Podcasts about Plexus

Dr. Linda Duska and Dr. Kathleen Moore discuss key studies in the evolving controversy over radical upfront surgery versus neoadjuvant chemotherapy in advanced ovarian cancer. TRANSCRIPT Dr. Linda Duska: Hello, and welcome to the ASCO Daily News Podcast. I am your guest host, Dr. Linda Duska. I am a professor of obstetrics and gynecology at the University of Virginia School of Medicine.  On today's episode, we will explore the management of advanced ovarian cancer, specifically with respect to a question that has really stirred some controversy over time, going all the way back more than 20 years: Should we be doing radical upfront surgery in advanced ovarian cancer, or should we be doing neoadjuvant chemotherapy? So, there was a lot of hype about the TRUST study, also called ENGOT ov33/AGO-OVAR OP7, a Phase 3 randomized study that compares upfront surgery with neoadjuvant chemotherapy followed by interval surgery. So, I want to talk about that study today. And joining me for the discussion is Dr. Kathleen Moore, a professor also of obstetrics and gynecology at the University of Oklahoma and the deputy director of the Stephenson Cancer Center, also at the University of Oklahoma Health Sciences.  Dr. Moore, it is so great to be speaking with you today. Thanks for doing this. Dr. Kathleen Moore: Yeah, it's fun to be here. This is going to be fun. Dr. Linda Duska: FYI for our listeners, both of our full disclosures are available in the transcript of this episode.  So let's just jump right in. We already alluded to the fact that the TRUST study addresses a question we have been grappling with in our field. Here's the thing, we have four prior randomized trials on this exact same topic. So, share with me why we needed another one and what maybe was different about this one? Dr. Kathleen Moore: That is, I think, the key question. So we have to level-set kind of our history. Let's start with, why is this even a question? Like, why are we even talking about this today? When we are taking care of a patient with newly diagnosed ovarian cancer, the aim of surgery in advanced ovarian cancer ideally is to prolong a patient's likelihood of disease-free survival, or if you want to use the term "remission," you can use the term "remission." And I think we can all agree that our objective is to improve overall survival in a way that also does not compromise her quality of life through surgical complications, which can have a big effect. The standard for many decades, certainly my entire career, which is now over 20 years, has been to pursue what we call primary cytoreductive surgery, meaning you get a diagnosis and we go right to the operating room with a goal of achieving what we call "no gross residual." That is very different – in the olden days, you would say "optimal" and get down to some predefined small amount of tumor. Now, the goal is you remove everything you can see.  The alternative strategy to that is neoadjuvant chemotherapy followed by interval cytoreductive surgery, and that has been the, quote-unquote, "safer" route because you chemically cytoreduce the cancer, and so, the resulting surgery, I will tell you, is not necessarily easy at all. It can still be very radical surgeries, but they tend to be less radical, less need for bowel resections, splenectomy, radical procedures, and in a short-term look, would be considered safer from a postoperative consideration. Dr. Linda Duska: Well, and also maybe more likely to be successful, right? Because there's less disease, maybe, theoretically. Dr. Kathleen Moore: More likely to be successful in getting to no gross residual. Dr. Linda Duska: Right. Yeah, exactly. Dr. Kathleen Moore: I agree with that. And so, so if the end game, regardless of timing, is you get to no gross residual and you help a patient and there's no difference in overall survival, then it's a no-brainer. We would not be having this conversation. But there remains a question around, while it may be more likely to get to no gross residual, it may be, and I think we can all agree, a less radical, safer surgery, do you lose survival in the long term by this approach? This has become an increasing concern because of the increase in rates of use of neoadjuvant, not only in this country, but abroad. And so, you mentioned the four prior studies. We will not be able to go through them completely. Dr. Linda Duska: Let's talk about the two modern ones, the two from 2020 because neither one of them showed a difference in overall survival, which I think we can agree is, at the end of the day, yes, PFS would be great, but OS is what we're looking for. Dr. Kathleen Moore: OS is definitely what we're looking for. I do think a marked improvement in PFS, like a real prolongation in disease-free survival, for me would be also enough. A modest improvement does not really cut it, but if you are really, really prolonging PFS, you should see that-  Dr. Linda Duska: -manifest in OS. Dr. Kathleen Moore: Yeah, yeah. Okay. So let's talk about the two modern ones. The older ones are EORTC and CHORUS, which I think we've talked about. The two more modern ones are SCORPION and JCOG0602. So, SCORPION was interesting. SCORPION was a very small study, though. So one could say it's underpowered. 170 patients. And they looked at only patients that were incredibly high risk. So, they had to have a Fagotti score, I believe, of over 9, but they were not looking at just low volume disease. Like, those patients were not enrolled in SCORPION. It was patients where you really were questioning, "Should I go to the OR or should I do neoadjuvant? Like, what's the better thing?" It is easy when it's low volume. You're like, "We're going." These were the patients who were like, "Hm, you know, what should I do?" High volume. Patients were young, about 55. The criticism of the older studies, there are many criticisms, but one of them is that, the criticism that is lobbied is that they did not really try. Whatever surgery you got, they did not really try with median operative times of 180 minutes for primary cytoreduction, 120 for neoadjuvant. Like, you and I both know, if you're in a big primary debulking, you're there all day. It's 6 hours. Dr. Linda Duska: Right, and there was no quality control for those studies, either. Dr. Kathleen Moore: No quality control. So, SCORPION, they went 451-minute median for surgery. Like, they really went for it versus four hours and then 253 for the interval, 4 hours. They really went for it on both arms. Complete gross resection was achieved in 50% of the primary cytoreduced. So even though they went for it with these very long surgeries, they only got to the goal half the time. It was almost 80% in the interval group. So they were more successful there. And there was absolutely no difference in PFS or OS. They were right about 15 months PFS, right about 40 months OS.  JCOG0602, of course, done in Japan, a big study, 300 patients, a little bit older population. Surprisingly more stage IV disease in this study than were in SCORPION. SCORPION did not have a lot of stage IV, despite being very bulky tumors. So a third of patients were stage IV. They also had relatively shorter operative times, I would say, 240 minutes for primary, 302 for interval. So still kind of short. Complete gross resection was not achieved very often. 