Podcasts about pisa italy

With Giovanni Donato Aquaro, University of Pisa - Italy, and Carmelo De Gori, Fondazione Monasterio, Pisa - Italy. Link to editorial Link to paper  

"We are near the Leaning Tower in Pisa (Italy). The ambient sounds plunged me into the heart of the hubbub, the perpetual movement linked to the passages, arrivals, comings and goings of tourists ... People go, walk, move, run. Rush? Maybe they stop and look, listen. Or not. Yes, the steps of life. "I stayed on this idea of ​​infinite movements, of life, words, times and spaces that move, cross and intersect. An organic movement of intermingled voices and noises. A kind of sound vision of this energy disappearing around the monument. Like a memory or rather an internal perception of the "chaos of the crowd" or the "noise of the Tower", a "noise of heritage"." Tower of Pisa piazza reimagined by Philippe Neau. ——————— This sound is part of the Sonic Heritage project, exploring the sounds of the world's most famous sights. Find out more and explore the whole project: https://www.citiesandmemory.com/heritage

As a Bajan Author, Cultural Theoretician, License Cultural Practitioner and Photojournalist I agree with creative-photographer.comthat black and white photography offers a unique perspective and artistic interpretation. It enhances lighting and shadow contrast, conveys emotion, and transports readers to specific times; And headshotlondon.co.uk that Black and white photography holds a deeper resonance and authenticity.The Beauty of Texture in A Bajan's Black and White Photography© 2024 is a genre that explores photography principles, culture, texture theories, with 32 global historic iconic landmarks. The Beauty of Texture in A Bajan's Black and White Photography© 2024 explores photography principles, culture, texture theories, and architectural, ecological, and natural awareness of 32 global historic iconic landmarks.This text explores photo-analysis, culture, beauty, and texture theories in photography, focusing on photography principles like rule of thirds, leading lines, symmetry, balance, and framing. It also explores beauty and texture in photography, highlighting how lighting and texture influence the perceived texture of scenes.Podcast 184 The Beauty of Texture in A Bajan's Black and White Photography© 2024 ISBN978-976-97267-6-5 First  Edition © 2024 All rights reserved. Was filmed by  William Anderson Gittens of Devgro Media Arts Services®2015On LocationRegarding The following-A Giant Basilica in Barcelona Spain by Antoni Gaudí, The Bust of Asdrúbal in Cartagena, A Bajan Fisherman Casting A Net, Brownes Beach Barbados,Buckingham Palace UK, Capernaum Israel, Castel Nuovo, Naples, Civitavecchia Rome, Ephesus Turkey,Farley Hill Barbados,Gibraltar,Hadrian's Arch Athens,New Jersey City University New Jersey,Leaning Tower of Pisa Italy,Little Bay Barbados,Marble statue of Jesus Christ and Saint Veronica Notre-Dame de la Garde Marseille, Mykonos Greece,Nova Carthago Naples,Pico Teneriffe  Barbados, Rapallo, Rhodes Island, Santorini Greece,Shhhh Statue Notre-Dame de la Garde Marseille, Saint Anne's Church Barbados,Sunset at Kusadasi Port, Turkey,The 'Homeless Jesus' Statue Caparnaum on the Sea of Galilee, Israel,The Acropolis of Athens,The Astronomical Clock of Messina, The Church of The Beatitudes the Sea of Galilee near Tabgha and Capernaum in Israel ,The Colosseum Rome, and The Courtyard of Limassol Castle in CyprusI wish to express gratitude to the Creator for guiding them and their late parents, Charles and Ira Gittens, for their guidance and creative expression.  Thanks to those who assisted me along this journey namely my Beloved wife Magnola Gittens, my Brothers Shurland, Charles, Ricardo, Arnott, Stephen, Sisters Emerald, Marcella, Cheryl, Cousins Joy Mayers, Kevin and Ernest Mayers, Donna Archer, Avis Dyer, Jackie Clarke, Uncles Clifford, Leonard Mayers, David Bruce, Collin Rock. My children Laron and Lisa.  Well-wishers Mr.and Mrs. Andrew Platizky, Mr. Matthew Sutton, Mr.& Mrs. Gordon Alleyne, Mr. Juan Arroyo, Mr. and Mrs. David Lavine, Mrs. Ellen Gordon, Dr.Nicholas Gordon, the late Dr.Joseph Drew, Merline Mayers, Mr. and Mrs. Trevor Millington, Rev. Dr. Scofield EverslSupport the showThis theoretical conversation explored the historical context of Christianity's doctrine of creation. It is important to note that these doctrines are global citizens religious principles, while the theories are conclusions based on accumulated evidence focusing on Genesis 1:1 and Revelation 1:8, addressing debates on creation days, earth's age, and evolution. The research indicates that Jesus' statements affirm God's independence and faith, as depicted in the discourse "Doctrine Is Part of The Christian Culture" ©2024 ” captured in publication 317 and ventilated in ISBN978-976-97146-9-4and framed in podcast 177

