Podcasts about PCI

In many organizations, security exception management is a manual process, often treated as a simple compliance checkbox. While necessary, this approach can lead to unmonitored configurations that drift from their approved state, creating inconsistencies in an organization's security posture over time. How can teams evolve this process to support modern development without compromising on security?In this episode, Ashish Rajan sits down with security expert Santosh Bompally, Cloud Security Engineering Team Lead at Humana to discuss a practical framework for automating exception management. Drawing on his journey from a young tech enthusiast to a security leader at Humana, Santosh explains how to transform this process from a manual task into a scalable, continuously monitored system that enables developer velocity.Learn how to build a robust program from the ground up, starting with establishing a security baseline and leveraging policy-as-code, certified components, and continuous monitoring to create a consistent and secure cloud environment.Guest Socials -⁠⁠ ⁠Santosh's LinkedinPodcast Twitter - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@CloudSecPod⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠If you want to watch videos of this LIVE STREAMED episode and past episodes - Check out our other Cloud Security Social Channels:-⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Cloud Security Podcast- Youtube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Cloud Security Newsletter ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Cloud Security BootCamp⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠If you are interested in AI Cybersecurity, you can check out our sister podcast -⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ AI Cybersecurity PodcastQuestions asked:(00:00) Introduction(00:39) From Young Hacker to Cybersecurity Pro(02:14) The "Tick Box" Problem with Exception Management(03:17) Exposing Your Threat Landscape: The Risk of Not Automating(05:43) Where Do You Even Start? The First Steps(08:26) VMs vs Containers vs Serverless: Is It Different?(11:15) Building Your Program: Start with a Security Baseline(14:44) What Standard to Follow? (CIS, PCI, HIPAA)(17:20) The Lifecycle of a Control: When Should You Retire One?(19:42) The 3 Levels of Security Automation Maturity(23:25) Do You Need to Be a Coder for GRC Automation?(26:16) Fun Questions: Home Automation, Family & Food

The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.Post-arrest care and recovery are the final two links in the chain of survival.Identification of ROSC during CPR.Initial patient management goals after identifying ROSC.The patient's GCS/LOC should be evaluated to determine if targeted temperature management (TTM) is indicated.Patients that cannot obey simple commands should receive TTM for at least 24 hours.Recently published studies on TTM and ACLS's current standard.Monitoring the patient's core temperature during TTM.Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

DESCRIPTION Kathleen Federici, Vice President of Professional Development at IPMI, discusses the transition from CAPP to PTMP. SPONSORS This episode is brought to you by Parking Today and the Parking Today Podcast Network. Learn more at parkingtoday.com/podcast. This episode is brought to you by Parker Technology, the customer experience solution of choice for the parking industry. Their solution puts a virtual ambassador in every lane, to help parking guests pay and get on their way in under a minute. Learn more at parkertechnology.com/parkingpodcast and subscribe to our podcast “Harder Than It Looks: Parking Uncovered.” This episode is brought to you by Scheidt & Bachman USA. Scheidt & Bachmann USA markets state-of-the-art Parking Solutions and Fare Collection Systems: the most innovative and advanced solutions in the US. Learn more at scheidt-bachmann-usa.com. This episode is brought to you by Breeze: Parking Concepts' digital platform that makes the parking experience a Breeze! For more than 50 years, PCI has been proactively managing parking & transportation operations with unparalleled integrity & service. Learn more at parkingconcepts.com. This episode is brought to you by Parkmobile. Parkmobile, a part of EasyPark Group, is the leading provider of smart parking and mobility solutions in North America, using a contactless approach to help millions of people easily find, reserve, and pay for parking on their mobile devices. Learn more about parkmobile.io. This episode is brought to you by Parkalytics. Parkalytics will take drone images of parking lots and/or on-street parking for a given time period and then upload those images into their parkalytics software. Within a matter of seconds, it will provide you parking counts, turnover studies, utilization studies, you name it. You can now wow your clients or supervisors by having a complete snapshot of the parking usage for a fraction of the price of a traditional parking study. Learn more at parkalytics.com. WEBSITES AND RESOURCES https://www.parkingcast.com/ https://parkingtoday.com/podcast/ www.parkertechnology.com/parkingpodcast scheidt-bachmann-usa.com parkingconcepts.com parkmobile.io parkalytics.com MERCH Check out some of our awesome parking themed t-shirts and other merch at parkingcast.com/swag. MUSEUM Check out some of our artifacts from the world's first parking museum at parkingcast.com/museum.

The chain of survival for ACLS is the same as was learned in your BLS class.The beginning steps of the Cardiac Emergency and Stroke chain of survival.ACLS's timed goals for first medical contact to PCI for STEMI and door-to-needle for ischemic stroke.Characteristics of areas that have significantly better stroke and out-of-hospital cardiac arrest outcomes.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Chronic Total Occlusion in 2025   Guest: Gregory Barsness, M.D. Host: Malcolm Bell, M.D.   Chronic (>3 months) complete epicardial coronary obstructive lesions, often referred to as CTOs, are recognized in a large minority of those referred for coronary angiography yet historically represent

Hoy tratamos varios temas con diferentes caracteristicas pero que tienen algo en común, todos representan frentes de lucha del proletariado tanto en Colombia como en el mundo.Continúamos llamando al internacionalismo proletario para enfrentar el genocido, la ocupación y el apartheid en Palestina, igualmente para respaldar la Guerra Popular en la India y la campaña contra la operación Kagaar que ha golpeado al PCI (maoísta) en los últimos meses.Todo esto en el marco de la necesaria lucha contra el capitalismo imperialista y sus guerras.Pero también hablamos de la realidad politica y social en Colombia en el momento actual, donde hechos como el atentado a Miguel Uribe y las posiciones reaccionarias del Senado y los partidos de derecha no estan aislados. Realidad que reafirma que se requiere fortalecer aun más la lucha independiente contra el Estado y contra los enemios del pueblo.Bienvenidos una vez más a Vanguardia Obrera.Apóyanos comentando, compartiendo el episodio y si quieres, también con una donación.Ingresa a:https://revolucionobrera.com/apoyanos/

What You'll Learn:Why technology may be increasing workplace isolation, not solving itHow EQ is overtaking IQ as the most valuable skill in a tech-driven economyThe four essential factors that drive employee engagementPractical strategies for building stronger relationships with remote teamsWhy work-life integration beats the myth of work-life balanceWhat great leaders do differently to retain top talentInsights from over 90,000 professionals in 20+ countriesKey Quote:“You'll never grow as a company if you're too busy replacing workers.”Resources & Mentions:Dan's book: Back to Human: How Great Leaders Create Connection in the Age of IsolationDan's podcast: Five Questions with Dan SchawbelVisit DanSchawbel.com for more Subscribe & Review:If you enjoyed this episode, please leave a review and subscribe to The Burleson Box on Apple Podcasts, Spotify, or wherever you listen. Your support helps us bring powerful conversations like this to more listeners in healthcare leadership. ***The Burleson Box is brought to you by Stax Payments:Save Big on Transaction Fees: Boost Your Bottom Line with Stax Payments.Did you know that your practice can start saving thousands of dollars on your monthly processing costs with our preferred payments partner, Stax? Simplify your practice operations and provide a quality patient experience. Healthcare practices like yours need a way to accept payments simply and securely. That's where Stax comes in.Stax helps you manage your entire payments experience from within one platform. You can safely accept touch-free payments in-person, online, or over the phone, securely store and manage patient information with layered security and Level 1 PCI compliance.
Take advantage of a simpler, more transparent way to process your payments with competitive flat-rate pricing, provided exclusively through Stax. No additional fees or contracts required!Power your practice and get paid faster with simple, safe and secure payment solutions. Have questions? Schedule time to speak with a dedicated payment consultant to learn more.Click Below to Lear More Today:StaxPayments.com/burleson-seminars*** Go Premium: Members get early access, ad-free episodes, hand-edited transcripts, exclusive study guides, special edition books each quarter, powerpoint and keynote presentations and two tickets to Dustin Burleson's Annual Leadership Retreat.http://www.theburlesonbox.com/sign-up Stay Up to Date: Sign up for The Burleson Report, our weekly newsletter that is delivered each Sunday with timeless insight for life and private practice. Sign up here:http://www.theburlesonreport.com Follow Dustin Burleson, DDS, MBA at:http://www.burlesonseminars.com