30% of primary cytoreduction. That is not acceptable. Dr. Linda Duska: Well, so let's talk about TRUST. What was different about TRUST? Why was this an important study for us to see? Dr. Kathleen Moore: So the criticism of all of these, and I am not trying to throw shade at anyone, but the criticism of all of these is if you are putting surgery to the test, you are putting the surgeon to the test. And you are assuming that all surgeons are trained equally and are willing to do what it takes to get someone to no gross residual. Dr. Linda Duska: And are in a center that can support the post-op care for those patients. Dr. Kathleen Moore: Which can be ICU care, prolonged time. Absolutely. So when you just open these broadly, you're assuming everyone has the surgical skills and is comfortable doing that and has backup. Everybody has an ICU. Everyone has a blood bank, and you are willing to do that. And that assumption could be wrong. And so what TRUST said is, "Okay, we are only going to open this at centers that have shown they can achieve a certain level of primary cytoreduction to no gross residual disease." And so there was quality criteria. It was based on – it was mostly a European study – so ESGO criteria were used to only allow certified centers to participate. They had to have a surgical volume of over 36 cytoreductive surgeries per year. So you could not be a low volume surgeon. Your complete resection rates that were reported had to be greater than 50% in the upfront setting. I told you on the JCOG, it was 30%. Dr. Linda Duska: Right. So these were the best of the best. This was the best possible surgical situation you could put these patients in, right? Dr. Kathleen Moore: Absolutely. And you support all the things so you could mitigate postoperative complications as well. Dr. Linda Duska: So we are asking the question now again in the ideal situation, right? Dr. Kathleen Moore: Right. Dr. Linda Duska: Which, we can talk about, may or may not be generalizable to real life, but that's a separate issue because we certainly don't have those conditions everywhere where people get cared for with ovarian cancer. But how would you interpret the results of this study? Did it show us anything different? Dr. Kathleen Moore: I am going to say how we should interpret it and then what I am thinking about. It is a negative study. It was designed to show improvement in overall survival in these ideal settings in patients with FIGO stage IIIB and C, they excluded A, these low volume tumors that should absolutely be getting surgery. So FIGO stage IIIB and C and IVA and B that were fit enough to undergo radical surgery randomized to primary cytoreduction or neoadjuvant with interval, and were all given the correct chemo. Dr. Linda Duska: And they were allowed bevacizumab and PARP, also. They could have bevacizumab and PARP. Dr. Kathleen Moore: They were allowed bevacizumab and PARP. Not many of them got PARP, but it was distributed equally, so that would not be a confounder. And so that was important. Overall survival is the endpoint. It was a big study. You know, it was almost 600 patients. So appropriately powered. So let's look at what they reported. When they looked at the patients who were enrolled, this is a large study, almost 600 patients, 345 in the primary cytoreductive arm and 343 in the neoadjuvant arm. Complete resection in these patients was 70% in the primary cytoreductive arm and 85% in the neoadjuvant arm. So in both arms, it was very high. So your selection of site and surgeon worked. You got people to their optimal outcome. So that is very different than any other study that has been reported to date. But what we saw when we looked at overall survival was no statistical difference. The median was, and I know we do not like to talk about medians, but the median in the primary cytoreductive arm was 54 months versus 48 months in the neoadjuvant arm with a hazard ratio of 0.89 and, of course, the confidence interval crossed one. So this is not statistically significant. And that was the primary endpoint. Dr. Linda Duska: I know you are getting to this. They did look at PFS, and that was statistically significant, but to your point about what are we looking for for a reasonable PFS difference? It was about two months difference. When I think about this study, and I know you are coming to this, what I thought was most interesting about this trial, besides the fact that the OS, the primary endpoint was negative, was the subgroup analyses that they did. And, of course, these are hypothesis-generating only. But if you look at, for example, specifically only the stage III group, that group did seem to potentially, again, hypothesis generating, but they did seem to benefit from upfront surgery.  And then one other thing that I want to touch on before we run out of time is, do we think it matters if the patient is BRCA germline positive? Do we think it matters if there is something in particular about that patient from a biomarker standpoint that is different? I am hopeful that more data will be coming out of this study that will help inform this. Of course, unpowered, hypothesis-generating only, but it's just really interesting. What do you think of their subset analysis? Dr. Kathleen Moore: Yeah, I think the subsets are what we are going to be talking about, but we have to emphasize that this was a negative trial as designed. Dr. Linda Duska: Absolutely. Yes. Dr. Kathleen Moore: So we cannot be apologists and be like, "But this or that." It was a negative trial as designed. Now, I am a human and a clinician, and I want what is best for my patients. So I am going to, like, go down the path of subset analyses. So if you look at the stage III tumors that got complete cytoreduction, which was 70% of the cases, your PFS was almost 28 months versus 21.8 months. Dr. Linda Duska: Yes, it becomes more significant. Dr. Kathleen Moore: Yeah, that hazard ratio is 0.69. Again, it is a subset. So even though the P value here is statistically significant, it actually should not have a P value because it is an exploratory analysis. So we have to be very careful. But the hazard ratio is 0.69. So the hypothesis is in this setting, if you're stage III and you go for it and you get someone to no gross residual versus an interval cytoreduction, you could potentially have a 31% reduction in the rate of progression for that patient who got primary cytoreduction. And you see a similar trend in the stage III patients, if you look at overall survival, although the post-progression survival is so long, it's a little bit narrow of a margin.  