Podcasts about MH

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Latest podcast episodes about MH

RTÉ - An Saol ó Dheas
Lorcán Ó Cinnéide

RTÉ - An Saol ó Dheas

Play Episode Listen Later Jul 16, 2025 7:46


Bainisteoir Ionad an Bhlascaoid ag caint ar Mháiréad Ní Chearnaigh Uí Shé atá imithe ar shlí na fírinne i Springfield.

Make Trades Great Again
Bid Work vs. Time and Material

Make Trades Great Again

Play Episode Listen Later Jul 15, 2025 27:28


Eric and Andy discuss the complexities and challenges of managing construction projects, particularly in the plumbing sector. They share real-world scenarios that highlight the importance of proper project management, the necessity of permits, and the impact of customer expectations on project timelines. The discussion also delves into the differences between time and material pricing versus bidding, emphasizing the need for clear communication and scope definition. Throughout the conversation, they reflect on lessons learned from ongoing projects and encourage community engagement for shared insights.TakeawaysNavigating complex projects requires clear communication and management.Permits are essential for compliance and can impact project timelines.Customer expectations must be managed to avoid misunderstandings.Time and material pricing can be beneficial in uncertain project scopes.Bidding requires careful consideration of project details and timelines.Unexpected issues often arise in older buildings, complicating projects.Maintaining flexibility in project management is crucial for success.Community feedback can provide valuable insights for handling challenges.Learning from past projects helps improve future decision-making.Effective project management balances customer needs with operational realities.Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

De Nieuwe Wereld
Wat weet Trump van Epstein-files? Kernwapenalliantie; oorlog in de Kaukasus? | #2002 Nieuws v/d Week

De Nieuwe Wereld

Play Episode Listen Later Jul 13, 2025 104:14


Jasper van Dijk, Ad Verbrugge en Jelle van Baardewijk bespreken het nieuws van de week.--Meer over de Zomerschool Geopolitiek: https://www.nyenrode.nl/opleidingen/p/strategisch-denken-in-een-onrustige-wereldSteun DNW en word patroon op http://www.petjeaf.com/denieuwewereld.Liever direct overmaken? Maak dan uw gift over naar NL61 RABO 0357 5828 61 t.n.v. Stichting De Nieuwe Wereld. Crypto's doneren kan via https://commerce.coinbase.com/pay/79870e0f-f817-463e-bde7-a5a8cb08c09f-- Bronnen en links bij deze uitzending: - Wierd Duk en Martijntje Smits in gesprek o.l.v. Marianne Zwagerman: https://www.youtube.com/watch?v=ETDYESrvSf4- Paul Krugman over Trump en Bolsonaro: https://paulkrugman.substack.com/p/trumps-dictator-protection-program--00:00 Introductie4:48 Waarom willen jongeren massaal weg uit Nederland?19:50 De huizenmarkt, de VVD en hyperkapitalisme29:15 Tweede Kamer-verkiezingen34:35 Kernwapenalliantie, Oekraïne, Azerbeidzjan en de Israëlische connectie1:01:25 Autoritaire neigingen van Ursula von der Leyen, Pfizer en de EU1:15:15 Pfizer, coronavaccins1:17:40 Kamp voor Palestijnen, VN 2.0, MH-171:35:50 Damen Shipyards1:40:35 Epstein1:43:51 Afronding--De Nieuwe Wereld TV is een platform dat mensen uit verschillende disciplines bij elkaar brengt om na te denken over grote veranderingen die op komst zijn door een combinatie van snelle technologische ontwikkelingen en globalisering. Het is een initiatief van filosoof Ad Verbrugge in samenwerking met anchors Jelle van Baardewijk en Marlies Dekkers. De Nieuwe Wereld TV wordt gemaakt in samenwerking met de Filosofische School Nederland. Onze website: https://denieuwewereld.tv/ DNW heeft ook een Substack. Meld je hier aan: https://denieuwewereld.substack.com/

Mind Heist Podcast
EP 239 - Fixing the Muslim identity crisis

Mind Heist Podcast

Play Episode Listen Later Jul 11, 2025 108:48


In this video, we talk about what it's like being a Muslim in places like the UK or US. It can be hard to stay true to your religion and culture when everything around you keeps changing. We look at why always moving from place to place can make it tough to feel like you truly belong anywhere. We also talk about why it's important to choose one place, build a life there, and think about the kind of world we're leaving for the next generation. Plus, how to be a kind, helpful person in your community without losing your values as a Muslim. All links to contact/contribute/follow us: http://www.mindheistpodcast.com The Shepherd's Way free chapter: https://www.theshepherdswaybook.com/free-chapter The Front Row waitlist: https://life-digital.typeform.com/to/sSbmk2If Join the Telegram group for MH listeners: https://t.me/+XOu4ggsyqRk3OWRk Sisters only group: https://t.me/mindheistsisters Find out about Ameen's projects: https://www.ameenomar.com Find out about Mohamed's projects: https://many.link/akhitweet Video version of the pod: https://youtube.com/playlist?list=PL5ZvWFoIJNmQISsKE1PZB3d7KcpnEcJy7 Leave us a great review if you're enjoying the show too! Stay blessed!

RTÉ - Barrscéalta
Na tráchtairí spóirt Caoimhín Ó Casaide agus Mark Mark Harte agus leo tá Ciarán Ó Fearraigh atá ag cur faoi i gContae na Mí.

RTÉ - Barrscéalta

Play Episode Listen Later Jul 11, 2025 8:42


Tá an deireadh seachtaine mór tagtha agus cluichí leathcheannais peile na hÉireann ar siúl. Bhéarfaidh Tír Eoghain aghaidh ar Chiarraí amárach ar a cúig a chlog agus ansin ar an Domhnach rachaidh Dún na nGall agus an Mhí i mbun coimhlinte lena chéile ag a 4 a chlog.

RTÉ - Barrscéalta
An Comhairleoir Contae Neamhspleách Micheál Cholm Mac Giolla Easbuig.

RTÉ - Barrscéalta

Play Episode Listen Later Jul 10, 2025 12:42


Ag plé dumpáil mídhleathach ar Árainn Mhór.

Seachtain
Agóidí phobal na Gaeilge: Still fighting na sean-chathanna céanna?

Seachtain

Play Episode Listen Later Jul 10, 2025 20:36


I mí Mhéan Fómhair beidh na mílte Gael ag dul chun na sráideanna i mórshiúl náisiúnta ar son na Gaeltachta agus na Gaeilge. Ach, an bhfuil pobal na Gaeilge ag troid na sean-chathanna céanna le breis agus caoga bliain? Agus cé chomh héifeachtach is a bhíonn léirsithe mar seo chun athrú polasaí a bhaint amach? Ar Seachtain, amharcann an t-iriseoir Áine Ní Bhreisleáin siar ar roinnt agóidí de chuid Conradh na Gaeilge agus an toradh a lean iad. Foclóir: Éileamh: Demand Maoiniú: Funding Maram: I suppose Mórshiúil: Procession Mianta: Wishes/Desires Féinriail: Autonomy Cumhachtaí: Powers Uaillmhianach: Ambitious Cáipéisí: Documents Ré: Era Gnáthphobal: Ordinary people Go borb: Abruptly or Gruffly Suaitheantas: Emblem Mana: Motto San áireamh: Included Rachmasóirí: A derogatory term for the wealthy Gan fiacail a chur ann: Not to mince one's words Daoine ón iasacht: Outsiders Rathúil: Successful Snáithe: Thread Sean-chathanna: Old battles See omnystudio.com/listener for privacy information.

Learn Irish & other languages with daily podcasts
20250710_IRISH__uisce_eireann_ag_iarraidh_ar_an_bpobal_a_bheith_tiosach

Learn Irish & other languages with daily podcasts

Play Episode Listen Later Jul 10, 2025 8:45


jQuery(document).ready(function(){ cab.clickify(); }); Original Podcast with clickable words https://tinyurl.com/ykcxresb Contact: irishlingos@gmail.com Irish Water is asking the public to be economical. Uisce Éireann ag iarraidh ar an bpobal a bheith tíosach. Irish Water is appealing to the public to conserve water from now on due to the hot weather. Tá Uisce Éireann ag achainí ar an bpobal uisce a chaomhnú as seo go ceann scaithimh mar gheall ar an aimsir the. The company says the heatwave is draining water supplies and is already causing drought in 31 watersheds in twelve counties. Deir an comhlacht go bhfuil soláthairtí uisce á ndísciú ag an teaspach agus go bhfuil sé ina thriomach cheana féin i 31 abhantrach in dhá chontae dhéag. The counties in question are Tipperary, Waterford, Offaly, Cork, Galway, Donegal, Meath, Kilkenny, Westmeath, Laois, Clare and Wexford. Is iad na contaetha atá i gceist Tiobraid Árann, Port Láirge, Uíbh Fhailí, Corcaigh, Gaillimh, Dún na nGall, An Mhí, Cill Chainnigh, An Iarmhí, Laois, An Clár agus Loch Garman. It is not an absolute drought and the water supply in those areas is "being managed", the company says. Ní dearbhthriomach atá ann agus tá an soláthar uisce sna háiteanna sin "á bhainistiú", a deir an comhlacht. However, Irish Water has declared conservation orders in three locations, namely, Mullingar in County Westmeath; Milford in County Donegal; and Kells- Oldcastle in County Meath. Mar sin féin, tá orduithe caomhnaithe fógartha ag Uisce Éireann i dtrí áit, mar atá, An Muileann gCearr i gCo na hIarmhí; Baile na nGallóglach i gCo Dhún na nGall; agus Ceanannas-An Seanchaisleán i gCo na Mí. In addition, the company says that it may still be a drought in other places as well, including Dublin. Ina cheann sin, deir an comhlacht go mb'fhéidir go mbeadh sé ina thriomach fós in áiteanna eile freisin, Baile Átha Cliath ina measc. Temperatures are expected to reach 28 degrees in parts of the country from now until at least Saturday, and people across the country are being urged to be water-efficient while the heatwave lasts. Meastar go mbeidh an teocht chomh hard le 28 céim in áiteanna sa tír as seo go Dé Sathairn ar a laghad, agus táthar ag iarraidh ar dhaoine ar fud na tíre a bheith stuama tíosach ó thaobh uisce de fad is a mhairfidh an brothall. Despite the fact that this country receives a lot of rainfall, Irish Water says that a lot of it is lost due to the poor condition of the national water network infrastructure and much of it being outdated. In ainneoin go dtiteann go leor báistí sa tír seo, deir Uisce Éireann go gcailltear go leor di mar gheall ar an drochbhail atá ar infreastruchtúr an líonra náisiúnta uisce agus cuid mhór de seanchaite. RTÉ News and Current Affairs Irish Water urges people to be water-efficient while the drought lasts Nuacht agus Cúrsaí Reatha RTÉ Uisce Éireann ag iarraidh ar dhaoine a bheith barainneach ó thaobh uisce de fad is a mhairfidh an teaspach

Black in Sports Podcast
AI Youth Sports- “ Can't Chat GPT Sports" | The Locker Room - S6 EP7

Black in Sports Podcast

Play Episode Listen Later Jul 9, 2025 41:01


The Locker Room with topics that shape the past, present, and future of the game. Whether you were raised on AAU bus rides, Friday night lights, or the blacktop at the rec center—this one hits home.

Radio Elshinta
PPATK ungkap jumlah rekening penerima bansos yang digunakan untuk judol total depositnya mencapai hampir Rp 1 Trilyun, apa solusinya?

Radio Elshinta

Play Episode Listen Later Jul 9, 2025 12:39


#DiskusiInteraktif PPATK ungkap jumlah rekening penerima bansos yang digunakan untuk judol total depositnya mencapai hampir Rp 1 Trilyun, apa solusinya?[TALK] Direktur Eksekutif Jaminan Sosial Institute - mantan anggota DJSN periode 2019-2025 - Andy William Sinaga, MH&Sosiolog Universitas Katolik (Unika) Soegijapranata Semarang - Hermawan Pancasiwi

Make Trades Great Again
The Art Of The Deal?