Smart CIOs Do This: The Unspoken Rules of Cybersecurity Leadership with Guest: Andrew Griffiths, CEO & Founder of Annexus TechnologiesHost: Julie RigaAbout This EpisodeIn this episode, Julie sits down with Andrew Griffiths, a legacy-minded CEO and founder of Annexus Technologies, a multinational IT firm known for building infrastructure so strong it rarely needs fixing. Andrew is a strategist, philosopher of security, and storyteller with a deep belief in designing systems that protect people, not just profits.Together, they dive deep into the three essential ingredients for CIO success and explore the unspoken rules of cybersecurity leadership that smart CIOs follow to protect their organizations.Guest BackgroundAndrew Griffiths is the CEO and founder of Annexus Technologies, a cybersecurity firm registered in Jamaica since 2014, now expanding into Canada. Andrew's unique perspective on IT infrastructure was shaped by early exposure to satellites, electronics, and various technologies, leading him to see IT as ubiquitous and transformative. His philosophy centers on optimizing existing systems and connecting people through technology.Fun Fact: Andrew's favorite food is ackee and corned pork - a unique twist on Jamaica's national dish that substitutes corned pork for the traditional saltfish.Key Topics DiscussedThe Three Ingredients for CIO Success:1 Visibility & AssessmentUnderstanding what's happening both inside and outside your networkThe importance of secure design for internal and external domainsImplementing layers of trust with zero-trust principles2 Proactive Analysis & PlanningMoving from prevention to proactivityUnderstanding your cybersecurity posture rating (0-100)Identifying compromised credentials on the dark webCreating mitigation plans for when breaches occur3 Strategic ImplementationBalancing cost-effectiveness with security requirementsPlanning for short-term, medium-term, and long-term security needsAligning business objectives with IT infrastructureThe Annexus Approach:Public Domain Assessments: Understanding external security postureMulti-standard Compliance: Meeting GDPR, PIPEDA, PCI, and other international standardsProactive Monitoring: Real-time detection of network scanning attemptsVirtual Network Infrastructure: Creating controlled environments for threat analysisKey Insights for CIOsThe Trust-Building Challenge:Cybersecurity sales cycles can take 6 months to a year due to trust requirementsBuilding relationships requires patience and consistent educationSometimes you need to wait for organizations to validate the need themselvesThe Titanic Analogy:Andrew compares cybersecurity professionals to engineers warning about icebergs - often dismissed until disaster strikes, highlighting the importance of persistent, consistent communication about security risks.Multi-Vendor Security Strategy:Avoid vendor lock-in for critical security infrastructureUse different firewall platforms in series to increase security complexityDesign solutions that make it harder for attackers to predict your security stackFuture-Forward ThinkingNext-Generation Platforms:Annexus is focusing on comprehensive ecosystems that protect:Data within organizationsData transfer between organizationsCloud redundancy strategies across multiple providers (Azure, AWS)The Future of IT:Andrew predicts the future lies in "redundancy at cloud scale" - ensuring business continuity even when major cloud providers experience outages.Connect with Andrew GriffithsWebsite: www.annexustech.caSocial Media: Available on YouTube, Twitter, Instagram, FacebookCompany: Annexus TechnologiesConnect with Julie RigaWebsite: www.julieriga.comSocial Media: www.linkedin.com/in/julierigaCoaching: Learn more about leadership coaching and transformationThis episode is perfect for sharing with CIOs and IT leaders in your network who need to hear these insights about modern cybersecurity leadership.

Você descobriu que vai precisar fazer uma radioiodoterapia ou uma PCI (pesquisa de corpo inteiro) depois do diagnóstico de câncer de tireoide e está cheio de dúvidas?Neste vídeo explico de forma clara e sem “mediquês” o que é cada um desses exames e tratamentos, para que servem, quando são indicados, como é o preparo e o que esperar nos dias seguintes.Tudo isso com explicações diretas, baseadas em evidências e na minha prática como cirurgião especialista em tireoide.Se você (ou alguém da sua família) vai passar por esse processo, esse vídeo pode te ajudar a entender e ficar mais tranquilo.▶Dr. Jônatas CatundaCirurgião de cabeça e pescoçoCRM 14951 RQE 8522▶Whatsapp - https://wa.me/5585981072268▶Consulta online - https://drjonatascatunda.com/consultaonline▶Esse canal é meramente educacional. Não deve ser utilizado para realizar autodiagnóstico ou auto tratamento!

Dive deep into the world of cloud security with Rocky Giglio and special guest Sean Atkinson, CISO at the Center for Internet Security (CIS), on this episode of Cloud and Clear! We examine the crucial role of CIS benchmarks and hardened images in establishing a robust and secure cloud infrastructure. In this insightful discussion, Sean breaks down: ✅ What CIS is and its mission to create a safer connected world. ✅ The evolution of CIS Controls from 20 to 18 for greater efficiency. ✅ Understanding CIS Benchmarks and how they standardize security configurations. ✅ The power of Hardened Images: Start secure from day zero in your cloud environment. ✅ Shifting security left and proactively integrating security into design. ✅ How CIS simplifies compliance with NIST, PCI, HIPAA, and other frameworks. ✅ The importance of community and partnership in cybersecurity. Whether you're a security professional, cloud engineer, or anyone concerned about keeping data safe in the cloud, this episode is packed with valuable knowledge. Learn how to leverage CIS resources to strengthen your security posture and simplify compliance. Tune in to discover how CIS is making cloud security more accessible and effective! Don't forget to subscribe to Cloud and Clear for more expert insights on cloud transformation. #CloudSecurity #CIS #Cybersecurity #CloudComputing #HardenedImages #SecurityBenchmarks #CloudAndClear #GoogleCloud #Compliance #NIST #PCI #HIPAA #CISO #TechPodcast Join us for more content by liking, sharing, and subscribing!

In this latest episode of the PCI podcast, David Thompson, Secretary of PCI's Council for Congregational Life and Witness talks with Gary Millar, Principal of Queensland Theological College in Brisbane, Australia about his recent book called Both/And Ministry: Living and leading like Jesus'. Present is a denomination wide initiative inviting and encouraging congregations and their members to make themselves fully present to God who is ever present to us. Find out more and watch a video about the Present initiative here www.presbyterianireland.org/present

Brandon Payne, executive director for the National Council on School Facilities, joins this month's episode of Security Management Highlights to discuss how to integrate security and safety into school facility planning and funding during both retrofits and new builds. Then, Kevin Jones, CPP, PCI, addresses key considerations for arming security professionals, from legal liability to insurance to continuous training. Additional Resources Read more from Brandon Payne about school facility management and where security and safety fit in here: https://www.asisonline.org/security-management-magazine/articles/2025/04/k12/school-facilities-managers/ Meet many of the other essential partners in school safety and security in this Security Management series: https://www.asisonline.org/security-management-magazine/articles/2025/04/k12/ Want to help drive school security forward? Keep an eye out for the forthcoming ASIS International School Security Standard. Learn more here: https://www.asisonline.org/publications--resources/news/blog/2024/press-briefing-school-security-standard/ Read more about arming security teams in the June issue of Security Technology: https://www.asisonline.org/security-management-magazine/monthly-issues/security-technology/archive/2025/june/ Hear more from Kevin Jones, CPP, PCI, in his latest article about considerations for selecting the right weapons for security: https://www.asisonline.org/security-management-magazine/monthly-issues/security-technology/archive/2025/june/how-to-make-a-weapon-selection-when-arming-your-security-team/

DESCRIPTION Dan Mathers, Co-Founder, President & CEO of eleven-x, and Melissa McMahon, Parking and Curbspace Manager with the Arlington County Department of Environmental Services discuss Arlington County's one-of-a-kind parking project. Part Two. SPONSORS This episode is brought to you by Parking Today and the Parking Today Podcast Network. Learn more at parkingtoday.com/podcast. This episode is brought to you by Parker Technology, the customer experience solution of choice for the parking industry. Their solution puts a virtual ambassador in every lane, to help parking guests pay and get on their way in under a minute. Learn more at parkertechnology.com/parkingpodcast and subscribe to our podcast “Harder Than It Looks: Parking Uncovered.” This episode is brought to you by Scheidt & Bachman USA. Scheidt & Bachmann USA markets state-of-the-art Parking Solutions and Fare Collection Systems: the most innovative and advanced solutions in the US. Learn more at scheidt-bachmann-usa.com. This episode is brought to you by Breeze: Parking Concepts' digital platform that makes the parking experience a Breeze! For more than 50 years, PCI has been proactively managing parking & transportation operations with unparalleled integrity & service. Learn more at parkingconcepts.com. This episode is brought to you by Parkmobile. Parkmobile, a part of EasyPark Group, is the leading provider of smart parking and mobility solutions in North America, using a contactless approach to help millions of people easily find, reserve, and pay for parking on their mobile devices. Learn more about parkmobile.io. This episode is brought to you by Parkalytics. Parkalytics will take drone images of parking lots and/or on-street parking for a given time period and then upload those images into their parkalytics software. Within a matter of seconds, it will provide you parking counts, turnover studies, utilization studies, you name it. You can now wow your clients or supervisors by having a complete snapshot of the parking usage for a fraction of the price of a traditional parking study. Learn more at parkalytics.com. WEBSITES AND RESOURCES https://www.parkingcast.com/ https://parkingtoday.com/podcast/ www.parkertechnology.com/parkingpodcast scheidt-bachmann-usa.com parkingconcepts.com parkmobile.io parkalytics.com https://www.arlingtonva.us/Government/Programs/Transportation/Parking/Performance-Parking-Pilot https://eleven-x.com/ MERCH Check out some of our awesome parking themed t-shirts and other merch at parkingcast.com/swag. MUSEUM Check out some of our artifacts from the world's first parking museum at parkingcast.com/museum.

