effort to salute and recognize these early career investigators, to congratulate them on outstanding work. We're pleased and privileged to publish it, so I'm particularly excited about that. Dr. Carolyn Lam: Wow, Joe. That is great. Thank you. I didn't know that was happening either. That's fabulous. Dharam or Laura, any other highlights that you may want to mention in this meeting? Dr. Laura Mauri: I think that it's just been a wonderful kickoff to the meeting. We've covered, I think, many of the really important trials so it's really exciting to be able to see the work in print. Dr. Carolyn Lam: That's great, and to discuss it as well. Dr. Dharam Kumbhani: Yeah, I agree. This is really exciting and hopefully, we can keep growing from strength to strength every year. Dr. Carolyn Lam: Yep. You heard it right here everyone. We are going to grow from strength to strength under your leadership and with this great team, so thank you very much for joining us today.
Communication is contextual. Find out what that meant for Joseph Hill, a deaf African-American researcher focusing on the way that culture influences languages. http://www.miusa.org/Resource/podcast/Joseph
While at Microsoft's Connect(); conference in New York we caught up with Joseph Hill to discuss all the latest and greatest announcements in the Xamarin world, as well as digging deeper into their new Live Player app. Want to get up to speed on all the latest announcements? Look no further! Special Guest: Joseph Hill.
Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Our podcast today highlights an important perspective piece on charting a future together and turning discovery science into cardiovascular health. You don't want to miss this, coming up right after these summaries. The first original paper tells us about the importance of changes in exercise capacity following transcatheter aortic valve replacement or TAVR. First author, Dr. Altisent, corresponding author, Dr. Rodés-Cabau, and colleagues from Quebec Heart and Lung Institute in Canada studied a total of 305 patients undergoing TAVR with baseline and six month followup exercise capacity assessments by six minute walk tests. They found that close to one-third of patients undergoing TAVR failed to improve their exercise capacity despite an optimal hemodynamic result post-procedure. Factors associated with a lesser exercise capacity improvement included patient characteristics such as older age, female sex, non-cardiac comorbidities, such as chronic obstructive lung disease, peripheral artery disease and bleeding episodes resulting in reduced hemoglobin levels. Importantly, the absence of an improvement in physical performance at six months post-TAVR was an independent predictor of mortality and adverse cardiovascular outcomes during the ensuing four years and particularly among patients with a greater impairment of exercise capacity pre-TAVR. Thus, implementing exercise capacity assessment pre and post-TAVR may help to improve patient risk stratification and augment the accuracy of the prognostic information given to patients, helping to identify those requiring more intensive followup assessment. The next study provides mechanistic insights into the adverse health outcomes associated with particulate matter exposure in the air. First author, Dr. Lee, corresponding author, Dr. Kahn, from Fudan University in Shanghai, China and colleagues conducted a randomized double-blind crossover trial in 55 healthy college students in Shanghai. Real and sham air purifiers were placed in participant's dormitories in random orders for nine days with a 12 day washout period. Serum metabolites were quantified using gas chromatography mass spec and ultra-high performance liquid chromatography mass spec. They found that higher particulate matter exposure led to a significant increase in cortisol, cortisone, epinephrine and norepinephrine. Between treatment, differences were also observed for glucose, amino acids, fatty acids and lipids. They also found that higher blood pressure, hormones, insulin resistance and biomarkers of oxidative stress and inflammation were present among individuals with higher exposure to particulate matter. Thus, this study showed that activation of the hypothalamus-pituitary-adrenal and sympathetic-adrenal medullary axis may contribute to the adverse cardiovascular and metabolic effects of particulate matter exposure in the air. In China, indoor air purification may be a practical way to reduce personal exposure to particulate matter. The next study shows that N-acetylcysteine may be new effective thrombolytic treatment. First author, Dr. Lizarrondo, corresponding author, Dr. Gauberti and colleagues from Inserm, France hypothesized that N-acetylcysteine might cleave the von Willebrand factor multimers