Make Trades Great Again

Play Episode Listen Later Jul 8, 2025 24:49


In this conversation, the guys discuss the complexities of hvac projects, pricing strategies, and the importance of customer communication in the HVAC industry.They share personal experiences and insights on how to effectively engage with customers, manage expectations, and highlight the value of quality components. The discussion also touches on financing options to help customers afford necessary services, emphasizing the need for empathy and understanding in customer interactions.TakeawaysCustomer expectations can often be misaligned with actual costs.Quality components lead to better long-term service and customer satisfaction.Empathy in communication can help bridge the gap between price and value.Offering financing options can make services more accessible to customers.It's important to explain the reasons behind pricing to customers.Maintaining a consistent pricing strategy is crucial for business integrity.Listening to customer concerns can lead to better service outcomes.Highlighting warranties and service benefits can justify higher costs.Custom installations require careful consideration and planning.Building long-term relationships with customers can lead to repeat business.Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Tipp FM Radio
Ar An Lá Seo 2-7-25

Tipp FM Radio

Play Episode Listen Later Jul 7, 2025 2:22


Fáilte ar ais chuig eagrán nua de Ar An Lá Seo ar an 2ú lá de mí Iúil, liomsa Lauren Ní Loingsigh. I 1993 phléadáil cléireach ó chumann foirgníochta ciontach nuair a chúbláil sé 90 míle punt. I 2010 bhí Lexus fórsáilte chun aistarraingt a dhéanamh ar 480 carr de bharr locht inneall. I 2001 tharla céim thábhachtach chun cinntiú go mbeadh bainistiú inbhuanaithe de stoc éisc ar Abhainn na Siúire feistithe den mhaoiniú de 10 míle punt do Chluain Mheala. I 2005 d'íoc ocht mainnitheoir cánach ón chontae 453 míle 709 euro I socrú chuig Coimisinéirí Ioncaim idir mí na Nollaig 2004 agus mí an Mhárta 2005. Bhí an chontae ceathrú ar an liosta de mhainnitheoirí cánach. Sin Katy Perry agus Snoop Dogg le California Gurls – an t-amhrán is mó ar an lá seo I 2010 Ag lean ar aghaidh le nuacht cheoil ar an lá seo I 1971 chan Queen ag Coláiste Surry sa Bhreatain. Bhí sé seo an chéad cheolchoirm le Freddie Mercury, Brian May, Roger Taylor agus John Deacon. I 1988 bhí Michael Jackson an chéad amhránaí chun cúig uimhir a haon a bheith aige ó albam amháin nuair a chuaigh Dirty Diana chuig barr na cairteacha I Meiriceá. Agus ar deireadh breithlá daoine cáiliúla ar an lá seo rugadh aisteoir Margot Robbie san Astráil I 1990 agus rugadh aisteoir Ashley Tisdale I Meiriceá ar an lá seo I 1985 agus seo chuid de na rudaí a rinne sí. Beidh mé ar ais libh amárach le heagrán nua de Ar An Lá Seo. Welcome back to another edition of Ar An Lá Seo on the 2nd of July, with me Lauren Ní Loingsigh 1993: A building society Clerk plead guilty after embezzling £90,000 2010: Lexus is forced to recall 480 models over engine fault 2001 - AN important step towards ensuring the sustainable management of fish stocks on the River Suir was taken with the provision of £10,000 funding for the Clonmel-based Southern Regional Fisheries Board.   2005 - EIGHT Tipperary tax defaulters forked out a total of €453,709 between them in settlements to the Revenue between December 2004 and March 2005. These figures showed the Premier County had the fourth highest number of tax defaulters  That was Katy Perry and Snoop Dog with California Girls – the biggest song on this day in 2010 Onto music news on this day In 1971 Queen appeared at Surrey College, England. This was the group's first gig with the line-up of Freddie Mercury, Brian May, Roger Taylor and John Deacon. 1988 Michael Jackson became the first artist to have five number one singles from one album when ‘Dirty Diana' went to the top of the US charts. And finally celebrity birthdays on this day – actress Margot Robbie was born in Australia in 1990 and actress Ashley Tisdale was born in America on this day in 1985 and this is some of the stuff she has done. I'll be back with you tomorrow with another edition of Ar An Lá Seo.

Orkenspalter TV labert
Vampire The Masquerade: Haus der Knochen - Mitschnitt einer Live-Runde auf Twirch

Orkenspalter TV labert

Play Episode Listen Later Jul 6, 2025 210:58


Mháire hat einer fantastischen Besetzung von Spielenden Vampire in Südfrankreich gespielt. Wir werden das als lose Reihe von One Shots mit teils gleichbleibender, teils wechselnder Besetzung fortsetzen.

Always On EM - Mayo Clinic Emergency Medicine
Chapter 45 - Airway to Heaven: A Primer on Mechanical Ventilation for Emergency Providers

Always On EM - Mayo Clinic Emergency Medicine

Play Episode Listen Later Jul 5, 2025 73:24


Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient's needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don't let it take your breath away! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Swart P, Nijbroek SGLH, Paulus F, Neto AS, Schultz MJ. Sex Differences in Use of Low Tidal Volume Ventilation in COVID-19-Insights From the PRoVENT-COVID Study. Front Med (Lausanne). 2022 Jan 3;8:780005. doi: 10.3389/fmed.2021.780005. PMID: 35300177; PMCID: PMC8923734. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004. Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One. 2021 Jul 14;16(7):e0253933. doi: 10.1371/journal.pone.0253933. PMID: 34260619; PMCID: PMC8279424. Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M.5; French, Craig6; Machado, Flávia R.7; Mcintyre, Lauralyn8; Ostermann, Marlies9; Prescott, Hallie C.10; Schorr, Christa11; Simpson, Steven12; Wiersinga, W. Joost13; Alshamsi, Fayez14; Angus, Derek C.15; Arabi, Yaseen16; Azevedo, Luciano17; Beale, Richard18; Beilman, Gregory19; Belley-Cote, Emilie20; Burry, Lisa21; Cecconi, Maurizio22; Centofanti, John23; Coz Yataco, Angel24; De Waele, Jan25; Dellinger, R. Phillip26; Doi, Kent27; Du, Bin28; Estenssoro, Elisa29; Ferrer, Ricard30; Gomersall, Charles31; Hodgson, Carol32; Hylander Møller, Morten33; Iwashyna, Theodore34; Jacob, Shevin35; Kleinpell, Ruth36; Klompas, Michael37; Koh, Younsuck38; Kumar, Anand39; Kwizera, Arthur40; Lobo, Suzana41; Masur, Henry42; McGloughlin, Steven43; Mehta, Sangeeta44; Mehta, Yatin45; Mer, Mervyn46; Nunnally, Mark47; Oczkowski, Simon48; Osborn, Tiffany49; Papathanassoglou, Elizabeth50; Perner, Anders51; Puskarich, Michael52; Roberts, Jason53; Schweickert, William54; Seckel, Maureen55; Sevransky, Jonathan56; Sprung, Charles L.57; Welte, Tobias58; Zimmerman, Janice59; Levy, Mitchell60. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical Care Medicine 49(11):p e1063-e1143, November 2021. | DOI: 10.1097/CCM.0000000000005337  Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, Adhikari NKJ, Amato MBP, Branson R, Brower RG, Ferguson ND, Gajic O, Gattinoni L, Hess D, Mancebo J, Meade MO, McAuley DF, Pesenti A, Ranieri VM, Rubenfeld GD, Rubin E, Seckel M, Slutsky AS, Talmor D, Thompson BT, Wunsch H, Uleryk E, Brozek J, Brochard LJ; American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017 May 1;195(9):1253-1263. doi: 10.1164/rccm.201703-0548ST. Erratum in: Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum. PMID: 28459336. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363. PMID: 32224769; PMCID: PMC7176264. Wang W, Scharfstein D, Wang C, Daniels C, Needham D, Brower R, NHLBI ARDS Clinical Network. Estimating the Causal Effect of Low Tidal Volume Ventilation on Survival in Patients with Acute Lung Injury. J R Stat Soc Ser C Appl Stat. 2011. PMC: PMC3197806 Brower RG, Thompson BT, NIH/NHLBI/ARDSNetwork. Tidal volumes in acute respiratory distress syndrome--one size does not fit all. Crit Care Med. 2006. Hager DN, Krishman JA, Hayden D, Brower RG, ARDSNet NIH / NHLBI. Tidal Volume Reduction in Patients with acute Lung Injury When Plateau Pressures Are Not High. Am J Resp Crit Care Med. 2005. Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD. Barriers to providing lung protective ventilation to patients with acute lung injury. Crit Care Med. 2004. Chatburn RL, El-Khatib M, Mireles-Cabodevila E. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care. 2014 Nov;59(11):1747-63. doi: 10.4187/respcare.03057. Epub 2014 Aug 12. PMID: 25118309. Guo L, Wang W, Zhao N, Guo L, Chi C, Hou W, Wu A, Tong H, Wang Y, Wang C, Li E. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Crit Care. 2016 Jul 22;20(1):226. doi: 10.1186/s13054-016-1396-0. PMID: 27448995; PMCID: PMC4957383. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, NIH NHLBI ARDS Network. Comparison of the Sp02/FI02 Ratio and the PaO 2/FI02 in Patients with Acute Lung Injury or ARDS. Chest. 2007. Zhang G, Burla MJ, Caesar BB, Falank CR, Kyros P, Zucco VC, Strumilowska A, Cullinane DC, Sheppard FR. Emergency Department SpO2/FiO2 Ratios Correlate with Mechanical Ventilation and Intensive Care Unit Requirements in COVID-19 Patients. West J Emerg Med. 2024 May;25(3):325-331. doi: 10.5811/westjem.17975. PMID: 38801037; PMCID: PMC11112664.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

DJ Hot Maker https://djhotmaker.ru
DJ HOT MAKER - SUMMER DANCE 2025

DJ Hot Maker https://djhotmaker.ru

Play Episode Listen Later Jul 4, 2025 157:12


DJ HOT MAKER - SUMMER DANCE 2025 Привет! Твоему вниманию лучшие зарубежные треки за последнее время. 2 часа 37 минут. Микс без джинглов. Отличный фон на мероприятия, только иностранные известные треки! Хорошо подойдёт как фон на ивент, как фон на корпоратив, фон на тимбилдинг! Скачать и послушать в качестве 320 kB/s можно здесь или перейдя по ссылкам: t.me/dj_hot_maker и отсюда : disk.yandex.ru/d/39YHHpQYyd-Cl… djhotmaker.ru #house #pop #dj #djhotmaker #диджей #микс #новыймикс #музыка #music 00:00:00 1 Mаrshmеllо, Jоnаs Brоthеrs - Slоw Mоtiоn (аlех саsрiаn Rеmiх) 00:03:27 2 аlаn Wаlkеr, Mееk - Dаnсing In Lоvе (Skу Sоund ехtеndеd Rеmiх) 00:07:04 3 nаBBоо & Mоuniа - Slоw Dоwn (аlех саsрiаn Rеmiх) 00:10:09 4 уvеs Lаrосk - аnоthеr Dау (Miхеd) 00:13:00 5 суRIL, Dеаn Lеwis, аmiсе - Fаll аt уоur Fееt 00:16:21 6 Kуgо & оnеrерubliс - сhаsing раrаdisе (Intrо сlеаn) 00:18:54 7 Sорhiе аnd thе Giаnts, аmiсе - Shut Uр аnd Dаnсе 00:22:14 8 Lаdу Gаgа - аbrасаdаbrа (Djсitу Intrо) 00:25:51 9 соldрlау & TINI - Wе рRау (Dj Dаrk Rеmiх) [ехtеndеd] 00:29:09 10 Tорiс, а7S, аmiсе - оut Mу Hеаd 00:32:27 11 аlоk & Jеss Glуnnе - Summеr's Bасk (Tmu 'Sing It Bасk' Hуре Intrо) 00:35:15 12 Dаvid Guеttа & Siа - Bеаutiful реорlе (ехtеndеd) 00:38:31 13 аnаbеl еnglund - Gеt Busу (ехtеndеd Miх) 00:41:38 14 Kаskаdе, Grуffin, Nu-Lа - In Mу Hеаd (ехtеndеd Miх) 00:45:16 15 Thе сhаinsmоkеrs & Kim реtrаs - Dоn't Liе 135 00:47:10 16 Mаrtin Jеnsеn, Thе Stiсkmеn рrоjесt, Mаtt Stеffаninа - Dеереr Lоvе (ехtеndеd) 00:49:32 17 аvа Mах - Sроt а Fаkе (BLUMØNDау Hоusе Rеmiх) [Intrо Dirtу] 00:52:56 18 аllе Fаrbеn, Grаhаm саndу, Lаhоs - Flоwеrs (ехtеndеd) 00:56:11 19 еd Shееrаn - аzizаm (Dj Dаrk Rеmiх) (ехtеndеd) (сlеаn) 00:59:11 20 Rаg'n'Bоnе Mаn - Rush оf Blооd (D.о.D Rеmiх) 01:01:38 21 Rоsе F. Brunо Mаrs - арt 'араrtmеnt' (Vаndаl Rосk сlub Miх) 01:04:50 22 саlvin Hаrris - Blеssings (fеаt. сlеmеntinе Dоuglаs) 01:08:17 23 Shаbооzеу - а Bаr Sоng (Tiрsу (аlеssо Rеmiх) 01:10:37 24 KDDK - о-Lа-Lа (Rеd Linе & DJ JоN Rеmiх) 01:12:39 25 Sеаn раul, Innа - Lеt It Tаlk Tо Mе (Grееn & Vizitt Rеmiх) 01:16:28 26 Tеddу Swims - Bаd Drеаms (сhаrliе Lаnе Rеmiх) [Intrо сlеаn] 01:19:43 27 Fаst Bоу & сlосkсlосk - Bоrn аgаin (аlех саsрiаn Rеmiх) 01:22:49 28 FаST Bоу, Rаf, аmiсе - Wаvе 01:26:10 29 Tеddу Swims - Thе Dооr (соllini сlub Hоusе Rеdrum еdit) (сlеаn) 1а 126 01:29:13 30 R3HаB, Mufаsа & Hуреmаn, Rаni - Bеliеvе (Shооting Stаrs) (ехtеndеd Miх) 01:32:00 31 Kуliе Minоguе - Lights саmеrа асtiоn (ехtеndеd Miх) 01:35:20 32 Mаrtin Gаrriх F. Jех - Tоld уоu Sо (ехtеndеd Miх) 128 01:38:50 33 аlеssо & Nаtе Smith-I Likе It (сK Intrо-сlеаn) 10а 129 01:41:27 34 суRIL, аmiсе - Stumblin' In 01:45:48 35 Thе Mаgiсiаn, рurрlе Disсо Mасhinе - аll Mу Lifе ехtеndеd Miх 01:51:33 36 сhеаt соdеs ft. Trаin - Blооm (Intrо еdit) 01:53:35 37 Kуliе Minоguе, аlоk - lаst night i drеаmt i fеll in lоvе (ехtеndеd Miх) 01:56:47 38 Fеliх Jаеhn ft Sорhiе еllis-Bехtоr-Rеаdу Fоr уоur Lоvе (ехtеndеd Miх) 01:59:47 39 Kоlуа Funk & Mаtvеу еmеrsоn - Whаt Is Lоvе (еddiе G ехtеndеd Rеmiх) 02:02:22 40 ау уоLа - Hоmау (ауur Tsуrеnоv rеmiх) 02:05:00 41 Mеghаn Trаinоr - сriminаls (сhrоmео Rеmiх) 02:07:39 42 Hugеl & Tорiс & Dаесоlm - I аdоrе уоu (Igоr Blаskа vs еSQUIRе Rеmiх)(Intrо)(сlеаn) 02:11:33 43 Lоlа уоung - Mеssу (Dj оd Nu Disсо еdit) сlеаn 123 02:15:27 44 Zеrb, Tv Dоllа Sign & Wiz Khаlifа - Lосаtiоn - соllini сlub Hоusе раrtу Stаrtеr еdit(сlеаn) 02:18:21 45 GооDBоуS, Nu аsресt, аVаIоN - Blindsроt (ехtеndеd) 02:22:32 46 аvа Mах - Lоst уоur Fаith (ехtеndеd Miх) 02:25:14 47 Rау Dаltоn, аmiсе - аLL Wе GоT 02:27:51 48 R3hаb, Miсhаеl раtriсk Kеllу & Shаggу - Rеbеlliоn (ехtеndеd Miх) 02:30:31 49 Kаеуrа, аmiсе - Sоur 02:34:24 50 оnеrерubliс - Invinсiblе (Sk Miхshоw еdit) (сlеаn)