But I do think there are some nuggets here that, one of our colleagues who is really one of the experts in surgical studies, Dr. Mario Leitao, posted this on X, and I think it really resonated after this because we were all saying, "But what about the subsets?" He is like, "It's a negative study." But at the end of the day, you are going to sit with your patient. The patient should be seen by a GYN oncologist or surgical oncologist with specialty in cytoreduction and a medical oncologist, you know, if that person does not give chemo, and the decision should be made about what to do for that individual patient in that setting. Dr. Linda Duska: Agreed. And along those lines, if you look carefully at their data, the patients who had an upfront cytoreduction had almost twice the risk of having a stoma than the patients who had an interval cytoreduction. And they also had a higher risk of needing to have a bowel resection. The numbers were small, but still, when you look at the surgical complications, as you've already said, they're higher in the upfront group than they are in the interval group. That needs to be taken into account as well when counseling a patient, right? When you have a patient in front of you who says to you, "Dr. Moore, you can take out whatever you want, but whatever you do, don't make me a bag." As long as the patient understands what that means and what they're asking us to do, I think that we need to think about that. Dr. Kathleen Moore: I think that is a great point. And I have definitely seen in our practice, patients who say, "I absolutely would not want an ostomy. It's a nonstarter for me." And we do make different decisions. And you have to just say, "That's the decision we've made," and you kind of move on, and you can't look back and say, "Well, I wish I would have, could have, should have done something else." That is what the patient wants. Ultimately, that patient, her family, autonomous beings, they need to be fully counseled, and you need to counsel that patient as to the site that you are in, her volume of disease, and what you think you can achieve. In my opinion, a patient with stage III cancer who you have the site and the capabilities to get to no gross residual should go to the OR first. That is what I believe. I do not anymore think that for stage IV. I think that this is pretty convincing to me that that is probably a harmful thing. However, I want you to react to this. I think I am going to be a little unpopular in saying this, but for me, one of the biggest take-homes from TRUST was that whether or not, and we can talk about the subsets and the stage III looked better, and I think it did, but both groups did really well. Like, really well. And these were patients with large volume disease. This was not cherry-picked small volume stage IIIs that you could have done an optimal just by doing a hysterectomy. You know, these were patients that needed radical surgery. And both did well. And so what it speaks to me is that anytime you are going to operate on someone with ovary, whether it be frontline, whether it be a primary or interval, you need a high-volume surgeon. That is what I think this means to me. Like, I would want high volume surgeon at a center that could do these surgeries, getting that patient, my family member, me, to no gross residual. That is important. And you and I are both in training centers. I think we ought to take a really strong look at, are we preparing people to do the surgeries that are necessary to get someone to no gross residual 70% and 85% of the time? Dr. Linda Duska: We are going to run out of time, but I want to address that and ask you a provocative question. So, I completely agree with what you said, that surgery is important. But I also think one of the reasons these patients in this study did so well is because all of the incredible new therapies that we have for patients. Because OS is not just about surgery. It is about surgery, but it is also about all of the amazing new therapies we have that you and others have helped us to get through clinical research. And so, how much of that do you think, like, for example, if you look at the PFS and OS rates from CHORUS and EORTC, I get it that they're, that they're not the same. It's different patients, different populations, can't do cross-trial comparisons. But the OS, as you said, in this study was 54 months and 48 months, which is, compared to 2010, we're doing much, much better. It is not just the surgery, it is also all the amazing treatment options we have for these patients, including PARP, including MIRV, including lots of other new therapies. How do you fit that into thinking about all of this? Dr. Kathleen Moore: I do think we are seeing, and we know this just from epidemiologic data that the prevalence of ovarian cancer in many of the countries where the study was done is increasing, despite a decrease in incidence. And why is that? Because people are living longer. Dr. Linda Duska: People are living longer, yeah. Dr. Kathleen Moore: Which is phenomenal. That is what we want. And we do have, I think, better supportive care now. PARP inhibitors in the frontline, which not many of these patients had. Now some of them, this is mainly in Europe, will have gotten them in the first maintenance setting, and I do think that impacts outcome. We do not have that data yet, you know, to kind of see what, I would be really interested to see. We do not do this well because in ovarian cancer, post-progression survival can be so long, we do not do well of tracking what people get when they come off a clinical trial to see how that could impact – you know, how many of them got another surgery? How many of them got a PARP? I think this group probably missed the ADC wave for the most part, because this, mirvetuximab is just very recently available in Europe. Dr. Linda Duska: Unless they were on trial. Dr. Kathleen Moore: Unless they were on trial. But I mean, I think we will have to see. 600 patients, I would bet a lot of them missed the ADC wave. So, I do not know that we can say we know what drove these phenomenal – these are some of the best curves we've seen outside of BRCA. And then coming back to your point about the BRCA population here, that is a really critical question that I do not know that we're ever going to answer. There have been hypotheses around a tumor that is driven by BRCA, if you surgically cytoreduced it, and then chemically cytoreduced it with chemo, and so you're starting PARP with nothing visible and likely still homogeneous clones. Is that the group we cured? And then if you give chemo first before surgery, it allows more rapid development of heterogeneity and more clonal evolution that those are patients who are less likely to be cured, even if they do get cytoreduced to nothing at interval with use of PARP inhibitor in the front line. That is a question that many have brought up as something we would like to understand better. Like, if you are BRCA, should you always just go for it or not? I do not know that we're ever going to really get to that. We are trying to look at some of the other studies and just see if you got neoadjuvant and you had BRCA, was anyone cured? I think that is a question on SOLO1 I would like to know the answer to, and I don't yet, that may help us get to that. But that's sort of something we do think about. You should have a fair number of them in TRUST. It wasn't a stratification factor, as I remember. Dr. Linda Duska: No, it wasn't. They stratified by center, age, and ECOG status Dr. Kathleen Moore: So you would hope with randomization that you would have an equal number in each arm. And they may be able to pull that out and do a very exploratory look. But I would be interested to see just completely hypothesis-generating what this looks like for the patients with BRCA, and I hope that they will present that. I know they're busy at work. They have translational work. They have a lot pending with TRUST. It's an incredibly rich resource that I think is going to teach us a lot, and I am excited to see what they do next. Dr. Linda Duska: So, outside of TRUST, we are out of time. I just want to give you a moment if there were any other messages that you want to share with our listeners before we wrap up. Dr. Kathleen Moore: It's an exciting time to be in GYN oncology. For so long, it was just chemo, and then the PARP inhibitors nudged us along quite a