inside occlusive thrombi, thereby leading to their disillusion and arterial recanalization. To test this hypothesis, the authors used experimental models of thrombotic stroke induced by either intra-arterial thrombin injection or ferric chloride application followed by measurement of cerebral blood flow using a combination of Laser Doppler Flowmetry and magnetic resonance imaging. They showed that intravenous and acetylcysteine administration promoted lysis of arterial thrombi that were resistant to conventional approaches such as recombinant TPA, direct thrombin inhibitors and anti-platelet treatments. Furthermore, through in vitro and in vivo experiments, they provided evidence that the molecular target underlying the thrombolytic effects of N-acetylcysteine were principally the von Willebrand factor that crosslinked platelets in arterial thrombi. Co-administration of N-acetylcysteine and a non-peptidic GP2B3A inhibitor further improved its thrombolytic efficacy essentially by accelerating thrombus disillusion and preventing rethrombosis. In a new large vessel thromboembolic stroke model in mice, this co-treatment significantly improved ischemic lesion size and neurological outcomes. Importantly, N-acetylcysteine did not worsen hemorrhagic stroke outcome suggesting that exerted thrombolytic effects without significantly impairing normal hemostasis. Thus, in summary, N-acetylcysteine was shown to be an effective and safe alternative to currently available anti-thrombotic agents to restore vessel patency after arterial occlusion. The clinical implications of the study are wide reaching considering the very wide availability, low cost and apparent safety of N-acetylcysteine. This is discussed in an accompanying editorial by Dr. Lillicrap from Queens University, Kingston, Canada. The final study identifies a novel mechanism for regulation of cardiac fibrosis that revolves around plasminogen activator inhibitor type 1 or PAI-1. First, author, Dr. Flevaris, corresponding author, Dr. Vaughan and colleagues of Northwestern University, Feinberg School of Medicine in Chicago, Illinois showed that cardiac fibrosis was detected by late gadolinium enhancement cardiac MRI in two otherwise healthy humans with complete PAI-1 deficiency due to a homozygous frameshift mutation in serpene 1. They further performed a series of mouse experiments to show that treatment of young PAI-1 deficient mice with angiotensin 2 induced extensive hypertrophy and fibrotic cardiomyopathy. Ventricular myocytes were found to be the important source of cardiac transforming growth factor beta or TGF beta and PAI-1 regulated TGF beta synthesis by cardiomyocytes in vitro as well as in vivo during cardiac injury. PAI-1 deficiency significantly enhanced multiple TGF beta signaling elements and transcriptional targets. Thus, in summary, this study show that PAI-1 is an essential repressor or cardiac fibrosis and access a molecular switch that controls the cardiac TGF beta access and its early transcriptional effects that lead to myocardial fibrosis. Modulation of the cardiomyocytes TGF beta access represents a unique therapeutic strategy that may abrogate fibrotic signaling and cardiac fibrosis. Well, that wraps it up for your summaries. Now for our featured discussion. We are incredibly privileged today to have the director of the National Heart, Lung and Blood Institute, Dr. Gary Gibbonss with us on the podcast, as he talks about his perspective piece entitled "Charting Our Future Together: Turning Discovery Science into Cardiovascular Health." Also, joining me today is our editor in chief, Dr. Joseph Hill from UT Southwestern. Joe, I know you share my incredible excitement and enthusiasm at having Dr. Gibbonss on this podcast with us. Maybe could I invite you to say a few words to frame just how important this perspective piece is for Circulation? Dr. Joseph Hill: We all know that cardiovascular medicine and science are evolving at an unprecedented pace. The challenges we face are evolving and yet the opportunities and the tools and the resources at our disposal are unprecedented in their scope and vision. We're very pleased that Gary has provided strong leadership at NHLBI now for several years and has laid out in this perspective piece here where he thinks the next steps are specifically around this strategic vision that focuses on precision medicine and data science. I would love to hear Gary provide additional perspective on that vision. Dr. Gary Gibbons: Well, thank you, Joe. As the director of NHLBI, clearly we're public servants and we're accountable stewards of the nation's investment in heart, lung and blood and sleep disorders. This piece gave us an opportunity to outline some of the opportunities that lay ahead in a strategic visioning process. First, I should