Speaker: Elisa Cencig (Norges Bank Investment Management)Cambridge 3CL invites you to a seminar on the responsible investment strategies of Norges Bank Investment Management (NBIM), the entity responsible for managing Norway's government pension fund, valued at over 1 trillion US dollars. Operating in over 70 countries, NBIM is at the forefront of shaping sustainable and fair market practices globally. This session will delve into NBIM's role in policy-making and standard setting, highlighting its commitment to responsible stewardship.The focus will be on NBIM's active investment approach across various levels - from market-wide initiatives to individual company engagements. NBIM works to ensure long-term growth in its investments while minimizing environmental and societal harm, through direct company engagement, goal setting, and strategic voting at shareholder meetings. Key topics like climate change action, responsible AI practices, and CEO compensation will be discussed, showcasing NBIM's dedication to guiding global investments towards ethical and sustainable outcomes.Leading this session is Elisa Cencig, Senior ESG Policy Advisor at NBIM. Her expertise will provide a comprehensive view into how a major global investor like NBIM navigates the complexities of responsible investment.Biography: Elisa is Senior ESG Policy Advisor at Norges Bank Investment Management, where she is responsible for the fund's engagement with international organisations, standard-setters and policymakers on sustainability, responsible investment and corporate governance. Prior to that, she worked at the UK Financial Authority, first on EU Withdrawal Policy and Strategy and more recently leading the FCA's engagement at the Financial Stability Board. Earlier in her career, she worked at the Association of Financial Markets in Europe's Brussels office on prudential and resolution policy and advocacy. She is an alumna of the Sant'Anna School of Advanced Studies in Pisa (Italy) and the College of Europe (Belgium) and holds a PhD in Political Science from the London School of Economics.3CL runs the 3CL Travers Smith Lunchtime Seminar Series, featuring leading academics from the Faculty, and high-profile practitioners.For more information see the Centre for Corporate and Commercial Law website:http://www.3cl.law.cam.ac.uk/

Speaker: Elisa Cencig (Norges Bank Investment Management)Cambridge 3CL invites you to a seminar on the responsible investment strategies of Norges Bank Investment Management (NBIM), the entity responsible for managing Norway's government pension fund, valued at over 1 trillion US dollars. Operating in over 70 countries, NBIM is at the forefront of shaping sustainable and fair market practices globally. This session will delve into NBIM's role in policy-making and standard setting, highlighting its commitment to responsible stewardship.The focus will be on NBIM's active investment approach across various levels - from market-wide initiatives to individual company engagements. NBIM works to ensure long-term growth in its investments while minimizing environmental and societal harm, through direct company engagement, goal setting, and strategic voting at shareholder meetings. Key topics like climate change action, responsible AI practices, and CEO compensation will be discussed, showcasing NBIM's dedication to guiding global investments towards ethical and sustainable outcomes.Leading this session is Elisa Cencig, Senior ESG Policy Advisor at NBIM. Her expertise will provide a comprehensive view into how a major global investor like NBIM navigates the complexities of responsible investment.Biography: Elisa is Senior ESG Policy Advisor at Norges Bank Investment Management, where she is responsible for the fund's engagement with international organisations, standard-setters and policymakers on sustainability, responsible investment and corporate governance. Prior to that, she worked at the UK Financial Authority, first on EU Withdrawal Policy and Strategy and more recently leading the FCA's engagement at the Financial Stability Board. Earlier in her career, she worked at the Association of Financial Markets in Europe's Brussels office on prudential and resolution policy and advocacy. She is an alumna of the Sant'Anna School of Advanced Studies in Pisa (Italy) and the College of Europe (Belgium) and holds a PhD in Political Science from the London School of Economics.3CL runs the 3CL Travers Smith Lunchtime Seminar Series, featuring leading academics from the Faculty, and high-profile practitioners.For more information see the Centre for Corporate and Commercial Law website:http://www.3cl.law.cam.ac.uk/

Photo: No known restrictions on publication. @Batchelorshow TONIGHT: The show starts in Maui's firestor and ranges to the nuclear fire deteriorating at ZNPP.  Looking in on Lancastaer County, PA and Pisa, Italy.  Talk about the new Omicron variant moving quickly ahead of a vaccine.And mre on the 17th Century revolutions in Mother Britain.