bit. We did move more patients, I believe, to the cure fraction. When we ultimately see OS, I think we'll be able to say that definitively, and that is exciting. But, you know, that is the minority of our patients. And while HRD positive benefits tremendously from PARP, I am not as sure we've moved as many to the cure fraction. Time will tell. But 50% of our patients have these tumors that are less HRD. They have a worse prognosis. I think we can say that and recur more quickly. And so the advent of these antibody-drug conjugates, and we could name 20 of them in development in GYN right now, targeting tumor-associated antigens because we're not really driven by mutations other than BRCA. We do not have a lot of things to come after. We're not lung cancer. We are not breast cancer. But we do have a lot of proteins on the surface of our cancers, and we are finally able to leverage that with some very active regimens. And we're in the early phases, I would say, of really understanding how best to use those, how best to position them, and which one to select for whom in a setting where there is going to be obvious overlap of the targets. So we're going to be really working this problem. It is a good problem. A lot of drugs that work pretty well. How do you individualize for a patient, the patient in front of you with three different markers? How do you optimize it? Where do you put them to really prolong survival? And then we finally have cell surface. We saw at ASCO, CDK2 come into play here for the first time, we've got a cell cycle inhibitor. We've been working on WEE1 and ATR for a long time. CDK2s may hit. Response rates were respectable in a resistant population that was cyclin E overexpressing. We've been working on that biomarker for a long time with a toxicity profile that was surprisingly clean, which I like to see for our patients. So that is a different platform. I think we have got bispecifics on the rise. So there is a pipeline of things behind the ADCs, which is important because we need more than one thing, that makes me feel like in the future, I am probably not going to be using doxil ever for platinum-resistant disease. So, I am going to be excited to retire some of those things. We will say, "Remember when we used to use doxil for platinum-resistant disease?" Dr. Linda Duska: I will be retired by then, but thanks for that thought. Dr. Kathleen Moore: I will remind you. Dr. Linda Duska: You are right. It is such an incredibly exciting time to be taking care of ovarian cancer patients with all the opportunities.  And I want to thank you for sharing your valuable insights with us on this podcast today and for your great work to advance care for patients with GYN cancers. Dr. Kathleen Moore: Likewise. Thanks for having me. Dr. Linda Duska: And thank you to our listeners for your time today. You will find links to the TRUST study and other studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers:   Dr. Linda Duska  @Lduska Dr. Kathleen Moore Follow ASCO on social media:     @ASCO on X (formerly Twitter) ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures of Potential Conflicts of Interest:    Dr. Linda Duska:   Consulting or Advisory Role: Regeneron, Inovio Pharmaceuticals, Merck, Ellipses Pharma  Research Funding (Inst.): GlaxoSmithKline, Millenium, Bristol-Myers Squibb, Aeterna Zentaris, Novartis, Abbvie, Tesaro, Cerulean Pharma, Aduro Biotech, Advaxis, Ludwig Institute for Cancer Research, Leap Therapeutics  Patents, Royalties, Other Intellectual Property: UptToDate, Editor, British Journal of Ob/Gyn  Dr. Kathleen Moore: Leadership: GOG Partners, NRG Ovarian Committee Chair Honoraria: Astellas Medivation, Clearity Foundation, IDEOlogy Health, Medscape, Great Debates and Updates, OncLive/MJH Life Sciences, MD Outlook, Curio Science, Plexus, University of Florida, University of Arkansas for Medical Sciences, Congress Chanel, BIOPHARM, CEA/CCO, Physician Education Resource (PER), Research to Practice, Med Learning Group, Peerview, Peerview, PeerVoice, CME Outfitters, Virtual Incision Consulting/Advisory Role: Genentech/Roche, Immunogen, AstraZeneca, Merck, Eisai, Verastem/Pharmacyclics, AADi, Caris Life Sciences, Iovance Biotherapeutics, Janssen Oncology, Regeneron, zentalis, Daiichi Sankyo Europe GmbH, BioNTech SE, Immunocore, Seagen, Takeda Science Foundation, Zymeworks, Profound Bio, ADC Therapeutics, Third Arc, Loxo/Lilly, Bristol Myers Squibb Foundation, Tango Therapeutics, Abbvie, T Knife, F Hoffman La Roche, Tubulis GmbH, Clovis Oncology, Kivu, Genmab/Seagen, Kivu, Genmab/Seagen, Whitehawk, OnCusp Therapeutics, Natera, BeiGene, Karyopharm Therapeutics, Day One Biopharmaceuticals, Debiopharm Group, Foundation Medicine, Novocure Research Funding (Inst.): Mersana, GSK/Tesaro, Duality Biologics, Mersana, GSK/Tesaro, Duality Biologics, Merck, Regeneron, Verasatem, AstraZeneca, Immunogen, Daiichi Sankyo/Lilly, Immunocore, Torl Biotherapeutics, Allarity Therapeutics, IDEAYA Biosciences, Zymeworks, Schrodinger Other Relationship (Inst.): GOG Partners

Série “7 Jours, 7 Chakras” – Épisode 3 : Le Chakra du Plexus Solaire (Manipura)Le lien de la plateforme gratuite pour accéder aux ressources du programme :https://preview.mailerlite.io/forms/1181199/169552010292495677/shareLa liste d'attente de la Formation Énergétique :https://dashboard.mailerlite.com/forms/1181199/138054905707365814/shareQu'est-ce qui régule notre volonté, notre pouvoir d'action et notre confiance en soi ?Comment notre ego influence-t-il notre santé physique et émotionnelle ?Dans ce troisième épisode de la série 7 jours, 7 chakras, on plonge au cœur du Manipura Chakra, le chakra du plexus solaire, centre énergétique de la puissance personnelle et de la transformation intérieure.Situé entre le nombril et le sternum, ce chakra agit comme un véritable soleil intérieur, irradiant énergie, confiance et vitalité.Au programme de cet épisode :Rôle du Manipura Chakra : découvrez comment ce centre énergétique influence votre équilibre émotionnel, votre digestion et votre pouvoir personnel.Déséquilibres et symptômes : identifiez les signes d'un chakra du plexus solaire bloqué (manque de confiance, colère, troubles digestifs, fatigue).Techniques d'harmonisation : explorez des postures de yoga, des exercices de respiration (pranayama)et des méditations guidées pour équilibrer votre feu intérieur.Éveiller le feu intérieur : apprenez à renforcer votre volonté d'agir, à oser vous affirmer et à transformer votre énergie émotionnelle en puissance créatrice.Accompagnement thérapeutique : comprenez quand il est nécessaire de se faire accompagner pour restaurer un équilibre énergétique durable.En équilibrant le chakra du plexus solaire, vous renforcez votre estime de vous-même, votre courage et votre motivation à agir.Ce centre énergétique vous invite à reconnaître votre valeur, à écouter votre feu intérieur et à vous reconnecter à votre pouvoir personnel sans tomber dans le contrôle excessif.Cet épisode est une invitation à allumer votre soleil intérieur et à rayonner pleinement dans votre vie.**********************************************Je suis Amba, énergéticienne, formatrice en énergétique, en cartomancie, et en médiumnité. J'accompagne depuis plusieurs années celles et ceux qui veulent intégrer la spiritualité dans leur vie, à travers mes formations professionnelles, mes accompagnements individuels et ce podcast qui rassemble aujourd'hui des centaines de contenus disponibles gratuitement !