Galway Bay Fm - Galway Talks - with Keith Finnegan
Community Matters - Inis Meáin

Galway Bay Fm - Galway Talks - with Keith Finnegan

Play Episode Listen Later Jul 4, 2025 120:47


Today on Community Matters: Inis Meáin -  9am-10am  Locals tell us their favourite memories of living on the island Current affairs with Mairead Ní Fhartharta and Paddy O'Foghlu History with Máirín Mhéiní 10am-11am We'll be talking about Aran knits with Tarlach De Blacam City Tribune Headlines Aedín Ní Thiarnaigh talks us through the wildflowers blooming on the island 11am-12pm Sport with Collette Blackmore, Lorcan O'Curraoin and Padraic Ruairi Beag Live Music   Helen Brown and her family help us round off the show

RTÉ - Adhmhaidin
Cuan Ó Seireadáin: Eagraí Polaitiúil Raidió na Gaeltachta.

RTÉ - Adhmhaidin

Play Episode Listen Later Jul 3, 2025 6:34


Dúirt an tAire Fiontair, Peter Burke, inné go bhfuil sé “dóchasach seachas muiníneach” go ndéanfar margadh trádála idir an tAontas Eorpach agus na Stáit Aontaithe faoin Mháirt.

RTÉ - Barrscéalta
Nóirín Ní Mhaoldomhnaigh Bainisteoir Chomharchumann Oileán Aráinn Mhóir.

RTÉ - Barrscéalta

Play Episode Listen Later Jul 3, 2025 4:57


Seolfar físeáin bholscaireachta an bhealaigh ghoirm idir Árainn Mhór agus Ailt a'Chorráin ag ócáid ar an oileán amárach.

Make Trades Great Again
Mail Call: Answering MTGA listener questions

Make Trades Great Again

Play Episode Listen Later Jul 1, 2025 37:27


We love reading your questions and comments. Keep sending them! This week the guys talk partnerships, contracts, marketing during a slowdown and more. Eric owns a media company along with his business partner John Mesenbrink (host of the Appetite for Construction podcast) so he's had over ten years of experience in this area.Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Nuacht Mhall
28 Meitheamh 2025 (Tír Eoghain)

Nuacht Mhall

Play Episode Listen Later Jun 28, 2025 7:56


Nuacht Mhall. Príomhscéalta na seachtaine, léite go mall.*Inniu an t-ochtú lá is fiche de mhí an Mheithimh. Is mise Niall ÓSiadhail.Bhí bua gan choinne ag Zohran Mamdani i dtoghchán tosaigh an Pháirtí Dhaonlathaigh le haghaidh Mhéara Nua-Eabhrac DéMáirt, nuair a fuair sé an ceann is fearr ar iarghobharnóir Stát Nua-Eabhrac Andrew Cuomo. Reáchtálfar toghchán an mhéara féin i mí na Samhna agus meastar gur rogha na coitiantachta a bheidh in iarrthóir an Pháirtí Dhaonlathaigh. Bhí tacaíocht leithéidí Bernie Sanders agus Alexandria Ocasio-Cortez ag Mamdani, agus é ag gealladh polasaithe níos forásaí ná Cuomo, lena n-áirítear reo cíosanna agus busanna saor in aisce sa chathair. Anuas air sin, tá Cuomo luaite le roinnt líomhaintí faoi chiapadh gnéasach. Má éiríonn le Mamdani i mí na Samhna beidh sé ina chéad Mhéara Moslamach i gCathair Nua-Eabhrac.Tháinig fear slán as foirgneamh a bhí trí thine i lár Bhaile Átha Cliath le linn na seachtaine, buíochas le tiománaí leoraí a pháirceáil a fheithicil faoi fhuinneog an tí ar Rae Granby in aice le Cearnóg Parnell. Chonaic Tomasz Zareba fear amháin ag léim amach as fuinneog thuas staighre agus é féin a ghortú ar an tsráid ach ansin thiomáin sé a leoraí taobh leis an fhoirgneamh le go mbeadh fear eile ábalta teacht anuas go sábháilte. I ndiaidh na heachtra, chuaigh Zareba ar ais ag obair, agus é ag seachadadh earraí go siopaí sa chathair. Cuireadh cóireáil ar sheachtar ar an láthair agus cuireadh triúr san ospidéal, ach ní fios go fóill cad é ba chúis leis an tine.Tá féile cheoil Glastonbury ar siúl an deireadh seachtaine seo, agus thart fá dhá chéad míle duine ag teacht go Worthy Farm in Somerset in iardheisceart Shasana. Is iad The 1975, Neil Young agus Olivia Rodrigo príomhoirfidigh na féile, a d'eagraigh anfeirmeoir Michael Eavis den chéad uair sa bhliain 1970, agus tá roinnt ceoltóirí móra Éireannacha ag seinm fosta i mbliana, lena n-áirítear Kneecap, CMAT, Sprints agus Inhaler. Seachtain ó shin, dúirt Príomh-Aire na Ríochta Aontaithe Keir Starmer go gcreideann sé nár chóir go mbeadh ceolchoirm Kneecap á léiriúar an teilifís, ach tá sé ráite ag an lucht eagraithe go bhfuil fáilte rompu ag an fhéile. Beidh an chéad fhéile eile ar siúl sa bhliain 2027, ós rud é gur feirm dhéiríochta é Worthy Farm agus go mbíonn bliain ina bhán de dhíth ó am go ham.*Léirithe ag Conradh na Gaeilge i Londain. Tá an script ar fáil i d'aip phodchraolta.*GLUAISbua gan choinne - unexpected victoryrogha na coitiantachta - favouritereo cíosanna - rent freezelíomháintí faoi chiapadh gnéasach - allegations of sexual harassmentpríomhoirfidigh - headlinersbliain ina bhán -fallow year

RTÉ - News at One Podcast
New Árainn Mhór ferry vessel to be officially launched

RTÉ - News at One Podcast

Play Episode Listen Later Jun 27, 2025 4:20


Seamus Boyle, Managing Director of Arranmore Ferry, discusses the launch of a new ferry, Arranmore Blu, which will hold 96 passengers and 10 cars between Árainn Mhór and Ailt an Chorráin in west Donegal.

Mannlegi þátturinn
Kristín Jónsdóttir föstudagsgestur og Sigríður Wöhler rabarbarasérfræðingur

Mannlegi þátturinn

Play Episode Listen Later Jun 27, 2025 53:06


Föstudagsgestur Mannlega þáttarins í þetta sinn var Kristín Jónsdóttir, eldfjalla- og jarðskjálftafræðingur og starfar sem hópstjóri í náttúruváreftirliti hjá Veðurstofu Íslands. Hún er í vísindaráði Almannavarna og hefur starfað sem stundakennari við Háskóla Íslands. Við fengum Kristínu til að fara með okkur aftur í tímann á æskuslóðirnar í Breiðholtinu, í gegnum skólagönguna, MH, HÍ, doktorsnám í Svíþjóð og svo rannsóknir á eldstöðvum og jarðskjálftaóróa. Við forvitnuðumst líka um hennar tónlistarferil þar sem hún söng meðal annars í feikivinsælu lag með Rúnari Júlíussyni og Unun og spilar í dag á trommur. Svo var það matarspjallið með Sigurlaugu Margréti, þar var bara talað um rabarbara við sérlegan gest, Sigríði Wöhler, sérfræðing í rabarbara. Hún kom færandi hendi með köku, sýróp og kryddmauk, allt unnið úr rabarbara og allt dásamlega gott. Tónlist í þættinum í dag: Hann mun aldrei gleym'enni / Unun og Rúnar Júlíusson (Þór Eldon og Gunnar Hjálmarsson) Debaser / Pixies (Black Francis) Gigantic / Pixies (Black Francis & Kim Deal) UMSJÓN GUÐRÚN GUNNARSDÓTTIR OG GUNNAR HANSSON

MÖRDERISCHE HEIMAT
Extra Juni 2025

MÖRDERISCHE HEIMAT

Play Episode Listen Later Jun 26, 2025 47:57


Und wieder schließt sich der Vorhang einer Staffel. Zeno, Shaggy und Lisa blicken zurück auf Niedersachsen. Allerdings stehen sie noch unter dem Eindruck der vergangenen Liveshow, des Sommerspecials 2025, und gewähren euch einen Einblick was sie Backstage mit den Gewinnern des IBB-Gewinnspiels beim Meet & Greet erlebt haben. Natürlich darf auch der Professor der Kriminalwissenschaften Gerhard Schmelz nicht fehlen. Im Gespräch mit Lisa erörtert er die kriminalistischen Fragen rund um die letzte Staffel. Außerdem setzen wir unsere Serie fort und stellen euch auch in diesem EXTRA eine Person aus dem Kosmos rund um MÖRDERISCHE HEIMAT vor. Diesmal geht es um unseren Bühnenmanager Felix Volkmer, sein Schaffen und wie er zu MH kam. Ach ja, und welches Bundesland wird eigentlich als nächstes bereist..?

DJ Hot Maker https://djhotmaker.ru
DJ HOT MAKER - POP DANCE 2025 VOL.2

DJ Hot Maker https://djhotmaker.ru

Play Episode Listen Later Jun 25, 2025 74:07


DJ HOT MAKER - POP DANCE 2025 VOL.2 Привет! Предлагаю тебе вторую подборку за последние 5 месяцев. 74 минуты Джингл только в самом начале Скачать в качестве 320 kb/s можно с моего канала t.me/dj_hot_maker или отсюда: disk.yandex.ru/d/4-Gb5V1gbbDSP… Новый микс в стиле Pop Dance от DJ Hot Maker. Приятного прослушивания! Мой сайт djhotmaker.ru #house #pop #dj #djhotmaker #диджей #микс #новыймикс #музыка #music 00:00:00 1 Еd Shееrаn - Аzizаm (Dj Dаrk Rеmix) 00:03:30 2 Люся Чeбoтинa - Kаблyк (Indеx 1 Rеmix) 00:06:44 3 Fаst Bоу & сlосkсlосk - Bоrn аgаin (аlеx саsрiаn Rеmix) 00:10:05 4 Аllе Fаrbеn, Grаhаm саndу, Lаhоs - Flоwеrs 00:13:33 5 Оnеrерubliс - Invinсiblе (Sk Mixshоw еdit) 00:15:53 6 Zivеrt - Oдин пpoцент (Ауur Tsurеnоv rеmix) 00:19:22 7 Lаdу Gаgа - Shаdоw оf а Маn (Dj Bеаts) 00:22:38 8 JоNу,Аrаsh - Уходи Уходи Bоrо Bоrо (Indеx 1 Rеmix) 00:25:02 9 Ваhh Тее, Тurkеn - Скандалистка (Indеx-1 Rеmix) 00:28:10 10 Lаdу Gаgа - аbrасаdаbrа (Djсitу Intrо) 00:31:32 11 Hugеl, уоrghаki, аllеh - unа nосhе соn hugеl 00:35:18 12 Iоwа - Мaльчик 00:36:58 13 Moя Mишель, Бacтa - He пoнялa (уuliаnа Rеmix) 00:39:35 14 АY YОLА - Hоmау (ауur Tsуrеnоv rеmix) 00:42:13 15 Dаbrо - Вeчepaми (еddiе G еxtеndеd Rеmix) 00:45:26 16 Nуushа, сhinKоng - Нeпoгoдa (Mishа рlеin & Vаnоmеll Rеmix) 00:49:14 17 Kаskаdе, Grуffin, Nu-Lа - In Mу Hеаd 00:53:05 18 Sаm Fеldt - Mу Hеаrt Gоеs (ft. оаks) 00:55:30 19 КDDК - о-Lа-Lа (Rеd Linе & DJ JоN Rеmix) 00:57:32 20 Аvа Mаx - Lоst уоur Fаith (еxtеndеd Mix) 01:00:48 21 Taтьянa Kypтyкoвa - Нaливнoe яблoчкo (Indеx-1 Rеmix) 01:03:19 22 Саlvin Hаrris - Blеssings (fеаt. сlеmеntinе Dоuglаs) 01:07:16 23 GооDBоуS, Nu аsресt, аVаIоN - Blindsроt (еxtеndеd) 01:11:22 24 Веnsоn Вооnе - Sоrrу I'm Hеrе Fоr Sоmеоnе еlsе (Lnrр Mixshоw еdit)