note that a key part of the legacy of the NHLBI is to make strategic investment with enduring principles in mind to really support investigator initiated discovery science as really the core foundational element of our research portfolio, as well as to maintain a balance portfolio to really expands to spectrum of basic translation clinical population and implementation science. In this piece, we particularly want to highlight our strategic visioning process in which we encourage the broad input of the NHLBI community that actually included over 4,000 participants in this process from every state in the country. Indeed, 42 countries around the world to provide the most compelling questions and critical challenges that the field faces around strategic goals of understanding normal human biology, reducing disease, accelerating translation and preparing a biomedical workforce and resources for the discovery science of the 21st century. Out of that strategic vision, we focus in on two elements that emerged that relate it to precision medicine and data science for this piece and really that was the central core of what we wanted to share with the Circulation readership about how these two areas we think are going to be transformative in the years ahead. Dr. Carolyn Lam: Dr. Gibbons, you know, when the term precision medicine is used, sometimes it's a bit fuzzy I think in the minds of a lot of people. Could you maybe give a few examples or perhaps a specific idea that comes to mind? Dr. Gary Gibbons: You're right. There's often a lot said about it than probably a bit of hype about it. In some ways you could see this as a legacy of cardiovascular medicine and science. It could be argued that the definition of cardiovascular risk factors that came out of the Framingham Heart Study many years ago was the first sort of forerunner of precision medicine. It helped us indeed define those individuals who are at the greatest risk of having a heart attack and that to this day has played a role in directing targeted preventive treatments of the highest risk individuals in order to prevent heart attacks. That has continued to evolve. I think what's new now is that we have, as Dr. Hill mentioned, new modalities of both imaging and analytics of computational science, as well as novel biomarkers and genetic markers that can help us be even more precise in that risk assessment. That's really I think the greater opportunity to further subcategorize patient populations to get the right drug to the right patient at the right time with a more strategic treatment approach. Dr. Joseph Hill: Gary, that's very exciting. I think your vision is absolutely compelling. I like how you categorize the NHLBI as a catalyst for the future. I'd like to think that the Biomedical Journals, the AHA Portfolio of Journals and Circulation are also catalysts that will partner with NHLBI and other entities to chart the course for the future. That again the challenges that we face now are different than they were back in the era when Framingham first got started after World War II. The tools that we have are also evolving rapidly and certainly our perspective from Circulation is that we are stewards of helping chart that course, helping identify and bring forth the best science around the world. In many ways we look to you as a partner. Dr. Gary Gibbons: Oh, absolutely. The NHLBI really can't fulfill our mission of turning discovery science into the health of the nation and indeed around the world without a circle of partners and that certainly includes the platforms of disseminating new knowledge like Circulation, as well as partner organizations such as American Heart Association. We definitely appreciate the value that your organ brings to really enhancing our efforts to not only take discovery science, but make that knowledge available to practitioners and researchers and patients. I think a key part of the 21st century is how we not only can discover and generate new knowledge, but how we can facilitate that movement of data to knowledge and from knowledge to action that actually enhances the lives of patients in the real world context. Again I believe your journal plays an important role in helping to do that. Dr. Carolyn Lam: You both mentioned critical challenges that we're facing and will face. The Chinese for these challenges or crisis, the word is actually wéijī. Okay? Wéi is actually meaning danger, whereas jī is for jīhuey which is opportunity. In every challenge, there's always this new opportunity and I just really would like to ask what are the greatest challenge and perhaps the greatest opportunity? Dr. Gary Gibbons: I think the challenge that we probably face is the emerging epidemic of non-communicable diseases typically cardiovascular disease throughout the