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3 episodes with Klempner
2 episodes with Klempner
2 episodes with Klempner
2 episodes with Klempner
2 episodes with Klempner
2 episodes with Klempner
4 episodes with Klempner
3 episodes with Klempner
2 episodes with Klempner
Heute spreche ich mit Dr. Silke Brand. Silke ist Diplompsychologin, Psychotherapeutin und Expertin darin, uns in unbeschwertem Leben zu lehren. Sie nennt es: Entbitterung. Wir sprechen über Verbitterung als eine Art Notwehr, als Reaktion auf erlebtes Unrecht. Wir reagieren vielleicht aggressiv mit Rache oder wir ziehen uns zurück. Oder wir erstarren vor Schmerz. Was geschieht, wenn es uns nicht gelingt, diesen Schmerz zu verarbeiten und zu überwinden? Wenn wir in einen Groll verfallen, der wie Gerümpel auf unserer Seele liegt und unser Leben verdunkelt?Wenn wir mit dem Schicksal hadern, mit dem untreuen Freund, mit dem unpünktlichen Klempner, mit der entsetzlichen Diagnose, mit dem Verlust eines geliebten Menschen. Es kann sehr, sehr schwerfallen, sich aus der Opferrolle zu verabschieden und in die Gestalterrolle zu schlüpfen.Verbitterung ist ein Schatten, der sich auf die Lebensfreude legt, sagt Silke. So sehr wir uns auch im Recht fühlen mögen, letztlich müssen wir uns eingestehen: Unrecht passiert; die Welt ist ungerecht. Die Verbitterung darüber ist eine Reaktion darauf, mit der wir uns das Leben selbst unnötig erschweren. Ich wünsche euch viele Inspirationen und kostbare Erkenntnisse bei dem folgenden Gespräch.Mehr zu Silke Brand: https://www.praxisdrbrand.de und https://www.entbitterung.dePublikationen, Kurse und Interviews:Unbeschwert Leben – wie Sie sich in 10 Schritten von Verbitterung befreien (Buch / das Arbeitsbuch)Vergiss dein nicht: Authentisch leben (Buch)Warum ich? Enttäuschungen ablegen und Zuversicht lernen (Kurs)Mit Achtsamkeit gegen Corona-Verbitterung (Deutschlandfunk)Mehr zu Ildikó von Kürthy:www.ildikovonkuerthy.deIldikó von Kürthy bei Facebook und Instagram(Hör-)Bücher von Ildikó von Kürthy:Eine halbe Ewigkeit (Buch und Hörbuch)Mondscheintarif (Buch und Hörbuch)Morgen kann kommen (Buch und Hörbuch)Es wird Zeit (Buch und Hörbuch)Weitere Bücher und Hörbücher Hosted on Acast. See acast.com/privacy for more information.
Früher reichten ja Beziehungen, um an gute Handwerker zu kommen, heute muss es offenbar eine Überweisung sein. Jedenfalls empfahl Handwerkspräsident Jörg Dittrich verzweifelten Kunden: "Pflegen Sie einen guten Kontakt zu Ihrem Handwerker wie zu Ihrem Arzt." Mit anderen Worten: Wer gerade einen Klempner oder einen Fliesenleger sucht, sollte zum Geldabnehmen nüchtern erscheinen und vor dem Lesen des Kostenvoranschlags seine Lungenfunktion überprüfen lassen. Eine Glosse von Peter Jungblut.
Der Witz des Tages vom 31.01.2025 mit dem Titel 'Zwei Klempner' als Video.
Der Witz des Tages vom 31.01.2025 mit dem Titel 'Zwei Klempner' zum Hören.
Die beiden Freunde Johannes und Stefan eröffnen ihre erste eigene Bäckerei. Und die braucht natürlich einen hippen Namen, denn was Friseursalons können, können Fachgeschäfte für Backwaren doch auch, oder? Und erst Klempner und Arztpraxen! Du hast auch ne Namensidee, die sich frech, fröhlich und frei anhört? Dann ab auf den Anruzfbeantworter damit: 0228-30412883.
Seit den 1980-er Jahren flimmert Super Mario über die Bildschirme der Videospielkonsolen. Es ist das erfolgreichste Videospielfranchise überhaupt – aber woher kommt es überhaupt? Und warum ist ein Klempner mit roter Mütze so erfolgreich? Darum dreht sich diese Folge von „Aha! History“. Außerdem geht es das erste Mal, als ein Computer einen Schwachweltmeister schlagen konnte. "Aha! History – Zehn Minuten Geschichte" ist der neue History-Podcast von WELT. Immer montags und donnerstags ab 6 Uhr. Wir freuen uns über Feedback an history@welt.de. Produktion: Christian Schlaak Host/Redaktion: Wim Orth Redaktion: Janne Hoppe Impressum: https://www.welt.de/services/article7893735/Impressum.html Datenschutz: https://www.welt.de/services/article157550705/Datenschutzerklaerung-WELT-DIGITAL.html
Jaja, der Dezember hat es jedes Jahr so richtig in sich. Anfangs denke ich, wie schön! Weihnachtsmarkt, Gemütlichkeit bei Kerzenschein... doch auch dieses Jahr stapeln sich wieder die Aufträge, sodass ich kaum weiß, wo mir der Kopf steht. Darum lese ich heute erneut eine Geschichte von mir vor, die ich vor wenigen Tagen geschrieben habe. In der Schreibwerkstatt hatten wir den Auftrag bekommen, ein „Memoir“ zu schreiben – eine eigene Erinnerung, die wir einer dritten Person zuordnen, und wo wir auch Zeit und Ort verändern. Heißt: Wir entfremden unsere Erinnerung. Da ich kurz zuvor den gewaltigen Science-Fiction-Klassiker Soylent Green noch einmal mit einem Freund gesehen habe, und da einen Tag vor der Schreibwerkstatt der Klempner bei mir eine Rohrverstopfung in der Wand gelöst hat – Voilà – wurde eine Geschichte daraus...
Liebius hat nach einer Woche keinen Ehering mehr, aber dafür Kabelbinder im Nachttisch. Darüber wundern sich die Gäste Casa Kardashian-Kestel aber im Zweifelsfall nicht mehr oder weniger als der Klempner über das, was er bei Kristin im Badezimmer findet.
Recording live at AAPD 2024, this episode of little teeth, BIG Smiles features Dr. Leon Klempner joining host Dr. Joel Berg to discuss the importance of marketing to grow a practice in this digital environment. In this candid conversation, Dr. Klempner elaborates on his path to choosing to specialize in orthodontics after dental school and how the specialties of pediatrics and orthodontics can come together to maximize business potential. Guest Bio: Dr. Leon Klempner is the director of orthodontics at the Icahn School of Medicine at Mount Sinai, assistant clinical professor in both the Department of Dentistry and the Department of Global Health as well as part-time faculty at the Harvard School of Dental Medicine. He completed his orthodontic specialty training at Tufts University and received his Doctorate degree from the University of Maryland. After graduation, he became a diplomate of the American Board of Orthodontics and practiced clinical orthodontics in private practice for 38 years. He has published articles in the American Journal of Orthodontics, Journal of Clinical Orthodontics, and numerous trade journals on the topics of early Class lll treatment and orthodontic marketing. In addition to teaching the Harvard orthodontic residents, he serves as the director of orthodontics and the cleft palate/craniofacial orthodontist for the Mount Sinai Hospitals in New York state. Dr. Klempner founded the Smile Rescue Fund for Kids, a nonprofit charity focused on helping children in Africa and is the CEO of People + Practice, a digital marketing agency for pediatric dentists and orthodontists.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Der Nachfolger von Mario 64 konnte damals zwar die Massen begeistern, hat aber im Laufe der Jahre eher einen negativen Ruf bekommen. Es ist fast ein Running Gag Super Mario Sunshine als das schlechteste Mario Game zu bezeichnen. Das können unsere Mario Experten aber so nicht stehen lassen. Der Urlaubstrip von Mario zu den Palmas auf der Isla Delfino ist mit Sicherheit etwas eigenwillig, aber wie gut oder wie schlecht er wirklich ist und inwiefern sich Meinungen darübre auch ändern können, bequatschen Dennsen und Matthias in dieser Folge.
... aber Olaf Scholz nicht Nationalspieler. Kontra K peitscht Nagelsmanns Jungs an. Alles Gute, Malu Dreyer. Gouda mit Erdbeer-Konfitüre. Suse, Paul und Hajo Schumacher starten mit Witzigem, Wichtigem uind Wirrem in eine spannende EM-Woche. Unsere Themen: Friedrich Merz im Eurofighter. Tomatensamen-Startup. Bodo Wartke und der eklektische Klempner. Fleisch zu Beton. Seetang und Aminosäuren. Kontaktschuld bei Milei? Imker tragen Gucci. Vorbild Coldplay. Plus: Fußballreporterin Suse eskaliert live. Folge 765.