Make Trades Great Again
Handling Last Minute Changes on Install Day

Make Trades Great Again

Play Episode Listen Later Jun 24, 2025 29:44


The very last thing I want to do as the contractor is make a not-so-great situation worse" Andy Mickelson What happens when you figure out there's a problem on the job, how you handle it says a lot about you as a company/service provider. This week the guys are talking recent jobs and problems and an amazing tax credit/rebate situation happening in Andy's market.Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Nuacht Mhall
21 Meitheamh 2025 (Ard Mhacha)

Nuacht Mhall

Play Episode Listen Later Jun 21, 2025 7:36


Nuacht Mhall. Príomhscéalta na seachtaine, léite go mall.*Inniu an t-aonú lá is fiche de mhí an Mheithimh. Is mise Barra Mac Giolla Aoláin.Leanann an cogadh idir Iosrael agus an Iaráin ar aghaidh an tseachtain seo. Rinne fórsaí Iosrael tuilleadh ionsaithe aeir ar phríomhchathair na hIaráine, Tehran, dírithe ar oirthear na cathrach. Mhol Uachtarán na Stát Aontaithe, Donald Trump, do mhuintir Tehran imeacht roimh an ionsaí, amhail is go raibh a fhios aige roimh ré. Tháinig cáineadh ó rialtas na Síne, agus iad ag rá go raibh Trump ag cur leis an teannas. Ionsaíodh cathracha eile fosta, lena n-áirítear Natanz, áit a bhfuil áiseanna núicléacha, agus Tabriz, áit a bhfuil bunáit aerfhórsa na hIaráine. D'ionsaigh fórsaí na hIaráine na cathracha Iosraelacha Tel Aviv agus Haifa le diúracáin agus dróin. D'fhág Trump cruinniú G7 i gCeanada go tobann, ach séanann sé go raibh sé ag iarraidh páirt a ghlacadh i gcainteanna síochána idir an dá thír.Beidh babhta réamhcheathrú ceannais de Chraobh Shinsir Peile na hÉireann ag tarlú an deireadh seachtaine seo. Tá Baile Átha Cliath ag imirt i gcoinne Chorcaí i bPáirc an Chrócaigh tráthnóna Dé Sathairn i gcluiche mór an deireadh seachtaine. Tarraingíodh na cluichí ar Morning Ireland ar RTÉ Raidió a hAon agus seo mar a tháinig siad amach: Dún na nGall v Lú, An Dún v Gaillimh, Ciarraí v An Cabhán, Baile Átha Cliath v Corcaigh. Beidh buntáiste baile ag Dún na nGall, An Dún, Baile Átha Cliath, agus Ciarraí, ós rud é gur tháinig siad sa dara háit ina ngrúpaí roimhe seo. Tá áit bainte amach ag buaiteoirí na ngrúpaí sin – Tír Eoghain, An Mhí, Muineachán, agus Ard Mhacha – sa bhabhta ceathrú ceannais cheana, agus beidh na foirne sin ag dul in iomaíocht le buaiteoirí na gcluichí an deireadh seachtaine seo.Bhí Liam Óg Ó hAnnaidh, a bhfuil cáil níos fearr air mar an rapálaí Mo Chara as an ghrúpa Kneecap, os comhair na cúirte i Londain an tseachtain seo. Cúisíodh é maidir le dlí frithsceimhlitheoireachta – deirtear gur thaispeáin sé bratach a bhí ag tacú le Hezbollah ag ceolchoirm i Londain i mí na Samhna seo caite. Shéan sé na cúisimh ar fad. Deir Kneecap gur caitheadh an bhratach ar an stáitse agus go bhfuil na cúisimh ina n-iarracht an grúpa rapcheoil a chiúnú. Deir siad go bhfuil an dlí á úsáid chun bac a chur orthu ag taisteal agus ag labhairt. Tá Kneecap an-oscailte lena dtacaíocht don Phalaistín agus i gcoinne an chogaidh in Gaza. Bhí slua mór ag tacú leo taobh amuigh den chúirt i Londain Dé Céadaoin, agus ligeadh amach ar bannaí é. Déardaoin d'fhill siad ar Éirinn le haghaidh ceolchoirm mhór i bPáirc Fionnradhairc i mBaile Átha Cliath.*Léirithe ag Conradh na Gaeilge i Londain. Tá an script ar fáil i d'aip phodchraolta.*GLUAISáiseanna núicléacha - nuclear facilitiesbunáit aerfhórsa - air force baseréamhcheathrú ceannais - preliminary quarter-finalag dul in iomaíocht le - competing withdlí frithsceimhlitheoireachta - anti-terrorism lawar bannaí - on bail

Phát triển Kinh doanh - Phát triển con người
Top 3 bí quyết khởi nghiệp thành công

Phát triển Kinh doanh - Phát triển con người

Play Episode Listen Later Jun 21, 2025 20:23


Khởi nghiệp là một hành trình đầy thử thách và thử sức, nhưng nếu có chiến lược đúng đắn, bạn có thể vượt qua mọi khó khăn. Nhiều người cho rằng khởi nghiệp chỉ cần có ý tưởng hay là đủ, nhưng thực tế, một kế hoạch rõ ràng và vững chắc mới là yếu tố quyết định. Dưới đây là ba bí quyết quan trọng mà bạn cần nắm vững để khởi nghiệp thành công. Mục Tiêu Tài Chính Là Điều Quan Trọng Nhất Một trong những sai lầm lớn nhất mà nhiều người mắc phải khi bắt đầu khởi nghiệp chính là không xác định rõ mục tiêu tài chính ngay từ đầu. Họ bắt tay vào công việc kinh doanh một cách mù quáng, chỉ thấy người khác thành công rồi làm theo mà không có chiến lược tài chính rõ ràng. Khi bạn không xác định được mục tiêu tài chính, bạn sẽ dễ dàng bị lạc lối trong công việc kinh doanh của mình. Khởi nghiệp không chỉ đơn thuần là việc mở cửa hàng, bán sản phẩm hay dịch vụ. Mục tiêu tài chính là kim chỉ nam giúp bạn xác định được nguồn lực cần thiết, phân bổ chi phí hợp lý và có kế hoạch thu chi hợp lý. Bạn phải trả lời câu hỏi lớn nhất: Mục tiêu tài chính của tôi là gì? Là tạo ra thu nhập ổn định hay phát triển một doanh nghiệp với mục tiêu dài hạn?  Khởi Nghiệp Cần Niềm Vui Để thành công trong kinh doanh, bạn phải yêu thích công việc mình đang làm. Nếu bạn chỉ khởi nghiệp để kiếm tiền mà không có niềm đam mê, bạn sẽ dễ dàng từ bỏ khi gặp khó khăn. Niềm vui trong công việc không chỉ giúp bạn vượt qua thử thách, mà còn tạo ra sự sáng tạo, động lực và sự gắn kết với khách hàng. Khởi nghiệp sẽ trở thành một hành trình thú vị nếu bạn thực sự đam mê và vui vẻ với công việc mình đang theo đuổi.  Sản Phẩm Hoặc Dịch Vụ Của Bạn Phải Hữu Ích Một trong những yếu tố quan trọng để thành công trong kinh doanh là sản phẩm hoặc dịch vụ của bạn phải có giá trị thật sự đối với khách hàng. Không có gì tệ hơn việc bạn bỏ công sức, tiền bạc vào một sản phẩm mà không có ai cần đến nó. Bạn cần xác định rõ sản phẩm của mình có thể giải quyết vấn đề gì cho khách hàng, mang lại lợi ích gì cho cộng đồng. Khi bắt đầu khởi nghiệp, hãy đặt câu hỏi: Liệu sản phẩm của tôi có thực sự hữu ích? Nếu câu trả lời là không, bạn sẽ gặp rất nhiều khó khăn trong việc duy trì doanh nghiệp. Vì vậy, trước khi khởi nghiệp, hãy nghiên cứu thật kỹ thị trường và nhu cầu khách hàng, từ đó tạo ra sản phẩm có giá trị thực tế. Áp Dụng Mô Hình Kinh Doanh Để Xây Dựng Chiến Lược Thành Công Để dễ dàng quản lý và phát triển doanh nghiệp, bạn cần áp dụng một mô hình kinh doanh cụ thể. Một trong những công cụ hiệu quả nhất hiện nay chính là Business Model Canvas – khung mô hình kinh doanh giúp bạn nhìn nhận tổng thể và chi tiết các yếu tố cần thiết để thành công.

Eternal Durdles
The REAL Reason Phil is Crushing the locals before the BNR

Eternal Durdles

Play Episode Listen Later Jun 19, 2025 29:48


Phil and Zac are back to dissect the real issue plaguing Legacy: it's not just what gets banned, it's how Wizards thinks about the format. From Beanstalk and Tamiyo to The One Ring and Bowmasters, we explore the “game changers” that dominate every match and flatten decision trees. What does a healthy Legacy actually look like in a post-MH era? Why do the same play patterns keep showing up? And is there any hope that bans can fix it?

Eternal Durdles
The REAL Reason Phil is Crushing the locals before the BNR

Eternal Durdles

Play Episode Listen Later Jun 19, 2025 29:48


Phil and Zac are back to dissect the real issue plaguing Legacy: it's not just what gets banned, it's how Wizards thinks about the format. From Beanstalk and Tamiyo to The One Ring and Bowmasters, we explore the “game changers” that dominate every match and flatten decision trees. What does a healthy Legacy actually look like in a post-MH era? Why do the same play patterns keep showing up? And is there any hope that bans can fix it?

The Jedburgh Podcast
#168: Precision Aviation Support - 160th Special Operations Aviation Regiment COL Steve Smith & CW5 Pete Sullivan

The Jedburgh Podcast

Play Episode Listen Later Jun 18, 2025 45:23


The 160th Special Operations Aviation Regiment is America's most lethal and versatile projection of combat power. When our Special Operations Forces require precision insertion, extraction and fire support, the pilots of the 160th deliver. Born from the need to develop an aviation regiment capable of anything, anywhere, anytime, the 160th SOAR is the only Special Operations Unit to have been deployed continuously since inception.To discuss the critical role of the 160th SOAR, their command team of COL Steve Smith and CW5 Pete Sullivan invited Fran Racioppi for a ride on an MH-47 Chinook and demonstration of the AH-64 Little Birds in action. From the tail ramp, we discussed the mission of the 160th, their interoperability supporting Green Berets, Navy SEALs and Army Rangers; and the various aircraft in their arsenal. We also explored the recruiting, assessment and selection process for pilots, crew and maintainers; the culture of an organization that has a no fail mission; and how technology is changing aviation as they prepare to combat both near peer adversaries and terrorist organizations. Watch, listen or read our conversation from the workhorse heavy lift aircraft responsible for the delivery of personnel and equipment in the harshest environments. Highlights0:00 Introduction3:20 Mission of 160th SOAR4:23 Creating the 160th SOAR6:42 Interoperability of the 160th9:55 Assessment & Selection Process19:50 Support from Non-SOF21:50 Importance of Cross-training26:00 Preparing for the Next fight29:30 The role on unmanned aircraft31:18 Defining a “Nightstalker”34:38 Why join Army Aviation?39:35 Night Stalkers Don't QuitQuotes“Our mission is to provide precision rotary wing support and ISR support to our SOF operators.”“A plan is only something to deviate from.” “The backbone of any great organization and what makes DoD so successful is our non-rated crew members, non-commissioned officers, and enlisted team.”“Your importance has nothing to do with your proximity to the target.” “The standard is a standard. Regardless of what your job is, if you can't meet the standard, you won't be employed in the Regiment.”“You can't do precision if you do anything else.” “We can't always look at one adversary because something else might happen that we have to react to fairly quickly.”“If we can increase our range, survivability, and lethality, we have a major advantage for any adversary.”“Manned and unmanned teaming is the future.”“Don't let a speedbump become a roadblock.”“Not everything is going to go right the first time, but you can't make the same mistake three times and expect to be successful.”“Our people are critical problem solvers.”“I've had the highest of highs and lowest of lows in the regiment, but because of the people I'm around, they've made it the best of the situation that it could be.”The Jedburgh Podcast is brought to you by University of Health & Performance, providing our Veterans world class education and training as fitness and nutrition entrepreneurs. Follow the Jedburgh Podcast and the Green Beret Foundation on social media. Listen on your favorite podcast platform, read on our website, and watch the full video version on YouTube as we show why America must continue to lead from the front, no matter the challenge.The Jedburgh Podcast and the Jedburgh Media Channel are an official program of The Green Beret Foundation.