world. Not only in the most industrialized nations, but indeed mainly the developing nations. This will quickly surpass communicable infectious diseases as the major burden and causes of mortality worldwide. We're dealing with a global challenge. Increasingly, we recognize that scientific discovery and analysis is often siloed in various packets. Our vision for the future is really to promote the creation of a global reach of what we're calling a Data Commons. That is that a disease has no borders. Science should not be limited to national states. It is part of the commonwealth if you will of information and knowledge that really should transcend national borders. We say this is a global community of data and information and knowledge exchange and collaboration. As part of this global community, it's that we think this diverse and inclusive approach will be critical to the best minds and best practitioners of the world learning from each other and contributing to this commonwealth of knowledge. We're excited because the opportunity on the other side of that challenge is that it's an unprecedented capability of power to communicate now. We I think are communicating with you from Singapore and we're in a digital age in which this notion of communication and knowledge exchange should be more fast than it's ever been before. Indeed, we can create computer platforms that are similar to what exist for a Facebook or a Google that are global in scope. The vision is really to say what would happen if we could turn that toward biomedicine and make biomedicine part of this data science such that we have global contributions to our understanding, knowledge exchange and really create that sort of global sandbox if you will of knowledge exchange and discovery. That's part of this notion of creating a Data Commons and really advancing data science as an element of a strategic vision. As we move forward with precision medicine and data science, our most sacrosanct stewardship is for the next generations. A critical element is to ensure that we're providing them with the tools and training to really lead the charge of advancing these exciting areas of science and that indeed will be a global enterprise. Dr. Joseph Hill: That's very exciting, Gary. I take my hat off to you for the leadership that you have maintained at the NHLBI during these times that are once very challenging and at the same time exhilarating. I look forward to working with you through our journal and partnering with you to bring to fruition much of what you had laid out in your vision. Dr. Gary Gibbons: Thank you, Joe. We look forward to our ongoing partnership. Dr. Carolyn Lam: Thank you, listeners, for joining us today. Do join us again next week.
We talk with Joseph Hill, one of the Xamarin co-founders about Visual Studio for the Mac and how you can do live UX design.
William Joseph Hill and Pamela Hill share their journey into the film and television industry. We discuss the changes they have witnessed Hollywood go through over the last decade. We also talk about the value of building strong relationships. According to William and Pamela, relationship building is the key to collaboration. People want to work with them due to the strong relationships they have cultivated. We discuss the genesis of Four Scorpio Productions — their independent production company — and the feature film, CYBER FIGHTER, that William is developing. We talk about THAT DARN GIRLFRIEND (web series), SUBTEXT, THE EAGLES, ROOM OF DOORS, MADAME ESMERALDA AND THE AUDITION, and ULTRAMAN X THE MOVIE. William Joseph and Pamela also share how they have been able to balance personal live and career, as well as how they have been able to collaborate so well over the years. http://pamelahill.net/ http://www.imdb.com/name/nm1107523 http://www.imdb.com/name/nm0384069
In this episode, Donn talks with Xamarin cofounder on how one can use Xamarin for Android development. They start off chatting about using Xamarin just for business logic sharing. This Joseph tells us was the original intention for use. They also touch on Xamarin forms which allows you to additionally build UI elements cross platform. Even if you don't use Xamarin or plan to use Xamarin right away, this was a fantastic insight into the platform, from the creators directly. They touch on advantages, how to really leverage the platform and potential downsides. show notes: http://fragmentedpodcast.com/episodes/67/
This week on the Xamarin Podcast, James Montemagno has the honor of taking with special guest Joseph Hill, co-founder of Xamarin and VP of Developer Relations. James sat down with Joseph to discuss not only the past, present, and future of Xamarin Evolve, but a full run down on his thoughts of the Microsoft acquisition. Special Guest: Joseph Hill.