Rétro Session - Dj Hs - Métropolys 31/10/25 >>> 22H00/23H00 01/KOLSCH grey 02/D-NOTE shed my skin 03/JULIET avalon 04/URBAN ELECTRO SQUAD ex-girlfirend 05/THE LOVE CLUB free my mind 06/UNA can you heart me 07/JOE T VANILLI play with the voice 08/LUSTRAL everytime 09/LAND OF OZ spooky 10/EMMANUEL TOP acide phase 11/MILK INCORPORATION la vache 12/AT THE VILLA PEOPLE open your eyes 13/MACKENZIE trance waves >>> 23H00/00H00 01/BRAIN TV hye 02/LAURENT GARNIER the man with the red face 03/ENERGY 52 cafe del mar 04/MIKE MAYO evolution 05/GROOVEYARD mary go wild 06/MADRID INC my sunday's love 07/PLEXUS cactus rythm 08/CARAT TRAXX 2 the message 09/DJ HS the last train 10/ECSTASY CLUB jesus love the acid 11/WATER WORLD give me love 12/JOHNNY VICIOUS ecstasy 13/SILVIO ECOMO no dip 14/MELLOW TRAX outa space 15/JAM AND SPOON stella >>> DjPod Dj HS >>> Soundcloud Dj HS >>> I-Tunes >>> Facebook "Dj HS" >>> Youtube "Dj HS"

In this week's smallcap investing show, UK equity analyst & markets commentator Paul Scott & I discussed our latest thoughts on 27 stock ideas. 00:00 CMA findings on the UK Vet industry and impact for Pets-at-home and CVS Group 05:25 Is this a bear or bull market for smallcaps? 06:30 Activeops 11:50 1Spatial (also 17:25 & 30:50) 15:05 Getbusy 17:40 Hollywood Bowl 19:10 Sanderson Designs 21:55 Sosander 23:40 AB Dynamics 27:15 Oxford Instruments 31:20 Gamma Communications 34:15 Feedback from call with Tribal management 39:30 Impact of lower crude price on oil field services industry, Hunting, Plexus & Gulf Marine Services 42:30 Yougov 45:40 Synectics 48:40 Gear4music 50:30 Morgan Advanced Materials 52:55 Oxford Metrics 55:25 Morgan Sindall 57:35 Bytes Technology 59:30 Gaming Realms 1:01:40 Big Yellow & Safestore 1:02:55 Goodwin 1:05:00 Software Circle

"How I Do It: Lumbar Plexus Block." From ASRA Pain Medicine News, August 2025. See the original article at www.asra.com/august25news for figures and references. This material is copyrighted. Support the show

Obelisk och Olympia press gav ut böcker ingen annan vågade röra. Några blev odödliga klassiker. Gabriella Håkansson berättar den vilda historien om Parisförlagen som förändrade litteraturhistorien. Lyssna på alla avsnitt i Sveriges Radio Play. ESSÄ: Detta är en text där skribenten reflekterar över ett ämne eller ett verk. Åsikter som uttrycks är skribentens egna. Först publicerad 2017. William S Burroughs, Samuel Beckett, Jean Genet, Henry Miller och James Joyce: alla har de en sak gemensamt – de har publicerat sig på ett obskyrt litet förlag i Paris, som under 1950-talet gav ut engelskspråkig litteratur i små gröna pocketböcker i serien ”Traveller's Companion”. Bakom den gemytliga rubriken dolde sig all den litteratur som inga andra förlag i Europa eller USA ville ta i med tång, av rädsla för att bli stämda. Allt började med att den brittiske dandyn Jack Kahane 1914 trampade på en landmina i Ypern (Ieper) i Belgien och entledigades från sin krigstjänstgöring. Under konvalescensen träffade han sin fru, fransyskan Marcelle Girodias, flyttade till Paris och började skriva böcker. Kahanes produktion var medelmåttig och innehöll lite för många erotiska anspelningar för att de engelska biblioteken skulle känna sig bekväma, så böckerna plockades bort och han fick dåligt rykte. Samtidigt började romanerna efterfrågas i bokhandeln. Kahane fick en insikt. Minsta inslag av erotik och den mest mediokra bok börjar sälja. I USA och England rådde fortfarande ålderdomliga censurlagar som satte stopp för allt som uppfattades som moraliskt eller erotiskt utmanande, men i Frankrike var situationen en annan, och nu hade Kahane fått en affärsidé. Han registrerade en fransk firma under namnet Obelisk Press och hyrde sunkig kontorslokal på vänstra stranden, nu gällde det bara att hitta sexuellt frispråkiga författare. Det var lättare sagt än gjort. I slutet av 20-talet kontaktar Kahane Sylvia Beach på bokhandeln Shakespeare & Co och får henne att förmedla kontakt med James Joyce, som några år tidigare gjort skandalsuccé på hennes förlag med den frispråkiga ”Ulysses”. Hade Joyce möjligen något mer som kunde publiceras? Det hade han. Experimentboken ”Haveth Childers Everywhere” blev Kahanes första framgångsrika publikation, snabbt åtföljd av Radcliffe Halls lesbiska roman ”Ensamhetens brunn”, som precis blivit förbjuden i England. Även D H Lawrences indragna ”Lady Chatterley's älskare” lades till på utgivningslistan, och nu rullade det på. Kahane fick snabbt rykte om sig att ge ut sånt som ingen annan vågade publicera, och snart köade folk utanför kontoret. Först ut var en helt okänd författare som hette Henry Miller och hade skrivit en bok med en titel som lät som något som handlade om cancer. Det var ”Kräftans vändkrets”. Snart hade även hans vänner Anaïs Nin och Lawrence Durrell fått manus antagna och Kahane var på banan, men när ”Kräftans vändkrets” efter många turer väl skulle ut, ja, då hade Kahane slut på pengar. Ett mönster som skulle komma att upprepa sig. Anaïs Nin visade handlingskraft och finansierade via sin psykoanalytiker Otto Rank trycket av både Millers och Durrells böcker. Som en gentjänst betalade sedan Durrell tryckningen av hennes bok ”Incest”. Sedan hann inte Kahane ge ut mer. Han dog oväntat 1939 vid bara 52-års ålder. Och med det kunde allt ha tagit slut. Det gjorde det inte. Hans 27-årige son Maurice Girodias hade hjälpt pappa på förlaget sedan han var liten, och när andra världskriget var över bestämde han sig för att blåsa liv i verksamheten igen. Nu skulle kampen för den sexuella frispråkigheten stegras ytterligare. Han började med att byta förlagsnamn till Olympia Press och kontaktade sedan faderns gamla författare för att sondera terrängen. Miller skickar in ”Plexus” men sedan var det stopp, så Girodias låter översätta alla franska erotiska böcker han hittar; Genet, Apollinaire, de Sade, Bataille, Queaneau, Reage men det räcker inte, läsarna går inte igång på litterär erotika, de vill ha hederlig porr som kan läsas med vänsterhanden. Girodias gör nu ett genidrag. Han kontaktar klicken kring avantagardetidskriften Merlin som som var de som hade översatt de franska erotiska böckerna, och frågar om de kan tänka sig att börja skriva pornografi istället. Naturligtvis under pseudonym, och gärna med lite kinky inslag. På så vis skulle de kunna finansiera sin tidskrift. Det vill de gärna. Merlin består av ett gäng jazzdansande, amfetaminsnortande utlänningar av båda könen, ledda av författaren Alexander Trocchi och finansierade av amerikanskan Jane Lougee. Kvinnor som män tar sig an uppgiften med förtjusning, och nu börjar Olympia Press glanstid. Merlin flyttar in på kontoret och redaktionen blir förlagets hårda kärna av redaktörer, sekreterare, korrekturläsare och allmänna hangaroaunds. Ur tryckpressarna spottas heta titlar som ”Tender was my flesh” och ”The Loins of Amon”. Olympia Press billiga gröna pocketböcker förses med myndigheternas varning att de inte får säljas i England eller USA, och sprids sedan till turister, matroser, soldater och pornografer som smugglar dem över gränserna en masse. Inkomsterna flödar, men Girodias är ännu värre än sin far vad gäller det ekonomiska. Han vägrar skriva kontrakt och betalar ut royalties lite när det passar. Författarna får köa utanför hans kontor när han är på gott humör, och hoppas på det bästa. Inte heller för han bok över hur många utgåvor han trycker. Ibland ger han ut en censurerad version för bokhandeln, och en annan för illegal spridning. Allt detta fungerar till en början väl med Merlins glada pornografer, men det går inte med riktiga författare som