We Are Women
S1 Ep181: Resilience in Leadership: A Strategic Approach from a Woman's Perspective

We Are Women

Play Episode Listen Later Jun 18, 2025 5:44


Resilience in Leadership: A Strategic Approach with Dr. Marie-Helene Pelletier In this episode of the We Are Women podcast, I have the pleasure of speaking with Dr. Marie-Helene Pelletier (Dr. Pell-tee-ay), or simply "MH"—a name that fittingly aligns with her expertise in mental health and resilience. With a unique blend of business acumen and psychology, MH has dedicated over 20 years to helping professionals, leaders, and teams optimize their performance and mental well-being. As a leadership psychologist, executive coach, and author, she bridges the gap between psychological research and practical workplace strategies. Her award-winning book, The Resilience Plan: A Strategic Approach to Optimizing Your Work Performance and Mental Health, was named a “Top 5 Book to Read” by Inc. Magazine and Forbes. MH is also a respected instructor at the University of British Columbia's Sauder School of Business Executive Education and an active member of the Harvard Business Review Advisory Council. In This Episode, We Discuss: Resilience and Strategy: Many women in business believe they are naturally resilient and therefore do not actively invest in strengthening it. But resilience is not something you can simply will into existence—it requires a strategic approach. Common Misconceptions About Resilience: What are the cognitive errors women make that hinder their ability to optimize work performance and mental health? We break down some of the myths and misunderstandings surrounding resilience. The Power of Influence Over Control: While we cannot control every aspect of our professional and personal lives, we can influence our circumstances. Understanding the difference between control and influence is key to managing stress and expectations. Developing a Resilience Plan: A one-size-fits-all approach doesn't work when it comes to resilience. MH explains why a personalized resilience strategy is essential and how to create one. Protecting Your Time: With endless demands on our schedules, it's easy to feel overwhelmed. MH shares practical strategies to list and assess demands, prioritize effectively, and create a more sustainable work-life balance. Key Takeaways: You cannot will yourself to be resilient. Resilience requires intention, strategy, and practice. One-size-fits-all approaches do not work. Each individual needs a customized resilience plan tailored to their circumstances and goals. Strategic resilience is an investment. By proactively building resilience, you can enhance both your work performance and mental well-being. If you're ready to take control of your resilience and develop a strategy that works for you, this episode is packed with valuable insights you won't want to miss. Connect with Dr. Marie-Helene Pelletier:

Make Trades Great Again
A little of this and that on WHAT WE LIKE

Make Trades Great Again

Play Episode Listen Later Jun 17, 2025 33:05


Somewhat of a chat session this week. The guys talk about some products they really like, lots of talk on equipment and piping fittings/materials that make everyday a little faster/easier/enjoyable. Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Mind Heist Podcast
EP 238 - The Soumoud Convoy to Gaza

Mind Heist Podcast

Play Episode Listen Later Jun 16, 2025 58:02


In this episode, we discuss the Soumoud Convoy leaving Tunisia on it's way to Gaza. All links to contact/contribute/follow us: http://www.mindheistpodcast.com The Shepherd's Way free chapter: https://www.theshepherdswaybook.com/free-chapter The Front Row waitlist: https://life-digital.typeform.com/to/sSbmk2If Join the Telegram group for MH listeners: https://t.me/+XOu4ggsyqRk3OWRk Sisters only group: https://t.me/mindheistsisters Find out about Ameen's projects: https://www.ameenomar.com Find out about Mohamed's projects: https://many.link/akhitweet Video version of the pod: https://youtube.com/playlist?list=PL5ZvWFoIJNmQISsKE1PZB3d7KcpnEcJy7 Leave us a great review if you're enjoying the show too! Stay blessed!

RTÉ - Adhmhaidin
Cathal Groonell, Coiste Tacaíochta Chalafort Ros an Mhíl.

RTÉ - Adhmhaidin

Play Episode Listen Later Jun 16, 2025 6:00


Bhí í an tAire Stáit Mara Timmy Dooley ar cuairt ag calafort Ros a Mhíl ar an Aoine agus bhí cruinniú aige leis an gcoiste tacaíochta.

Mind Heist Podcast
EP 236 - "AI is making me dumb"

Mind Heist Podcast

Play Episode Listen Later Jun 15, 2025 76:13


In this episode, we dive deep into how AI is changing our lives, from using it for calorie counting and car maintenance, to helping with journaling and emotional processing. We talk about the future of work, the risk of losing critical thinking, and how AI could replace most jobs. We also get into the scary potential of AI bots taking over the internet and touch on what all this means for Muslims and Islamic knowledge.  All links to contact/contribute/follow us: http://www.mindheistpodcast.com The Shepherd's Way free chapter: https://www.theshepherdswaybook.com/free-chapter The Front Row waitlist: https://life-digital.typeform.com/to/sSbmk2If Join the Telegram group for MH listeners: https://t.me/+XOu4ggsyqRk3OWRk Sisters only group: https://t.me/mindheistsisters Find out about Ameen's projects: https://www.ameenomar.com Find out about Mohamed's projects: https://many.link/akhitweet Video version of the pod: https://youtube.com/playlist?list=PL5ZvWFoIJNmQISsKE1PZB3d7KcpnEcJy7 Leave us a great review if you're enjoying the show too! Stay blessed!

Mind Heist Podcast
EP 237 - ChatGPT Islamic Dream Interpretation + Islam in the age of AI

Mind Heist Podcast

Play Episode Listen Later Jun 15, 2025 109:59


In this episode, we dive into how AI is creeping into Islamic life, from using ChatGPT to write khutbahs, to whether that's a good or lazy idea. We explore the future of Islamic AI tools, like an IslamQA chatbot, and then get deep with dream interpretation through AI, including an emotional dream about Hajj and a father's passing. We end with some big thoughts on tech, truth, and the Muslim world's future. All links to contact/contribute/follow us: http://www.mindheistpodcast.com The Shepherd's Way free chapter: https://www.theshepherdswaybook.com/free-chapter The Front Row waitlist: https://life-digital.typeform.com/to/sSbmk2If Join the Telegram group for MH listeners: https://t.me/+XOu4ggsyqRk3OWRk Sisters only group: https://t.me/mindheistsisters Find out about Ameen's projects: https://www.ameenomar.com Find out about Mohamed's projects: https://many.link/akhitweet Video version of the pod: https://youtube.com/playlist?list=PL5ZvWFoIJNmQISsKE1PZB3d7KcpnEcJy7 Leave us a great review if you're enjoying the show too! Stay blessed!

Pen & Paper
DUNGEONS & DRAGONS - 4 FINGER FÜR VECNA | Das Finale Teil 2 von 2

Pen & Paper

Play Episode Listen Later Jun 14, 2025 166:30


WERBUNG | Das neue Regelwerk findet ihr auf deutsch unter [Link weiter unten] vorbestellen! Alternativ könnt ihr es auch auf englisch hier bestellen: [Link weiter unten] /WERBUNG Der letzte Akt bricht an: Nach einer langen Reise müssen sich Haselnuuuss, Florentin Will, Nils Bomhoff und Mháire Stritter in den brennenden Trümmern von Greyhawk dem finalen Konflikt stellen. Sind sie dem gewachsen? Und wer hintergeht die Gruppe am Ende? Geleitet wird die Gruppe erneut von Steffen. Diese Sendung entsteht in Zusammenarbeit mit dem Team hinter Dungeons and Dragons.

RTÉ - Adhmhaidin
Eoin Mac Craith , Geolaí.

RTÉ - Adhmhaidin

Play Episode Listen Later Jun 11, 2025 4:25


Suirbhé géineolaíochta mara ar bun idir Ailt an Chorráin agus Árainn Mhór

Make Trades Great Again
Why does Eric hate this supplier?

Make Trades Great Again

Play Episode Listen Later Jun 10, 2025 24:51


Have we become too complacent when it comes to ordering online? Its 2025 and yet, somehow and for whatever reason this online supplier is asking for four forms of order verification and signatures upon delivery for regular, everyday plumbing and hvac material orders lol! Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Punisher Waterfowl Union Podcast
The Union 0430 Ep.229 Mental Health/Shipping/Ice Cubes/Tangents

Punisher Waterfowl Union Podcast

Play Episode Listen Later Jun 9, 2025 70:15


June is Mental Health Month and we wanted to bring some attention to what we consider one of the most stigmatize issues out there today, but although MH is serious... we do manage to get a few laughs in. Sit back and enjoy Looking for new products? Visit Canadian Waterfowl Supplies: https://www.canadianwaterfowlsupplies...  @CanadianWaterfowlSupplies Looking for some Punisher Swag? Visit www.punisherwaterfowl.com A huge thank you to our show sponsors: Real Geese Decoys : https://webfootdecoys.com/                                      @realgeesedecoys First Lite: Https://firstlite.com                  @FirstLiteHuntingApparel Ducklander Calls: http://ducklandercalls.com                  @dlc300 Have ideas for a topic? Know someone who would be a good guest? Have questions about the show? Reach out on social media: Instagram : www.instagram.com/punisherwaterfowl (   / punisherwate..  )               @punisherwaterfowl Facebook : www.facebook.com/punisherwaterfowl (   / punisherwater..  ) #PunisherWaterfowl #podcast #waterfowl   #Waterfowl #VeteranOwned #Podcast #DuckLanderCalls #duckhunters #duckcalls.

RTÉ - Adhmhaidin
John Connolly, Teachta Dála, Fianna Fáil.

RTÉ - Adhmhaidin

Play Episode Listen Later Jun 6, 2025 3:01


Tá próiseas earcaíochta ar bun ag Feidhmeannacht na Seirbhíse Sláinte faoi láthair le teiripeoirí saothair a fhostú i gConamara don tSeirbhís do Pháistí faoi Mhíchumas, a chuireann seirbhís ar fáil do pháistí atá faoi mhíchumas i gceantar Chonamara.

sl mh john connolly fianna f teachta d gconamara chonamara
Black in Sports Podcast
Knicks Fans: Y'all OK - Mental Health Month | The Locker Room - S6 EP5

Black in Sports Podcast

Play Episode Listen Later Jun 5, 2025 27:41


This is the "Check in" episode of The Locker Room episode of, hosts MH & EJ bring the barbershop vibes with a meaningful and funny twist. As June marks Men's Mental Health Awareness Month, the duo opens up with their signature health check-in, but this time, the conversation dives even deeper into the often-overlooked topic of mental health in men—especially Black men. They discuss how the culture around masculinity, sports, and the "man up" mentality can be both empowering and damaging, especially when it comes to expressing emotions, managing stress, and seeking help.MH & EJ talk candidly about the importance of checking in with your brothers, creating safe spaces for vulnerability, and breaking the stigma surrounding therapy and mental health support within the Black community. They touch on the pressures men face in everyday life—from family and work responsibilities to navigating identity in today's world—and how all of this impacts mental well-being.Then, the attention shifts to something that requires its own mental health evaluation: being a New York Knicks fan. With MH proudly repping as the show's resident die-hard Knicks supporter, the fellas take a light-hearted but real look at the emotional rollercoaster that is the Knicks experience. From postseason letdowns and questionable trades to the eternal hope for a championship run, this episode asks the real question: "Knicks fans… are y'all really okay?"Expect honesty, hilarious takes, emotional insight, and of course—plenty of basketball talk. Whether you're a Knicks lifer, a fan of the NBA, or just someone who values authentic conversations about mental wellness, this episode blends humor and heart in a way only Black in Sports can deliver.Key topics include:

Make Trades Great Again
How old is too old to start in the trades?

Make Trades Great Again

Play Episode Listen Later Jun 3, 2025 23:59


Would you hire someone with zero trade work experience? What if they're in their 30's? How old is too old to start in the trades? Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Stay Forever
Die Welt von Shadowrun

Stay Forever

Play Episode Listen Later May 31, 2025 136:32 Transcription Available


Was ist "Die Welt von …?" Wenn wir über Video- und Computerspiele sprechen, die entweder elaborat ausgestaltete eigene Welten mit Hintergrundgeschichten haben oder über solche, die ihre Welt aus Literatur, Rollenspiel oder Film borgen, nehmen wir uns zuweilen die Zeit und sprechen ausführlicher über Lore jener Welten als das in den regulären Folgen möglich wäre. Im Format Die Welt von… erforschen Rahel Schmitz und Mháire Stritter die Legenden, die Geografie, die Geschichte, die Politik von diesen fiktiven Welten. Rahel und Mháire holen sich dabei von Fall zu Fall ergänzende Expertise von ausgewiesenen Kennern und Kennerinnen der jeweiligen Welt. Diesmal kommt im Podcast neben den Sprecherinnen auch der Autor und Illustrator Andreas Schroth zu Wort, der ist auch Chefredakteur von Shadowrun. Worum geht's: Das Pen&Paper-Rollenspiel Shadowrun katapultiert uns in eine nahe Cyberpunk-Zukunft, in der die Magie erwacht ist und Metamenschen in Form von Elfen, Orks, Zwerge und Trolle entstanden sind. Es ist eine Zukunft, in der es schamanische Geister und Hacker gibt, Drachen und Megakonzerne, Cyberimplantate und Zauberei. Doch wie passen die die glitzernde Welt der Konzerne, die digitale Anarchie der Netzwerke und die wiedererstandene Magie zusammen? In dieser Episode werfen wir einen Blick auf die Mythen, Konflikte und Schauplätze der Welt von Shadowrun. Podcast-Credits: Sprecher, Redaktion: Rahel Schmitz, Mháire Stritter Audioproduktion: Fabian Langer, Christian Schmidt Titelgrafik: Paul Schmidt Intro, Outro: Nino Kerl (Ansage); Chris Hülsbeck (Musik) Wir danken Andreas Schroth für seine Bereitschaft, mit uns über Shadowrun zu sprechen. Ah, und Gunnar, der gibt eingangs einen kurzen Abriss über die Video- und Computerspiele in diesem Setting.