January 4: Saint Elizabeth Ann Seton, Religious (U.S.A.)1774–1821Optional Memorial; Liturgical Color: WhitePatron Saint of Catholic schools, widows, loss of parentsShe had it all, lost it all, and then found it all againIn late 1803, Elizabeth Ann Seton, with her husband, left the United States for Italy, as a confident, high-born, wealthy, educated Yankee Protestant. She returned in June 1804, bankrupt, a widow, burning with love for the Holy Eucharist, tenderly devoted to Mary, and with the heart of a Roman Catholic. She was received into the Church the next year. Her upper-class friends and family abandoned her out of anti-Catholic spite.Our saint was an unexpected convert. She was, well into adulthood, a serious U.S. Episcopalian. She loved the Lord. She loved the Bible. She loved to serve the poor and the sick. Her excellent Episcopalian upbringing provided sufficient preparation for not being Episcopalian any longer. She took that faith as far as it could go. She probably never suspected her faith was lacking until she experienced the abundance of Catholicism. After her husband died of tuberculosis in Pisa Italy, Elizabeth and her daughter were taken in by family friends from nearby Livorno. In God's providence, this Italian family lived their faith with relish. Elizabeth was not only consoled and cared for by them in her grief but also saw how engrossing their faith was. The longer she stayed in Italy, the more its Catholic atmosphere enveloped her. She wept at Italians' natural devotion to Mary. She wondered at the beauty of a Corpus Christi procession through the narrow streets of her town. She understood the Holy Father's link to the early Apostles with clarity. And so she came to see the gaps in her native religion. She hadn't noticed them before. Having seen the real thing with her own eyes, she knew that she held a replica in her hands. The real presence of Christ in Catholicism is often understood only after a real absence is felt in non-Catholic Christianity.After her conversion, Elizabeth spent the rest of her short life dedicated to Catholic education. She started a Congregation of sisters in Maryland that taught girls, especially poor girls who could not afford an education. She was the first of tens of thousands of teaching sisters to operate Catholic schools in the United States. She is rightly considered in the United States as the foundress of Catholic parochial education. Besides her husband, she also lost two of her five children during her lifetime. She struggled, like all founders, to build up her Congregation. But her intelligence, charm, and drive paid off. Her Order thrived and thrives still. The Daughters of Charity of St. Vincent de Paul gather each year on this feast near her tomb inside an immense Basilica in Northern Maryland to thank God for their foundress, for a life so well lived.Saint Elizabeth Ann Seton, help us overcome the alienation of family due to our religious convictions. Aid us in persevering through the hardships of illness and death, and give us the same zeal for souls that you showed toward your students, seeing in each one the image of God.