Episode Topic: Ruston Miles of Bluefin joins PayPod to unravel the real story behind payment data security. From debunking myths around chip card protection to highlighting the need for encryption at the point of interaction, Ruston shares critical insights into why businesses must adopt P2P encryption and tokenization to stay ahead of evolving threats. Lessons You'll Learn: How to distinguish fraud prevention from data security, the necessity of protecting data at the entry point, why chips don't equal encryption, and how upcoming technologies like quantum computing and AI are reshaping the threat landscape. About Our Guest: Ruston Miles is the Founder and Chief Strategy Officer at Bluefin, a payment security company that pioneered PCI-validated point-to-point encryption. With decades of experience in cybersecurity, Ruston has been instrumental in setting encryption standards adopted by Visa, Mastercard, and global universities. He's also a strong advocate for tokenization, quantum-resistant encryption, and secure digital wallets. Topics Covered: The difference between fraud and data breaches   How P2P encryption protects data before it can be stolen   Why EMV chips give a false sense of security   Storing tokens instead of real card numbers   Security challenges in higher education and enterprise   Quantum computing's potential threat to public key encryption

In this industry-sponsored episode, host Praveen Ranganath, MD is joined by Yader Sandoval, MD and Jonathon Leipsic, MD, MSCCT, the chair and co-chair of the recently published inter-society roundtable document on CCTA for PCI planning. Conversation topics include the origin of this expert roundtable, the benefits of and evidence supporting CCTA for PCI planning, a deep-dive into heavily calcified and bifurcation lesion planning, and insights on how to tackle current barriers to adoption. Coronary Computed Tomography Angiography to Guide Percutaneous Coronary Intervention: Expert Opinion from a SCAI/SCCT RoundtableThis episode is sponsored by Heartflow. References to a specific product, process, or service by speakers in this podcast episode do not constitute or imply an endorsement by the Society of Cardiovascular Computed Tomography. The views and opinions expressed in do not necessarily reflect those of the Society of Cardiovascular Computed Tomography.

Lancet 1999;353:2001-07Background: Beta-blockers directly reduce cardiac contractility and myocardial oxygen demand. For decades, they were avoided in patients with acute and chronic heart failure over concerns they would facilitate decompensation of the condition. The therapeutic cornerstones of treatment, prior to the modern era of clinical trials, focused on managing symptoms and quality of life with diuretics and inotropic agents like digoxin; however, new paradigms were arising that focused on addressing neurohormonal mechanisms of chronic disease that were over-activated in the failing heart. The first major success came with inhibition of the renin angiotensin aldosterone system with angiotensin converting enzyme inhibitors whose effect on mortality for patients with mild and severe forms of chronic heart failure were demonstrated in the V-HEFT II, CONSENSUS, and SOLVD trials. Additional benefits were demonstrated with the mineralocorticoid receptor antagonist spironolactone in the RALES trial. These drug classes primarily work by reducing afterload and volume retention. Appreciating why they work for improving cardiac performance and managing symptoms in heart failure patients is straightforward when we consider the major factors that effect cardiac stroke volume - preload, afterload and contractility; however, it is also noteworthy the effects these agents have on sudden death. How beta-blockade benefits the failing heart is less obvious (outside prevention of sudden death). Mechanistic studies in patients with chronic heart failure have consistently shown that when beta blockers are used for more than 1 month, left ventricular function improves. Beta blocker therapy appears to restore the density of beta-adrenergic receptors after they have been downregulated by the chronic overactivity of the sympathetic nervous system. The first major placebo-controlled RCT to demonstrate a mortality benefit used the non-selective beta blocker carvedilol. The trial was small and not originally designed to test mortality and was stopped early without clearly predefined stopping rules. Furthermore, 8% of total patients selected for participation in the trial were excluded prior to randomization after a 2 week, open-label run-in phase with the study drug, which saw 2% of all patients experience worsening heart failure or death representing 24 patients (the difference in total deaths between groups was 9 when the trial was stopped). The Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF) was the first large scale trial designed to test the hypothesis that beta-blockade with metoprolol controlled/extended release (CR/XL) added to optimum medical therapy reduces mortality in patients with chronic systolic heart failure.Patients: Patients were recruited from 313 sites in 13 European countries and the United States. Eligible patients were men and women between the age of 40 to 80 years with symptomatic heart failure (NYHA class II-IV) for >/= 3 months before randomization. They had to be on a diuretic and ACE inhibitor for at least 2 weeks. Other drugs, including digoxin, could also be used. Patients also had to have an EF of /=68 beats per minute.Patients were excluded if: they had an MI or unstable angina within 28 days; had an indication or contraindication for treatment with beta-blocker; beta blockade within 6 weeks; heart failure due to systemic disease (i.e., amyloidosis) or alcohol abuse; scheduled or performed cardiac transplant; an ICD; procedures such as CABG or PCI planned or performed in the past 4 months; 2nd or 3rd degree AV block unless a pacemaker was present; unstable or decompensated heart failure defined by pulmonary edema or hypoperfusion or supine systolic BP 25% deviation of the number of observed versus expected consumed placebo tablets during the run-in period.Baseline characteristics: The mean age of patients was 64 years and approximately 78% were male. Slightly more than 30% of patients were above the age of 70. The average EF was 28%. The average SBP was 130 mmHg and heart rate was 82 bpm. Most patients had mild to moderate heart failure, with 41% in NYHA Class II, 56% in Class III, and only 3% in Class IV. Ischemic cardiomyopathy accounted for 65% of cases and nonischemic causes accounted for 35%. Most patients were on an ACE inhibitor or ARB (95%) and diuretic (90%). Digoxin was used in 63%. Trial procedures: Prior to randomization, the study was preceded by a single-blind, 2-week placebo run-in period. Patients meeting eligibility were then randomized to placebo or metoprolol CR/XL. The starting dose of placebo or metoprolol CR/XL was 12.5 mg daily for patients in NYHA class III or IV and 25 mg daily for patients in NYHA class II. The dose was doubled every 2 weeks until the target dose of 200 mg daily was reached. Patients were followed every 3 months.Endpoints: The primary outcome was all-cause mortality. It was estimated that 3,200 patients would need to be followed for 2.4 years to detect a 30% relative reduction in mortality based on annual mortality rate of 9.4% in the placebo group. This would achieve at least 80% power with a 2-sided alpha of 0.04. Patients were recruited faster then planned and so the final sample size of 3,991 patients increased the power of the study.The study was monitored by an independent safety committee and predefined stopping rules for efficacy were based on all-cause mortality, done when 25%, 50%, and 75% of expected deaths had occurred. Results: The trial was stopped early after the 2nd preplanned interim analysis when 50% of expected deaths had occurred. The mean duration of follow-up at the time of stopping was 1 year. The mean daily dose of metoprolol CR/XL was 159 mg once daily, with 87% receiving 100 mg or more and 64% receiving the target dose of 200 mg daily. In the placebo group, the corresponding values were 179 mg daily, 91% and 82%. The study drug was discontinued permanently in 14% of patients in the metoprolol group and 15% in the placebo group. Six months after randomization, heart rate decreased by 14 bpm in the metoprolol group compared to only 3 bpm in the placebo group. Systolic blood pressure decreased less in the metoprolol group (-2.1 vs 3.5 mmHg).Compared to placebo, metoprolol significantly reduced all-cause mortality (7.3% vs 10.8%; RR 0.66; 95% CI 0.53—0.81). Cardiovascular mortality accounted for 91% of all deaths; with sudden death accounting for 58% and death from worsening heart failure accounting for 24% of all deaths. All 3 of these causes of death were significantly reduced by metoprolol. The relative and absolute effects on death were greatest for patients with NYHA class III heart failure.Conclusions: In this trial of stable patients with mild to moderate chronic systolic heart failure, who were optimized on an ACEi or ARB and diuretic, metoprolol CR/XL significantly reduced all-cause mortality. Approximately 30 patients would need to be treated with metoprolol compared to placebo for 1 year to prevent 1 death. This trial represents a significant win for beta blockade in patients with chronic systolic heart failure. While the NNT in this trial is slightly higher than in SOLVD, it is important to appreciate that follow-up time in SOLVD was more than 3x longer. Limitations to external validity in this trial include the run-in period and stringent inclusion and exclusion criteria. Our enthusiasm is also tempered by early stopping, which has been found to be associated with false positive or exaggerated results but this concern is mitigated to some extent in this trial because the rules for early stopping were clearly defined in the protocol.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

In a SlatorPod first, four guests — Scott Cooper, CEO of Language Services Associates (LSA), Pablo Tercero, COO of LSA, Jerry Song, CEO of Lingolet, and Edward Varela, VP of Business Development at Lingolet — shared their insights into a newly forged partnership.Scott explained that the decision to partner instead of building an in-house AI solution allowed LSA to stay focused on its core strengths while leveraging Lingolet's technical edge. The alliance goes beyond a vendor agreement, with LSA taking an equity stake in Lingolet, anchoring the relationship in shared strategy and long-term commitment. For Jerry and Edward, the partnership is a natural progression, rooted in their deep knowledge of both software development and the language services market.In a standout use case, the two companies helped a Major League Soccer team enable multilingual, AI-assisted communication in coaching sessions — bridging language gaps in real time for international players.On the tech front, Jerry and Edward explained that Lingolet doesn't build large language models from scratch but instead acts as an orchestrator, offering clients the ability to customize and deploy AI tools within secure, dedicated environments. Pablo underscored LSA's HIPAA and PCI compliance, as security, compliance, and privacy are essential pillars, especially in regulated sectors like healthcare.Looking ahead, LSA and Lingolet are preparing to offer hybrid solutions where AI can bridge the gap during interpreter unavailability, even for brief moments, potentially transforming session wait times. Their roadmap includes broader language coverage, deeper integration with healthcare platforms, and innovative pricing models that will reshape how interpretation services are sold and scaled.