JCO PO author Dr. Samuel J. Klempner shares insights into his JCO PO article, “PD-L1 Immunohistochemistry in Gastric Cancer: Comparison of Combined Positive Score and Tumor Area Positivity across 28-8, 22C3, and SP263 assays”. Host Dr. Rafeh Naqash and Dr. Klempner discuss assessing the analytical comparability of three commercially available PD-L1 assays and two scoring algorithms used to assess PD-L1 status in gastric cancer samples. TRANSCRIPT Dr. Abdul Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I am your host, Dr. Abdul Rafeh Naqash, Social Media Editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center. Today we are excited to be joined by Dr. Samuel J. Klempner, Director of Gastro Esophageal Medical Oncology and Assistant Professor at Harvard Medical School Mass Gen Cancer Center and author of the JCO Precision Oncology article, “PD-L1 Immunohistochemistry in Gastric Cancer: Comparison of Combined Positive Score and Tumor Area Positivity Across 28-8, 22C3, and SP263 Assays.” At the time of this recording, our guest disclosures will be linked in the transcript. Dr. Klempner, welcome to our podcast and thanks for joining us today. Dr. Samuel J. Klempner: Happy to be here. Thanks for having me. Dr. Abdul Rafeh Naqash: For the sake of this podcast, we'll be using our first names. So, Sam, it was great to see you at ASCO recently, where I believe you presented these data as an abstract as well. Dr. Samuel J. Klempner: Yes, we had a poster presentation for this paper, which was published in parallel with the meeting. Dr. Abdul Rafeh Naqash: Congratulations, and I'm very happy that you chose JCO PO as the destination for these data. So we're going to be talking about a lot of different things today in the context of gastric cancer, which I know you treat very often in your clinic. So could you tell us what the treatment landscape for advanced gastric cancer currently is? Because that goes into the context of why I believe you and your colleagues went ahead with this project. Dr. Samuel J. Klempner: Yeah, happy to. As you know, unfortunately, half or more of our patients, by the time they come to medical attention for a gastric or GE junction or esophageal adenocarcinomas, unfortunately have advanced disease, often metastatic at presentation. So we have this large population of patients with advanced disease, and over the last couple years, we've actually made some substantial advances in the management and survival of this population. This has been mainly driven by biomarker selection, whether it be adding immunotherapy on top of HER2 therapy, whether it be testing for claudin and seeing the results with claudin directed therapies. And perhaps the vast majority of patients are potentially eligible for immune checkpoint inhibitors. We've seen several phase three trials, perhaps highlighted by CheckMate 649, KEYNOTE 859, rationale studies confirming that there are populations of patients who derive significant survival advantages from the addition of anti PD-1 on top of chemotherapy. So the landscape has really evolved into a biomarker directed world, which is exactly what we hope, because ultimately, the goal is, of course, to match patients with the best drugs at the right time. And that's really the background of where this analytical effort came from. Dr. Abdul Rafeh Naqash: Thank you for giving us that overview. Going to the second part, which, as you mentioned in your initial overview about the role of immunotherapy, and as we all know, immunotherapy has changed the treatment landscape for a lot of different tumor types. And as clinicians, we often see or ask, what is the PD-L1 positivity for, let's say, lung cancer, which is what I treat, and gastric cancer, which is what you treat. Some of the nuances that we don't necessarily go into when we're looking at those reports is the combined positivity score, the tumor proportion score, or the tumor area positivity. Could you give us an understanding, for the sake of our audience or for the sake of our trainees who might be listening to this podcast, what the CPS, or what the TAP mean and where they are used in the treatment landscape for biomarker selection in the context of gastric cancer? And how do you approach the different cutoffs for CPS when you're treating an individual in the standard of care setting for gastric cancer? Dr. Samuel J. Klempner: For sure, happy to. So I think eventually it all comes back to patients. When we're sitting in a clinic room with the patient, we want to be able to have features about the tumor that's going to tell us if a therapy is more or less likely to work, maybe if there's a prognostic implication so we have predictive and prognostic biomarkers. And PD-L1 expression does not appear to be particularly prognostic, but it does appear to be predictive of benefit from immune checkpoint inhibitors. Therefore, all of the phase 3 trials that we've seen in some way have linked the biomarker expression to outcomes, whether it's the primary endpoint, whether it's post hoc retrospective analyses, etc. What we've seen is that all of these phase 3 trials have largely used different antibodies to define PD-L1 strata within the trial. So whether that's 22C3, whether it's 28-8, whether it's 263, those are the predominant antibody clones used to examine PD-L1 expression in tumor samples. And it's been pretty clear across these large phase 3 trials that there is a trend with increasing PD-L1 expression and increasing magnitude of benefit. We see this in the improved hazard ratios in the CPS greater than five or greater than ten versus less than one, etcetera. However, the scoring systems have varied. There is TPS tumor positivity, which only accounts for tumor cells. There is combined positive score, which accounts for tumor cells and mononuclear infiltrates and involves counting cells. And then perhaps the most recent one is the tumor area positivity, which is essentially a non counting method to look broadly at the area of the sample that is expressing PD-L1. It was on this background that we said, is there analytical concordance among the main antibodies? Our work does not address whether there is difference in clinical outcomes between testing 28-8 and 22C3 and SP263. It is simply a pure analytical comparison of the three antibodies. Is a CPS 5, when you call it by 28-8, somewhat agreeable to a TPS or a TAP greater than five with the same antibody and with a different antibody. So we felt that this was kind of a question that hadn't really been fully addressed in the field and may help contextualize results for clinicians and ultimately cross trial comparisons. Dr. Abdul Rafeh Naqash: Thank you for that explanation. And you bring forth a very important question. And I remember this example of a patient with lung cancer who had tissue NGS done, and they had a limited gene panel with PD-L1 testing sent that showed a PD-L1 of close to 15 or 20%, and then another NGS panel with a different antibody, suggesting that they had a PD-L1 of close to 60-70%, which significantly changes the overall approach for treatment in the context of blood cancer. Is that something that you experience in gastric cancer also, in terms of variability for CPS, determining what treatment combinations you might be able to put an individual patient on? Dr. Samuel J. Klempner: It's rare that we have samples at any institution tested in multiple methods, but these types of papers and others had looked at some stuff similar and prior to our publication, but we know that there is both spatial heterogeneity. So if you test a tumor versus metastasis, you may have different PD-L1 scoring even in regions of large samples, like surgical resections, there will be some intra tumor heterogeneity in regions of expression. And then we also know that sometimes after therapy, for example, post radiation, there's some data that at the time of surgery, the PD-L1 expression may be higher than what the presurgical sample was. So there's a lot of variables that are factored in. But one thing that wasn't really well known is, across the standard antibodies, how well is the inter assay comparison? There had been some work from a group in Singapore, a very nice paper suggesting that at the higher cut points, the agreement was pretty good across the assays, CPS greater than 5 and greater than 10, and maybe slightly less so at the lower. They had used a different method, which was not really what is standard, and they had used multiplex immunofluorescence or IHC. This is not a validated method for PD-L1 scoring. So that was an open question, sort of. Although they laid a very important piece of data down, we wanted to use the most standard assays and essentially do a very similar analysis, but using the standard scoring criteria. Dr. Abdul Rafeh Naqash: Very interesting. So, could you walk us through the approach of how you looked at this question, what kind of samples you used and what kind of testing algorithms you implemented to look at the cross validation of these three different antibodies? Dr. Samuel J. Klempner: The antibodies were chosen primarily because those are the standard ones that either have companion diagnostics or have been used most commonly in phase 3 trials. So 22C3 has most commonly been linked to pembrolizumab, 28-8 to nivolumab, and 263 used with Roche and Genentech trials primarily. And so we selected the antibodies based on the common use. We selected the scoring systems of CPS and TAP, again based on the most commonly used and validated scoring algorithms in gastric cancer. And then, although most patients in clinic and metastatic disease present with biopsy samples from the primary tumor, there may be some limitations in biopsy samples in terms of small amount of material and ability to reliably count 100 cells, etc., for CPS. So we actually use surgically resected samples from a commercial biobank, 100 samples, and essentially 28-8 was really the reference. And we picked samples that, using 28-8 CPS PD-L1 expression represented the entire spectrum, meaning we had CPS less than 1, we had greater than 1 and less than 5, greater than 5 and less than 10, and greater than 10, so that we could compare across these different strata, because those are the most common strata that have been used in clinical trials and linked to magnitude of benefit. Dr. Abdul Rafeh Naqash: And something that, interestingly, I see here when we go to some of the results, and I'm pretty sure you'll talk about the concordance, is the correlation coefficient seems to increase as the percentage positivity increases for a certain antibody. Could you try to help us understand why that might be the case? Is it because it's easier for the pathologist to look at the slide when there is a certain level of positivity that crosses a certain threshold? Or could there be some other factors that are not well understood. Dr. Samuel J. Klempner: Yeah, it's a totally good question, and I think it's something that's seen in other IHC biomarkers as well. If you look at HER2, you'll see some similar trends. The agreement at IHC 3+ is pretty good and greater than it is at lower cut points. And having talked to multiple pathologists, and I'm not a pathologist, we had three pathologists scoring all of these samples, and essentially, it's what you might expect. It is just easier when there's a lot of the marker. It is easier to judge the high extremes of the strata. So the agreement at greater than 10 is quite good, and this has already been shown by others. It's just an easier thing to score for anyone. The agreement is better across all of the assays at higher cut points, whether it's TAP greater than 10% or CPS greater than 10%. And you can see that pretty clearly in our data, and it's also been shown in other data sets looking at roughly similar questions in other tumor types. Dr. Abdul Rafeh Naqash: Going to the interesting results that you have in this paper, could you highlight for us some of the important findings that you had and put them into context of what their clinical implications may be? Dr. Samuel J. Klempner: Yeah, I think I'll start with the clinical implications so that what clinicians, and we're both clinicians, what we want to know is, if I have a report that says the CPS is greater than 1 and it's done with a 22C3 test, is that also likely to be greater than one if it had been done with a 28-8 test or scored with a different algorithm - CPS versus TAP? So, essentially, some degree of confidence on the interchangeability between the assays themselves, that is really the clinical implication. And so, to accomplish this, we set out to basically do the comparisons you'd have to do to convince yourself that that is true. So you take samples against a reference range, in this case, across the PD-L1 strata, you pick a reference test, in this case, 28-8, you have one pathologist be the start, and then you compare other pathologists against each other and that person, and you look. And in the pathology literature, they have strata of agreement which tend to go from poor, moderate, good to excellent. And these are sort of accepted standards in the pathology world about inter reader agreement. So between one pathologist and another, and things that are moderate or good are considered essentially acceptable at interchangeable levels. And so, as you suggested, at the higher cut points, the agreement is very good. The clinical interpretation of that is that if you get a TAP greater than 10% scored on a 22C3 antibody on a Dako staining system, you can feel relatively confident that that would also be called a TAP or a CPS greater than 10 by a 28-8 antibody, suggesting there is good agreement between the two antibodies at that cut point. As you move down, there is a little bit less agreement, and that is consistent with what's been shown before. But in our data set, the agreement was still pretty good across all three of the antibody clones, even at the lower cut point, so greater than 1% for TAP or CPS greater than 1. And that provides, I think, some reassurance to clinicians that whatever test their own pathology lab is using, if it's one of these three assays, they can provide some degree of confidence that what they're seeing would be similar to what they were seeing if it had been done with another test. Dr. Abdul Rafeh Naqash: I think that that is very important, because even though we do want broad testing in general for metastatic tumors, as you probably will agree with, but there's a lot of practices still that institutions tend to do their own testing with limited gene panels or even IHCs. So I think to put that in the context of your study, as you said, if you have a certain antibody that is positive, as you've shown, then that also likely means that with another antibody that your institution may not test for, it's likely the tumor sample is likely going to be positive at a similar level. So I think you also used digital pathology as part of this project, even though that may not be the most important aspect. As we move slowly and steadily towards artificial intelligence and machine learning, could you tell us how you incorporated the digital assessments and how you utilize them to correlate with the pathologist assessment and the futuristic perspective of how we could eventually try to incorporate digital pathology assessments for this kind of staining approach, which might limit interobserver operability differences as well as time constraints? Dr. Samuel J. Klempner: I hope I can do this part justice, because, again, I'm not a pathologist. But the digital imaging analysis was really essentially used as a quality check and verification tool in our own paper. Our intent was not to establish DIA directly as a superior methodology to TAP or CPS, but simply to provide ourselves some degree of confidence in the staining pattern and distribution across the three assays, and whether or not this would generate significant differences in what the PD-L1 score would have been called. And so, the bottom line is, the digital imaging analysis suggested there were very minor differences across the three assays in terms of, like, percent cell positivity, which is one of the main readouts, and the mean difference was actually quite small. So we felt that the digital imaging analysis, which was really considered somewhat exploratory in our own work, supported what we saw with the pathology comparators read in traditional methods. I think it sets somewhat of an initial pilot data benchmark to say that maybe we can think about moving tools like digital imaging analyses forward in terms of PD-L1 scoring approaches in the future. But it does not provide adequate data to say that we can do this now or we have enough samples and enough comparisons to say that, “Hey, for sure, digital imaging is equivalent to pathology reading.” I think that we're getting there and our data supports that that may ultimately be the conclusion, but for us it was really essentially an orthogonal support and sanity check for our traditional approach, which is, of course, a pathologist based scoring. So supportive and suggestive, but not definitively conclusive. Dr. Abdul Rafeh Naqash: Definitely early days for visual pathology assessments, but I think that it's a very rapidly evolving field, and hopefully we'll see more of this in the next few years, as well as incorporating some assessments into clinical trials. Now, shifting away from your honorary pathologist role as part of this project to your actual role as a clinician investigator/clinician scientist, could you tell us your career trajectory, how you started, how you've self paced yourself, and how you've tried to mentor certain different individuals in your current role? Dr. Samuel J. Klempner: Yeah, I remember my grandfather and other people telling me, just try to leave it a little bit better than you found it. And so that's, I think, a guiding principle. I hope that at the end of my own career, I can leave oncology a little bit better than when I started. I think the best way to do that is to mentor and train the next generation who are going to drive these practices. I started, like many others, personally touched by cancer in my family, which started me on a journey towards oncology, was somewhat frustrated by the lack of options available to my mom, and then became deeply interested in the science and how come we knew so little about cancer, so spent a fair amount of time in labs, and had a really formative experience with Lew Cantley looking at PI3 kinase resistance and signal transduction, and wanted to learn to speak the language and interact with people driving the lab based work. And that's been something I've tried to keep as central to my career as someone who has a very strong translational interest. And so I try to think of ways that I think we can learn from every single patient and every subgroup. I mean, for example, in our own work here, it's very unclear if there's a biology linked to the different PD-L1 strata. So for example, does a PD-L1 CPS greater than 10 tumor have a very high interferon gene signature? Or are there features of the T cells that are different between a CPS 10 or higher versus a less than 1? So PD-L1 is a biomarker, but is it really telling us about biology? And so these are the types of questions that I try to stimulate in all the residents and fellows and hopefully it will drive translational projects. But I think just having the conversations and asking the questions and talking to people. I mean, I love the ASCO Career Lounge and always try to do that when possible. I know you do the same. I think staying curious is really the thing that I try to remain in life and also in my career and have fun and enjoy with your colleagues. And I think that will make us all better researchers and ultimately translate to better outcomes for our patients, which is, of course, why we all do this. Dr. Abdul Rafeh Naqash: Wonderfully said Sam, thank you so much. Thanks again for choosing JCO PO as the final destination for your work. Hopefully we see more of the similar work that you do in your field in JCO PO. And thank you for talking to us about your journey as well. Dr. Samuel J. Klempner: Yes, thanks for having me. I'll talk to you sometime soon. Dr. Abdul Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Disclosures Dr. Klempner Stock and Ownership Interests TP Therapeutics Nuvalent, Inc Honoraria Merck Serono Consulting or Advisory Role Atellas Pharma Bristol-Myers Squibb Merck Daiichi Sankyo/UCB Japan Sanofi/Aventis Mersana Exact Sciences Novartis SERVIER AstraZeneca Amgen I-Mab iho Oncology
Nach einer Weile der Abstinenz melden wir uns mit einer neuen Folge des RetroCast zurück. Heute besprechen Kim und Flo den Game Boy-Klassiker Super Mario Land, der nicht nur der erste Mario-Titel auf der beliebten Handheld-Konsole war, sondern auch retroperspektiv ziemlich vieles anders macht, als wir es von den Spielen rund um den beliebten Klempner gewohnt sind. Kim und Flo gehen neben eben diesen Unterschieden näher auf die Entwicklungsgeschichte, dem eigentlichen Gameplay und ihre eigenen Erfahrungen mit dem Titel ein und beantworten dazu noch die Frage, wieso Super Mario Land nie im Bundle mit dem Game Boy erschienen ist. Und dann klären wir euch noch auf, wieso denn Adis nicht an Flos Seite über diesen Klassiker spricht.