Guests featured in this episode: Nadia Urbinati, the Kyriakos Tsakopoulos Professor of Political Theory at Columbia University. She is also a permanent visiting professor at the Scuola Superiore Sant'Anna in Pisa (Italy), and has taught at Bocconi University Milan (Italy), Sciences Po Paris (France) and the UNICAMP University (Brazil). Her main fields of expertise are modern and contemporary political thought and the democratic, as well as anti-democratic traditions. GLOSSARYWhat is the People's Party?(13:05 or p.4 in the transcript)The People's Party: (also known as the Populist Party) was an important political party in the United States of America during the late nineteenth century. The People's Party originated in the early 1890s. It was organized in Kansas, but the party quickly spread across the United States. It drew its members from Farmers' Alliances, the Grange, and the Knights of Labor. Originally, the Populists did not form a national organization, preferring to gain political influence within individual states. The Populist Party consisted primarily of farmers unhappy with the Democratic and Republican Parties. The Populists believed that the federal government needed to play a more active role in the American economy by regulating various businesses, especially the railroads. In particular, the Populists supported women's suffrage the direct election of United States Senators. They hoped that the enactment women's suffrage and the direct election of senators would enable them to elect some of their members to political office. Populists also supported a graduated income tax, government ownership of the railroads, improved working conditions in factories, immigration restrictions, an eight-hour workday, the recognition of unions, and easier access to credit. source What is the Reconstruction?(13:10 or p.4 in the transcript)Reconstruction: in U.S. history, the period (1865–77) that followed the American Civil War and during which attempts were made to redress the inequities of slavery and its political, social, and economic legacy and to solve the problems arising from the readmission to the Union of the 11 states that had seceded at or before the outbreak of war. Long portrayed by many historians as a time when vindictiveRadical Republicans fastened Black supremacy upon the defeated Confederacy, Reconstruction has since the late 20th century been viewed more sympathetically as a laudable experiment in interracial democracy. Reconstruction witnessed far-reaching changes in America's political life. At the national level, new laws and constitutionalamendments permanently altered the federal system and the definition of American citizenship. In the South, a politically mobilized Black community joined with white allies to bring the Republican Party to power, and with it a redefinition of the responsibilities of government. source What is austerity?(16:23 or p.4 in the transcript)Austerity: (also called austerity measures) is a set of economic policies, usually consisting of tax increases, spending cuts, or a combination of the two, used by governments to reduce budget deficits. Austerity measures can in principle be used at any time when there is concern about government expenditures exceeding government revenues. Often, however, governments delay resorting to such measures because they are usually politically unpopular. Instead, governments tend to rely on other means—for example, deficit financing, which involves borrowing from financial markets—to mitigate budget deficits in the short run, a decision that usually necessitates the adoption of harsher austerity measures in the long run. source What is universal suffrage?(18:32 or p.5 in the transcript)Universal suffrage: generally understood as the right to vote for political representatives conferred to almost all adult citizens or residents, regardless of their social status, property, knowledge, religion, race, gender, or other similar qualifications. The principle of universal suffrage, together with principles of equal, free, secret, and direct suffrage, present fundamental principles of elections common to all democracies around the world. Universal suffrage is one of two historically developed concepts of the suffrage—consisting of the right to vote and the right to stand for election. The other one, a concept contrary to universal suffrage, can be denominated as so-called limited suffrage. The concept of limited suffrage, preferred until the nineteenth century, was based on the exclusion of a large number of people from the suffrage. It was done based on social status, property, knowledge, religion, race, or gender. source  Democracy in Question? is brought to you by:• Central European University: CEU• The Albert Hirschman Centre on Democracy in Geneva: AHCD• The Podcast Company: Novel Follow us on social media!• Central European University: @CEU• Albert Hirschman Centre on Democracy in Geneva: @AHDCentreSubscribe to the show. If you enjoyed what you listened to, you can support us by leaving a review and sharing our podcast in your networks! 

With Filippo Cademartiri & Alberto Clemente, Fondazione Toscana "Gabriele Monasterio", Pisa - Italy. Link to paper Link to editorial

Matt of @wesaygravy and Mike of @banderas_mkt are joined by special guest cakesbymike_90. Mike is the Pastry Chef at @j.paceandson in Saugus, MA. Mike moved to the States from Pisa Italy when he was 21. We dig into his favorite italian food spots around Boston, what life was like in Italy, his thoughts on American Pizza vs Italy Pizza, and much more!

January 4: Saint Elizabeth Ann Seton, Religious (U.S.A.)1774–1821Optional Memorial; Liturgical Color: WhitePatron Saint of Catholic schools, widows, loss of parentsShe had it all, lost it all, and then found it all againIn late 1803, Elizabeth Ann Seton, with her husband, left the United States for Italy, as a confident, high-born, wealthy, educated Yankee Protestant. She returned in June 1804, bankrupt, a widow, burning with love for the Holy Eucharist, tenderly devoted to Mary, and with the heart of a Roman Catholic. She was received into the Church the next year. Her upper-class friends and family abandoned her out of anti-Catholic spite.Our saint was an unexpected convert. She was, well into adulthood, a serious U.S. Episcopalian. She loved the Lord. She loved the Bible. She loved to serve the poor and the sick. Her excellent Episcopalian upbringing provided sufficient preparation for not being Episcopalian any longer. She took that faith as far as it could go. She probably never suspected her faith was lacking until she experienced the abundance of Catholicism. After her husband died of tuberculosis in Pisa Italy, Elizabeth and her daughter were taken in by family friends from nearby Livorno. In God's providence, this Italian family lived their faith with relish. Elizabeth was not only consoled and cared for by them in her grief but also saw how engrossing their faith was. The longer she stayed in Italy, the more its Catholic atmosphere enveloped her. She wept at Italians' natural devotion to Mary. She wondered at the beauty of a Corpus Christi procession through the narrow streets of her town. She understood the Holy Father's link to the early Apostles with clarity. And so she came to see the gaps in her native religion. She hadn't noticed them before. Having seen the real thing with her own eyes, she knew that she held a replica in her hands. The real presence of Christ in Catholicism is often understood only after a real absence is felt in non-Catholic Christianity.After her conversion, Elizabeth spent the rest of her short life dedicated to Catholic education. She started a Congregation of sisters in Maryland that taught girls, especially poor girls who could not afford an education. She was the first of tens of thousands of teaching sisters to operate Catholic schools in the United States. She is rightly considered in the United States as the foundress of Catholic parochial education. Besides her husband, she also lost two of her five children during her lifetime. She struggled, like all founders, to build up her Congregation. But her intelligence, charm, and drive paid off. Her Order thrived and thrives still. The Daughters of Charity of St. Vincent de Paul gather each year on this feast near her tomb inside an immense Basilica in Northern Maryland to thank God for their foundress, for a life so well lived.Saint Elizabeth Ann Seton, help us overcome the alienation of family due to our religious convictions. Aid us in persevering through the hardships of illness and death, and give us the same zeal for souls that you showed toward your students, seeing in each one the image of God.