In the latest JACC offering from EuroPCR, JACC Associate Editor Celina M. Yong, MD, FACC, interviews Dr. Ashkan Eftekhari, PhD, to discuss insights into his study, Biolimus-Eluting Biomatrix Stent Versus a Dual-Therapy Sirolimus-Eluting Stent in PCI: SORT OUT XI Randomized Trial. The biolimus A9-eluting BioMatrix Alpha stent (BES), has not been compared with another contemporary drug eluting stent. This study compared one-year target lesion failure (TLF) in BES versus the dual-therapy sirolimus-eluting Combo stent (DTS) in an all-comer population undergoing PCI. A total of 3,136 patients were randomized 1:1 to either BES or DTS. The primary result showed that BES was non-inferior to DTS. Additionally, there was a significantly higher rate of definite stent thrombosis in the BES arm. In conclusion, BES was non-inferior to DTS at one-year follow-up with respect to the primary endpoint, TLF.

The chain of survival for a cardiac emergency and stroke start the same:1. preparedness & recognition of an emergency;2. activation of EMS;3. delivery of Advanced Life Support; and4. transporting to the most appropriate facility.ALS ambulances are staffed with paramedics who have training in ACLS skills.Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference.ACLS's timed benchmarks for:point of first medical contact to PCI for ST elevation MI;door to tPA for ischemic stroke; andonset of symptoms to EVT for LVO strokes.Why EMS should bypass a close hospital to transport a STEMI or suspected stroke patient to a hospital capable of 24/7 PCI or a certified stroke center.Check out the Pod Resource page at passacls.com for links to the "EMS On Air" podcast for links to episodes that look at EMS's role in stroke outcomes in the rural vs urban area.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In this latest episode of the PCI podcast, Jonny McClune and David Thompson from PCI's Council for Congregational Life and Witness are joined by missiologist David Smith to explore what it looks like for congregations to be present in today's changing communities. Present is a denomination wide initiative inviting and encouraging congregations and their members to make themselves fully present to God who is ever present to us. Find out more and watch a video about the Present initiative here www.presbyterianireland.org/present

Credit card processing fees can eat away at your brewery's profits, but expert Patrick MacLellan from Merchant Cost Consulting shows how you can save an average of 20% on these costs without changing your current processor or disrupting operations.Summary• 3 main fee components: interchange charges from card brands, processor markups, and miscellaneous fees• Why most businesses are overpaying – processing statements are deliberately confusing and contracts often allow price changes without notice• How processors typically adjust pricing three times per year, slowly increasing your costs• The truth about POS systems that bundle processing with their software solutions• How to identify bogus fees like non-PCI compliance charges that can be eliminated• Pros and cons of customer surcharges and how to implement them legally• Contract considerations including early termination fees and auto-renewalsVisit merchantcostconsulting.com to learn more or request a free statement analysis to see potential savings.Sign up for the FREE brewery financial training newsletter.

Marcela Belleza e Raphael Coelho convidam Matheus Rezende, residente do último ano de Cardiologia - Incor, para conversar sobre manejo de doença coronariana crônica em tres tópicos:- Como realizar a investigação inicial?- Como fazer a terapia medicamentosa inicial?- O que fazer com o paciente que não melhora?Referências: 1. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes [published correction appears in Eur Heart J. 2025 Feb 21:ehaf079. doi: 10.1093/eurheartj/ehaf079.]. Eur Heart J. 2024;45(36):3415-3537. doi:10.1093/eurheartj/ehae1772. Virani, Salim S et al. “2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines.” Circulation vol. 148,9 (2023): e9-e119. doi:10.1161/CIR.00000000000011683. Montone RA, Rinaldi R, Niccoli G, et al. Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy, and Lifestyle Interventions. J Am Coll Cardiol. 2024;84(8):744-760. doi:10.1016/j.jacc.2024.06.0154. Mortensen MB, Dzaye O, Steffensen FH, et al. Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. J Am Coll Cardiol. 2020;76(24):2803-2813. doi:10.1016/j.jacc.2020.10.0215. Doenst T, Haverich A, Serruys P, et al. PCI and CABG for Treating Stable Coronary Artery Disease: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;73(8):964-976. doi:10.1016/j.jacc.2018.11.0536. Maron DJ, Hochman JS, Reynolds HR, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020;382(15):1395-1407. doi:10.1056/NEJMoa19159227. Rajkumar CA, Foley MJ, Ahmed-Jushuf F, et al. A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina. N Engl J Med. 2023;389(25):2319-2330. doi:10.1056/NEJMoa23106108. Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377(14):1319-1330. doi:10.1056/NEJMoa17091189. Howlett JG, Stebbins A, Petrie MC, et al. CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial. JACC Heart Fail. 2019;7(10):878-887. doi:10.1016/j.jchf.2019.04.01810. Nidorf SM, Fiolet ATL, Mosterd A, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020;383(19):1838-1847. doi:10.1056/NEJMoa202137211. Boden WE, O'Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356(15):1503-1516. doi:10.1056/NEJMoa07082912. Ford TJ, Stanley B, Good R, et al. Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial. J Am Coll Cardiol. 2018;72(23 Pt A):2841-2855. doi:10.1016/j.jacc.2018.09.00613. Carvalho, Tales de et al. “Brazilian Cardiovascular Rehabilitation Guideline - 2020.” “Diretriz Brasileira de Reabilitação Cardiovascular – 2020.” Arquivos brasileiros de cardiologia vol. 114,5 (2020): 943-987. doi:10.36660/abc.20200407

DESCRIPTION Dan Mathers, Co-Founder, President & CEO of eleven-x, and Melissa McMahon, Parking and Curbspace Manager with the Arlington County Department of Environmental Services discuss Arlington County's one-of-a-kind parking project. SPONSORS This episode is brought to you by Parking Today and the Parking Today Podcast Network. Learn more at parkingtoday.com/podcast. This episode is brought to you by Parker Technology, the customer experience solution of choice for the parking industry. Their solution puts a virtual ambassador in every lane, to help parking guests pay and get on their way in under a minute. Learn more at parkertechnology.com/parkingpodcast and subscribe to our podcast “Harder Than It Looks: Parking Uncovered.” This episode is brought to you by Scheidt & Bachman USA. Scheidt & Bachmann USA markets state-of-the-art Parking Solutions and Fare Collection Systems: the most innovative and advanced solutions in the US. Learn more at scheidt-bachmann-usa.com. This episode is brought to you by Breeze: Parking Concepts' digital platform that makes the parking experience a Breeze! For more than 50 years, PCI has been proactively managing parking & transportation operations with unparalleled integrity & service. Learn more at parkingconcepts.com. This episode is brought to you by Parkmobile. Parkmobile, a part of EasyPark Group, is the leading provider of smart parking and mobility solutions in North America, using a contactless approach to help millions of people easily find, reserve, and pay for parking on their mobile devices. Learn more about parkmobile.io. This episode is brought to you by Parkalytics. Parkalytics will take drone images of parking lots and/or on-street parking for a given time period and then upload those images into their parkalytics software. Within a matter of seconds, it will provide you parking counts, turnover studies, utilization studies, you name it. You can now wow your clients or supervisors by having a complete snapshot of the parking usage for a fraction of the price of a traditional parking study. Learn more at parkalytics.com. WEBSITES AND RESOURCES https://www.parkingcast.com/ https://parkingtoday.com/podcast/ www.parkertechnology.com/parkingpodcast scheidt-bachmann-usa.com parkingconcepts.com parkmobile.io parkalytics.com https://www.arlingtonva.us/Government/Programs/Transportation/Parking/Performance-Parking-Pilot https://eleven-x.com/ MERCH Check out some of our awesome parking themed t-shirts and other merch at parkingcast.com/swag. MUSEUM Check out some of our artifacts from the world's first parking museum at parkingcast.com/museum.

 Dòng chảy kinh tế 09/05/2025 có những nội dung sau:- Chỉ số Năng lực cạnh tranh cấp tỉnh PCI - vai trò và yêu cầu trong bối cảnh mới.- Quỹ thúc đẩy sử dụng năng lượng tiết kiệm và hiệu quả, "đòn bẩy" hỗ trợ doanh nghiệp đầu tư công nghệ và chuyển đổi xanh.- Dịch vụ công trực tuyến của kho bạc hỗ trợ tích cực các đơn vị sử dụng ngân sách ở địa phương miền núi.

Key Takeaways:AI can be viewed as a necessity for growth to drive both cost savings and revenue growth.Establishing a strong governance framework is crucial for managing risks associated with AI, such as data breaches and compliance with regulations like HIPAA and PCI.AI can be used both reactively to address immediate pain points and proactively to predict and optimize future business operations.While speed and scale are important, startups must ensure they do not compromise on compliance and governance, which are vital for sustainable growth.Developing an AI use policy is a best practice to guide internal and external applications of AI, ensuring responsible and effective usage.