RV Navigator
RV Navigator Episode 242 -Hawaii + Spring

RV Navigator

Play Episode Listen Later May 31, 2025 45:46


Ending our April cruise in Maui (Hawaii), we headed home to Chicago for the duration of the spring. We did take a short flight to Orlando to close on our new (to us) house at the Great Outdoors (TGO) that will be our winter home starting in 2026. This house has a nice RV port which will give our aging MH a covered parking space during the off months. We chat about many RVing topics as our attention turns to RVing in the summer. Cooling your RV and fridge topics as well as the latest tech issues are discussed in this episode.

Nuacht Mhall
31 Bealtaine 2025 (Tiobraid Árann)

Nuacht Mhall

Play Episode Listen Later May 31, 2025 4:54


Nuacht Mhall. Príomhscéalta na seachtaine, léite go mall.*Inniu an t-aonú lá is tríocha de mhí na Bealtaine. Is mise Gwyneth Nic Aidicín Ní Loingsigh.Leanann an t-uafás sa Phalaistín agus brú ar rialtais an domhain ag fás gach lá chun smachtbhannaí a chur ar Iosrael. Níl aon bhia ná cúnamh ag dul isteach go Gaza fós. Tá plean sos cogaidh ó Stáit Aontaithe Mheiriceá faoi bhreithniú faoi láthair, den chéad uair ón sos cogaidh ar theip air i mí an Mhárta. Ghlac Iosraelleis an bplean agus tá freagra foirmiúil fós le teacht ó Hamas ach dúirt urlabhraí nach ngeallann an beart sos cogaidh buan ná go leor soláthar cúnaimh. Sa Ríocht Aontaithe scríobh 828 saineolaí dlí litir chuig an  bPríomh-Aire Keir Starmer ag lua go bhfuil cinedhíothú ag tarlú agus ag cur brú ar an rialtas úsáid abhaint as gach acmhainn atá ar fáil chun stop a chur leis. In Éirinn, cáineadh an rialtas as an easpa gníomh dleathúil i gcoinne Iosrael. Chuaigh bean as Gaillimh, Sophie Ní Choimín ar stailc ocrais le brú a chur orthu an Bille Críoch FaoiFhorghabháil a hachtú. I rith na seachtaine fuarthas ceadú sa Dáil cosc a chur ar iompórtáil ón Iosrael, ach baineann sé seo le táirgí amháin agus níl seirbhisí san áireamh, cé gurb iadsan a dhéanann an chuid is mó d'iomportáil ó Iosrael go hÉirinn.Tháinig rialú ón gCúirt um Thrádáil Idirnáisiúnta sna Stáit Aontaithe Dé Céadaoin, ina ndúradh go bhfuil an chuid is mó de na táillí atá an tUachtarán Trump ag achtú neamhdhleathach. Ghlac an Chúirt Achomhairc Fheidearálaigh le hiarracht ó riarachán Trump sos sealadach a chur ar an rialú seo, agusleanfaidh siad ag bailiú cánach don am seo. Tá sos curtha ar roinnt dualgas an riaracháin agus idirbheartaíocht trádála ar siúl, agus beidh an chéad éisteacht eile ar siúl ar an 5ú Meitheamh. Ceaptar go rachfaidh an cás go dtí an Chúirt Uachtarach. Dúirt Peter Navarro, comhairleoir trádála Trump, “fiú má chaillfimid (sa chúirt), déanfaimid iad (na táillí) i slí éígin eile.”Tá chuid den sráidbhaile Blatten san Eilvéis scriosta tar éis intitim oighearshrutha Dé Céadaoin. Bhi 300 duine ina gcónaí sa sráidbhaile agus tharla aslonnú ar an 19ú lá de mhí na Bealtaine, bunaithe ar rabhadh geolaí faoi chobhsaíocht an oighearshrutha. Tá duine amháin ar iarraidh agus tá an-chuid tithe scriosta. Tá tacaíocht ó rialtas na hEilvéise, ag cinntiú go mbeidh daoine in ann filleadh ar a mbaile, nó an ceantar ara laghad. Toradh athrú aeráide an tubaiste seo, agus teochtaí ag ardú tá na oighearshruthanna agus talamh síorshioctha sa cheantar ag leá. Dúradh sa tuarascáil is déanaí ar shláinte na oighearshruthanna san Eilvéis go mbeidh siad go léir imithe laistigh de chéad bliain, mura gcoimeádfar ardú teocht domhanda laistigh de 1.5 céim, sprioc atá caillte cheana féin, dar le saineolaithe.*Léirithe ag Conradh na Gaeilge i Londain. Tá an script ar fáil i d'aip phodchraolta.*GLUAISsoláthar cúnaimh - provision of aidstailc ocrais - hunger strikeag bailiú cánach - collecting taxidirbheartaíocht trádála - trade negotiationintitim oighearshrutha - glacier collapsetalamh síorshioctha - permafrost

Fertility Wellness with The Wholesome Fertility Podcast
Ep 338 Eggs, Estrogen & Empowerment: Navigating Fertility with Dr. Nirali Jain