Dr. Sonia Grego, Ph.D. is Associate Research Professor in the Department of Electrical and Computer Engineering, at Duke University (https://ece.duke.edu/faculty/sonia-grego). Dr. Grego is also the Founding Director of the Duke Smart Toilet Lab (https://smarttoilet.pratt.duke.edu/), dedicated to the opportunities that data-rich human excreta offer to improve individual and public health. The objective of the organization is to empower individuals and groups in communal living with health information for early warning of disease, health and wellness, and management of chronic diseases through wastewater analysis, without any changes of daily habits. Dr. Grego is passionate about the opportunities that advanced sanitation technologies offer to improve global health and to provide a paradigm shift in health screening both for individuals and for communities. A major project of Dr. Grego's research portfolio over the past 5 years, she has led the field testing of 10+ onsite sanitation technology prototypes from multiple organizations in international settings. She has managed year long deployments of sophisticated chemo-mechanical systems with electronic monitoring connected to wastewater pipes of buildings, ensuring no disruption of service to users while evaluating the treatment process performance. Dr. Grego has an M.S. from Università di Pisa (Italy) and a Ph.D. from University of Copenhagen (Denmark). Dr. Grego has also founded Coprata Inc. (https://coprata.com/) to commercialize technologies developed at Duke University, to detect or manage acute and chronic gastrointestinal diseases, provide early warning of infectious disease and monitor personalized wellness.

Travel: Genoa, Lucca, Pisa (Italy, Solo Traveling, La Dolce Vita) by Bold Perceptions

With Danilo Neglia & Riccardo Liga, University of Pisa - Italy. Link to paper Link to editorial

In part 2, we chat with Keith Shiban about flying combat operations during Operation Desert Storm in 199 and flying in the first wave of B-52 low-level attacks against Iraqi targets on night one of Desert Storm. We also chat about flying the KC-135 with the 121st Air Refueling Wing, Ohio Air National Guard conducting combat operations during Operation Joint Forge (Bosnia) from Istres France and Pisa Italy.

With Ernesto Schiffrin McGill, University of Montreal - Canada & Stefano Taddei, University of Pisa - Italy   Link to paper Link to editorial

Andrew Tilling shares a very personal and honest story of losing his way in life only to find it again by coaching and helping others to manage change

We landed in Pisa en route to Cinque Terre, so we took the time to walk around the city for a bit. Of course, we hit the Leaning Tower of Pisa, drank some Italian wine and had some delicious pizza! We will be back one day, but we defintitely enjoyed the few hours that we had in the city. Enjoy! www.365daysoftravel.com www.facebook.com/365daysoftravelproject IG: @365daysoftravelproject twitter:@365daysoftravel  