(This episode originally aired on October 22, 2024.) For years, the best word to describe Medicare Advantage (MA) was “untouchable.” Hugely popular among seniors, profitable for health plans—the hybrid public-private payment model grew to the point that it now covers more seniors than traditional Medicare. But in the past few years, the tide has started to change. And if you've been paying attention in recent months, you'll have seen headlines announcing that payers that are scaling back their MA offerings and providers are exiting MA contracts. The MA market has gone from “untouchable” to “volatile.” The question is: why is this happening, and what does it mean for payers, providers, and seniors moving forward? In this episode, hosts Rachel (Rae) Woods and Abby Burns invite health plan experts Max Hakanson and Chelsea Needham to dissect what is going on in MA and how plans and providers are—or should be—navigating the changing tide. Links: Ep. 203: Value series: Is the future of VBC in specialty care? Zing Health & Strive Health say yes. Ep. 149: Senior Care (Part 1): Specialized primary care for an aging population Ep. 150: Senior Care (Part 2): The rapid growth of Medicare Advantage 3 traits health plans want in a provider partner 4 traits providers want in a health plan partner Around the nation: CMS releases Medicare Advantage Star Ratings Q&A: Cardiologist Navin Kapur discusses the future of complex PCI

(This episode originally aired on October 22, 2024.) For years, the best word to describe Medicare Advantage (MA) was “untouchable.” Hugely popular among seniors, profitable for health plans—the hybrid public-private payment model grew to the point that it now covers more seniors than traditional Medicare. But in the past few years, the tide has started to change. And if you've been paying attention in recent months, you'll have seen headlines announcing that payers that are scaling back their MA offerings and providers are exiting MA contracts. The MA market has gone from “untouchable” to “volatile.” The question is: why is this happening, and what does it mean for payers, providers, and seniors moving forward? In this episode, hosts Rachel (Rae) Woods and Abby Burns invite health plan experts Max Hakanson and Chelsea Needham to dissect what is going on in MA and how plans and providers are—or should be—navigating the changing tide. Links: Ep. 203: Value series: Is the future of VBC in specialty care? Zing Health & Strive Health say yes. Ep. 149: Senior Care (Part 1): Specialized primary care for an aging population Ep. 150: Senior Care (Part 2): The rapid growth of Medicare Advantage 3 traits health plans want in a provider partner 4 traits providers want in a health plan partner Around the nation: CMS releases Medicare Advantage Star Ratings Q&A: Cardiologist Navin Kapur discusses the future of complex PCI

In this episode, Dr. Valentin Fuster, provides a concise summary of the May 13, 2025 issue. He discusses four original studies on key cardiovascular topics, including the impact of chronic kidney disease and obesity on heart failure, the role of dobutamine stress echocardiography in predicting PCI outcomes, the effects of empagliflozin on erythropoiesis in heart failure, and the influence of adiposity, insulin resistance, and diabetes in heart failure with preserved ejection fraction. He highlights emerging insights into treatment strategies and ongoing challenges in understanding these complex cardiovascular conditions. Concluding with a separate review on anthracycline cardiotoxicity in cancer patients.

In this podcast, Dr. Valentin Fuster discusses a groundbreaking study from the Orbiter 2 trial, which explores how dobutamine stress echocardiography (DSE) can predict the efficacy of percutaneous coronary intervention (PCI) in relieving angina in patients with stable coronary artery disease. The study reveals that the degree of ischemia, as measured by DSE, is strongly correlated with improvement in symptoms, offering new insights into patient selection for PCI treatment.

In this episode, Dustin Burleson sits down with the powerhouse leadership team behind Rock Dental Brands to answer one of the most pressing questions in modern dentistry and orthodontics: How do I avoid choosing the wrong DSO?You'll hear directly from CEO Kristi Casey, Chief Development Officer Spencer Lunghino, and Co-Founder Dr. Mark Dake as they share a transparent look into the origins, philosophy, and strategic direction of Rock Dental Brands. Together, they bust myths around private equity, clinical autonomy, and growth timelines—and reveal what doctors should really be asking before joining a DSO.If you're a dentist, orthodontist, or specialist considering your next move, this episode is a must-listen. What You'll Learn:The real story behind private equity in dentistry—where the money comes from and how it worksWhy not all DSOs (or equity structures) are created equalHow Rock Dental Brands evolved from a doctor-led support model to a nationally respected DSOThe biggest myths around clinical autonomy, ownership, and growthWhy Rock's equity model is designed to treat doctors fairly—and how that differs from joint venturesHow to reverse-engineer a smart partnership decision using Charlie Munger's “invert and avoid” philosophyWhat questions to ask during DSO due diligence (and how to avoid future regret) Key Quotes:“We were built to be proud of the work we're doing 50 years from now." —Dr. Mark Dake“You're not giving up control of your practice. You're gaining part of 110 practices.” —Kristi Casey Connect with Our Guests:Spencer Lunghino – spencer.lunghino@rockdentalbrands.comrockdentalbrands.com Resources Mentioned:GreyFinch Practice Management SoftwareDentiCon by Planet DDSVistria Group – Private equity partner of Rock Dental Brands Subscribe & Review:If you enjoyed this episode, please leave a review and subscribe to The Burleson Box on Apple Podcasts, Spotify, or wherever you listen. Your support helps us bring powerful conversations like this to more listeners in healthcare leadership. ***The Burleson Box is brought to you by Stax Payments:Save Big on Transaction Fees: Boost Your Bottom Line with Stax Payments.Did you know that your practice can start saving thousands of dollars on your monthly processing costs with our preferred payments partner, Stax? Simplify your practice operations and provide a quality patient experience. Healthcare practices like yours need a way to accept payments simply and securely. That's where Stax comes in.Stax helps you manage your entire payments experience from within one platform. You can safely accept touch-free payments in-person, online, or over the phone, securely store and manage patient information with layered security and Level 1 PCI compliance.
Take advantage of a simpler, more transparent way to process your payments with competitive flat-rate pricing, provided exclusively through Stax. No additional fees or contracts required!Power your practice and get paid faster with simple, safe and secure payment solutions. Have questions? Schedule time to speak with a dedicated payment consultant to learn more.Click Below to Lear More Today:StaxPayments.com/burleson-seminars*** Go Premium: Members get early access, ad-free episodes, hand-edited transcripts, exclusive study guides, special edition books each quarter, powerpoint and keynote presentations and two tickets to Dustin Burleson's Annual Leadership Retreat.http://www.theburlesonbox.com/sign-up Stay Up to Date: Sign up for The Burleson Report, our weekly newsletter that is delivered each Sunday with timeless insight for life and private practice. Sign up here:http://www.theburlesonreport.com Follow Dustin Burleson, DDS, MBA at:http://www.burlesonseminars.com

The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.Post-arrest care and recovery are the final two links in the chain of survival.Identification of ROSC during CPR.Initial patient management goals after identifying ROSC.Indications for starting TTM.Monitoring the patient's core temperature.Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Chapters0:00 Identifying ROSC0:59 Additional ACLS Resources (https://passacls.com)1:05 Save on prescription meds (https://safemeds.vip)1:21 Post Arrest Assessment & Goals3:04 Indications & Initiation of TTM4:02 Two TTM Tips4:50 Share Pass ACLS on LinkedIn

Send us a textDr. Nicole Gensicke, a new vascular surgeon with St. Luke's and Physicians' Clinic of Iowa Vascular Surgery program, joins Dr. Arnold to talk about her background, clinical and personal interests, what led her to PCI and UnityPoint Health and much more.Patients experiencing vein issues may call (319) 368-8346 to schedule an appointment with Dr. Gensicke. This is another episode in a segment on the podcast called "New Clinician Spotlight." In these episodes, Dr. Arnold will sit down with new clinicians at UnityPoint Health - Cedar Rapids and get to know them as a clinician and as a person.Do you have a question about a trending medical topic? Ask Dr. Arnold! Submit your question and it may be answered by Dr. Arnold on the podcast! Submit your questions at: https://www.unitypoint.org/cedarrapids/submit-a-question-for-the-mailbag.aspxIf you have a topic you'd like Dr. Arnold to discuss with a guest on the podcast, shoot us an email at stlukescr@unitypoint.org.

DESCRIPTION Vanessa Cummings, Founder of Ms. V Consulting, discusses customer service, IPMI and college basketball. SPONSORS This episode is brought to you by Parking Today and the Parking Today Podcast Network. Learn more at parkingtoday.com/podcast. This episode is brought to you by Parker Technology, the customer experience solution of choice for the parking industry. Their solution puts a virtual ambassador in every lane, to help parking guests pay and get on their way in under a minute. Learn more at parkertechnology.com/parkingpodcast and subscribe to our podcast “Harder Than It Looks: Parking Uncovered.” This episode is brought to you by Scheidt & Bachman USA. Scheidt & Bachmann USA markets state-of-the-art Parking Solutions and Fare Collection Systems: the most innovative and advanced solutions in the US. Learn more at scheidt-bachmann-usa.com. This episode is brought to you by Breeze: Parking Concepts' digital platform that makes the parking experience a Breeze! For more than 50 years, PCI has been proactively managing parking & transportation operations with unparalleled integrity & service. Learn more at parkingconcepts.com. This episode is brought to you by Parkmobile. Parkmobile, a part of EasyPark Group, is the leading provider of smart parking and mobility solutions in North America, using a contactless approach to help millions of people easily find, reserve, and pay for parking on their mobile devices. Learn more about parkmobile.io. This episode is brought to you by Parkalytics. Parkalytics will take drone images of parking lots and/or on-street parking for a given time period and then upload those images into their parkalytics software. Within a matter of seconds, it will provide you parking counts, turnover studies, utilization studies, you name it. You can now wow your clients or supervisors by having a complete snapshot of the parking usage for a fraction of the price of a traditional parking study. Learn more at parkalytics.com. WEBSITES AND RESOURCES https://www.parkingcast.com/ https://parkingtoday.com/podcast/ www.parkertechnology.com/parkingpodcast scheidt-bachmann-usa.com parkingconcepts.com parkmobile.io parkalytics.com https://login.parking-mobility.org/contacts/vanessa-r-cummings https://www.linkedin.com/in/vanessa-r-cummings-m-div-ptmp-6a80054/ MERCH Check out some of our awesome parking themed t-shirts and other merch at parkingcast.com/swag. MUSEUM Check out some of our artifacts from the world's first parking museum at parkingcast.com/museum.