Carolyn: Welcome to Circulation on the Run. You're weekly podcast summary and backstage pass to the journal. I'm Dr. Carolyn Lam from the National Heart Center in Duke National University of Singapore. I am thrilled to be your host every week. Joining me today to introduce our podcast are two very very special guests. Dr. Joseph Hill from UT Southwestern is editor and chief of Circulation. Hi Joe. Joe: Pleasure to be here, Carolyn. Carolyn: Thanks, and your second guest, Dr Amit Kara is also from UT Southwestern and the associate editor for digital strategies of Circulation. Hi Amit. Amit: Hi, Carolyn. Happy to be here. Carolyn: No Joe and Amit, if you don't mind I'm going to start the ball rolling by sharing my little story of how these podcasts came to be. Now do you guys remember when we first talked about this? All right well I do. Joe: Absolutely. Carolyn: Ha ha because frankly, and I don't know if you know this Joe, it wasn't a very good day for me. I had just landed very early in the morning from a long trip and I was battling jet lag while trying to get a million things done such as unpack, clear my mail, get ready for work. You know, the usual. Of course the thing I needed most was to learn that I also needed to do weekly podcasts for Circulation right. So after our chat I did I suppose what a lot of us do when things seem a little bit overwhelming. I dropped everything and I headed for a run in the gym. But in the gym as always I was trying to multitask as well, so I brought my mobile device for my jog so that I could read my mail at the same time, you know. I can already see the smiles of everyone listening because I know you've done this before. Anyone who's done it will know what a pain it is trying to read while you're bouncing up and down on the treadmill. It was just at this point when I was about to go cross-eyed that the radio in the gym started to play the morning news and the news headlines. I remember thinking to myself, oh wow, how I wish I could have someone read my mail or at least the headlines of the mail to me so that I could get the gist of everything even while I was literally on the run. That's how the Circulation podcast idea came to me and hence it's name, Circulation on the Run. To me it's an audio summary of the headlines of the journal so that you the listener can in 15 minutes get caught up literally on the run or drive or whatever it is you're doing when you'd rather listen than read. Just so you know you haven't missed the big things. But in addition to getting an overview of the issues contents every week, you get main take home messages as a clinician. Because it will be dull to talk to myself every week I will be inviting an author, an editor, of a featured article of particular clinical significance so that we can give you a behind the scenes look of the paper. That is the idea of the Circulation podcast. Joe, how does this fit with your vision of the journal? Joe: Carolyn, I love your story behind the scenes on how this all got started and I really, truly appreciate your energy and leadership here. This is such an important endeavor for where we want to take the journal. In fact, your leadership here illustrates one of the major initiatives that we have started and that is a global footprint of editorial oversight for Circulation. We are afforded an extraordinary privilege here to see the best science as it emerges from all around the world and we want to do everything we can to make sure that the journal meets the needs of the clinicians, the practitioners, and the investigators everywhere in the world. Here you are leading this important initiative from your home base in Singapore. That's exactly what we're looking to foster and develop going forward. Carolyn: Oh Joe thanks so much for that. I really so appreciate this privilege of doing this and it's true that I'm a living example of the journal going global so to speak. I also really like the way you say that with this overwhelming knowledge that we're facing, we do need help to synthesize and synergize that information. Especially in the clinically oriented way. I think you made that very clear to us in your leadership of our editorial board. Thanks for that. Maybe speaking of trying to reach the world, social media and digital strategies play a big roll. Amit maybe you could tell us a little bit more about how the podcasts fit in your larger scheme for the journal. Amit: Absolutely and I just want to echo Joe's comments and thank you, Carolyn, for taking the lead of this important endeavor. We couldn't think of a better person to do so. When we look digital strategies we have to remember that the journal is producing so much valuable content. The authors are working very hard and creating such an immense amount of new knowledge. We have to appreciate that people consume knowledge in different ways. In the current era there's so many different ways to do that. One hand we still have the traditional print journal which is incredibly valuable and important. Has depth of information that certainly many and most people would want to investigate. But the other end of the spectrum we have our bite sized information which is Twitter and Facebook and so forth which certainly helps people sort of prioritize or are able to glean what's exciting that week and then they can go back and do a deeper dive. The podcast fits somewhere in between. I love what you said, Circulation on the Run, you're example was a great one for people who are wanting to consume this information but perhaps in a different way. The audio component and also a time component where they have 10 to 15 minutes to take in this information. Your vision for this is a great one. We'll have a brief component where you will review the weekly articles and people can then learn what's in the journal and what's the most important findings and content that week. Similarly they have the opportunity to really get to know an author and get to know some editors and to