Fast zwanzig Jahre nach der Erstveröffentlichung für den GameCube im Jahr 2004, haben Nintendo und Intelligent System ein Nintendo-Switch-Remake von Paper Mario: Die Legende vom Äonentor veröffentlicht. Das zweite Papier-Rollenspiel-Abenteuer von Mario führt den Klempner auf die Suche nach den Sternjuwelen. Alex, Markus und Sören haben sich nach Rohlingen begeben und die umliegenden Gebiete gemeinsam […]
Völlig überraschend ist am Dienstag der Produzent Steve Albini gestorben, einer der einflussreichsten Musiker der letzten Jahrzehnte. Nirgendwo klang ein Schlagzeug besser, echter, kraftvoller als bei ihm. Jan erinnert an den Mann, der Nirvana und die Pixies produzierte, und der sich als Handwerker verstand und „wie ein Klempner“ bezahlt werden wollte. Zudem geht es in dieser Folge um das neue Album der Kings of Leon, die zum ersten Mal mit dem Starproduzenten Kid Harpoon gearbeitet haben. Hat diese Band of Brothers noch was zu bieten? Klingt "Can We Please Have Fun", als hätten sie Spaß? Jan und Birgit sind da geteilter Meinung. Und: Sie sprechen über den Eurovision Song Contest, ihre Favoriten, und die Kontroverse um die Teilnahme Israels. Der Brief Steve Albinis an Nirvana: https://news.lettersofnote.com/p/nirvana 00:00 Steve Albini (1962–2024) 09:50 Kendrick vs. Drake: Die nächste Runde 11:45 Eurovision Song Contest '24 21:30 Jessica Pratt, "Here in the Pitch" 22:55 Kings of Leon, "Can We Please Have Fun" Learn more about your ad choices. Visit megaphone.fm/adchoices
Welcome to another insightful episode of the Oncology Brothers podcast! In this episode, hosts Rahul and Rohit Gosain are joined by Dr. Sam Klempner, a medical oncologist specializing in upper GI malignancies. Together, they delve into the current treatment strategies for esophageal, GE junction, and gastric adenocarcinoma. The discussion covers a range of topics, including the evolving paradigms in neoadjuvant and adjuvant therapies, the importance of biomarker testing such as MSI and PD-L1, and the potential impact of new targets like Claudin 18.2 in upper GI cancers. Dr. Klempner also shares insights on the management of metastatic disease, including the role of targeted therapies like TDXD and Zolbetuximab. Whether you're a healthcare professional or simply interested in the latest advancements in oncology, this episode provides valuable information on the current landscape of upper GI malignancies. Stay informed and join the Oncology Brothers as they navigate the complexities of treating these challenging cancers. Don't miss out on this informative discussion! Tune in to the Oncology Brothers podcast for more expert insights and discussions on oncology topics. Remember to like, share, and subscribe for more content on the latest developments in cancer care. Thank you for listening!
Ganz entspannter Sonntagsfahrer, Foltergeräusche aus der Nachbarschaft, Reizüberflutung am Handheld und sympathische Serienmörder aus den 80ern.
In dieser Folge der Creepy Hour nimmt dich Bibi mit nach Kanada. Sie stellt dir den True Crime Fall rund um Adam Strong aus Oshawa vor, ein Mann, dem jeglicher Sinn für Recht und Unrecht fehlte. Bibi hat sich intensiv mit diesem Fall auseinandergesetzt, und was sie dabei entdeckt hat, ist nichts für schwache Nerven. Warum ausgerechnet zwei Klempner dafür gesorgt haben, dass dieser Fall aufgeklärt wurde, erfährst du in dieser Folge. Hinweis: Diese Folge behandelt grausame und verstörende Handlungen. Zartbesaitete Creepys seien gewarnt.
Das wird gleich weh tun! Abgestürzt auf einem Wüstenplanet kämpfen sich Niklas & David verkleidet als Klempner zurück in die Freiheit. Klingt komisch, wird aber noch komischer. Nach dieser Folge hinterfragt ihr das Konzept Tisch und lernt den Mann kennen, der vor Davids Augen plötzlich zwei echte Oscars ausgepackt hat. Willkommen zur schönsten Zeit der Woche - Happy Hour mit den Dudes LIVE TOUR 2024 SOLD OUT Instaram: https://www.instagram.com/niklasunddavid/?hl=de dudes. Der Podcast: https://www.instagram.com/dudesderpodcast/ TikTok: https://www.tiktok.com/@niklasunddavid Du möchtest mehr über unsere Werbepartner erfahren? Hier findest du alle Infos & Rabatte!: https://linktr.ee/dudes_podcast
Manchmal fühlt sich eine Folge Lehrersprechtag schon bei der Produktion so anstrengend und beschwerlich an wie den Gotthardtunnel zu bauen. Der erste Spatenstich erfolgt noch mit voller Motivation doch schon bald merken die Studienräte, dass sie direkt beim Thema Schaltjahr mit einem Holzbohrer auf Granit stoßen. Auch bei aktuellen Themen wie der Ergreifung der RAF-Terroristin Daniela Klette und neuen Waffenlieferungen an die Ukraine schaben sie sich nur mit Löffeln durch das Massiv des Gotthard und buddeln auch Blindschächte wie ein Assoziationsspiel mit Skandinavien. Beim Klopper der Woche über Herrn Batzkes absurdes Erlebnis mit den Klempnern wird dann doch Meter gemacht, bevor sich die mündliche Prüfung dann nochmal anfühlt wie 1717 Meter Deckgebirge, schwer zu durchdringen, aber mit hoher Relevanz. Es geht nämlich um den Väterreport 2023 und Alex' persönliche Einordnung in seine Vaterrolle. Ist er eher ein "Überzeugter Engagierter" oder ein "Überzeugter Rollenbewahrer"? Findet es heraus. Der Tunnel mäandert dann noch hin zur Frage nach Jobs und Alternativen zum Lehrerberuf wie zum Beispiel Politurmodel auf der IAA. Wie durch ein Wunder schaffen die Studienräte am Ende den Durchstich auf der anderen Seite des Gebirgsmassivs und zwar mit einer Musikhausaufgabe, die perfekt zum Heute vor passt. Und dann tretet ihr heraus in das sonnendurchflutete und schneebedeckte Tal der Schweizer Alpen, hört in der Ferne schon den Après Ski Hit "Die Könige vom Berg" von den räudigen Studienräten und denkt euch: Zum Glück findet eine solche Schaltjahrfolge Lehrersprechtag erst wieder im Jahr 2052 statt.
Man zockt gerne mit ihm und seinen Gefährten, doch wie hat alles für Super Mario begonnen? Mic und Foxi begeben sich auf Spurensuche in die Nintendowelt. Bei ihren Recherchen stießen die beiden Super Mario Fans auf spannende Fakten zur Entstehung des Konsolen-Helden. Klar, "Its a me, Mario" heißt wohl eigentlich "Itsumi Mario", was auf Japanisch so viel bedeutet wie "Super". Doch musste Super Mario auch seinen Beruf wechseln, denn ursprünglich war er nicht Klempner sondern Zimmermann ;-) Hosted on Acast. See acast.com/privacy for more information.
Mario kann nicht nur zwei sondern auch 3D. Und in keinem anderen Spiel hat er alle Himmelsrichtungen so sehr ausgenutzt wie in Super Mario Galaxy. Vor mittlerweile schon 17 Jahren schoss sich der hüpfende Klempner ins All um das zu tun was er nun mal am besten kann. Ob dieses Spiel aber insgesamt vielleicht etwas nostalgisch verklärt ist, oder ob es wirklich seinen Platz unter den Sternen verdient, darüber sprechen Dennsen und Matthias in dieser Folge!