N Engl J Med 2017;377:2419-2432Background: A small fraction of patients with acute myocardial infarction (5-10%) have cardiogenic shock. These patients have a high baseline mortality. Early revascularization had been established as better than initial stabilization with medical therapy. Many patients with cardiogenic shock due to acute myocardial infarction (AMI) have multivessel disease. The question arises about whether to do culprit-only percutaneous coronary intervention (PCI) or more complete PCI at the time of the initial intervention.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock (CULPRIT-SHOCK) trial was designed to test the hypothesis that PCI of the culprit lesion only, with the option of staged revascularization of nonculprit lesions, would result in better clinical outcomes than immediate multivessel PCI among patients who have multivessel coronary artery disease and acute myocardial infarction with cardiogenic shock.Patients: The trial enrolled 706 patients with acute myocardial infarction (ST-segment elevation or non-ST-segment elevation) complicated by cardiogenic shock who had multivessel coronary artery disease. Cardiogenic shock was defined as SBP < 90 mmHg for more than 30 minutes or requiring pressors, clinical signs of pulmonary congestion, and signs of organ hypoperfusion (altered mental status, cold/clammy skin, oliguria, or lactate > 2 mmol/L).Exclusion criteria were extensive and designed to exclude patients with extremely poor prognosis: prolonged resuscitation, no intrinsic heart action, fixed dilated pupils, an indication for urgent CABG, a mechanical cause of shock, age > 90 years, massive pulmonary embolism, or severe renal insufficiency at baseline.Baseline Characteristics: The median age was 70 years, and approximately 75% were male. About 63% of patients had three-vessel disease. More than half the patients had ST-segment elevation myocardial infarction (about 62%), and anterior ST-segment elevation MI accounted for approximately 54% of these cases. About 53% of patients required resuscitation before randomization. The median left ventricular ejection fraction was between 30-33%.Procedures: In the culprit-lesion-only PCI group, only the culprit lesion was treated during the initial procedure, with staged revascularization encouraged based on residual ischemic lesions. In the multivessel PCI group, PCI of all major coronary arteries with >70% stenosis was performed, including attempts to recanalize chronic total occlusions. Crossover from the culprit-lesion-only PCI group to the multivessel PCI group occurred in 12.5% of patients, while crossover in the opposite direction happened in 9.4% of patients. The overall dose of contrast material was significantly higher and the duration of fluoroscopy significantly longer in the multivessel PCI group. Other interventional therapeutic measures were allowed, independent of the assigned treatment strategy.Endpoints: The primary endpoint was a composite of death from any cause or severe renal failure leading to renal-replacement therapy within 30 days after randomization. Secondary endpoints included the individual components of the primary endpoint, recurrent myocardial infarction, rehospitalization for heart failure, repeat revascularization, time to hemodynamic stabilization, catecholamine therapy duration, ICU stay duration, and measurements of renal and myocardial injury. Safety end points included bleeding, which was defined as type 2, 3, or 5 on the Bleeding Academic Research Consortium (BARC) scale.Trialists estimated an event rate of the composite primary endpoint of 38% in the culprit-only group vs 50% in the complete group. Using a global type I error level of 0.05, the authors calculated that a sample of 684 patients would give the trial 80% power to rule out the null hypothesis of no difference between the two treatment groups in the event rate for the primary end point.Results: At 30 days, the composite primary endpoint occurred in 45.9% of patients in the culprit-lesion-only PCI group versus 55.4% in the multivessel PCI group (relative risk, 0.83; 95% CI, 0.71 to 0.96; P=0.01). Death occurred in 43.3% of the culprit-lesion-only PCI group versus 51.6% of the multivessel PCI group (relative risk, 0.84; 95% CI, 0.72 to 0.98; P=0.03). The rate of renal-replacement therapy was 11.6% in the culprit-lesion-only PCI group and 16.4% in the multivessel PCI group (relative risk, 0.71; 95% CI, 0.49 to 1.03; P=0.07).Rates of recurrent myocardial infarction, rehospitalization for heart failure, bleeding, and stroke did not differ significantly between groups. Subgroup analyses showed consistent results across all prespecified subgroups. The time to hemodynamic stabilization, the use of catecholamine therapy and the duration of such therapy, the duration of the ICU stay, and the use of mechanical ventilation and the duration of such therapy also did not differ significantly between the two groups.Conclusion: In patients with myocardial infarction and cardiogenic shock, culprit-only PCI was superior to multivessel PCI. Both components of the primary endpoint, death and severe renal failure were lower in the culprit-only arm. The authors and editorialists speculate why these findings contrast with trials in hemodynamically stable myocardial infarction patients, where early multivessel PCI showed benefit over culprit-only PCI.If you accept the thesis that multi-vessel PCI was superior to culprit-only PCI in stable AMI patients, the likely reason for the disparate results are that patients with cardiogenic shock differ substantially from stable patients. The sicker patients with cardiogenic shock benefit from a less-is-more approach where culprit-only PCI reduces treatment harm relative to multivessel PCI.We at CardiologyTrials, however, find the evidence for complete revascularization in stable AMI patients less than clear. The COMPLETE trial found benefit from multivessel PCI over culprit-only, but both composite endpoints were driven largely by non-fatal MI. CV death was not substantially different. The difference in MI could have been related to excluding procedure-related MI.What's more, the FULL-REVASC trial, which also compared culprit-only and multivessel PCI, failed to replicate the COMPLETE trial results. In FULL-REVASC the rates of the composite primary outcome of death, MI or unplanned revascularization were not significantly different. Sadly, FULL-REVASC was stopped early when COMPLETE results were published, which led to a possible loss of power.It's possible, likely even, that the null results of CULPRIT-SHOCK are not really that disparate from prior trials in patients with more stable AMI.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

ST. PETERSBURG, FL - April 2025 - As the cloud communications sector embraces artificial intelligence (AI), BroadSource is stepping forward with a practical message for resellers: You can profit from AI — if you first help your customers solve data privacy challenges. Speaking with Technology Reseller News at the Cloud Communications Alliance's Cloud Connections 2025 event, Bill Placke, President of Americas for BroadSource, outlined how the company's SecureCall platform helps overcome a critical barrier to AI adoption. “Legal and compliance concerns around collecting personal data are slowing AI deployment,” said Placke. “Our SecureCall solution removes sensitive personal information like credit card or Social Security numbers at the time of collection — enabling safe and compliant AI use.” BroadSource's SecureCall product, which earned Cisco's Top 3 Global Innovation Award, enables secure data input during phone-based customer interactions. Customers input card details or other personal information directly, while the merchant remains on the call without hearing sensitive tones. Data is transmitted securely for processing, bypassing the merchant's internal systems and eliminating storage liability. With new PCI DSS 4.0 standards taking effect and global regulations such as GDPR and CCPA evolving, businesses face growing risks for non-compliance. Placke noted that SecureCall removes this burden from the enterprise. “Companies can rely on BroadSource's own PCI certification for compliance,” he said. “That means fewer headaches for IT and finance leaders — and real value for the reseller who delivers the solution.” BroadSource is expanding SecureCall's capabilities under the SecurePII brand to address broader categories of personal data. The goal is to create a foundation of data minimization, enabling enterprises to leverage AI and LLMs (large language models) without running afoul of data protection laws. Placke likens the opportunity to the 1840s Gold Rush: “AI is the gold. BroadSource is the pickaxe and blue jeans — the tools every prospector needs to get started.” For resellers navigating the fast-moving AI landscape, Placke advises aligning with customer priorities. “Cybersecurity is the top concern for IT leaders,” he said. “Look at breach points like passwords and explore solutions that offer more secure alternatives. When you bring customers practical AI tools with compliance built in, you're not just selling a service — you're building trust.” BroadSource also offers EMU CAPP, a behavioral analytics product that uses AI to monitor user behavior on BroadWorks platforms and detect anomalies, helping prevent toll fraud. “Resellers should lean in,” Placke concluded. “There's a real opportunity to lead by helping your customers adopt AI safely.” For more information, visit broadsource.com or secure-pii.com.