Dr Carolyn Lam:                Welcome to Circulation On The Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore.                                                 This week's journal features two papers. One a research letter and the second an original article, both focusing on the effect of ionizing radiation on interventional cardiologists. I'm sure that cuts close to the heart, so please stay tuned. Coming up right after these summaries.                                                 The first two original articles in this week's journal describe a metabolic adaptation that is good for the abnormal cell but bad for the patient. This is a shift in glucose metabolism called the Warburg phenomenon where there is failure of two fundamental pathways. Number one glucose metabolism and number two mitochondrial oxygen sensing. This Warburg phenomenon enables a reliance on glycolysis despite an abundance of available oxygen. These two circulation articles uncover new players in the Warburg phenomenon, both in the setting of pulmonary arterial hypertension. One in the pulmonary arterial endothelial cells, and the second in fibroblasts.                                                 In the first paper, first and corresponding author Dr. Caruso and co-corresponding author Dr. Morrell from the University of Cambridge examined the microRNA and proteomic profiles of blood outgrowth endothelial cells from patients with heritable pulmonary arterial hypertension due to mutations in the bone morphogenetic protein receptor type two, or BMPR2 gene, and in patients with idiopathic pulmonary arterial hypertension. They demonstrated that reduced expression of microRNA-124 in pulmonary arterial hypertension endothelial cells was responsible for the dysregulation of the splicing factor polypyrimidine tract binding protein 1, and its target pyruvate kinase M2 or PKM2, which is a major regulator of glycolysis and which contributes to abnormal cell proliferation. Reduced BMPR2 levels were associated with reduced microRNA-124 expression.                                                 In the second paper first author Dr. Zhang, corresponding author Dr Stenmark and colleagues from the University of Colorado studied pulmonary adventitial fibroblasts isolated from cows and humans with severe pulmonary hypertension. PKM2 inhibition reversed the glycolytic status of pulmonary hypertension fibroblasts, decreased their cell proliferation and attenuated macrophage interleukin beta expression.                                                 Normalizing the PKM2 to M1 ratio in pulmonary hypertension fibroblasts by using microRNA-124 over expression, or by PTBP1 knockdown, reversed the glycolytic phenotype, rescued mitochondrial reprogramming and decreased cell proliferation. Finally, pharmacological manipulation of PKM2 activity or treatment with histone deacetylase inhibitors produced similar results. These findings provide new avenues for the treatment of pulmonary arterial hypertension and are discussed in an accompanying editorial by Stephen Archer from Queen's University in Ontario Canada.                                                 The next paper tells us that the addition of ezetimibe to simvastatin in patients stabilized after acute coronary syndrome reduces the frequency of ischemic stroke, with a particularly large effect seen in patients with a prior stroke. First and corresponding author Dr. Bohula and colleagues from the TIMI study group investigated the efficacy of the addition of ezetimibe to simvastatin for prevention of stroke in the IMPROVE-IT trial where post ACS patients were randomized to placebo and simvastatin or ezetimibe and simvastatin and followed for a median of six years.                                                 The current study focused on patients with a history of stroke prior to randomization. The authors found that the addition of ezetimibe to simvastatin reduced the frequency of ischemic stroke with a hazards ratio of 0.79, with a particularly large effect seen in patients with a prior stroke, where the hazards ratio was 0.52, compared to patients without a prior stroke where the hazards ratio was 0.84. Hemorrhagic strokes were rare and a non significant increase in hemorrhagic stroke was observed with the addition of ezetimibe. Thus, the authors concluded that it is reasonable to consider the addition of ezetimibe, a generic lipid lowering therapy with an acceptable safety profile, to a moderate to high intensity statin regimen for the prevention of ischemic stroke in patients with established ischemic heart disease, with or without a prior stroke.                                                 Atrial fibrillation is the most common sustained arrhythmia in hypertrophic cardiomyopathy, but the influence of atrial fibrillation on clinical course and outcomes in hypertrophic cardiomyopathy had remained incompletely resolved. That is until today's paper in circulation. First and corresponding author Dr. Rowin and colleagues from Tufts Medical Center accessed the records of 1,558 consecutive patients followed at the Tufts Medical Center hypertrophic cardiomyopathy institute for an average of 4.8 years from 2004 to 2014.                                                 20% of patients had episodes of atrial fibrillation, of which 74% were confined to symptomatic paroxysmal atrial fibrillation, while 26% developed permanent atrial fibrillation. They found that the timing and frequency of paroxysmal atrial fibrillation events were unpredictable with an average two year interval between the first and second symptomatic episodes but progressing to permanent atrial fibrillation uncommonly. They further found that atrial fibrillation was not a major contributor to heart failure morbidity, nor a cause of arrhythmic sudden death, and when atrial fibrillation was treated it was associated with low disease related mortality, no different than for patients without atrial fibrillation. Finally, atrial fibrillation was an uncommon primary cause of death in hypertrophic cardiomyopathy, but this was virtually limited to embolic stroke, thus supporting a low threshold for initiating anticoagulation therapy.                                                 