J.P. Donleavy och Vladimir Nabokov. De rasar och drar honom inför rätta. Inte heller går det att betala skatt med vänsterhanden. Bara några år in på det nya äventyret är Maurice Girodias skuldsatt, belånad och åtalad för såväl brott mot obscenitetslagarna som obetalda royalties. Och så här håller det på. Mygel, skulder, porr, åtal – allt i en eskalerande spiral, tills Girodias mot slutet av sextiotalet tröttnar på myndigheternas hetsjakt och författarnas pengatjat, och flyttar till USA för att starta ett amerikanskt Olympia Press. Där går det ännu sämre. Valerie Solanas, som författaren heter, går tre kvarter bort och skjuter Andy Warhol istället. Förläggaren som hela sitt liv bekämpat censuren verkar ha grävt sin egen grav. Den nya tidens libertiner behövde inte längre hans förlag, och när han 1968 struntar i att publicera en av sina nya författare som det är bestämt, så går hon upp på kontoret för att skjuta honom. Girodias är inte på plats och Valerie Solanas, som författaren heter, går tre kvarter bort och skjuter Andy Warhol istället. Girodias är inte sen att utnyttja publiciteten och får snabbt iväg SCUM-manifestet till tryck, det blir hans sista viktiga utgivning, innan allt går utför i ett träsk av hårdporr, scientologi och boxningsböcker. Hans livshistoria kan låta tragisk, men den ledde faktiskt fram till en av 1900-talets stora landvinningar: avskaffandet av censuren. De många och långa rättsprocesserna Girodias drogs inför och tappert utkämpade blev prejudicerande, och satte stopp för en puritanism som präglat bokbranschen i flera hundra år. Vi har familjen Kahane/Girodias att tacka för den frihet litteraturen åtnjuter idag. Och för att banbrytande böcker som Millers ”Kräftans vändkrets”, Burroughs ”Den nakna lunchen”, Trocchis ”Young Adam” och Nabokovs ”Lolita” överhuvudtaget kom i tryck. Och de gröna pocketböckerna som på 50-talet kostade några kronor när de kom ut, betingar idag skyhöga priser på den antikvariska marknaden. Samlarna dammsuger gamla lumplådor och porraffärer för att hitta kvarglömda Olympia Press, och granskar sedan böckernas omslag med lupp för att avgöra vilken utgåva det kan röra sig om. Finns påklistrade prislappar, myndighetsstämplar och korrekta tryckorter där, kan de ha stött på en äkta förstautgåva. Är det någon av klassikerna, som till exempel ”Lolita” kan de räkna med att vara 100 000 kronor rikare. Maurice Girodias dör utblottad och bitter 1990 och begravs på Père-Lachaisekyrkogården i Paris. På hans gravsten låter brodern Eric Kahane gravera ”Une journée sur la Terre”. En dag på jorden. Gabriella Håkansson, författare LitteraturJohn de St Jorre – Venus Bound. The Erotick Voyage of the Olympia Press and its Writers, Random House, 1994.A Life in Pieces. Reflections on Alexander Trocchi. Edited by Alan Campbell & Tim Niel, Rebel Inc, 1977.Lawrence Durrell and Henry Miller. A Private Correspondance. Edited by George Wickes, Faber&Faber, 1962.Sylvia Beach – Shakespeare and Company, översättning ERik Andersson, Ellerström, 2008. Ett urval av berömda Olympia Press-titlar från Parisåren:Samuel Beckett Watt (1953)Henry Miller Plexus (1953)D.A.F. de Sade 120 Days of Sodom (1953)Jean Genet The Thief's Journal (1953)Pauline Reage The Story of O (1954)Vladimir Nabokov Lolita (1955)J.P. Donleavy The Ginger Man (1955)Jean Cocteau The White Paper (1957)William S. Burroughs The Naked Lunch (1959)Lawrence Durrell The Black Book (1959)Raymond Queneau Zazie dans la Métro (1959)

Episode 2696 - Vinnie Tortorich and Chris Shaffer host a call-in show with a discussion around combating aging, managing Type 1 diabetes, and more. https://vinnietortorich.com/2025/09/managing-type-1-diabetes-episode-2696 PLEASE SUPPORT OUR SPONSORS   YOU CAN WATCH THIS EPISODE ON YOUTUBE - Managing Type 1 Diabetes Vinnie has been a lifelong athlete and has some aches and pains. (2:30) Vic is the first call-in guest. (9:00) They chat about being neighbors in New Orleans. Vic has been NSNG® for a while and is close to his goal. (14:00) He asks Vinnie about stretching and flexibility. Vinnie understands the benefits of fasting, but his concern is that it should be done healthily so it doesn't become disordered eating. (22:00) Mike is the next guest and shares his background, including his experience with Type 1 diabetes. (27:00) He was following the suggested protocol from nutritionists, but was gaining weight. He went full-on NSNG® and lost 60 pounds in approximately three months. They discuss Zone 2 training as a form of glucose control, and also HIIT training. (40:00) You will achieve more lean body mass by doing strength training as opposed to just aerobics. (43:00) Sherry joins in. (47:00) She had tried Plexus, which is an MLM product. Vinnie explains the difference between cheating and “life into living.” (51:00) Sherry lost her husband to diabetes and other complications. He ate whatever and whenever he wanted, and relied on taking insulin to "fix" him. She has also noticed her autoimmune flare-ups (Hashimoto's)  have reduced. If you are interested in the NSNG® VIP group, it will be reopening soon. But you can get on the wait list - More News If you are interested in the NSNG® VIP group, it will be reopening soon. But you can get on the wait list - Don't forget to check out Serena Scott Thomas on Days of Our Lives on the Peacock channel.  “Dirty Keto” is available on Amazon! You can purchase or rent it . Make sure you watch, rate, and review it! Eat Happy Italian, Anna's next cookbook, is available!  You can go to  You can order it from .  Anna's recipes are in her cookbooks, website, and Substack–they will spice up your day!  Don't forget you can invest in Anna's Eat Happy Kitchen through StartEngine.  Details are at Eat Happy Kitchen.    PURCHASE  DIRTY KETO (2024) The documentary launched in August 2024! Order it TODAY! This is Vinnie's fourth documentary in just over five years. Visit my new Documentaries HQ to find my films everywhere:  Then, please share my fact-based, health-focused documentary series with your friends and family. Additionally, the more views, the better it ranks, so please watch it again with a new friend! REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! PURCHASE BEYOND IMPOSSIBLE (2022) Visit my new Documentaries HQ to find my films everywhere:  REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! FAT: A DOCUMENTARY 2 (2021) Visit my new Documentaries HQ to find my films everywhere:  FAT: A DOCUMENTARY (2019) Visit my new Documentaries HQ to find my films everywhere: 

Can CRISPR help build a unified platform for biological discovery?Dr Kaivalya Shevade from the Laboratory for Genomics Research (UCSF) is developing new CRISPR-based screening methods to map gene networks, understand drug resistance, and track neuronal activity in disease. The research team's innovations, including the CAT-ATAC assay and the Plexus machine learning model, show how combining biology with computation could accelerate the search for new treatments.Read the original research: doi.org/10.1101/2025.02.11.637716