In this episode, Tyler and Brad discuss DMARC and how the latest version of the PCI framework requires phishing protection. You'll also learn about DMARC, DKIM, and SPF and how to elevate them to help protect your organization from attacks like Business Email Compromise (BEC).Blog: https://offsec.blog/Youtube: https://www.youtube.com/@cyberthreatpovTwitter: https://x.com/cyberthreatpov Spencer's Twitter: https://x.com/techspenceSpencer's LinkedIn: https://linkedin.com/in/SpencerAlessi Work with Us: https://securit360.com

DESCRIPTION Joe Galeas, CEO of Parking Solutions and Graham Haldeman, Vice President of Sales of Scheidt and Bachmann discuss culture, data and technology. SPONSORS This episode is brought to you by Parking Today and the Parking Today Podcast Network. Learn more at parkingtoday.com/podcast. This episode is brought to you by Parker Technology, the customer experience solution of choice for the parking industry. Their solution puts a virtual ambassador in every lane, to help parking guests pay and get on their way in under a minute. Learn more at parkertechnology.com/parkingpodcast and subscribe to our podcast “Harder Than It Looks: Parking Uncovered.” This episode is brought to you by Scheidt & Bachman USA. Scheidt & Bachmann USA markets state-of-the-art Parking Solutions and Fare Collection Systems: the most innovative and advanced solutions in the US. Learn more at scheidt-bachmann-usa.com. This episode is brought to you by Breeze: Parking Concepts' digital platform that makes the parking experience a Breeze! For more than 50 years, PCI has been proactively managing parking & transportation operations with unparalleled integrity & service. Learn more at parkingconcepts.com. This episode is brought to you by Parkmobile. Parkmobile, a part of EasyPark Group, is the leading provider of smart parking and mobility solutions in North America, using a contactless approach to help millions of people easily find, reserve, and pay for parking on their mobile devices. Learn more about parkmobile.io. This episode is brought to you by Parkalytics. Parkalytics will take drone images of parking lots and/or on-street parking for a given time period and then upload those images into their parkalytics software. Within a matter of seconds, it will provide you parking counts, turnover studies, utilization studies, you name it. You can now wow your clients or supervisors by having a complete snapshot of the parking usage for a fraction of the price of a traditional parking study. Learn more at parkalytics.com. WEBSITES AND RESOURCES https://www.parkingcast.com/ https://parkingtoday.com/podcast/ www.parkertechnology.com/parkingpodcast scheidt-bachmann-usa.com parkingconcepts.com parkmobile.io parkalytics.com MERCH Check out some of our awesome parking themed t-shirts and other merch at parkingcast.com/swag. MUSEUM Check out some of our artifacts from the world's first parking museum at parkingcast.com/museum.

Channel Partners Conference & Expo 2025 | Las Vegas "Be the trusted business advisor." That's the message from Ryan Henley, Chief Revenue Officer at NUSO, who joined Technology Reseller News publisher Doug Green live on the opening day of the Channel Partners 2025 expo. For years, Henley noted, MSPs have been encouraged to be “trusted technology advisors.” But at this year's show, NUSO is pushing for a shift—one that positions channel partners not just as tech experts, but as core strategic partners who help customers grow and protect their businesses. “It's not about selling software—it's about elevating the business,” said Henley. “Whether it's customer experience or compliance, we can help our partners deliver real business outcomes.” Helping MSPs Go Beyond the Stack NUSO offers a fully integrated service platform that includes: Omnichannel contact center solutions for both enterprise and informal CX environments Compliance tools to support HIPAA, PCI, and GDPR requirements A UCaaS foundation powered by NUSO's own telephony network What sets NUSO apart is ownership. All platform elements are built and operated in-house, offering MSPs a single partner with end-to-end accountability. “You've got one throat to choke, or one back to pat,” Henley quipped. “It simplifies support and strengthens the value MSPs can offer.” A Channel-Only Strategy As a 100% channel-focused company, NUSO is using its presence at Channel Partners to reinforce its commitment to resellers and service providers across North America and beyond. “We're here to help partners break out of the technology-only mindset,” said Henley. “By enabling them to deliver customer experience, compliance, and communications—under one roof—we're helping them transform into true business advisors.” Henley sees this evolution as essential in a changing market. “When you focus on the success of others, everyone wins,” he said. To learn more, visit nuso.cloud or stop by their booth if you're attending Channel Partners this week. Listen to the full podcast at TelecomReseller.com or on your favorite platform.

In this insightful episode, Dr. Burleson is joined by Blake Morgan, customer experience futurist and bestselling author of More is More: How the Best Companies Go Farther and Work Harder to Create Knock-Your-Socks-Off Customer Experiences. Blake shares powerful lessons from her book and real-world examples from top companies like One Medical and Amazon.Blake emphasizes that great customer experiences start with a strong internal culture and happy, well-equipped employees. The conversation explores how companies can differentiate in a sea of sameness by being relentlessly customer-centric—from streamlined operations to hiring for attitude and integrity.Healthcare professionals, especially those in elective care, will find actionable advice on improving patient experience, embracing digital transformation, and building engaged teams that thrive.What You'll Learn:Why customer experience starts with employee experience—and how culture drives profitabilityHow One Medical disrupts traditional healthcare through intentional design and empathyWhat Amazon gets right by being obsessively focused on the customerWhy logistics, technology, and internal efficiencies are the “invisible levers” of great serviceHow small business owners can lead by example and build service-oriented teamsHiring tips for identifying the “servant leaders” who elevate customer careHow to adapt to change and embrace disruption (with help from a surprising fish metaphor!) Resources & Mentions:More is More by Blake MorganThe Customer of the Future (Blake's upcoming book)The Employee Experience Advantage by Jacob MorganOne Medical, Amazon, and Ritz-Carlton customer experience examplesGallup research on employee engagementThe “CX Imperative” and the Mexican tetra fish—yes, really!Connect with Blake:

Send us a textWho knew that the breakthrough moment of AI sentience would come from interacting with an annoying neo-Luddite?After failing to raise a single dollar for PCI's newest initiative — the $350 billion Transdisciplinary Institute for Phalse Prophet Studies and Education (TIPPSE) —  Jason, Rob, and Asher devise the only profitable pitch for raising capital: using AI technology to cure the loneliness that technology itself causes. The only problem is that AI chatbots won't talk to us, as evidenced by Asher's experience of being blocked by an AI “friend.” So Asher turns to the flesh-and-blood author of Blood in the Machine, Brian Merchant, to discuss the rise of the neo-Luddite movement — the only people who might be able to stand your humble Crazy Town hosts. Brian Merchant is a writer, reporter, and author. He is currently reporter in residence at the AI Now Institute and publishes his own newsletter, Blood in the Machine, which has the same title as his 2023 book. Previously, Brian was the technology columnist at the Los Angeles Times and a senior editor at Motherboard.Originally recorded on 1/3/25 (warm-up conversation) and 3/24/25 (interview with Brian).Warning: This podcast occasionally uses spicy language.Sources/Links/Notes:Press Release announcing closure of TIPPSEFunding for FriendScreenshot of Asher's conversation with Friend's bot, FaithLyrics to “Not Going to Mars” by PyrrhonBrian Merchant's Substack, Blood in the MachineBrian's book, Blood in the Machine: The Origins of the Rebellion Against Big Tech  New York Times article on the Luddite Club: “‘Luddite' Teens Don't Want Your Likes”Crazy Town Episode 72: Sucking CO2 and Electrifying Everything: The Climate Movement's Desperate Dependence on Tenuous TechnologiesBrian's essay in The Atlantic, “The New Luddites Aren't Backing Down”Support the show