Feedback is the cornerstone of your practice's professional standing. Both patients and referring doctors actively search for reviews, underscoring the pivotal role that effective review management plays in shaping and maintaining your good reputation. Today, Jessie Pressman, the Head of Consulting at People + Practice, will impart crucial insights into navigating patient reviews. Drawing upon her extensive experience in overseeing the reputations of orthodontists, Jessie will provide proven strategies for addressing negative feedback and offer guidance on responding to positive reviews. And remember, for forward-thinking Orthos, there has never been a better time to be an Orthodontist. It's the Golden Age, so take advantage of it. IN THIS EPISODE: [0:00] Dr Leon introduces today's topic: Managing Your Reviews with Jessie Pressman. [3:06] Jessie explains how managing a practice's reputation has changed over the years and ways that you can collect positive feedback. [7:04] Jessie discusses what strategy and approach she has made to the People + Practice Program and gives examples of how her approach has resolved issues. [11:20] Jessie explains what to do and say when you get a negative review and why you never apologize. [15:47] Jessie outlines the times you don't respond to a review and when to report them to Google. [19:31] Jessie recommends some tips regarding getting reviews and responding to them. KEY TAKEAWAYS: [4:13] There are ways to collect positive feedback from your patients. The tip is to ask for a review. When someone is happy, they don't think of leaving a review. You have to ask by prompting the client for a review. [4:53] Google is the search engine where you should spend your time and energy cultivating and responding to reviews. Facebook is no longer the preferred platform to use. Google is King. [14:10] There are legal reasons you should never apologize for a patient's bad experience in the office. Be very careful that you do not violate HIPAA laws. RESOURCE LINKS People + Practice - Website Leon - Email Amy - Email People + Practice - Email Jessie Pressman - Email People + Practice Blog - Jessie Pressman BIOGRAPHY: NEW YORK, Oct. 3, 2023 /PRNewswire/ -- People + Practice LLC, a leading marketing agency specializing in strategic consulting and brand development for healthcare practices, is thrilled to announce the appointment of Jessie Pressman as Head of Consulting. This strategic step signifies an ongoing commitment to enhancing consulting services, coupled with a robust investment in team development. Jessie is passionate about fueling practice growth for the doctors and teams that make healthcare happen. Her 20 years of experience managing people and marketing for small businesses, combined with her positivity and innovation, has fueled People + Practice's growth over the past decade. With an eye for efficiency and growth opportunities, Jessie will lead the People + Practice team of Growth Consultants, who serve a diverse range of clients across the country and abroad, helping them navigate the complex marketing landscape to achieve their business objectives. Her focus will be on providing strategic guidance and actionable solutions. "As Head of Consulting for People + Practice, I'm excited to help our team of consultants grow in their careers, stretch their creativity and uncover growth opportunities for practices. I'm eager to help our company scale, but it's equally important to me to build upon the agency's core values of creating a meaningful and inclusive work environment that allows for work-life balance," said Jessie about her commitment to the company. "People + Practice has always supported me and I'm eager to continue extending that support to our team." Jessie's extensive expertise spans multiple industries, including technology, healthcare, finance, and consumer goods, and she has previously served in executive roles at Bluewolf (an IBM Company) and BSL Concepts. She has consulted with nameworthy brands like Sony Music Entertainment, The Hearst Corporation, HBO, Ogilvy & Mather and Time Inc. Jessie is a proud Brandeis University alumna, a committed New Yorker and a bookworm. "We are delighted to announce Jessie Pressman as our Head of Consulting," said CEO and Co-Founder Dr. Leon Klempner. "Her exceptional talent and passion for delivering strategic solutions align perfectly with our vision to provide unparalleled marketing consultancy services. Her unique ability to analyze market dynamics and identify untapped opportunities will be instrumental in driving measurable results for our clients," concludes Klempner. About People + Practice LLC: People + Practice LLC is a leading marketing agency specializing in strategic consulting and brand development. We help our clients navigate the ever-changing marketing landscape and achieve their business objectives through innovative strategies, creative solutions, and measurable outcomes. With a team of seasoned professionals and a deep understanding of diverse healthcare industries, we deliver exceptional results and drive sustainable growth for our clients. For more information, visit www.pplpractice.com. QUOTES: “I saw practices who had never seen a negative comment come through in five or six years and suddenly start receiving negative comments, two, three times a month, which is concerning for practices because your reputation online means a lot. Prospective patients and referring doctors are looking at those. It's your name. So, there has been a spike in negativity, and we need to work to combat it.” Jessie Pressman “Another pro tip is to respond to the positive reviews. People love getting a response from you as a practice. It looks fabulous for prospective patients coming and looking at your page. Also, it's great for SEO. Again, we want to ensure that that is integrated into our marketing, which helps raise the profile.” Jessie Pressman
Der Winter hat Deutschland fest im Griff und auch in der Bundesregierung herrscht eine eisige Atmosphäre: Wo sollen bloß die fehlenden Milliarden Euro für den Haushalt herkommen? Viel Zeit bleibt nicht mehr. Da hilft nur eins: Ein Besuch in der weihnachtlichen "Haushaltsbäckerei". Und wenn der Kanzler schon auf Bäcker macht, dann kann er den Job als Heizungssanitär auch gleich mit übernehmen. Den Titel als "Klempner der Macht" hat er laut Friedrich Merz ja bereits sicher. Wenn Scholz den Titel jetzt klug vermarktet, könnte das den Haushalt retten. Vergesst "Super Mario“ – jetzt kommt "Super Olaf"! Außerdem fragt Moderator Peter Stein: Wenn die deutschen U17-Fußballer so gut sind: Können wir die dann nicht auch bei der WM im nächsten Jahr antreten lassen? Exklusive Recherchen zeigen: Der DFB denkt schon über eine Kinderfußball-Nationalmannschaft nach, und die FIFA wittert ein großes Geschäft mit den Kleinen! Aus den Kinderschuhen ist Chat-GPT inzwischen raus, in diesen Tagen feiert die künstliche Intelligenz ihren ersten Geburtstag. Höchste Zeit sich den wichtigen Themen der Welt anzunehmen: Wie können wir den Klimawandel stoppen? Für eine Antwort auf diese Frage muss man nämlich gar nicht bis nach Dubai zur Weltklimakonferenz reisen. Unser Gewinnspieltipp: NDR Info verlost Sprechrollen in der Intensiv-Station https://www.ndr.de/ratgeber/weihnachten/Adventskalender-NDR-Info-verlost-Sprechrollen-in-der-Intensiv-Station,intensivstationadvent103.html Unser Audiothekstipp: "Schumacher. Geschichte einer Ikone": https://www.ardaudiothek.de/sendung/schumacher-geschichte-einer-ikone/12909235/ Musiktitel in dieser Folge: "Man of many words" – Joe Louis Walker "Money, money, money" – Nils Landgren Funk Unit "Everybody wants to rule the world" – Bow Anderson "Happy" – Angel "An irgendeinem Tag wird die Welt untergehen" – Kapelle Petra "Klimawandel" – Alex Döring "We are the champions" - Max Raabe und das Palast Orchester
Wenn die Ampel-Kreditkarte gesperrt ist, hilft kein Klempner, sondern hoffentlich die Opposition. Es darf gespart werden beim Winter-Start-Verkauf mit Onkel Fisch! Inklusive kostenlosem Elbtower in jedem 7. Podcast. Versprochen. Ihre Signa-Holding. Von Onkel Fisch.
Kann der Rückzug ins Private gefahrlich sein für die Demokratie? Unsere Gesprächspartnerin sieht die Risiken woanders. Satiriker Mathias Tretter zwischen Klempnereien und Neuwahlen. Und Host Carolin Courts staunt über deutschen Mut zum Weihnachtsmarkt. Von WDR 5.
NEU: Weltwoche Deutschland. Hier klicken, um die neue App gratis herunterzuladen: http://tosto.re/weltwochedeutschland Hier finden Sie das kostenlose E-Paper der ersten Ausgabe: https://weltwoche.de/erste-ausgabe Steigen Sie ein, fliegen Sie mit! https://weltwoche.de/ Abonnieren Sie kostenlos den täglichen Newsletter der Weltwoche: https://weltwoche.de/newsletter-abonnieren/ Friedrich Merz beleidigt die deutschen Klempner. Deutschland braucht weniger Staat, mehr Freiheit. Macht vor Recht: Westliche Doppelmoral in Israel. Milliarden für Teheran: Interessanter Saudi-Friedensplan. ARD will Programme für Ältere streichenDie Weltwoche auf Social Media:Instagram: https://www.instagram.com/weltwoche/ Twitter: https://twitter.com/Weltwoche TikTok: https://www.tiktok.com/@weltwoche Telegram: https://t.me/Die_Weltwoche Facebook: https://www.facebook.com/weltwoche Hosted on Acast. See acast.com/privacy for more information.
Eine Regierungserklärung voller Rechtfertigungen – so reagierte der Kanzler auf das Urteil zum Nachtragshaushalt. Dagmar Rosenfeld und Robin Alexander diskutieren über die ausbleibende Entschuldigung von Olaf Scholz, die Suche nach einem Ausweg aus dem Schuldenbremsen-Dilemma und die nächste Angriffsstufe von Oppositionsführer Friedrich Merz. Außerdem geht es im „Hinterzimmer“ um den Schuldenbremsen-Kurs der Union und in der „Erkenntnis der Woche“ um einen Grünen-Parteitag zwischen Wunsch und Wirklichkeit. Wir freuen uns über Feedback an machtwechsel@welt.de Noch mehr Politik? „Das bringt der Tag“ – jeden Morgen ab 5 Uhr die aktuellen News und dazu das Thema des Tages. Für alle, die wissen wollen, was heute wichtig ist. WELT-Redakteure, Korrespondenten und Reporter ordnen die aktuellen Schlagzeilen ein, erklären, wie es dazu kam und was die Nachrichten für uns bedeuten. Weil morgens oft wenig Zeit bleibt, bringen wir Sie in etwa 10 Minuten auf Stand. Redaktion: Sonja Gillert, Wim Orth Produktion: Lilian Hoenen Impressum: https://www.welt.de/services/article7893735/Impressum.html Datenschutz: https://www.welt.de/services/article157550705/Datenschutzerklaerung-WELT-DIGITAL.html
Friedrich Merz hat Olaf Scholz vorgeworfen, ein Klempner der Macht zu sein - hier kommt seine musikalische Antwort...
Unsere Gesellschaft wird immer digitaler & und schließt damit einige Menschen aus. Außerdem: Warum traut sich die Regierung nicht, wegen des Klimas die Notlage auszurufen? Und: Host Carolin Courts mahnt: Trotz aller Krisen, wach bleiben! Von WDR 5.
Super Mario ist Kult. Seit den 80er-Jahren kennt fast jeder diese Videospiel-Figur. Gamechecker Alex hat mal geschaut, welche Höhen und Tiefen der Klempner durchlebt hat.