That warps it up for our summaries. Now for our feature discussion. This week's journal carries two papers that refer to the health risks of ionizing radiation to interventional cardiologists. Yes, you heard me right. You're going to want to listen up. These are going to send chills up our spine, or rather maybe chills into our brains and into our blood according to the papers.                                                 To discuss these two papers I have with us associate editor from UT Southwestern, Dr. Manos Brilakis, as well as the corresponding author of the first paper Dr. Maria Andreassi from CNR Institute of Clinical Physiology from Pisa Italy. Maria, could you start us off by telling us what you found in your research letter? Dr Maria Andreassi:        In our study we evaluated the circulating microRNA profile in interventional cardiologists in order to provide insights into the molecular and the biological situation and the underlying association between occupational low dose radiation exposure in cath lab and the potential long term disease risk. The hypothesis of our study was based on the evidence that the microRNAs are crucial regulators of gene expression. And they have been shown to be dysregulated in many human disease. Moreover, the stability and the tissue selectivity of circulating microRNAs make them ideal biomarkers to explore disease potential clinical disease risk.                                                 In summary, our findings exhibited the dysregulation and the down regulation of acute specific circulating microRNA, the brain specific microRNA-154 and the microRNA-2392. This tells us significantly involved in the deregulation of the three brain pathways and the brain cancer pathway as demonstrated by systematic analysis. In particular, the dysregulated labels so the brain specific microRNA-154 in interventional cardiologists support the notion that the brain damage is one of the main potential long term risk on unprotected head radiation in interventional cardiologists with possible long lasting consequences on the cognitive function. Dr Carolyn Lam:                That is really striking. Brain specific microRNA was shown to be dysregulated in interventional cardiologists compared to controls who were not exposed to radiation. As I understand it, these dysregulated microRNAs can be seen in certain forms of epilepsy and Alzheimer's disease and certain brain cancers and so the concern is very obvious for those of us who are interventional cardiologists. But your study did not actually relate these two specific adverse events. Is that correct? Dr Maria Andreassi:        You're right. Yes. microRNA-154 was first identified as a brain specific microRNA which is involved with inner synapse development and the directly implicated in [inaudible 00:12:15] and memory. Additionally, decreased expression of this microRNA class, was previously reported in several brain disorders including the thymus disease and bipolar disorder. This microRNA has also been shown to be down regulated in several brain cancers such as neuroblastomas. The reduced expression of the microRNA-154 is a predictor of progression and prognosis of human gliomas. This data strongly support it's important role in brain tumors. Our findings are of particular interest in relation the handle exposure to the pathology of the head, the [inaudible 00:13:13] 20, 50 millisieverts. The equivalent to 1,000, 2,000 chest x-rays and can reach a lifetime cumulative exposure around two sieverts for left hippocampus and one sievert for right hippocampus. Dr Carolyn Lam:                That really makes me go, yikes. But Manos, as an interventional cardiologist yourself, what are your thoughts? And also your thoughts please on that other paper that's in this week's journal? Dr Manos Brilakis:            First of all, let me just congratulate Maria Andreassi, she's been one of the leaders in this area and published several papers and this is one of them. It's really important to have these studies because unfortunately we as interventional cardiologists tend to forget about the negative affects of radiation because as you hear, people don't really see them and this can happen many years down the line. And by the time they happen, it's too late. It's really useful to have the studies to bring our attention the importance of keeping the radiation exposure to the patient and to ourselves as low as possible.                                                 The other paper in addition to the one just discussed, is a paper that looks at DNA damage on operators performing endovascular aortic repair. As a preface, these are procedures demonstrated the aortic aneurism repairs which are very intense radiation wise. They are long procedures, fielding can sometimes be challenging for the operator. There is significant exposure of the operator to x-ray. What they did is they measured some markers of DNA damage and repair. Specifically gamma-H1AX and DDR, the DNA damage response marker and the pATM. They measured them in circulating lymphocytes in operators who performed the endovascular aortic aneurism. What they found is that there were significantly higher levels of those markers immediately after those operators performed those procedures. And they did the same thing after x-ray using leg shielding.                                                 