really get behind the scenes. This backstage pass if you will. We finally have to remember that we're appealing to a broad audience. People of different ages and around the world. People like to consume information in different ways. We really like to have this as an important part of our offering towards helping people consume this information. Carolyn: Oh Amit. I couldn't have said it better. Thank you so much. Just to be true to ethos. Let me remind everyone that it's going to be a 15 minute podcast and we're going to do our very best to compress all that you need to know into those 15 minutes. I just want to echo what you said that this is only part of the broader strategy and it doesn't mean that the print journal is dead in any way. In fact I am so excited to see the new journal. I don't know about you. It's got a whole new look. It is really really quite good looking, if I might say so. Everyone out there, you're going to expect this new journal on June 29th, 2016. Look out for it. Trust me. You won't be disappointed because there's also a very special little part of the cover that I'd like to discuss before we sign off. That is the doodle. Joe could you tell us a little bit more about the doodle? Joe: As you say the journal look I think is fantastic. It has a clean and modern look to it. The judicious use of color to highlight the different types of content, which as before spans a spectrum of basic science, the definition going forward is vertebrate models, pre clinical models, and disease oriented questions. Starting there, traversing through clinical science, population sciences, health services research, the entire spectrum. Again we are afforded an extraordinary privilege here to help frankly shape the future of cardiovascular medicine. We take that responsibility very seriously. That's why we've recruited an extraordinary team of editors from literally around the world. At the same time, we want to have a little fun. We want to make it fun and engaging as well as very very serious. As part of that, we've launched something that we're calling the Circulation Doodle. That is an idea that leverages the google.com website where I think everyone is familiar with. They, based on an event that occurred that day or week or month, they play around with the visual depiction of the word Google. We're going to do the same thing with Circulation. Every month we will reach out and solicit doodles from artists all around the world. Everyone who's listening to this podcast, I encourage you to think about this. Every month there will be a doodle theme. The first one for July will be Texas. Commemorating the fact that the journal headquarters is moving back to Texas after having been in Boston for 12 years. Previous to that it was under the leadership of Jim Willerson. It's coming back to Texas and the first Circulation doodle depicts a Texas theme. In fact, if you're interested you can find this in the April 25th issue of the journal where in the third of four notes from the incoming editor in that third one on April 25th, we show the first doodle. We're asking people to submit doodles according to monthly themes. The month of August will be vacation. I can tell you start thinking about ways in which you might incorporate a vacation theme in the depiction of the world Circulation for August and the one that comes in that's the best, that the editors like the most, it will be placed on the cover of the print journal and on the website for a full month. We've also conceived themes for the rest of the year all the way through to June of 2017, and in the first issue that comes out from our team, we will list those themes and you'll have plenty of time to start thinking about what you would like to submit. Then in subsequent years, those monthly themes will also evolve. We'd like to get people's ideas about issues that come up related to holidays or national heritage months. Things that we might not know about from our base in the US. We want to do that around the world. It's an opportunity to be creative at the level of themes, and again artistic depiction of the word circulation. Carolyn: I love that. Thank you so much Joe and that just exemplifies that we are all about science and all about having fun at the same time. That was a brilliant introduction to what our podcasts are going to be like as well. Thank you so much Joe and Amit for joining me today. Again, everyone, this was Circulation on the Run. Don't forget, first issue coming out 29th June, 2016.
Volatility Views 94: We Are Back! Volatility Views is back from hiatus and in this episode, Mark is joined by Mark Sebastian and Pat Fay, Director of Listed Derivatives, Russell Indexes Volatility Review: RVX options and futures are back. Why bring them back? What's unique to the RVX relative to the VIX? An overview/analysis of all the recent trading activity in VIX options and futures as well as VIX-related ETPs. Volatility Voicemail: What Do You Want to Know? Comment from Mr. Inc.: @Options Great to see that Volatility Views is returning to the schedule. My fav show. Cannot wait to hear it again. Question from Joseph Hill, Spokane, WA: Great episode with Russell Rhoads from the CBOE. I hope Vol Views will be back on a more regular basis going forward. I also have a question about vol trading. I like the idea of VIX options, but I am not heavily invested in S&P 500 stocks. I think something like the NASDAQ VIX for my tech portfolio and Russell VIX for my small cap. My question is - Are these products identical to regular VIX options except for a different underlying? Or do they have different calculation formulas, settlement dates, etc.? Any plans to launch a futures show? Question from SID S., Des Moines, IA: What is a good way to trade corn volatility? Do I have to do straddles on the big futures options or is there something else? Maybe a corn VIX that offers a more direct approach? Crystal Ball: Our expectation from the upcoming week in VIX, RVX, ETPs and more.