N Engl J Med 2005;353:1095-1104Background: Prior trials on revascularization in patients with acute coronary syndromes without ST-segment elevation have yielded mixed results. While FRISC II and TACTICS-TIMI 18 demonstrated a significant reduction in myocardial infarction, this benefit was not observed in RITA 3. None of these trials showed a significant reduction in mortality. Further research is needed to guide treatment strategies in this population, particularly after the introduction of early use of clopidogrel and intensive lipid-lowering therapy.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Invasive versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) trial sough to test the hypothesis that an early invasive strategy is superior to selective invasive strategy for patients with non-ST elevation myocardial infarction (NSTEMI).Patients: Eligible patients had to have all of the following: Worsening symptoms of ischemia or symptoms at rest with the last episode being 24 hours before randomization, elevated cardiac troponin T level (≥0.03 μg per liter); and either ischemic EKG changes (defined as ST-segment depression or transient ST-segment elevation exceeding 0.05 mV, or T-wave inversion of ≥0.2 mV in two contiguous leads) or a documented history of coronary artery disease.Patients were excluded if they were older than 80 years, had an indication for primary percutaneous coronary intervention or fibrinolytic therapy, hemodynamic instability or overt congestive heart failure, oral anticoagulant drugs use in the past 7 days, fibrinolytic treatment within the past 96 hours, percutaneous coronary intervention within the past 14 days, elevated bleeding risk, plus others.Baseline characteristics: The trial randomized 1,200 patients from 42 Dutch hospitals – 604 randomized to early invasive strategy and 596 randomized to selective invasive strategy.The average age of patients was 62 years and 74% were men. Approximately 39% had hypertension, 14% had diabetes, 35% had hyperlipidemia, 23% had prior myocardial infarction and 41% were current smokers.Approximately 48% of the patients had ST deviation equal to or greater than 0.1 mV.Procedures: Patients were randomly assigned in a 1:1 ratio to undergo early invasive vs selective invasive strategy.Patients received 300 mg of aspirin at the time of randomization, followed by at least 75 mg daily indefinitely, and enoxaparin (1 mg/kg for a maximum of 80 mg) subcutaneously twice daily for at least 48 hours. The early use of clopidogrel (300 mg immediately, followed by 75 mg daily) in addition to aspirin was recommended to the investigators after the drug was approved for acute coronary syndrome in 2002. Intensive lipid-lowering therapy, preferably atorvastatin 80 mg daily or the equivalent was recommended as soon as possible after randomization. All interventional procedures during the index admission were performed with the use of abciximab.Patients assigned to the early invasive strategy were scheduled to undergo angiography within 24 - 48 hours after randomization. Patients assigned to the selective invasive strategy underwent coronary angiography if they had refractory angina despite optimal medical therapy, hemodynamic or rhythm instability, or significant ischemia on pre-discharge exercise test.In both groups, percutaneous coronary intervention (PCI) was performed when appropriate, without providing more details in the manuscript.The level of creatine kinase MB was measured at 6-hour intervals during the first day, after each new clinical episode of ischemia, and after each percutaneous revascularization procedure.Endpoints: The primary endpoint was a composite of all-cause death, myocardial infarction, or rehospitalization for angina at 1-year.The estimated sample size to provide 80% power to detect 25% relative risk difference between the two treatment groups at 5% alpha was 1,200 patients. This assumed that 21% of the patients in the early invasive arm would experience the primary outcome.Results: During the index admission, 98% of the patients in the early invasive strategy arm underwent coronary angiogram compared to 53% in the selective invasive arm. At 1-year, 79% of the patients in the early invasive strategy arm underwent revascularization compared to 54% in the selective invasive arm.The primary outcome was not significantly different between both treatment groups (22.7% with early invasive vs 21.2% with selective invasive, RR: 1.07; 95% CI: 0.87 - 1.33; p= 0.33). All-cause death was the same in both groups (2.5%). Myocardial infarction was significantly higher with the early invasive strategy (15.0% vs. 10.0%, RR: 1.50, 95% CI: 1.10 – 2.04; p= 0.005), while rehospitalization for angina was lower with early invasive (7.4% vs. 10.9%, RR: 0.68, 95% CI: 0.47 – 0.98; p= 0.04). Most myocardial infarctions were revascularization related and these were significantly more frequent with early invasive (11.3% vs 5.4%). Spontaneous myocardial infarctions were 3.7% with early invasive and 4.6% with selective invasive and this was not statistically significant.Major bleeding, not related CABG, during the index admission was more frequent with the early invasive strategy (3.1% vs 1.7%).There were no significant subgroup interactions for the primary outcome, including based on ST deviation and troponin levels.Conclusion: In patients with NSTEMI, an early invasive strategy was not superior to selective invasive strategy in reducing the composite endpoint of all-cause death, myocardial infarction, or rehospitalization for angina at 1-year. An early invasive strategy was associated with more myocardial infarctions with a number needed to harm of 20 patients, which was secondary to revascularization related myocardial infarction. An early invasive strategy reduced rehospitalization for angina with a number needed to treat of approximately 29 patients.The ICTUS trial showed that revascularization can cause harm and highlighted how counting procedural myocardial infarctions can influence outcome estimates. While there is ongoing debate about the significance of periprocedural myocardial infarctions, evidence indicates an association with increased mortality. Whether periprocedural myocardial infarctions are 'less severe' than spontaneous myocardial infarctions remains controversial, as their impact varies based on infarct size and patient characteristics. This underscores the importance of including all-cause mortality or advanced systolic heart failure as endpoints in trials of revascularization.Patients in ICTUS received better background medical therapy compared to prior trials in this area. While this could be responsible for the divergent results compared to other prior trials. It also highlights the heterogeneity of NSTEMI patients and that an invasive strategy is not appropriate for all.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Stopping oral anticoagulation after AF ablation, the core problem with paradoxes like the smoker's paradox, chronic total occlusion PCI, and an ACC/EHRA preview are discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Oral Anticoagulation after Successful AF Ablation Iwawakie et al https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831851 OCEAN protocol paper https://doi.org/10.1016/j.ahj.2017.12.007 II Smoker's Paradox Presch et al https://www.jacc.org/doi/10.1016/j.jcin.2024.12.028 Gupta et al https://doi.org/10.1161/JAHA.116.003370 III CTO PCI Main sub-analysis paper Bangalore et al https://doi.org/10.1016/j.jacc.2025.01.029 DECISION CTO https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.031313 Main EURO CTO trial https://doi.org/10.1093/eurheartj/ehy220 3-year MACE of EURO CTO https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-comparing-revascularization-and-optimal-medical-therapy-for-chronic-total-coronary-occlusions EXPLORE https://www.jacc.org/doi/abs/10.1016/j.jacc.2016.07.744 ISCHEMIA CTO https://www.clinicaltrials.gov/study/NCT03563417   IV ACC and EHRA Preview Mandrola's 5 Trials to Look for at the 2025 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/mandrolas-5-trials-look-2025-american-college-cardiology-2025a10006zu You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal. References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309

CardioNerds (Dr. Rick Ferraro and Dr. Dan Ambinder) join Dr. Sri Mandava, Dr. David Meister, and Dr. Marissa Donatelle from the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami. Expert commentary is provided by Dr. Pranav Venkataraman.   They discuss the following case involving a patient with cardiac sarcoidosis presenting as STEMI:  A 57-year-old man with a history of hyperlipidemia presented with sudden onset chest pain. On admission, he was vitally stable with a normal cardiorespiratory exam but appeared in acute distress and was diffusely diaphoretic. His ECG revealed sinus rhythm, a right bundle branch block (RBBB), and ST elevation in the inferior-posterior leads. He was promptly taken for emergent cardiac catheterization, which identified a complete thrombotic occlusion of the mid-left circumflex artery (LCX) and large obtuse marginal (OM) branch, with no underlying coronary atherosclerotic disease. Aspiration thrombectomy and percutaneous coronary intervention (PCI) were performed, with one drug-eluting stent placed. An echocardiogram showed a left ventricular ejection fraction (EF) of 31%, hypokinesis of the inferior, lateral, and apical regions, and an apical left ventricular thrombus. The patient was started on triple therapy. A hypercoagulable workup was negative. A cardiac MRI was obtained to further evaluate non-ischemic cardiomyopathy. In conjunction with a subsequent CT chest, the results raised suspicion for cardiac sarcoidosis with systemic involvement. In view of a reduced EF and significant late-gadolinium enhancement, electrophysiology was consulted to evaluate for ICD candidacy. A decision was made to delay ICD implantation until a definitive diagnosis of cardiac sarcoidosis could be established by tissue biopsy. The patient was started on HF-GDMT and discharged with a LifeVest. Close outpatient follow-up with cardiology and electrophysiology was arranged.  US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Cardiac Sarcoidosis Presenting as STEMI Cardiac sarcoidosis can present with a variety of symptoms, including arrhythmias, heart block, heart failure, or sudden cardiac death. Symptoms can be subtle or mimic other cardiac conditions.  Conduction abnormalities, particularly AV block or ventricular arrhythmias, are common and may be the initial indication of cardiac involvement with sarcoidosis.  The additive value of Echocardiography, FDG-PET, and cardiac MR is indispensable in the diagnostic workup of suspected cardiac sarcoidosis.  Specific role of MRI/PET: Both cardiac MRI and FDG-PET provide a complementary role in the diagnosis of cardiac sarcoidosis. Cardiac MRI is an effective diagnostic screening tool with fairly high sensitivity but is limited by its inability to decipher inflammatory (“active” disease) versus fibrotic myocardium. FDG-PT helps to make this discrimination, refine the diagnosis, and guide clinical management. Ultimately, these studies are most useful when interpreted in the context of other clinical information.  Primary prevention of sudden cardiac death in cardiac sarcoidosis focuses on risk stratification, with ICD placement for high-risk patients. For patients awaiting definitive diagnosis, a LifeVest may be used as a temporary measure to protect from sudden arrhythmic events until an ICD is placed.  Notes - Cardiac Sarcoidosis Presenting as STEMI 1. Is STEMI always a result of coronary artery disease?  By definition, a STEMI is an acute S-T segment elevation myocardial infarction. This occurs when there is occlusion of a major coronary artery, which results in transmural ischemia and damage,

Listener feedback on asymptomatic aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR), coronary artery calcium (CAC), and revascularization for patients with ischemic LV dysfunction are discussed by John Mandrola, MD, in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Aortic Valve Intervention for Asymptomatic AS Asymptomatic Aortic Stenosis: “Time to Act” or Not So Fast? https://www.medscape.com/viewarticle/asymptomatic-aortic-stenosis-time-act-or-not-so-fast-2025a10005o9 EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec Reddy et al: https://doi.org/10.1016/j.jacc.2024.12.031 Wallach editorial https://doi.org/10.1016/j.jacc.2025.01.020 Guerrero https://www.tctmd.com/slide/tavr-young-patients-current-treatment-patterns-us II CAC - Coronary Artery Calcium Coronary Artery Calcium Testing—Too Early, Too Late, Too Often https://jamanetwork.com/journals/jamacardiology/fullarticle/2830950 CAUGHT-CAD https://jamanetwork.com/journals/jama/fullarticle/2831115 III CABG, PCI or Meds for Ischemic LV Dysfunction STICH https://www.nejm.org/doi/full/10.1056/NEJMoa1100356 STICHES https://www.nejm.org/doi/full/10.1056/NEJMoa1602001 REVIVED BCIS https://www.nejm.org/doi/full/10.1056/NEJMoa2206606 EHJ paper https://doi.org/10.1093/eurheartj/ehaf080 IV Preview https://www.medscape.com/viewarticle/shed-lead-and-injuries-should-cath-labs-go-lead-free-2024a1000hnb You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net