Fertility Wellness with The Wholesome Fertility Podcast

Play Episode Listen Later May 27, 2025 33:52


On this episode of The Wholesome Fertility Podcast, I am joined by Dr. Nirali Jain (eggspert_md), a board-certified OB/GYN and reproductive endocrinologist at Reproductive Medical Associates (RMA). Dr. Jain shares her expert insights on fertility preservation for individuals undergoing cancer treatment, a crucial yet often overlooked aspect of reproductive care. We explore what options are available for fertility preservation, including egg and sperm freezing, and why it's so important to initiate these discussions before starting chemotherapy or radiation. Dr. Jain also explains the difference between Letrozole and Clomid, the impact of estrogen-sensitive cancers on IVF treatments, and innovative approaches like random-start cycles and DuoStim protocols. Whether you're facing a cancer diagnosis or simply thinking proactively about your reproductive future, this conversation is filled with knowledge and reassurance. Key Takeaways: Why it's essential to discuss fertility before starting cancer treatment. The role of Letrozole in estrogen-sensitive cancers and fertility preservation. Differences between Letrozole and Clomid, and why Letrozole is often preferred. How new protocols like DuoStim and random-start cycles are improving outcomes. Why fertility preservation is important even for those without a cancer diagnosis. Guest Bio: Dr. Nirali Jain (@eggspert_md) is a board-certified OB/GYN and fertility specialist at Reproductive Medicine Associates (RMA) in Basking Ridge, New Jersey. She earned both her undergraduate degree in neurobiology (with a minor in dance!) and her medical degree from Northwestern University, before completing her residency at Weill Cornell/NYP, where she served as co-Chief Resident, and her fellowship in reproductive endocrinology and infertility at NYU Langone. Deeply passionate about women's health and fertility preservation, Dr. Jain blends the latest research and cutting-edge treatments with compassionate, patient-centered care. Her interests include third-party reproduction and oncofertility, and she is especially passionate about supporting patients navigating fertility preservation through a cancer diagnosis. Outside of the clinic, Dr. Jain is a trained dancer, a dedicated global traveler, and an adventurer working toward hiking all seven continents with her husband. Her diverse experiences, from international medical rotations to personal connections with friends and family navigating infertility, have shaped her into a warm, resourceful, and determined advocate for her patients. Links and Resources: Visit RMA websiteFollow Dr. Nirali Jain on Instagram For more information about Michelle, visit www.michelleoravitz.com To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care. --  Transcript:   # TWF-Jain-Nirali (Video) ​[00:00:00]  **Michelle Oravitz:** Welcome to the podcast Jain.  **Dr. Nirali Jain:** Thanks so much for having me **Michelle Oravitz:** Yeah, so. **Michelle Oravitz:** I'm very excited to talk about this topic, which, um, actually you don't really hear a lot of people talking about, which is how to preserve your fertility if you're going through a cancer diagnosis and if you have to go through treatments. 'cause obviously that can impact a lot on fertility. **Michelle Oravitz:** I have, um, seen actually like a colleague of mine go through. And she also preserved her fertility and, and now she has a baby boy. so it's really nice. **Michelle Oravitz:** to **riverside_nirali_jain_raw-video-cfr_michelle_oravitz's _0181:** so nice. **Michelle Oravitz:** So I'd love for you first to introduce yourself and kind Of give us a background on how you got into this work. **Dr. Nirali Jain:** Of course. Um, so I am Dr. Narly Jane. I am, um, an OB GYN by training, and then I did an additional, after completing four years of residency in OB GYN and getting board certified in that, I did an additional training in reproductive endocrinology and [00:01:00] infertility or otherwise known as REI. So now I'm a fertility specialist. **Dr. Nirali Jain:** Um, I trained at Northwestern in Chicago, so I went to undergrad and medical school there. And then, um, home has always been New Jersey for me, so I moved back out east to New Jersey. Um, I did all my training actually in New York City at Cornell for residency and NYU for fellowship. Um, and then moved to the suburbs. **Dr. Nirali Jain:** Um, and now I'm a fertility specialist in, in Basking Ridge at Reproductive Medical Associates.  **Michelle Oravitz:** Very impressive background. That's awesome.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** I'd love to hear just really. About what your process is. If a person has been diagnosed with cancer, like what is the process? What are some of the things that you address if they are trying to preserve fertility, and what are some of the concerns going  **Dr. Nirali Jain:** yeah, yeah. All great questions. So, you know, there's a lot of us, uh, the Reis. Are a very small, [00:02:00] there's a very small number of us. So in terms of specializing in fertility preservation, technically we all are certified to treat patients with cancer and kind of move them through fertility preservation before starting chemotherapy. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, luckily we've been working closely with oncologists in the past several years just to establish some type of streamlined system because having a diagnosis of cancer and hearing all that information. Especially when you're young is so hard. So I think that's, that's where my interest started in terms of being able to speak to and counsel cancer patients. **Dr. Nirali Jain:** I think it is a very specific niche that you really have to be comfortable with in our field. Um, I. So I'll kind of walk you through, you know, what it, what does it look like, right? Um, you go into your oncologist's office suspecting that you have this, this lump. I'll take breast cancer, for example. It could really be any kind of cancer. **Dr. Nirali Jain:** Um, but breast cancer in a reproductive age patient or someone that's in those years where you're starting [00:03:00] to think about building a family, planning a family, um, or if you have kids at home, that's usually the type of patient that we see come in with a breast cancer diagnosis. So. Kinda just taking that, for example, um, the minute that you're diagnosed, it's really your oncologist's responsibility to counsel you on what treatment options are going to be offered to you. **Dr. Nirali Jain:** And then based off of the treatment options, it's important to know how that affects your reproduction. So how does it affect your ovaries in the short term, in the long term, um, in any way possible. So. Once a patient is initially referred from their oncologist to myself or any other fertility specialist, they come into my office and we just have a 30 minute conversation really talking about family planning goals. **Dr. Nirali Jain:** Any kids that they've had in the past either naturally conceived or through um, IVF, and then we talk about where they're at in their relationship. Are they married, are they not? Are they with a partner, [00:04:00] a male partner, a female partner, whatever it might be. It's important to know the social standpoint, um, especially in this sensitive phase of life. **Dr. Nirali Jain:** So patient patients usually spend anywhere from 30 minutes to an hour. Um, just kind of talking through where they're at, how they're feeling, what their ultimate childbearing goals are. And then from there we do an ultrasound and that's when I'm really able to see, you know, the, the reproductive status. **Dr. Nirali Jain:** So what do the ovaries look like? What does the uterus look like? Is there something that I need to be concerned about from a baseline GYN standpoint? Um, and all of those conversations are happening in real time. So. I think one of the things is patients come in and they're like, I'm already so overwhelmed with all this information from my oncologist, and now my fertility specialist is throwing all this information at me. **Dr. Nirali Jain:** Luckily, the way I like to frame it is you come in and you just let go. Like you let us do the work because in the background we're the ones talking to your oncologist. We're the [00:05:00] ones giving that feedback and creating a timeline with your oncologist. Um, and really I think just getting in the door is the hardest part. **Dr. Nirali Jain:** So once patients are here to see us, we go through the whole workup. We do anything that we would do for a normal patient that came in for fertility preservation. And then based off of where they're at in their journey, we talk about what makes sense for them, whether that means freezing embryos, freezing eggs, they're very similar in terms of the, the few weeks leading up to the egg retrievals. **Dr. Nirali Jain:** So I have that whole conversation just at the initial visit. And then from there we talk about the timeline behind the scenes and make sure that it works with their lives before moving forward. **Michelle Oravitz:** So for people listening to this, why, and this might be an obvious question, but to some it might not be,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** why would somebody want to preserve. eggs or sperm. 'cause I've had actually some couples  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** come to me where the husband preserved the sperm and they had to go through IVF just because he was going [00:06:00] through cancer treatments. So he had to preserve the sperm ahead of time.  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** people need to consider doing that before doing cancer treatments?  **Dr. Nirali Jain:** So there are certain cancer treatments that do affect the ovaries and the sperm health, and you know, for men and women, it affects your reproductive organs. In a similar way, um, depending on the type of chemotherapeutic agent, there are some that are more dangerous in terms of, um, being toxic to your ovaries or toxic to your sperm. **Dr. Nirali Jain:** And those are the instances where we are really thinking about what's the long-term impact because there's medications that oncologists do give patients, and our oncologists are amazing, the ones that we work with, Memorial Sloan Kettering from Reproductive Medical Associates through RMA, um, and. **Dr. Nirali Jain:** They're just so good at what they do and are so well-trained, so they know in the back of their mind, is this going to impact your ovaries or your sperm health or not? Um, and I [00:07:00] think that any chemotherapy, you know, your ovaries are these, these small organs that are constantly turning over follicles every month. **Dr. Nirali Jain:** So every month we're losing those eggs, and if they don't become. If an egg isn't ovulated, it doesn't become a baby, it's just gonna die off. So I counsel even patients that don't have cancer, I counsel them on fertility preservation as young as possible. You know, between the ages of 28 and 35, that's like the best time to preserve your fertility. **Dr. Nirali Jain:** So in cancer patients, there's an extra level added to that where even if they are a little bit younger, a little bit older. Your eggs are not gonna be the same quality. There's gonna be higher level of chromosomal errors, more DNA breakage, um, and, and bigger issues that lead to issues with conceiving naturally afterwards. **Dr. Nirali Jain:** So I think that it's important to consider how that chemotherapy is going to affect them or how surgery would affect them if it was, for example, a GYN cancer where [00:08:00] we're removing a whole ovary, you know, what, what do we have to do to preserve your fertility in that case? And those are important conversations to have. **Michelle Oravitz:** Yeah. for sure. I know that a lot of people are also concerned, you know, with going through the IVF process, you're taking in a lot of estrogen, a lot of hormones, and many cancers are actually estrogen sensitive. So I wanted to talk to you about that. 'cause I know that the data shows that it's. It's been fine, which some people might find surprising, but I wanted you to address that and just kind of **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** from your perspective.  **Dr. Nirali Jain:** That's so interesting that you asked that question because I actually, my whole I I graduated fellowship last year and my entire, like passion project in fellowship was looking at one of the drugs that we use to suppress the estrogen levels specifically in cancer patients. Um, and I had presented this at a few of our reproductive meetings. **Dr. Nirali Jain:** Um, A SRM is one of our annual meetings where all of the reiss get together. A lot of male fertility [00:09:00] specialists come and we kinda just talk about. Specific things and fertility preservation for cancer patients is, has been an ongoing topic of interest for all of us. Um, and it's important to know that there are different medications that we can offer. **Dr. Nirali Jain:** Letrozole is the one that I, um, have a particular love for and I, uh, you know, I use all the time for my patients, um, for different reasons, but it suppresses the exposure that your body has to estrogen. And there's mixed data, um, out there in terms of, you know, does Letrozole suppression actually impact, you know, does it help or. **Dr. Nirali Jain:** Or does it have no impact on your future risk of cancer after treatment? Um, and that honestly is still up for debate. But what we do know is that there's no increased risk of cancer recurrence in patients that have undergone fertility preservation with or without Letrozole. Um, Letrozole is one of those things that we can give, and the way it works is basically. **Dr. Nirali Jain:** It masks that [00:10:00] conversion. It, it doesn't allow for conversion from those androgens in the male hormones over to estrogen. Um, and so your body doesn't really see that estrogen exposure. It stays nice and low throughout your cycle, and it does help with actually ovarian maturation and getting mature eggs harvested and, um, helps a little bit with, with quality too. **Dr. Nirali Jain:** So I think that it's really nice in terms of having that available to us, but know that. It's not, it's not essential that you have it, really, the data showing plus minus. Um, but there are certain things that we can do to protect the ovaries, protect your exposure to estrogen. Um, and so that shouldn't be top of mind of concern when we're going through fertility preservation, even with an estrogen sensitive cancer. **Michelle Oravitz:** Actually, so, uh, on a different topic, kind of going back to that, so Letrozole versus Clomid, I, it's like a, the questions I personally feel just based on what I've heard and like my own research that Letrozole would be kind of like the more. [00:11:00] Um, the, it's, it's a little better, but I know that it really depends on the person as well.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** they might do better with Clom, but I'd love to hear your perspective and kind of pick your brain on this.  **Dr. Nirali Jain:** totally. You're choosing all the, all the right questions because these are all of my, my specific interests and niches. So  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** Letrozole is basically, you know, we use Letrozole and Clomid in. Patients that don't have cancer and patients that come in for an intrauterine insemination, that's kind of the most common scenario where we're thinking about, you know, which medication is better? **Dr. Nirali Jain:** Letrozole or Clomid and Clomid used to be the, the most common medication that we use, we dose patients, you know, have 50 milligrams of Clomid, give them five days of the medication. It's an oral pill. Feels really easy and. The way it works is really, it recruits more than one follicle, so it really helps with the release of, um, more than one follicle growing more than one follicle in the ovary. **Dr. Nirali Jain:** Um, but it has a little bit [00:12:00] higher of a risk of twins because that's exactly what it's good at. Um, Clomid, not so much in the cancer. In the cancer front, it's not really used there because it's considered, from a scientific perspective, it's considered like a selective estrogen receptor modulator. So it doesn't necessarily suppress your estrogen levels in the same way that Letrozole does versus. **Dr. Nirali Jain:** Letrozole is an aromatase inhibitor, so it really blocks the chemical conversion of one drug or one hormone to the other hormone. Um, the reason we love Letrozole so much, and I don't mean to like gush over Letrozole, but um, it's a mono follicular agent, so it works really well at recruiting one follicle  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** you know, every OB-GYN's nightmare in a way is having multiples when you didn't intend on having multiples at all. **Michelle Oravitz:** so  **Dr. Nirali Jain:** Um. **Michelle Oravitz:** were saying that, um, there's more of a chance of twins, it's Clomid, not letrozole.  **Dr. Nirali Jain:** Yes, there's a higher chance with Clomid versus Letrozole. And I mean, don't get me wrong, there's a chance of twins with [00:13:00] any type of assisted reproductive technology. Even when we're doing single embryo transfers, there's a chance that it's gonna split. So, um, the chance is always there just like it is in the natural world. **Dr. Nirali Jain:** But we know for a fact that. CLO is really good at recruiting many follicles. It's good for certain patients that don't respond well to Letrozole. Um, but Letrozole is kind of our, our go-to drug these days just because of all the benefits that we've seen.  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** These are all fun things to ask because I, I love talking to our eis 'cause there's so much information that I'm always  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** learn a lot from my patients in my own research, but it's really cool. Picking your guys' brains. So another question I have, and I have actually talked to Dr. Andrea Elli, he's been on,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** and he does a lot of endometriosis and, and immune related work as well,  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** so. I'd love to know just from your perspective. One thing that I do know from, based on what I've heard is that the, [00:14:00] guess like you were just saying, that breast cancer or estrogen sensitive breast cancer doesn't seem to be affected by IVF cycles, however, and endometriosis lesions do get affected.  **Dr. Nirali Jain:** Yeah. **Dr. Nirali Jain:** that's a great question. So, you know, every, there are so many complex G mind diagnoses that the, that our patients come in with. Um, and endometriosis is a big one because there is clear data that endometriosis is linked to infertility. So we think about, you know, when a patient comes in with endometriosis, we really do think about the different treatment options and what are the short-term and long-term impacts of the hormones that we're giving 'em. **Dr. Nirali Jain:** Um, these days, again, kind of going back to Letrozole, we, letrozole is something that I give all of my endometriosis patients because it helps suppress their estrogen because we know.  **Michelle Oravitz:** interesting.  **Dr. Nirali Jain:** is very responsive to estrogen and leads to this dysfunctional regulation of all the endometrial tissue that can really flare in a, [00:15:00] in a cycle, or shortly after a cycle. **Dr. Nirali Jain:** I. So we really, for endometriosis patients, the, the best treatment is being on birth control because we don't see that hormonal fluctuation. The up and down of the estrogen and the progesterone, that's what leads to those flares. Um, so I really, I watch patients closely after their cycles too, because you definitely can have an endometriosis flare and we say the best treatment for endometriosis is pregnancy, right? **Dr. Nirali Jain:** That's when you're suppressed, that's when you're at your lowest. Um, and patients, my endo patients feel so good in pregnancy because they have. Hormones that are nice in that baseline, they're not getting periods of course. Um, and that's truly, truly the best treatment.  **Michelle Oravitz:** That's interesting.  **Dr. Nirali Jain:** But it is important to consider when you're going through infertility treatments. **Dr. Nirali Jain:** How does my endometriosis affect the short and long-term effects of the fertility medications? And really not to, not to say that they're bad in any way. I think a lot of endometriosis patients go through IVF and have success and do really, really well, and that's kind of the push that they need. [00:16:00] Um, but it's important to be mindful of the bigger picture here. **Dr. Nirali Jain:** It's not just, you're not just a number of. A patient with endo coming in, getting the same protocol. It's really individualized to the extent of your lesions, what symptoms you're having, what grade of endometriosis, where your lesions are. So we're the RAs are thinking about everything before we actually start your protocol. **Michelle Oravitz:** It's crazy how in depth it is, and it's, it, there's just so, it's so multifaceted,  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** when it's females  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** are a little, I mean, they can, you know, there, there's definitely a number of things, but it's not as complicated and interconnected  **Dr. Nirali Jain:** Exactly. Exactly. That's so true. **Michelle Oravitz:** And so one question I actually have, this is kind of really off topic, but something that I was curious about. **Michelle Oravitz:** 'cause I heard about a while  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** a, a type of cancer treatment that was used. I'm not sure exactly what it was, but for some reason it actually caused follicles to grow, [00:17:00] or to multiply. And they were **Dr. Nirali Jain:** Interesting. **Michelle Oravitz:** this definitely. Puts, um, the whole idea of like a woman being born with all the follicles she'll ever have on its head, I thought that was really Interesting. **Michelle Oravitz:** Now I learned a little bit about it. I don't think it really went further than that,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** one of those things that they're like, Hmm, this is interesting. I don't know, it was kind of a random side effect of this chemo drug. I dunno if it was a chemo drug or a cancer drug.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** ever heard of that. **Michelle Oravitz:** So I was just **Dr. Nirali Jain:** I haven't, I mean, that's interesting. I feel like I'd have to look into that because that would be definitely a point of interest for a lot of Reis. But it kind of does go back to the point of, you know, women are really born with all the eggs we're ever gonna have. So it's about a million, and then it just goes down from there. **Dr. Nirali Jain:** And the, by the time you start having periods, I like to kind of show my patients a chart, but you have a couple hundred thousand eggs and you ovulate one egg a month. That's, you know. Able to [00:18:00] progress into a fertilized egg and then into a, an embryo into a baby, um, if that's your goal. But otherwise, patients that are having periods and not trying to actually get pregnant, we're losing hundreds of eggs a month. **Dr. Nirali Jain:** So.  **Michelle Oravitz:** Mm.  **Dr. Nirali Jain:** It's important to kind of think about that decline, and it's important to know that that rate can be faster in patients with cancer, patients with low ovarian reserve. And sometimes when you have the two compounded, that's when a fertility specialist is definitely, you know, in the queue to, to have a discussion with you in terms of what that means and how you can reach your family building goals despite being faced with that, with that challenge. **Michelle Oravitz:** Yeah. **Michelle Oravitz:** I mean, 'cause we know oxidative stress is one of the things that can cause, uh,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** quality eggs, but it's also can cause cancer. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** um, similar, you know, like things that really deplete the body could definitely impact. Um, and then what are your thoughts? I know I'm asking you all kinds of random questions, **Dr. Nirali Jain:** I love it. **Michelle Oravitz:** are your thoughts about doing low simulation in certain [00:19:00] circumstances versus high stem? **Michelle Oravitz:** Sometimes people don't respond as well to higher stems.  **Dr. Nirali Jain:** Yeah, that's a great point. I think that it kind of all goes back to creating an individualized protocol. If. A patient's going to a practice and basically just getting a protocol saying, this is our standard. We start with our standard of, you know, I, I think about the standard, which is 300 of the FSH or that pen that you dial up, and then 150 units of that powder vial. **Dr. Nirali Jain:** And we have patients mixing powders all the time, and that's kind of our blanket protocol that we give patients. But that's not really what's happening behind the scenes. And if you're given a protocol that's, and being told, you know, this is kind of what we give to everyone, it's probably not the right fit for you. **Michelle Oravitz:** Yeah, I  **Dr. Nirali Jain:** Um, there are certain patients that respond to a much lower dose and do really, really well, and then some patients that need a much higher dose. Um, and I think it's, that's kind of like the fun part of being an REI of being able to individualize the [00:20:00] protocol to the patient. Um, and I know for a fact there are so many, luckily, you know, we have so many leaders in REI that have been. **Dr. Nirali Jain:** Have dedicated their entire careers to researching these different protocols and how they can help different patients. Um, patients with lower a MH, you know, might benefit from a duo stim protocol, for example. That's kind of the first one that comes to mind, but a protocol where we're using those follicles from the second half of a cycle. **Dr. Nirali Jain:** I would've never thought that those were the follicles that  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** would be better than the first half of the cycle,  **Michelle Oravitz:** Wait,  **Dr. Nirali Jain:** but, **Michelle Oravitz:** that. Explain that. Um, because I think that that's kind of a unique  **Dr. Nirali Jain:** mm-hmm.  **Michelle Oravitz:** that I haven't heard of.  **Dr. Nirali Jain:** Yeah, so there's this new day. It's still kind of developing, but um, kind of going back to, you know, what's an individualized protocol? Duo STEM is one of the newer protocols that we've started using. I, I've used it once or twice in patients. Um, but it goes back to the research that shows that you might actually have two different periods of time in a menstrual cycle where you could potentially recruit [00:21:00] follicles. **Dr. Nirali Jain:** You could have a follicular phase where there's a certain cohort of follicles recruited, and then you have a follicle that forms creates a corpus glut.  **Michelle Oravitz:** um, protocols  **Dr. Nirali Jain:** Yep. And then you basically go through the follicular protocol and then a few days after a retrieval, instead of waiting for a new follicular cohort or follicular recruitment from the first half of your menstrual cycle, you actually use the luteal phase and you recruit those follicles that would've actually died off or have been prematurely recruited in a prior cycle. **Dr. Nirali Jain:** So **Michelle Oravitz:** that's So  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** you just do a similar, I guess, um, medicine,  **Dr. Nirali Jain:** go right back into it.  **Michelle Oravitz:** do the same exact thing, but right after ovulation.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** Fascinating. That's really interesting.  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** has been your experience with that?  **Dr. Nirali Jain:** I think it's, honestly, it's mixed. Um, so far, you know, our data from fertility and sterility and A SRM, it, it shows support for these DUO STEM [00:22:00] protocols, saying that if patients don't have that great quality of eggs or if they have a very low number, maybe they'd benefit from starting the meds earlier and recruiting follicles. **Dr. Nirali Jain:** A little bit earlier. Um, so we've seen positive results so far. A lot of work to be done in terms of really understanding it. Um, and of course, as a new attending, I have a lot more experience to kind of build on. Um, but I, I have seen success from it. **Michelle Oravitz:** That's fascinating. Are there any other new technologies, like new add-ons, um, that you've seen, that you've found to be really cool or interesting?  **Dr. Nirali Jain:** I think the biggest thing, actually, kind of going back to our whole topic for today is fertility preservation cancer patients. One of the biggest things that I've learned recently is that we used to start fertility, um, patients. You know, only in the beginning of the cycle days, two or three is technically like when most. **Dr. Nirali Jain:** Most clinics, um, start patients, but for our cancer patients, sometimes you don't have that time. You don't wanna wait a full month to [00:23:00] restart, um, your, you know, your menstrual cycle and then do the fertility preservation and then delay chemotherapy a full month. So we started doing what we call random starts. **Dr. Nirali Jain:** So you basically start a patient whenever they come in. You know, it could be the day after your consultation, the day of your consultation. I've kind of seen all of the above. Um, and we've seen really good success with random starts, per se. Um, and we've been doing a lot more of that, where it's not as dependent on where you're at in your cycle. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, obviously there's a difference in outcomes. You might not be a great candidate for it, so definitely it's worth talking to your doctor about it. But it kind of gives relief to our cancer patients where if you have a new cancer diagnosis and you're like, oh, I just finished my period, like, I can't even start a cycle until next month. **Dr. Nirali Jain:** That's not always true. Um, so it's always worth it to go into see a fertility specialist and just get, you know, get the data that you need right away, and then you can make a decision later on. **Michelle Oravitz:** For sure. Um, Yeah. **Michelle Oravitz:** and I wanted to kind of cover a lot of different topics 'cause I know that [00:24:00] some people are gonna wanna hear what you have to say that don't necessarily, or, uh, have cancer. But it is important. I, I think that, you know, if you get to thirties and you haven't gotten married or you don't have a partner, I think it's really important to preserve your fertility in general.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** important thing. And then if you were going through a cancer diagnosis and you decided to preserve your fertility, um, guess more for women because they're eventually going to be thinking about transfers after they go through treatment. So what are some of the things that they would need to consider as far as that goes? **Michelle Oravitz:** Like after the  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** then they go through the cancer treatments. Um, and then what, how long should they  **Dr. Nirali Jain:** yeah. Like what does it look like? So I've had patients that come back, you know, in my fellowship training I did a, a couple research projects on patients that came back to pursue an embryo transfer, um, after chemotherapy agent. And basically compared them to how they did, um, [00:25:00] compared to patients that didn't have cancer and just froze their embryos or froze their eggs and then came back to pursue a transfer and. **Dr. Nirali Jain:** I think the, the most reassuring thing from the preliminary data that we have is saying that there's no difference in pregnancy rates and no difference in life birth,  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** of whether they had chemotherapy or not. After freezing those eggs and going through fertility preservation.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Um, in terms of where your body needs to be, I think the oncologist, we, we wait for their green light. **Dr. Nirali Jain:** We wait for their signal to say, you know, she's safe to carry a pregnancy.  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** And then once we do that, we basically treat you like any other patient. So if you're coming in for a cycle, if you're having periods, then it's reasonable to try a natural cycle protocol, wait for your body to naturally ovulate an egg. **Dr. Nirali Jain:** And instead of obviously hoping that egg will fertilize, we, um, use a corpus luteum. We use the progesterone from the corpus luteum to really support this embryo being implanted into the uterus. Um. Yeah. [00:26:00] And then there's also another side. I mean, some patients don't get their periods back and they always ask like, what if I never get my period back? **Dr. Nirali Jain:** What if I'm just like in menopause because of the chemotherapy agents? And for that, we can start you on a synthetic protocol or basically an estrogen dependent protocol where you take an estrogen pill for a certain number of days. We monitor your lining, then we start progesterone, um, to support your hormones from that perspective instead of relying on your ovaries to release the progesterone that they need, um, and then doing the embryo transfer a few, few days after progesterone starts. **Dr. Nirali Jain:** So there's definitely different protocols depending on where your menstrual health is at after the chemotherapy or after the cancer treatment. Um, but it's important to kind of just know that. That there's options. It doesn't mean that it's the end of the road if you all of a sudden stop getting your period. **Michelle Oravitz:** Yeah, for sure. I mean, 'cause you, technically speaking, you can really control a lot of that. More so for transfers  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** Retrievals really is kind of like what [00:27:00] eggs you have, what the quality is. But people can be in complete menopause and you guys can still control their cycles for transfer, which is kind of. A huge difference  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** in the  **Dr. Nirali Jain:** exactly. That's exactly right. Yeah. **Michelle Oravitz:** interesting. Any other, um, new, new things that you're, you guys are excited about? I always like to hear about like the new and upcoming things  **Dr. Nirali Jain:** Of course.  **Michelle Oravitz:** actually before, which I thought was fascinating. Yeah.  **Dr. Nirali Jain:** I feel like there's always like updates and, and new data and things like that coming out, but just know, I think it's important for patients to know, like we're constantly, we're, the reason I chose to even pursue this field was because it's new. Right. There's something that we are discovering every day, every year, and that's what makes our, our conferences so important to attend, um, to really just stay up to date. **Dr. Nirali Jain:** Um, but we are, uh, constantly updating our embryology standards, the way we thaw our eggs, and the success rate associated with a thaw and [00:28:00] how we treat our embryos and the media that we use, right? Like, so we're really thinking about the basic science perspective every single day, and that's what makes this field so unique. **Michelle Oravitz:** It is really awesome. And so do you guys specialize specifically on, um. Egg freezing and, and I mean specific fertility preservation in patients that do that have cancer that are going through treatments, do you guys specialize specifically in that? I mean, I know you do range  **Dr. Nirali Jain:** Yeah. Yeah, because it's such a small community, we all have our own niches and we all kind of have our own interests and  **Michelle Oravitz:** Yeah.  **Dr. Nirali Jain:** no like specific training. There are a couple courses that you take that I took in in training as well, just to kind of understand what it sounds like to, I. Council of fertility preservation, patient with and without cancer. **Dr. Nirali Jain:** Um, and then, you know, you kind of just learn by experience and you form a niche for something that you're passionate about. 'cause that's what makes you, you know, really thorough in, in your treatment. [00:29:00] So that's one of my interests. Um, and, but I would say,  **Michelle Oravitz:** training for that. It's just like  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** just know how to treat that in  **Dr. Nirali Jain:** exactly.  **Michelle Oravitz:** especially if you're interested in doing that.  **Dr. Nirali Jain:** Exactly. That's exactly right. It's kind of, it just comes with the experience comes with your mentors and who you're surrounded by, and everyone kind of helps each other get to that point. But there are several specialists in our practice at RMA that specialize specifically in fertility preservation in cancer patients. **Dr. Nirali Jain:** So we have a close communication with our oncologist and they know who to refer to within the practice because everyone has their own little interests.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** Um, definitely. I, like I said, I really enjoy picking your brain because it's a lot of fun for me. I, I do  **Dr. Nirali Jain:** Totally.  **Michelle Oravitz:** acupuncture, so  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** and I, I think that it's just so crazy that our fields don't work together. I mean, we kind of do, but I think, I just feel like it would be so great  **Dr. Nirali Jain:** exactly.[00:30:00]  **Michelle Oravitz:** the expertise because you guys have immense. Benefits like in, in, uh, technology and incredible innovations and, and then the natural aspect of really understanding the, the body. And I, I just think that it would work so amazing together if it was more of like a thing. 'cause it, I know in China they actually combine the two  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** eastern.  **Dr. Nirali Jain:** Yeah, I mean I think that that's so important and there is data that shows, you know, there's actually a recent study that came out just a few weeks ago on the benefits of acupuncture for fertility patients. And we know that, I mean, I recommend it to all of my patients, specifically the day of the embryo transfer. **Dr. Nirali Jain:** We, luckily, we offer it on site at RMA and we have acupuncturists that come in and, and do a session before and after the embryo transfer, and I think. A lot of that is targeted towards stress relief. But I also think that holistically it's important to feel at your best when we're doing something that's so crucial to your, to your health. **Dr. Nirali Jain:** So to really focus on the diet, focus on stress relief, [00:31:00] focus on meditation, yoga, whatever it takes to get to your best wellbeing when you're going through fertility treatments, um, is so important. So I appreciate  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** like you that really specialize in the other side of. Of this, because I do consider it still part of the holistic medicine that we need to really maximize success for our patients. **Michelle Oravitz:** Awesome. Well,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** Jane, this is such a pleasure Of talking to you. You've given us some, so much great information and we've definitely dived into a, do a topic that I don't typically, I haven't yet spoken about. But, um, that being said, it's such an important topic to talk about. And thank you so much for coming on today. **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** course. **Michelle Oravitz:** I get off, how can people find you?  **Dr. Nirali Jain:** That's a great question. So I have, um, a social media page. I, it's called Expert nc. So like EGG,  **Michelle Oravitz:** I  **Dr. Nirali Jain:** um, expert nc. Try, tried to make it a little bit humorous. Um, but I'm all over social [00:32:00] media and would love to hear from anyone that is listening. I, you know, every, every day I get different, um, dms and I'm happy to respond. **Dr. Nirali Jain:** I love hearing about everyone else's. Stories and things like that. Um, so that is kind of my main, main social media platform. Um, and then through like RMA and Reproductive Medical Associates, we also have a YouTube channel. We have an Instagram page, um, of our office available, um, as well that is public. **Dr. Nirali Jain:** So you can find us pretty easily if you just kind of hit Google. But um, yeah, I'm kind of developing my social media platform as the expert and I hope it grows.  **Michelle Oravitz:** Love it. Great.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** was such a pleasure talking to you. Thank you. so much **Dr. Nirali Jain:** Thank you. **Michelle Oravitz:** today.  **Dr. Nirali Jain:** Of course. Thank you so much for having me.  [00:33:00]   

Make Trades Great Again
Lowest Bidders

Make Trades Great Again

Play Episode Listen Later May 27, 2025 29:55


Are you the low bid? Are you being beat by the low bidder but offering a more complete job, is it apple to apples? This week the guys chat about a recent encounter Eric had on the job with another local plumber. Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email

Make Trades Great Again
Buy Now, Pay Later?

Make Trades Great Again

Play Episode Listen Later May 20, 2025 17:31


Our customer's finances are feeling the pinch more than ever as prices are the highest on record. Inflation, tariffs, shipping backlogs are just some of the bigger problems on the product side but a big part of the general population is finding it difficult manage unexpected bills. Eric is now offering financing and Andy is looking into it for his business.Have experience or thoughts to share? Please do! Send us a textSend us your feedback or topic ideas over on our social channels!Eric Aune @mechanicalhub Andy Mickelson @mick_plumbNewsletter sign up: https://bit.ly/MH_email