Experience the unexpected power of sound healing as Dr. Binyamin Klempner's extraordinary journey unfolds. From the tender age of six, the mesmerizing music of Tchaikovsky ignited a spark within him, setting him on a path unknown. But it wasn't until his son's diagnosis with paranoid schizophrenia that his exploration of sound therapy truly began. Join us as we delve into the transformative world of sound, where ancient instruments and melodies hold the key to profound healing and inner peace. Brace yourself for a tale filled with twists and turns, as the untold possibilities of sound therapy unravel before your very ears. In this episode, you will be able to: Navigate the transformative realm of sound healing. Explore the practice of Nad yoga for inner acoustics. Set free from the confines of understanding in meditation. Realize the potent impact of compassion in healing with sound. Expose yourself to the HARP method as sonic therapy. Embrace the transformative power of sound therapy with Binyamin Klempner. Dr. Klempner offers a unique approach to healing by utilizing sound. With an early spark of interest in the healing impact of music, Dr. Klempner took a sojourn into the power of sound. From reveling in the cosmic beats of the Grateful Dead to finding peace in the melodic rhythm of native flutes to a deep connection with the gong, his extensive journey with sound has led him to develop the therapeutic 'Harmonic Affect Regulation Protocol'. His work is a testament to his belief that true healing is tied to our ability to listen to and express our inner song. Dr. Klempner's dedication towards seeking alternative healing methods paves the way for an enlightening conversation. The key moments in this episode are: 00:00:15 - Introduction 00:03:55 - Journey and Healing with Sound 00:10:21 - Experimenting with Sound for Healing 00:14:10 - Expanding Sound Healing with Different Instruments 00:17:47 - The Graduation of Nad Yoga 00:19:19 - Language of the Inner Sound 00:20:38 - Letting Go of the Need to Understand 00:23:17 - Stepping Beyond Mental Acuity 00:29:47 - Compassion in Sound Healing 00:35:11 - The Power of Sound and Memory 00:36:23 - The Harp Method and its Origins 00:38:02 - Healing Traumatic and Positive Memories 00:40:01 - The Beauty of Ancient Healing Instruments 00:41:56 - Resources for Sound Therapy Resources: Check out Dr. Binyamin Klempner's work at https://theharpmethod.com/ Try Viori shampoo and conditioner bars to reduce plastic waste and support the environment. Use code Kara for 10% off your order. Explore the range of steel tongue drums available on Amazon for a calming and meditative experience Discover the healing power of native flutes and their ability to transport you to a meditative state Experiment with different types of chimes, such as koshi chimes and sulfagio chimes, for unique meditative experiences Consider adding a gong to your meditation practice, like a small 19-inch wuhan win gong or a larger 22-inch chow gong Explore the meditative and vibrational experiences of different types of gongs, such as Chinese gongs and Italian Grata Sonora gongs Embrace the opportunity to shift your mind, body, and spirit complex with simple healing practices like music and sound therapy
Join us for an enlightening episode of The Yakking Show as we delve into the world of sound-based therapy with the pioneering Dr. Binyamin Klempner, creator of the HARP method. Discover how bells, gongs, and chimes are harnessed to stimulate the Vagus nerve and the parasympathetic nervous system, bringing about profound healing and transformation. Dr. Klempner shares his groundbreaking work with prisoners, his unique training methods, and the life-changing benefits of his innovative system. Tune in and immerse yourself in the harmonious world of healing through sound! www.theharpmethod.com #VagusNerve #HARPMethod #Wellness #HealingThroughSound #WellBeing The Yakking Show is brought to you by Peter Wright & Kathleen Beauvais contact us to be a guest on our show. https://TheYakkingShow.com peter@theyakkingshow.com kathleen@theyakkingshow.com Join our community today so you don't miss out on advance news of our next episodes. https://bit.ly/3JW9w46 Timeline 01:40 What is HARP? 05:30 Working with prisoners 18:00 The Vagus nerve 19:00 The Sympathetic Nervous System 20:00 Conditions that HARP may help with 23:00 HARP Training Program 26:20 How many sessions? 30:00 Contact Dr. Klempner Here are some of the tools we use to produce this podcast. Hostgator for website hosting. Podbean for podcast hosting Airtable for organizing our guest bookings and automations. Audio Pen for transcribing voice notes Clicking on some links on this site will let you buy products and services which may result in us receiving a commission, however, it will not affect the price you pay.
David Gill ist Generalkonsul der Bundesrepublik Deutschland in New York. Er kann aber auch Wasserhähne austauschen, weil er gelernter Klempner ist. Er weiß um die Macht des Wortes, weil er Theologie und Jura studiert und lange mit Joachim Gauck zusammengearbeitet hat. Und er weiß, wie man steife deutsche Besuchsrunden in der Residenz auflockert - sei es mit Weihnachtsliedern am Klavier oder an einer großen runden Tafel, bei der keiner am Rand sitzen muss. Kurz: David Gill ist ein ziemlich cooler Diplomat. Und wir freuen uns riesig, ihn bei Wunderbar Together zu begrüßen und herauszufinden, wie er das geschafft hat.
United Souls Weekly Emuna Class by Eli Goldsmith featuring Dr. Binyamin Klempner "Healing Vibrations" Part 2 - https://fb.watch/kIqsvf4bQN/ Emuna is our Future - Mindful Inner Soul Work! Join the #practical #mindfulness #emunaclass #innerpeace Unity Inspires Projects - Partner here #Emunatour 2023 TBA - https://www.breslev.co.il/emuna-is-our-future.html #focusing on the #truth... Practical Spiritual Mastery In 3 Parts! Part 1 - https://www.youtube.com/watch?v=ZHO1a60zFNE Part 2 - https://www.youtube.com/watch?v=7trN3NrvMp4 Part 3 - https://www.youtube.com/watch?v=-fX4wgsFJ7Y Connect to Dr. Benjamin Klempner's "Vibrational Healing" - https://youtube.com/@soundsforthesoul896 Enjoy "Vibrational Healing" Part 1 - https://www.youtube.com/watch?v=qFoS1Ym_LMQ - Visit our website, Breslev Israel, presided by Rabbi Shalom Arush: https://breslev.com/video/emuna-is-our-future-practical-spiritual-mastery/ United Souls Latest Extract - Subscribe now - https://eligoldsmith.substack.com/p/united-souls-extracts-from-new-book-a0b?sd=pf Unity Focus by Eli Goldsmith :) #unitybookings #unitedsouls https://unityinspireprojects.com/speakers-mentalist-creatives/ https://unityinspireprojects.com/musicians/ Change the flow & go - enjoy our #relationship podcast - click & share - https://open.spotify.com/episode/6lyXvUaXUqsMrM5cySuSGm?si=8S-0T8goTZqJ6nJZAOPK7w Watch a recent #relationshippodcast - https://youtu.be/InwIhvakR-I Subscribe to our Youtube channel: https://youtube.com/playlist?list=PLCXGtU6y_0mgx28d2hehPKQC6xVXvjHVY Visit us on our official Facebook page: https://www.facebook.com/breslev.english Visit us on Instagram: https://www.instagram.com/breslev_english/ Did you like it? Don't forget to give it a like!
Hopefully, we shall be uploading many episodes from our Emuna Podcast as we make a transistion... stay tuned for a lot of content... till then Good Yom Tov! @EliUnityGoldsmith featuring Dr. Binyamin Klempner - @soundsforthesoul896 "Healing Vibrations" Part 2 - https://fb.watch/kIqsvf4bQN/ Emuna is our Future - Mindful Inner Soul Work! Join live, Click & Share on - https://www.youtube.com/watch?v=26a2w26f6VY Join the #practical #mindfulness #emunaclass #innerpeace Unity Inspires Projects - Partner here #Emunatour 2023 TBA - https://www.breslev.co.il/emuna-is-our-future.html #focusing on the #truth... Practical Spiritual Mastery In 3 Parts! Part 1 - https://www.youtube.com/watch?v=ZHO1a60zFNE Part 2 - https://www.youtube.com/watch?v=7trN3NrvMp4 Part 3 - https://www.youtube.com/watch?v=-fX4wgsFJ7Y Connect to Dr. Benjamin Klempner's "Vibrational Healing" - https://youtube.com/@soundsforthesoul896 Enjoy "Vibrational Healing" Part 1 - https://www.youtube.com/watch?v=qFoS1Ym_LMQ - Visit our website, Breslev Israel, presided by Rabbi Shalom Arush: https://breslev.com/video/title-emuna-is-our-future-climax-of-exile-to-geula/ United Souls Latest Extract - Subscribe now - https://eligoldsmith.substack.com/p/united-souls-extracts-from-new-book-a0b?sd=pf Unity Focus by @EliGoldsmith :) #unitybookings #unitedsoulshttps://unityinspireprojects.com/speakers-mentalist-creatives/https://unityinspireprojects.com/musicians/ Change the flow & go - enjoy our #relationship podcast - click & share - https://open.spotify.com/episode/6lyXvUaXUqsMrM5cySuSGm?si=8S-0T8goTZqJ6nJZAOPK7w Watch a recent #relationshippodcast - https://youtu.be/InwIhvakR-I Subscribe to our Youtube channel: https://youtube.com/playlist?list=PLCXGtU6y_0mgx28d2hehPKQC6xVXvjHVY Visit us on our official Facebook page: https://www.facebook.com/breslev.english Visit us on Instagram: https://www.instagram.com/breslev_english/ Did you like it? Don't forget to give it a like!
In this episode, we have the privilege of hosting a true trailblazer in the field, Dr. Leon Klempner. With over 38 years of experience as a board-certified orthodontist, Dr. Klempner brings a wealth of knowledge and expertise to the table.After graduating from the prestigious University of Maryland School of Dentistry, he pursued his passion for orthodontics and obtained his certification from Tufts University.With a deep understanding of the evolving landscape of orthodontic practices having practiced for many years, Dr. Klempner has become a recognized authority in the field of digital marketing and practice growth.Driven by his commitment to helping orthodontic practices thrive in a highly competitive economy, Dr. Klempner co-founded People + Practice with his daughter, Amy Epstein, a leading full-service digital marketing consultancy.As the CEO of this innovative firm, he has pioneered strategic approaches to position orthodontic practices for success in the modern era.In addition to his impactful work at People & Practice, Dr. Klempner extends his influence through various mediums. He co-hosts the popular podcast "The Golden Age of Orthodontics," where he shares invaluable insights, practical tips, and expert advice to empower orthodontists in navigating the challenges of their profession.His dedication to the industry and love for technology has earned him a well-deserved reputation as a thought leader and catalyst for positive change.Join us as we dive deep into his remarkable journey, where he shares his wisdom on the future of the orthodontics profession, dental technology to look out for, and some thoughts on early orthodontic treatment. Get ready for an engaging conversation that is sure to inspire and empower orthodontic professionals.Key Takeaways- Meet Dr. Leon Klempner (00:28)- Is modern orthodontics more difficult? (06:35)- Work-life balance as an orthodontist (09:20)- Leveraging technology to benefit patients (15:18)- Benefits of remote monitoring in dentistry (20:04)- People + Practice digital marketing consultancy (26:38)- Early orthodontic treatment (29:44)Additional Resources
My guest this week is Jesse Klempner, a partner in McKinsey's Washington DC office. McKinsey is focusing more on space recently and has published a number of interesting articles (see below for some examples). We discuss why McKinsey is paying more attention to space now and how corporates can and do work with space, among other topics. Enjoy! JUST OUT: Raphael's fully revised introductory book on the Space economy, "To Infinity" - https://a.co/d/6jIQ2LO Follow us: Twitter - https://www.twitter.com/podcast_space LinkedIn - https://www.linkedin.com/in/raphaelroettgen/ Instagram - www.instagram.com/raphael_space/ Learn more about space & the space economy: Check out the edX/EPFL Space Economy MOOC: https://www.edx.org/course/new-space-economy There is now a certificate for those wanting to enter the space sector: https://www.spacecertificate.com Do you want to specifically learn about investing in Space? Join the pre-release of Raphael's new live-taught course on Maven: https://maven.com/space-business-institute/investing-course The Space Business Podcast is sponsored by NanoAvionics. Support us at https://www.patreon.com/spacebusinesspodcast Example McKinsey space articles: Space: The missing element of your strategy Space launch - are headed for a shortfall? The potential of microgravity: How companies across sectors can venture into space Timestamps: 0:00 Intro 2:45 Why McKinsey is focusing more on space now 5:15 Getting space & non-space companies to cooperate 9:35 Taking the friction out of space 14:07 Companies integrating space as an enabling technology 18:29 Space mining 22:17 Space-based solar power 23:33 Lunar business models 25:14 Talking about space with the biggest companies in the world 29:15 Successful case studies of corporates implementing space 31:05 Successfully implementing new tech in an organization 31:47 How corporates can inform themselves 34:01 Most exciting space use case 36:15 Favorite space business model if you were an entrepreneur 37:31 Sci Fi