Plexus Holdings PLC (AIM:POS) CEO Craig Hendrie talked with Proactive's Stephen Gunnion about the company's focus on rental wellhead operations and strategic growth in the Middle East. Hendrie explained that over the past year, Plexus reoriented its strategy to prioritise the rental wellhead business, putting complex products on hold to accelerate the path to sustained profitability. He noted the £3.5 million fundraising completed in March, enabling Plexus to double its Exact EX rental fleet to sixteen units, with deliveries planned by the end of the year. “Having inventory ready on the shelf is absolutely key,” Hendrie said, adding that shorter project timelines are driving the need for readily available equipment. The company is preparing shipments to the UAE, targeting the active offshore oil and gas sector. Hendrie highlighted that nearly half of the world's jack-up rigs operate in the Middle East, making it an important market for Plexus's offerings. Looking to 2026, Hendrie emphasised the versatility of the Exact EX wellhead system, which can be used for exploration, development, and plug-and-abandonment projects across multiple regions. He expressed confidence that the combination of diverse applications and global operational experience will support continued growth despite macroeconomic challenges in the UK and the North Sea. Visit Proactive's YouTube channel for more videos like this. Don't forget to like this video, subscribe to our channel, and enable notifications to stay updated on future content. #PlexusHoldings #OilAndGas #WellheadEquipment #MiddleEastEnergy #UAEExploration #OffshoreDrilling #EnergyInvestment #ExactEX #OilfieldServices #ProactiveInvestors

  Summary In this Pain Exam Podcast episode, Dr. David Rosenblum discusses a journal club article on low volume neurolytic retrocrural celiac plexus blocks for visceral cancer pain. The study reviewed 507 patients with severe malignancy-related abdominal pain, with data retained for 455 patients at the 5-month mark. Dr. Rosenblum explains that the procedure involves injecting 3-5ml of 6% aqueous phenol at the T12-L1 level under fluoroscopic guidance, with an average procedure time of 16.3 minutes. The study found significant pain relief lasting up to six months, reduced opioid consumption, and improved quality of life for patients with primary abdominal cancer or metastatic disease. Dr. Rosenblum shares his personal experience with celiac plexus blocks, including the trans-aortic approach he trained on, and mentions his interest in ultrasound-guided approaches. He also announces upcoming teaching engagements at ASPN, Pain Week, and other conferences, as well as CME ultrasound courses available through nrappain.org. Additionally, he mentions a new community page on the website where users can share board preparation information, though he emphasizes that remembered board questions should not be posted as he is a board question writer himself. Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights Introduction and Upcoming Events Dr. David Rosenblum introduces the Pain Exam Podcast and shares information about upcoming events. He mentions teaching ultrasound at ASPN in July, attending Pain Week in September, and participating in the Latin American Pain Society conference. Dr. Rosenblum also promotes his CME ultrasound courses available at nrappain.org and mentions he's considering organizing another regenerative medicine course in fall or winter. He offers private training for those wanting more intensive ultrasound instruction. Board Prep Community Announcement Dr. Rosenblum announces a new community page on the nrappain.org website for board preparation. He explains that registered users can access free information and keywords relevant to board exams. He emphasizes that users should not post remembered questions as this would be inappropriate, noting that he himself is a board question writer for various pain boards. Dr. Rosenblum mentions that a post about phenol in this community inspired today's podcast topic. Journal Article Overview on Celiac Plexus Block Dr. Rosenblum introduces a journal article on low volume neurolytic retrocrural celiac plexus block for visceral cancer pain, a retrospective review of 507 patients with severe malignancy-related abdominal pain. He explains that the study assessed pain relief provided by this procedure, its duration, reduction in daily opioid consumption, and quality of life improvements. The patients received neurolytic blocks without previous diagnostic blocks due to multiple comorbidities, which Dr. Rosenblum acknowledges is sometimes necessary with very sick patients despite the typical preference for diagnostic blocks before neurolysis. Dr. Rosenblum's Personal Experience with Celiac Plexus Blocks Dr. Rosenblum shares his personal training experience with trans-aortic celiac plexus blocks, where a needle is inserted through the aorta after confirming no plaques or aneurysms are present. He describes it as a safe and effective procedure despite sounding intimidating. He mentions he's only performed a handful of these procedures and doesn't do many now as an outpatient pain doctor. Study Methods and Results Dr. Rosenblum details the study methods, noting that of 507 patients studied, data for 455 was retained at the end of the review. Patients were evaluated before and after the neurolytic retrocrural celiac plexus block under fluoroscopic guidance. Assessment included procedure duration, pain scores (0-10 scale), daily opioid consumption, and quality of life improvement. Follow-up was completed six months after the procedure, showing improved pain scores, reduced opioid consumption, and better quality of life throughout the study period. Some pain returned during months 4-6 due to disease progression and the anticipated duration of the neurolytic agent. The study noted a 6.7% initial vascular contrast uptake during the procedure while using digital subtraction angiography with fluoroscopy. Study Limitations and Conclusions Dr. Rosenblum discusses the study's limitations, including the need for a larger sample size and a prospective trial with a control group, though he acknowledges this is unrealistic given the patient population. He mentions that a proven quality of life questionnaire would be beneficial, and that comparing alcohol, phenol, and RF thermocoagulation would be interesting to evaluate duration effects and side effects. The study concluded that low volume neurolytic retrocrural celiac plexus block with phenol is safe, providing up to six months of pain relief for abdominal pain due to primary malignancy or metastatic spread. Detailed Procedure Technique Dr. Rosenblum explains the detailed procedure technique used in the study. The retrocrural celiac plexus was targeted at L1 level with aim towards T12. Anterior and posterior radiographic imaging aligning the spinous process of T12-L1 junction was used with 15-20 degree oblique rotation. Local anesthetic (1% lidocaine with sodium bicarbonate) was infiltrated along the injection path. A 22 or 25 gauge 3.5-7 inch curved spinal needle was used depending on patient body habitus. Dr. Rosenblum notes he typically uses a 6-inch Chiba needle or 25 gauge spinal needle for such procedures. Procedure Execution and Monitoring Dr. Rosenblum continues describing the procedure, noting that the needle was advanced to the anterior border of T12-L1 under multiple imaging views. Contrast dye studies verified spread and location, with digital subtraction angiography used to check for intravascular uptake. A test dose of 1ml of 0.5% bupivacaine with epinephrine per site was administered, which Dr. Rosenblum finds interesting as he typically doesn't mix bupivacaine with epinephrine. After confirming no vascular uptake, 3-5ml of 6% aqueous phenol was injected in 1ml aliquots while communicating with the patient. The average procedure time was 16.3 minutes with minimal or no sedation. Patients remained prone for 30 minutes afterward to avoid neuroforaminal spread, as phenol is heavier and more viscous than alcohol. Post-Procedure