That's a very good reminder for us that the x-ray tube actually is not on the top of the table, but the x-ray tube, the generator, of the x-rays is actually on the bottom. Then the x-ray goes through the patient and the detector is at the top of the table and what happens is the x-ray comes from below the patient and gets scattered from the patient and coming towards the operator so actually it's the legs get the higher dose during any sort of x-ray guided procedure. Sometimes we're forgetting importance of shielding the legs 'cause we think the legs, whatever the muscles, the bones, they're fine. But as the study shows, it's not just the muscles and the bones there but the whole circulation blood gets exposed to x-ray in the lower extremity circulation and that can translate to many other potentially adverse events. Dr Carolyn Lam:                Manos, I love that you manage both these papers. What important messages for increase in risk awareness. This was really very, very well accomplished by both these papers. As well by the editorial that you asked for and that was so well written by Dr. Charles Chambers on both these papers. But beyond risk awareness, what I really love is what you brought up just a while earlier about risk reduction and methods that we can take, for example, in the second paper, by Dr. Modoari and colleagues about shielding the legs. What are the implications for example, wearing a helmet or shielding the head for interventional cardiologists? What do you think? Dr Manos Brilakis:            These are very, very good points. The reality is for the head there have been a couple studied that looked at shielding with lead caps or there's some lead free caps that can be worn and also there are radiation protective glasses. However, what was interesting, there was a paper earlier last year that showed that because the radiation actually comes from below the operator that wearing those helmets, although it seems appealing, it is simple to do obviously, it actually did not significantly reduce the dose to the brain and it only partially reduced the dose to the eyes. Though shielding is useful but may not be as good as we think it is.                                                 In my mind, the starting point of all this is the basics of radiation safety which again, sound very simple and we learn about them in the beginning of training, unfortunately what happen is people tend to forget them as time goes by. These are things like don't step on the x-ray pedal unless you need to look at the pictures and that's very common done. People just have this heavy foot syndrome. They keep on x-raying when they don't need to. There's also the important things having the patient as high as possible and the detector as close to the patient so there is not as much distance for the x-ray to travel. Things like using low, not very steep angles so there is not as much radiation because they have to go through less amount of tissue. And there's some technologies actually coming along there's some technologies that focus the radiation beam only specific areas. And cut the overall dose. And there are x-ray machines that also can have much less radiation overall for the patient and the operator. As you said, having good shielding habits is very important. Dr Carolyn Lam:                Yeah, that's exactly it. That risk awareness should lead to action. I'm just curious, who do you think should primarily take hold of these risk reduction and safety procedures and the enforcement and so on? Us as a community, but what do you think of the role of things like professional societies, quality improvement programs, FDA even? Dr Manos Brilakis:            It's a great point. What we hear here Maria's comments on this as well. But my feeling is absolutely societies are very important for leading these efforts and they do have actually guidelines. There's procedural guidelines for radiation protection. But the end of the day it's the individuals themselves, the operators, each and every one who is in charge of this in their care or his own cath lab and their procedures. Dr Maria Andreassi:        I agree. We all of our findings can contribute to the increase of cross cultural assessment in cath lab and by promoting the diffusion but not the reduction technologies whereas diligent about your protection habits. Moreover it is important to let the design, the relationship between occupational radiation exposure, clinical risk and there are very important future studies studying larger population. We should focus on the molecular epidemiology studies by using biomarkers and this will be clinical and points as early predictors of a clinical event. Because this information is a model likely to better define the risk of radiation use disease at low doses as a comparative tool, the classical epidemiological approach that require a very large sample sizes spread over [inaudible 00:20:51].                                                 Now it's time where largest studies involving scientific societies at an international level. Possible breaking the additional exposure in already recruited the Roth case. And by combining the conventional epidemiology, and the molecular studies and the expected results to better define the clinical risk as a good lesson to implement a more effective protection program. And better as the surveillance at the individual level. Dr Carolyn Lam:                That is wonderful. And thank you, this truly is an international call, isn't it? Another thing that we should keep in mind that all measures that we use to protect our patient from receiving excessive radiation is likely to help us as well as cardiologists.                                                 Thank you so much, both of you, for joining me today on this podcast. What an important message and I'm sure that our listeners will agree. Thank you listeners for joining us. Tune in again next week.  

Fabio Recchia, Scuola Superiore Sant'Anna, Pisa - ITALY, Department of Physiology, Temple University School of Medicine, Philadelphia - USA speaks on "Cardiac imaging in regenerative medicine" . This seminar has been recorded by ICGEB

Today we discuss the plenary indulgence announced by Pope Benedict on the occasion of the 150th Anniversary of the appearance of Our Lady to Bernadette Soubirous in Lourdes, France. Join Paul and son Chris in a tour around the Campo dei Miracoli, the Field of Miracles that contains the immense Duomo of Pisa, the beautiful Baptistery, the Campo Santo (cemetery), and of course, the Leaning Tower. Visit the SaintCast.org website for pictures of the day. Fr Jim Martin answers listeners questions and more on SaintCast #88.