JCO PO author Dr. Brandon Huffman shares insights into his JCO PO article, “Analysis of Circulating Tumor DNA to Predict Risk of Recurrence in Patients With Esophageal and Gastric Cancers” and discusses the article's findings of ctDNA levels in the preoperative, postoperative, and surveillance settings in patients with EGC. Host Dr. Rafeh Naqash and Dr. Huffman discuss ctDNA assessments, treatment paradigms and interventions, and tumor-informed assays. TRANSCRIPT Dr. Abdul Rafeh Naqash: Hello, and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, social media editor for JCO Precision Oncology, and I'm also an Assistant Professor in Medical Oncology at the OU Stephenson Cancer Center. Today, I am excited to be joined by Dr. Brandon Huffman. Dr. Huffman is a gastrointestinal medical oncologist, and he's also an instructor in medicine at the Dana-Farber Cancer Institute at the Harvard Medical School. He's the lead author on today's JCO Precision article, "Analysis of Circulating Tumor DNA to Predict Risk of Recurrence in Patients with Esophageal and Gastric Cancers." Our guest's disclosures will be linked in the transcript. Dr. Huffman, welcome to our podcast and thanks for joining us today. Dr. Brandon Huffman: Of course. Thanks for having me. Dr. Abdul Rafeh Naqash: For the sake of this discussion, we'll refer to each other using our first names. So, Brandon, exciting to have you today. We're going to talk about this very interesting topic on circulating tumor DNA and how your team used the ctDNA assessment in patients with esophageal and gastric cancers. For the sake of the listeners, could we start by asking you what are the current treatment paradigms for early-stage esophagogastric cancers? Since you practice this on a daily basis, what is the current approach, briefly, which will play into how this study looked at ctDNA in the context of early-stage esophagogastric cancers? Dr. Brandon Huffman: Yes, definitely. Thanks first for having me. Thanks for highlighting our work, and I'm really excited to talk with you about our manuscript and research today. To answer your question about how to treat localized esophagogastric cancer, it's a little bit more specific depending on where in the esophagus, GE junction or stomach where the tumors arise. For instance, we treat esophageal and upper gastroesophageal junction cancers with, often, chemoradiation, neoadjuvantly, and that is followed by surgery. And if there's a pathologic incomplete response, then many patients will get Adjuvant Nivolumab, a PD-one inhibitor, whereas the lower the tumor is in the upper GI tract, most often, perioperative chemotherapy is used for the lower GEJ and gastric cancers. Dr. Abdul Rafeh Naqash: Thank you so much. And I know, I think to some extent, if I remember correctly, immunotherapy has been incorporated into this paradigm. Is that a fair assessment? Dr. Brandon Huffman: That's exactly right. So, excitingly, we treat patients with neoadjuvant chemo or chemoradiation, and surgery is really the crux of the treatment paradigm for esophagogastric cancers in general. However, recently the CheckMate 577 clinical trial for the use of adjuvant Navolumab showed an improvement in disease-free survival in patients who had an incomplete path response. They used one year of Nivolumab compared to placebo. So it has recently become a standard of care where I practice, and I feel like a common practice around the country. Dr. Abdul Rafeh Naqash: Thank you so much. Now, going to the premise of this paper where you and your team basically looked at circulating tumor DNA as a prognostic marker in these patients that had early-stage esophagogastric cancers, was there a specific reason why you wanted to look at the early stage? What was the rationale for evaluating this biomarker in this patient population? Dr. Brandon Huffman: So, esophageal and gastric cancers affect a large number of patients every year. And unfortunately, despite our best efforts with curative intent therapy, over 50% recur within three years. So we know that there are pre surgical risk factors such as a larger bulky primary tumor or lymph node-positive disease that increase the risk for progression or recurrence after surgery. And we know, in addition, in other GI malignancies and other malignancies such as colorectal cancer, for instance, that the presence of circulating tumor DNA after surgical resection of localized tumors is associated with an increased risk of recurrence. So this has actually led to clinical trials investigating whether or not ctDNA can be integrated into the decision-making for adjuvant colorectal cancer treatment, such as ongoing trials such as the BESPOKE trial, COBRA, DYNAMIC trials that have recently been reported. The use of ctDNA is being used in other malignancies. And to give you a little bit of background, this project started when I was seeing patients with Dr. Sam Klempner at Mass General during my fellowship, where I was in the combined Dana-Farber/Mass General program. And he and others had begun collecting serial plasma samples on every patient we saw with esophagus, gastroesophageal junction and gastric cancers to assess for the presence or absence of ctDNA. And we used the tumor-informed ctDNA assay from Signatera, which, for those who aren't familiar, this is a ctDNA platform where a panel is built from the results of whole exome sequencing on the patient's FFPE tumor. The panel includes 16 patient-specific somatic single nucleotide variants for each patient, and it's new for each patient. Once that panel is built, the cell free DNA is tested from a plasma sample. And if there are two or more of the tumor-specific variants present, then they're considered ctDNA positive. So some of those colorectal cancer trials that I mentioned before are using this assay, and we wanted to investigate whether or not this high-risk population could be further assessed for risk of recurrence. Dr. Abdul Rafeh Naqash: Excellent. Thank you so much. And I know that a lot of these ctDNA based assessments have made inroads into the GI malignancy space, lesser in the other tumor types. I think we are all trying to catch up to what you guys are doing in the early-stage colon cancer space or the early-stage esophagogastric cancer space. So it's definitely very a interesting avenue to assess minimal residual or molecular residual disease. Now, going back to the methodology, I found it very interesting, and I think it's very important for listeners especially to understand the context of ctDNA assessments because I think a majority of oncologists are used to the liquid biopsy aspect. But this is not necessarily the liquid biopsy. It's somewhat different. So what I've understood, and I'd like to ask you to explain in the context of tumor-informed and tumor uninformed assays, what are the assays that are available, and how do they differ in terms of serial monitoring? And why is this ctDNA-based assessment somewhat different or more patient-customizable than our regular liquid biopsy assays, which are also blood based but not tumor-informed? Dr. Brandon Huffman: That is the question of the hour. And many different research projects are ongoing to try and identify which one is better, if one is better. I know that there are some commercial assays, for instance, that are not tumor-informed. They take a blood sample and then test for cell free DNA. The risk behind that is it's testing for common genetic mutations from a next-generation sequencing panel platform. And it may also detect CHIP variants or clonal hematopoiesis of indeterminate potential variants that aren't related to the underlying solid tumor malignancy. So a tumor-informed assay, for instance, such as the one that we used in this study, uses the patient's tumor and sequences it with whole exome sequencing and identifies very specific variants within the tumor that are only present within the tumor because they compare it also with a normal blood sample from the patient at the same time. And so they pick tumor-informed specific variants that then they test for on their assay. And that increases the sensitivity of the ctDNA assay so that you can really try to understand, is this cell free DNA that we are detecting related to the tumor or can we ignore it potentially? I don't know if we can necessarily ignore it in all honesty because it could affect- there's a lot of ongoing work that is looking at the risk of CHIP. But overall, this is specific for the primary tumor that we were investigating. Dr. Abdul Rafeh Naqash: I definitely agree with you there. I think the important point, as you mentioned, is that using the whole exome approach, in the blood and the tumor, you're able to eliminate the CHIP variants or the germline variants that may not be contributing. And that way you're able to specifically look at certain genetic alterations that eventually, I think using PCR-based approaches, you identify the same and quantify the same in the blood serially. And that's how this tumor-informed assay is somewhat unique and different. Now, going to the crux of this study, could you tell us a little about the patient population? I think you stratified patients. You had a pre-operative cohort, you had an MRD cohort, you had a surveillance cohort, and you had a cohort where you assessed ctDNA positivity at any time point. So, several different cohorts, and you assess recurrence-free survival in those cohorts. Could you tell us a little bit more about how you evaluated these cohorts? What were the selection criteria, and how many patient samples did you have for these different cohorts? Dr. Brandon Huffman: Absolutely. So, we aimed to determine the feasibility of testing ctDNA in patients with gastroesophageal cancer. And so, there were several clinicians from over 70 institutions across the United States who began prospectively collecting serial plasma samples for the presence or absence of the tumor-informed ctDNA. And they included patients from stages one through stage four, gastroesophageal cancer specifically, they included patients who were stages one through four with gastroesophageal cancer. They were collected at the discretion of the ordering clinicians and then incorporated into their routine clinical care as they saw fit. Within this dataset, we have a subset, a large number of patients that is unique to this dataset, specifically in that we have clinical outcomes, treatment, and follow-up data for the patients that were reported on the main findings in the paper. So, overall, we collected and analyzed over 900 plasma samples in almost 300 patients with gastroesophageal cancer, esophageal, gastroesophageal junction and gastric cancers. And in many of the analyses, we lumped them all together. But then we also wanted to separate it out because, as I mentioned before, the treatment paradigm does differ amongst a more proximal esophageal tumor compared to a distal gastric cancer. So, we focused a majority of our analyses on the detection of ctDNA and localized disease, which included 212 patients with stages one through three gastroesophageal cancer. And I would say we had three major findings. Most of the patients who were tested beforehand, which was a small subset, as I mentioned, this was pragmatic at the discretion of the ordering clinician, but most of the patients who were tested beforehand had positive preoperative ctDNA present. Of the patients who were tested for postoperative ctDNA at any time point, and then specifically within the different subsets of populations that we talked about, postoperative ctDNA was associated with at least a tenfold increased risk of recurrence in all subsets. And ctDNA detection postoperatively was independently associated with recurrence when controlling for age, sex, tumor location, and microsatellite status. So, a few of the populations that we wanted to test for, one in particular was the molecular residual disease, or MRD window. We labeled this MRD window as the time from surgical resection until 16 weeks. So, if patients were ctDNA positive within that window, we counted that in the primary outcome. And the reason that we chose the MRD window, in addition to this time point of 16 weeks - I should say that the 16 weeks is without any therapy postoperatively, so they have not been treated with any chemo or immunotherapy in this window. We thought that this MRD window was an interesting research topic because the CheckMate 577 Adjuvant Nivolumab clinical trial identified that 16 weeks was the window in which patients could be enrolled up until that timepoint to receive adjuvant nivolumab. So, we're thinking from a future project standpoint, a future clinical trial, perhaps, that if we have identified that patients who are ctDNA positive within this timepoint window, is there an increased risk for recurrence? Because if there is, then perhaps nivolumab intervention will decrease that risk or something that is escalated further. And that's a question that we don't have the answer for, a question that our data can't answer adequately. But it's an interesting one that I see the future questions that can be answered from these data. Dr. Abdul Rafeh Naqash: Thank you so much. And I agree with you there that this is a very intriguing approach of finding out whether treatment escalation has to be done based on ctDNA positivity, but also, conversely, treatment de-escalation, which there is a lot of emphasis being laid on, especially in the early phase trial in lung cancer, especially in the early setting when targeted therapies or immunotherapies are approved for one to three years, depending on what kind of therapy you're looking at. In those individuals that perhaps have negative ctDNA after one year, maybe therapy de-escalation would be a reasonable approach. So, definitely more interesting clinical trial ideas in this space focusing on ctDNA assessments. Now, one of the questions that comes to my mind is, when you use ctDNA-based assessments, initially, the patient gets biopsied, and it usually takes four to six weeks for ctDNA-based assessments to come back--I'm talking about tumor-informed assay results to come back, in my personal experience. So, could that potentially, or in your practice, how do you mitigate those delays? If you're trying to schedule a patient for surgery, for example, does that cause any delays in any care because you're trying to get the assessment done, or does your workflow proceed as planned and then you get the results and then subsequently you perhaps make a decision based on their ctDNA assessment? Dr. Brandon Huffman: At the present time, we are trying to gather more data to understand what we should do with the results that we're receiving. And I think the starting point of collecting serially to just understand the process is helpful. One of the questions we wanted to know that we weren't able to answer with this dataset was: is there lead time? In many cases, ctDNA detection can occur even a year prior to radiographic recurrence. In our case, because this was a pragmatic, clinically at the discretion of the investigators when they decided to test patients for ctDNA, there is heterogeneity among those who are ctDNA positive, and when they get their radiographic imaging, maybe they were moved up. I know in our practice with Dr. Klempner, when I was seeing these patients with him, it was a flag for us to order scans earlier in a patient that we might not have historically ordered so that we could then see, is there something intervenable? Maybe there was a positive lymph node on PET imaging that we could radiate or that wasn't included in the neoadjuvant radiation, for instance. So, we could not predict the lead time from positivity to radiographic recurrence, but I think that that's the hope is that we detected micrometastatic disease, my hope is that we can intervene in the future. But these data aren't able to quite answer that question perfectly. Dr. Abdul Rafeh Naqash: Sure. And there's definitely caveats to doing this in a pragmatic manner based on investigator assessments. Now, another question I was thinking of is, when you do do these ctDNA based assessments, and since these are tumor-informed, meaning you biopsy the tumor initially, you identify certain single nucleotide variants and those are the ones that you basically barcode and do PCR assessments using blood. We've learned time and again that tumors can change based on the kind of therapy that you give the patient. So, if your tumor is seeing FOLFOX nivolumab, or all the other novel therapies that you guys give in the setting, is there a chance that the tumor changes over time and you may not be able to capture those newer single-nucleotide variants that are coming up? It's just a provocative question, but I wanted to see what your thoughts are on that. Dr. Brandon Huffman: It's a great question. I don't entirely know the answer. I'll just be forthright about that. I do think that when designing these assays, they try to choose the more clonal rather than subclonal variants. And so the hope is that, despite the heterogeneity that we know occurs in esophagogastric cancers, we can eliminate that possibility. But you're right, there's no perfect way of knowing that. Dr. Abdul Rafeh Naqash: I really appreciate you using that word subclonal versus clonal. I think that perhaps makes a difference there. But again, more to do in this field to understand how the tumor evolves and whether it's the clonal mutation, subclonal mutation that needs to be followed. But definitely a lot of interesting work in this space that's ongoing, and, like you mentioned, there are ongoing trials, and both in the neoadjuvant adjuvant space, this field is definitely moving fast in the right direction. I briefly want you to highlight that one patient case study example that you had. And this was a patient with oligometastatic disease recurrence where you used the ctDNA assessment. And I do some of this in my daily practice, and I really found it useful to have this sort of a patient case example that elaborates in the bigger picture of how this kind of assessment works in a real-life scenario. So it's not just data, it's a patient's trajectory over the course of time where the treating physician was able to use this assay. Could you tell us a little bit more about this individual example here? Dr. Brandon Huffman: Yeah, absolutely. So this was a 56-year-old man that we saw in clinic with stage three esophageal adenocarcinoma, and was treated with the standard neoadjuvant cross chemoradiation, had an R0 resection with residual disease with a significant treatment effect. And there were lymph nodes that were positive on surgical resection with 39 lymph nodes removed. The patient recovered well and was followed with the standard of care radiographic and clinical surveillance. We also were looking for ctDNA, and what we noted was that there were, often you find these undulating pulmonary nodules that come and go, and they may or may not be infectious, and maybe there's one that's sub-centimeter that slowly grows, and what we found was that at about five months post-surgery, there was a positive ctDNA MRD, and we repeated it at short interval and noted a rising value, which this assay will give you a quantitative value. Once we did that, we ordered imaging and saw a nine-millimeter pulmonary nodule and ultimately biopsied it. It was there in the right upper lobe, and it was positive for metastatic adenocarcinoma. So we treated the patient with the standard FOLFOX plus Nivolumab and actually did SBRT, stereotactic body radiotherapy, to the lung metastasis. And his ctDNA became undetectable. So because FOLFOX is toxic, we transitioned to a maintenance of Nivolumab and he was on maintenance therapy for several months and had no radiographic evidence of disease and remained ctDNA negative for twelve months. So we biopsied the right upper lobe lung lesion. It was positive for metastatic adenocarcinoma, and then after a multidisciplinary discussion, we treated him with SBRT and then FOLFOX and Nivolumab and then dropped down to Nivolumab maintenance once his ctDNA was undetectable. That highlights the fact that this was an isolated recurrence, which we continued to monitor, and then he had another site of disease a few months later, and we did SBRT to that area while he maintained on just Nivolumab, and the ctDNA came down as well. So I think, although it doesn't prove anything necessarily, other than demonstrating there is a correlation with the newly diagnosed metastatic disease, it does note that you can use this in dynamic ways, and if it really helps patients live longer, although this is anecdotal--who knows? If we hadn't done SBRT to that area, it was 9 mm. We could have waited until it grew, but then maybe some subclonal, more aggressive metastasis could have really put this patient in a much tougher situation. So it's an interesting case example, and there are several others that we could have put in here that are pretty similar. Dr. Abdul Rafeh Naqash: Thank you so much for highlighting that case. I couldn't agree more that there is a certain aspect to the ctDNA assessment, where in individuals like the example that you've highlighted here, this can provide lead time potentially and help with earlier management of perhaps more like oligometastatic disease rather than diffuse disease burden. And in that context, one of the questions that I was going to ask you, based on your data, was there any correlation of tumor burden preoperatively and ctDNA positivity after surgery that you guys were able to identify or thinking of identifying? Dr. Brandon Huffman: Unfortunately, with our data set, we weren't able to look at that assessment of comparing the overall tumor burden to the quantitative value. But it's an interesting one because we know that in other malignancies, for instance, if there is a correlation of overall disease burden, it also depends on the tumor type, but we also know that perhaps patients will respond differently to chemo or immunotherapy if they have a lower tumor burden, if they have a lower ctDNA value, potentially. I think that's an interesting question for a future project. Dr. Abdul Rafeh Naqash: Thank you so much, Brandon. We do like to talk a little bit about the person behind the work. So tell us a little bit more about yourself, your training, your interests, and some little advice for other early-career investigators who might be looking into a similar space and hopefully get inspired by the kind of work that you've done or are planning to do. Dr. Brandon Huffman: Sure. So, as I mentioned, when I started this project, I was in fellowship. I was seeing patients with Dr. Sam Klempner at Mass General, where I saw patients with him for a year, and as part of my clinical training in the Dana-Farber/Mass General HemOnc Fellowship. Since that time, I have graduated fellowship. I'm a GI Medical Oncologist at Dana-Farber Cancer Institute, and in the GI division, I see patients with all GI malignancies, and I focus on the development of clinical trials in upper GI malignancies, along with investigating the use of circulating tumor DNA as a biomarker, hopefully, we can understand whether it's a predictive biomarker that we can intervene upon in the future. I think the greatest advice that I received and that I will give to all future trainees; I'm not sure that I'm qualified to tell this to all the junior investigators, but here it is: Find yourself a mentor who really cares and invests in you and your ideas. I have that with Sam, and this project was an incredible part of my development as a junior investigator. I've asked really interesting questions. There are more questions that can be answered from this data set, and I'm excited for the opportunity. Dr. Abdul Rafeh Naqash: Thank you so much, Brandon. Thanks for taking the time to speak with us today and thank you for choosing JCO Precision Oncology as a destination for your work. Hopefully, we'll see more of this subsequently in the years to come. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating, a review, and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Guest Bio Dr. Brandon Huffman, MD, is a gastrointestinal medical oncologist and Instructor in Medicine at Dana-Farber Cancer Institute and Harvard Medical School. Guest Disclosures Brandon M. Huffman Stock and Other Ownership Interests: Doximity