Volatility Views 94: We Are Back! Volatility Views is back from hiatus and in this episode, Mark is joined by Mark Sebastian and Pat Fay, Director of Listed Derivatives, Russell Indexes Volatility Review: RVX options and futures are back. Why bring them back? What’s unique to the RVX relative to the VIX? An overview/analysis of all the recent trading activity in VIX options and futures as well as VIX-related ETPs. Volatility Voicemail: What Do You Want to Know? Comment from Mr. Inc.: @Options Great to see that Volatility Views is returning to the schedule. My fav show. Cannot wait to hear it again. Question from Joseph Hill, Spokane, WA: Great episode with Russell Rhoads from the CBOE. I hope Vol Views will be back on a more regular basis going forward. I also have a question about vol trading. I like the idea of VIX options, but I am not heavily invested in S&P 500 stocks. I think something like the NASDAQ VIX for my tech portfolio and Russell VIX for my small cap. My question is - Are these products identical to regular VIX options except for a different underlying? Or do they have different calculation formulas, settlement dates, etc.? Any plans to launch a futures show? Question from SID S., Des Moines, IA: What is a good way to trade corn volatility? Do I have to do straddles on the big futures options or is there something else? Maybe a corn VIX that offers a more direct approach? Crystal Ball: Our expectation from the upcoming week in VIX, RVX, ETPs and more.
Reggae Legend GLEN WASHINGTON and ANTHEM BAND Washington evolved from humble beginnings. Born in the parish of Clarendon, Jamaica he is currently one of the most in demand artist in reggae music; this has come after many years of recording and waiting in the wings. In 1997, he released his debut album ‘Brother To Brother' and, to date, has released 10 albums. Fans and critics alike say there is not one bad song in his catalog.Washington began his musical career in the early 70s as lead singer for “Names And Faces.” also became the lead singer in“35 Incorporated” and learned to play the drums under the guidance of, then drummer, Joseph Hill. His musical career is reminiscent of Boris Gardener, singer, bass player and bandleader who after 25 years in the music industry recorded the golden “I Wanna Wake Up With You.” In the same vein, it was thirty years after recording the classic “Black Magic Woman” that Santana went on to sweep the 2000 Grammy awards for the gigantic hit “Maria Maria”. ANTHEM :Coozie Mellers - (Rhythm Guitar & Vocals)Carey Mellers - (Keyboards & Vocals)Jermaine Mellers - (Bass guitar & Vocals)Rob Williams - (Lead Vocals)Charles Mellers - (Drums & Vocals) Anthem perform throughout the USA, from roots to dance hall . Anthem has appeared with Sister Carol on the Conan O'Brien show & was Judy Mowatte's backing band. Anthem has toured Korea, Japan, Guam, Hawaii, Bermuda, Canada, etc. Anthem shared the stage with Third World, Yellow man, Jimmy Cliff, Big Mountain, The Wailers, Burning Spear, Black Uhuru, The Neville Bros, The Temptations, Freddy Jackson, George Benson, The Isley Brothers, Buju Banton, Capleton, Chacadimus and Pliers, John Holt, Ken Booth, Dennis Brown, Super Cat, Gyptian and moreMaxi Priest www.crsradio.com listener call in # 661-467-2407
This time we each chose a short story and discussed it. Vinnie chose The Phoenix on the Sword by Robert E. Howard , Jess chose The Yellow Wallpaper by Charlotte Perkins Gilman, and Diego chose 20th Century Ghost by Joseph Hill.
Scott chats with Mono Product Manager Joseph Hill and Monospace conference organizer and continous learner Scott Bellware about the state of Mono. Is Mono competition or diversity? How hard are cross platform apps? Can you really write apps for your iPhone in C#? Where can you learn more about Mono?
Scott chats with with Miguel de Icaza and Joseph Hill, the folks behind Moonlight. It's Silverlight on Linux with Mono and it's Open Source!