Ruki ist am Ende - Sonic Lost World 3DS hat ihn gebrochen. Wir blicken zurück auf den letzten Stream, bevor Sonic schließlich ins All geschossen wird - Mit an Bord: Die Angry Birds! Außerdem wird Sonic von einem Klempner attackiert und vom Thron gestoßen, während SEGA fleißig weitere Charaktere gnadenlös ins Grab befördert. Heute steht Krokodilsleder auf dem Speiseplan! Doch nicht nur das: Eine längst vergessene und gestrichene Zone aus Sonic 2 verspürt noch deutlich mehr Mordlust... Zeitstempel: (0:00) Intro & Videospiel-Gerede (27:06) News-Rückblick (1:19:26) Outro Livestreams jeden Donnerstag um 20 Uhr auf Twitch: http://www.twitch.tv/ruki185 Kontakt: gottapodcast@gmail.com Hier geht's zu unserem Discord-Server: https://discord.gg/KEAmvmKVPF Hinterlasst uns gerne einen Kommentar mit Feedback, Fragen und/oder Kritik! Das könnt ihr unter anderem im Newsbeitrag auf SpinDash.de bzw. im dortigen Forum und auf dem Discord-Server tun. Auf Social Media sind wir natürlich auch vertreten: Sowohl auf Instagram (@gottapodcast), als auch auf Twitter (@spindash_de) und Facebook (GottaPodCast) oder aber einfach unter dem Hashtag #GottaPodCast! Auch über eine positive Bewertung freuen wir uns immer! Die Weblinks zum Nachlesen gibt's im Newsbeitrag auf spindash.de Livestreams jeden Donnerstag um 20 Uhr auf Twitch: http://www.twitch.tv/ruki185 Kontakt: gottapodcast@gmail.com Hier geht's zu unserem Discord-Server: https://discord.gg/KEAmvmKVPF Hinterlasst uns gerne einen Kommentar mit Feedback, Fragen und/oder Kritik! Das könnt ihr unter anderem im Newsbeitrag auf SpinDash.de bzw. auf dem Discord-Server tun. Auf Social Media sind wir natürlich auch vertreten: Sowohl auf Instagram (@gottapodcast), als auch auf Twitter (@spindash_de) und Facebook (GottaPodCast) oder aber einfach unter dem Hashtag #GottaPodCast! Auch über eine positive Bewertung freuen wir uns immer! Die Weblinks zum Nachlesen gibt's im Newsbeitrag auf spindash.de
Nachdem letzte Woche eine kleine Zwangspause eingelegt werden musst, sind die Angry Men aus dem Exil zurückgekehrt, und haben sich am Verhandlungstisch eingefunden, um Schuhe zu designen, Videospiele zu spielen, und die wahre Liebe zu finden (plot twist: wir sind nicht für die Liebe geschaffen). Falls ihr uns unterstützen, verbreiten oder eure Anregungen schicken wollt, ist unser Instagram-Kanal dazu die beste Möglichkeit. Ihr findet uns dort unter "threeangrymenpodcast". Timestamps: (00:00:00) Intro (00:00:41) Was hast du zuletzt gesehen? (00:22:08) Air (00:42:11) Rye Lane (00:53:13) Super Mario Bros.: The Movie
Thomas ist nach seinem Kurztrip ins Mutterland des LEGO-Steins wieder zurück und präsentiert Dir hier mit unnachahmlicher Effizienz, Souverenität und Leichtigkeit die LEGO News der Woche! Show Notes http://www.Spielwaren-Investor.com Mehr Infos zu unseren Werbepartnern findest Du hier: https://linktr.ee/spielwareninvestor Thomas´Profil auf Instagram: https://www.instagram.com/brickntosh/?hl=de Spielwaren Investor auf YouTube: https://www.youtube.com/channel/UCU6B66hnds2qgdewJPly_yg?view_as=subscriber
Featuring perspectives from Dr Yelena Janjigian, Prof Florian Lordick and Dr Zev Wainberg, moderated by Dr Samuel Klempner, including the following topics: • Optimizing the Selection of Therapy for Newly Diagnosed Advanced Gastric or Gastroesophageal Junction (GEJ) Cancer — Dr Klempner o Introduction (0:00) o Case: A man in his mid 50s with HER2-negative gastroesophageal adenocarcinoma (PD-L1 100%) — Victoria Giffi, MD (1:15) o Cases: A woman in her early 80s with a history of Stage 0 chronic lymphocytic leukemia, now with unresectable gastric adenocarcinoma, develops Coombs-positive hemolytic anemia after 2 cycles of FOLFOX and nivolumab and a man in his early 60s with localized adenocarcinoma of the GEJ receives the CROSS regimen but is found at surgery to have metastatic disease and tumor NGS demonstrates an ARID1A mutation — Matthew R Strickland, MD and Priya Rudolph, MD, PhD (8:05) o Faculty presentation: Dr Klempner (14:05) • Current Considerations in the Treatment of HER2-Positive Advanced Gastric/GEJ Adenocarcinoma — Dr Janjigian o Case: A woman in her early 30s with newly diagnosed metastatic HER2-amplified signet cell gastric adenocarcinoma — Farshid Dayyani, MD, PhD (22:36) o Cases: A man in his mid 80s with newly diagnosed HER2-positive gastroesophageal cancer metastatic to the liver and lung, tumor 3+ by IHC for HER2 with a PD-L1 of 10 and a woman in her mid 70s with HER2-positive esophageal adenocarcinoma and brain metastases after stereotactic radiosurgery — Warren S Brenner, MD and Dr Strickland (31:43) o Faculty presentation: Dr Janjigian • Selection and Sequencing of Therapy for Relapsed/Refractory Gastric/GEJ Cancer; Novel Investigational Approaches — Prof Lordick o Cases: A woman in her mid 70s with Lynch syndrome and a history of Stage III colon cancer presents with poorly differentiated GEJ carcinoma with liver and lung metastases and a man in his early 60s presents with a 70-lb weight loss and locally advanced high-grade neuroendocrine carcinoma of the distal esophagus — Namrata I Peswani, MD and Ranju Gupta, MD (46:19) o Case: A man in his early 60s with metastatic gastric adenocarcinoma (PD-L1 CPS 0) with clinical and radiographic progression of disease after 4 cycles of FOLFOX — Dr Strickland (52:31) o Faculty presentation: Prof Lordick (55:26) • Current Approaches to the Management of Esophageal Cancer — Dr Wainberg o Cases: A man in his late 50s with dysphagia, weight loss and a lower esophageal adenocarcinoma (T3N3) and a man in his mid 70s with dysphagia is found to have a lower esophageal adenocarcinoma with regional adenopathy and pulmonary nodules (CPS 40 by SP263) — Gurveen Kaur, MD and Liudmila N Schafer, MD (1:03:56) o Case: A woman in her early 60s with a known germline BRCA2 mutation and a history of Hodgkin lymphoma, breast and anaplastic thyroid cancers now has localized squamous cell esophageal cancer — Dr Brenner (1:11:56) o Faculty presentation: Dr Wainberg (1:17:49) CME information and select publications
Spät im Lebenszyklus des SNES verbündeten sich Nintendo und Square, um gemeinsam ein klangvolles Projekt zu realisieren: SUPER MARIO RPG. Erstmals sollte der pummelige Klempner ein ausladendes Rollenspiel spendiert bekommen - programmiert von der Firma, die sich dank exzellenter Spiele einen legendären Ruf erarbeitet hatte, deren Spiele im Westen bis dato allerdings nicht den gewünschten Erfolg hatten. In Japan und den USA kam der Mix gut an, Europa schaute damals leider in die (leere TV-) Röhre. Die Gründe dafür sind so vielfältig, wie nachvollziehbar und sind natürlich auch Thema dieser Episode. Sprecher: Ben Dibbert & Hardy Heßdörfer Lust direkt über diese Folge zu diskutieren? Schau doch mal im Nerdwelten Discord Kanal oder auf unserer Facebook Seite vorbei! Auf Twitter sind wir ebenfalls zu finden und freuen uns über dein Feedback! Für Unterstützung via Patreon und Steady sind wir sehr dankbar! Dort erhalten Unterstützer Zugang zu monatlichen Bonus-Folgen. Lust auf Nerdwelten Merchandise (Shirts, Tassen, Caps...)? HIER ENTLANG Nerdwelten Musik: Ben Dibbert (Nordischssound) Introstimme: Claudia Urbschat-Mingues Schnitt: Hardy Heßdörfer Produktion: Hardy Heßdörfer Verwendete Bilder und Musik stammen aus Super Mario RPG: Legend of the Seven Stars (Musik: Hello, Happy Kingdom; Happy Adventure, Delightful Adventure; Still, the Road is Full of Dangers; The Sword Descebds and the Stars Scatter; Beware the Forest's Mushrooms; Long Long Ago...; Fight Against Culex; The End!)
CME credits: 0.25 Valid until: 21-11-2023 Claim your CME credit at https://reachmd.com/programs/cme/emerging-evidence-in-second-line-and-potential-considerations-in-first-line-agc-and-gej-cancers/14038/ HER2 is an essential biomarker to be assessed in all patients with gastric/GEJ cancer. Its importance is not only related to its role as a therapeutic target for pathway inhibition, but also to its ability to anchor the application of non-HER2 pathway therapeutic strategies with direct and bystander impact in the tumor microenvironment. Join Drs. Janjigian and Klempner as they delve into historical and exciting emerging data that may well bring new hope to your patients with gastric/GEJ cancers.
Ist der Syphon dicht, dann hilft nur ein Klempner oder Gabriel Gabe Logan. Der bringt dann gleich noch seinen spezial Filter mit und dann bleibt der Abfluss frei von bösen deutschen Terroristen, die versuchen mit Viren die Weltherrschaft an sich zu reißen. Noch zwei oder drei Plot-Twists weiter, ein bißchen Verrat hier und ein bißchen Überraschung da und die Vorlage eines so ziemlich jeden 90er Jahre Action Movies ist fertig. Am Ende weiß keiner so genau wer was will und wer hier überhaupt warum mitspielt aber Hauptsache es wird geballert! Inspiriert von diesem Erfolgsrezept haben sich EIDETIC 1999 daran gemacht ihre Schmach von Erstlingswerk für die PSX vergessen zu machen und somit eine ziemlich erfolgreiche Spieleserie erschaffen. Ob der erste Ableger aus der Syphon Filter Reihe noch heute überzeugen kann? Nur so viel Vorweg: Murat und Steffen haben diesmal den Ellis gemacht und sind frühzeitig ausgestiegen. Danny hat die Modchip Fahne hoch gehalten und den Syphon knallhart durchgespült.
Dr. Benjamin Klempner is joining us for our Double Emuna Tuesday Class Q/A #84 at 12 pm - https://soundsymphony.net/ - a trained psychotherapist with a Master's degree in Social Work and a PhD in psychotherapy and certification in Medical Hypnosis. My educational and professional career bridge Sicily with the Blackfeet Indian Reservation of Montana, the Florida Everglades with New York City, and, of course, Jerusalem with Tiberias. Over the years I have discovered that sound and vibration have healing powers that, through the application of various frequencies, bring health, healing, and rejuvenation to the minds, bodies, and souls of individuals, couples, families, and communities... Partner here & Join our EMUNA WhatsApp Group Channel 2 - https://chat.whatsapp.com/G0MKECzqq0Q1Ctq9ViCcia Please contact Direct Eli G for updates and Emunalive Tour 2022 - Eli.Goldsmith@Breslev.Co.il Join live weekly here - & - IG Flow - https://www.instagram.com/tv/ChmThMuKLhc/?igshid=YmMyMTA2M2Y= - & IG Live @Breslev_English - On all our Audio Platforms & the YouTube link TBA... --- Support this podcast: https://anchor.fm/breslevisrael/support
Mirko Drotschmann — besser bekannt als MrWissen2go ist einer der bekanntesten deutschen YouTuber im Bereich Bildung. In seinen genau recherchierten Videos erklärt er Themen aus Politik, Geschichte und dem aktuellen Zeitgeschehen. In unserem Gespräch verrät er uns, wie ein MrWissen2go-Video entsteht, wie er sich damit fühlt, dass sein Kanal mittlerweile auch in vielen Schulen geschaut wird, und wie man auf YouTube Erfolg findet. Transkript und Vokabelhilfe Werde ein Easy German Mitglied und du bekommst unsere Vokabelhilfe, ein interaktives Transkript und Bonusmaterial zu jeder Episode: easygerman.org/membership MrWissen2go MrWissen2go (YouTube-Kanal) MrWissen2go Geschichte (YouTube-Kanal) DIESDAS (Mirkos privater Podcast) TerraX (ZDF Mediathek) Terra X Geschichte (ZDF Podcast) Wichtige Vokabeln in dieser Episode die Beleidigung: Schimpfwörter gegen eine andere Person benutzen spießig: negatives Wort für eine Person, die keine Veränderungen in ihren Lebensbedingungen möchte etw belächeln: eine andere Person oder deren Projekte und Pläne nicht wirklich ernst nehmen öffentlich-rechtlich: Fernseh- und Radiosender, die von den Bürger*innen finanziert werden, heißen in Deutschland "öfffentlich-rechtliche Sender". die Reichweite: wie viele Menschen man mit einem Video, z.B. auf Youtube, erreicht vorpreschen: sich sehr schnell fortbewegen / metaphorisch für "schnell handeln". die Meinungsfreiheit: das Recht, dass Menschen ihre Meinung offen äußern dürfen, ohne dass vom Staat dafür bestraft zu werden der Handwerker: z.B. Elektrikerinnen, Klempner, Malerinnen oder Schreiner*innen. eins und eins zusammenzählen (ugs.): eine Situation interpretieren und verstehen das Gegengewicht: im übertragenen Sinne etwas, was eine Balance bzw. Ausgeglichenheit bringt Support Easy German and get interactive transcripts, live vocabulary and bonus content: easygerman.org/membership
Zur Feier der 40. Folge servieren wir Euch heute: Lange Leichenlisten, garstige Gerüche, nichtsahnende Nachbarschaften und damit die selbst für hartgesottene Ermittler kaum zu glaubende Geschichte des Mister Dennis Nilsen, Beamter im öffentlichen Dienst. Immerhin ist das 40ste Jubiläum das „rubinene“ – also kurz vor Gold und - passt ja_ rot wie Blut. Außerdem erfindet Etienne den Eierkühler und George den dazu passenden Sitz mit Eierkühleraussparung. Und ein cleverer Klempner kommt auch zu Wort. Viel Spannung Euch mit uns und dem, der im Serienmörderquartett immerhin drei von vier Maniac Factor Sternen bekommen hat!
In der Gaskrise soll sich der Bund an Unternehmen der kritischen Infrastruktur beteiligen können. Die rechtliche Grundlage dafür wird in aller Eile geschaffen. *** Hier gehts zu unserem Abo-Angebot für unsere Morning Briefing Leser: https://www.handelsblatt.com/mehrerfahren
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