Guest: Joseph Hill, MD, PhD Host: Matthew J. Sorrentino, MD, FACC, FASH Dr. Joseph Hill, Chief of the Division of Cardiology at the University of Texas Southwestern Medical Center, talks to host Dr. Matthew Sorrentino about the changes that occur in the myocardium when the heart begins to fail. They explore more specifically autophagy, a new concept of cardiac remodeling that may be both beneficial and detrimental to cardiac function.
Guest: Joseph Hill, MD, PhD Host: Matthew J. Sorrentino, MD, FACC, FASH Is cardiac remodeling a beneficial adaptation or a sign of increased cardiovascular risk? As a cardiologist-scientist our guest, Dr. Joseph Hill, Chief of the Division of Cardiology at the University of Texas Southwestern Medical Center compares changes in the heart muscle that occur during athletics vs. stress. Join host Dr. Matthew Sorrentino to learn more about physiologic and pathologic influences on the myocardium.
Colin Corner was appointed Principal Bass of Atlanta Symphony in 2015, after playing in the same position with the Rochester Philharmonic for seven seasons. He previously played with the Minnesota Orchestra, the Vancouver Symphony and the Louisiana Philharmonic. He received first place in the 2003 ISB Orchestral Competition, which led to a one week internship with the Detroit Symphony, and he received third place in the same competition in 2001. Mr. Corner was also a recipient of the Interlochen Double Bass Class Studio award in 1997, which has since been renamed The Colin Corner Bass Award in his honor. Mr. Corner is a graduate of the Interlochen Arts Academy, and he received his bachelor's degree from Indiana University, where he studied with Lawrence Hurst. While in Rochester, he served on the faculty at The Hochstein School and played with Chamber Music Rochester, The Rochester Chamber Orchestra, and The Finger Lakes Opera Festival. He has also served as Guest Principal Bass with the NAC Orchestra. Mr. Corner also enjoys playing electric bass and many different styles of music, mainly jazz. In Rochester, he played with The Shuffling Madness, a Jethro Tull tribute band, The Debbie Kendrick Quartet, a soulful acoustic blues group, The Greener Grass Band, a funky jam band, and various other groups. Mr. Corner is passionate about teaching and has presented masterclasses/recitals at ISB Conventions, Ithaca College, Interlochen Center for the Arts, Shenandoah Conservatory, and Palm Beach Atlantic University. In 2015, he joined the faculty at the Golden Gate Bass Camp in San Francisco, where he was a founding faculty member in the NorCal Orchestra Studies Academy. Proud of his instruments, he plays a bass made by Joseph Hill, c. 1780, and a bass made in Atlanta by Luthier Albert Jakstadt.
Imagine being in the house for the ultimate reggae concert headlined by Bob Marley and friends. Bob opens the show setting the mood for a night of stellar entertainment. Steel Pulse performs, then to the crowd's surprise, Dennis Brown takes the stage. After D. Brown rocks, he invites U-Roy to come up and sing. The Wailers, Dennis Brown, and daddy U-Roy take turns thrilling the audience. Next, on stage, we have Culture with original singer, Joseph Hill at his peak. Freddie McGregor joins in to deliver one of his greatest hits. Peter Tosh follows with two of his notorious numbers. Bob and U-Roy return to partake in the elevating vibes before making way for Frankie Paul. F.P. displays crowd control and exemplifies dancehall style as the crowd jumps and sings out loud. The Steel Pulse band returns to contribute more musical excitement infused with meaning. Then to close the show, the legend, Ms. Lauryn Hill shuts it down as only L Boogie could. Now that's a bucket-list concert experience! Apple Podcast (iTunes) link: https://itunes.apple.com/us/podcast/reggae-lover/id1126663530?mt=2&app=podcast&at=11l6hT iHeartRadio link: https://www.iheart.com/podcast/269-Reggae-Lover-29076656/ Stitcher Radio link: http://www.stitcher.com/podcast/reggae-lover/the-reggae-lover-podast Google Play link: https://play.google.com/music/m/Ixihhi6rfw26zi6333hocwv6diq?t=Reggae_Lover TuneIn Radio link: https://tunein.com/radio/Reggae-Lover-p1033580/Support this podcast at — https://redcircle.com/reggae-lover/donationsWant to advertise on this podcast? Go to https://redcircle.com/brands and sign up.