Care and Study Evaluation Dr. Rosenblum explains that patients were monitored in recovery for one hour for adverse events and their ability to eat and void easily. They were discharged once hospital post-anesthetic criteria were met and received a follow-up call 24 hours later. Dr. Rosenblum praises the study and notes that the procedure looks similar to a lumbar sympathetic plexus block, which is also a sympathetic block. Ultrasound Considerations and Alternative Approaches Dr. Rosenblum shares his interest in ultrasound-guided celiac plexus blocks but acknowledges concerns about bowel perforation. He mentions a conversation with an interventional radiology colleague who suggested a transhepatic approach. Dr. Rosenblum recalls scanning a very thin patient where the aorta was easily visible and close to the anterior abdominal wall, making the celiac plexus potentially accessible if bowel perforation, liver bleeding, or gallbladder perforation could be avoided. He shares an experience with a patient suffering from severe pancreatitis pain who received temporary relief from a paravertebral thoracic nerve block at T8-T10, noting that paravertebral blocks provide some sympathetic spread. Conclusion and Community Resource Reminder Dr. Rosenblum concludes by recommending the article, noting its well-written analysis and graphs showing morphine consumption dropping over months following the procedure. He suggests neurolytic procedures are underutilized because they sound intimidating. He again encourages listeners to check out the community he created with separate chat rooms for regenerative medicine, regional anesthesia, and pain boards, where users can share keywords but not specific board questions. Dr. Rosenblum reminds listeners about upcoming courses and his website resources, mentions an upcoming PRP lecture, and asks for five-star reviews if listeners enjoy the podcast. The episode ends with a standard medical disclaimer. Reference https://www.painphysicianjournal.com/current/pdf?article=NTQwOA%3D%3D&journal=113

  Summary In this Pain Exam Podcast episode, Dr. David Rosenblum discusses a journal club article on low volume neurolytic retrocrural celiac plexus blocks for visceral cancer pain. The study reviewed 507 patients with severe malignancy-related abdominal pain, with data retained for 455 patients at the 5-month mark. Dr. Rosenblum explains that the procedure involves injecting 3-5ml of 6% aqueous phenol at the T12-L1 level under fluoroscopic guidance, with an average procedure time of 16.3 minutes. The study found significant pain relief lasting up to six months, reduced opioid consumption, and improved quality of life for patients with primary abdominal cancer or metastatic disease. Dr. Rosenblum shares his personal experience with celiac plexus blocks, including the trans-aortic approach he trained on, and mentions his interest in ultrasound-guided approaches. He also announces upcoming teaching engagements at ASPN, Pain Week, and other conferences, as well as CME ultrasound courses available through nrappain.org. Additionally, he mentions a new community page on the website where users can share board preparation information, though he emphasizes that remembered board questions should not be posted as he is a board question writer himself. Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights Introduction and Upcoming Events Dr. David Rosenblum introduces the Pain Exam Podcast and shares information about upcoming events. He mentions teaching ultrasound at ASPN in July, attending Pain Week in September, and participating in the Latin American Pain Society conference. Dr. Rosenblum also promotes his CME ultrasound courses available at nrappain.org and mentions he's considering organizing another regenerative medicine course in fall or winter. He offers private training for those wanting more intensive ultrasound instruction. Board Prep Community Announcement Dr. Rosenblum announces a new community page on the nrappain.org website for board preparation. He explains that registered users can access free information and keywords relevant to board exams. He emphasizes that users should not post remembered questions as this would be inappropriate, noting that he himself is a board question writer for various pain boards. Dr. Rosenblum mentions that a post about phenol in this community inspired today's podcast topic. Journal Article Overview on Celiac Plexus Block Dr. Rosenblum introduces a journal article on low volume neurolytic retrocrural celiac plexus block for visceral cancer pain, a retrospective review of 507 patients with severe malignancy-related abdominal pain. He explains that the study assessed pain relief provided by this procedure, its duration, reduction in daily opioid consumption, and quality of life improvements. The patients received neurolytic blocks without previous diagnostic blocks due to multiple comorbidities, which Dr. Rosenblum acknowledges is sometimes necessary with very sick patients despite the typical preference for diagnostic blocks before neurolysis. Dr. Rosenblum's Personal Experience with Celiac Plexus Blocks Dr. Rosenblum shares his personal training experience with trans-aortic celiac plexus blocks, where a needle is inserted through the aorta after confirming no plaques or aneurysms are present. He describes it as a safe and effective procedure despite sounding intimidating. He mentions he's only performed a handful of these procedures and doesn't do many now as an outpatient pain doctor. Study Methods and Results Dr. Rosenblum details the study methods, noting that of 507 patients studied, data for 455 was retained at the end of the review. Patients were evaluated before and after the neurolytic retrocrural celiac plexus block under fluoroscopic guidance. Assessment included procedure duration, pain scores (0-10 scale), daily opioid consumption, and quality of life improvement. Follow-up was completed six months after the procedure, showing improved pain scores, reduced opioid consumption, and better quality of life throughout the study period. Some pain returned during months 4-6 due to disease progression and the anticipated duration of the neurolytic agent. The study noted a 6.7% initial vascular contrast uptake during the procedure while using digital subtraction angiography with fluoroscopy. Study Limitations and Conclusions Dr. Rosenblum discusses the study's limitations, including the need for a larger sample size and a prospective trial with a control group, though he acknowledges this is unrealistic given the patient population. He mentions that a proven quality of life questionnaire would be beneficial, and that comparing alcohol, phenol, and RF thermocoagulation would be interesting to evaluate duration effects and side effects. The study concluded that low volume neurolytic retrocrural celiac plexus block with phenol is safe, providing up to six months of pain relief for abdominal pain due to primary malignancy or metastatic spread. Detailed Procedure Technique Dr. Rosenblum explains the detailed procedure technique used in the study. The retrocrural celiac plexus was targeted at L1 level with aim towards T12. Anterior and posterior radiographic imaging aligning the spinous process of T12-L1 junction was used with 15-20 degree oblique rotation. Local anesthetic (1% lidocaine with sodium bicarbonate) was infiltrated along the injection path. A 22 or 25 gauge 3.5-7 inch curved spinal needle was used depending on patient body habitus. Dr. Rosenblum notes he typically uses a 6-inch Chiba needle or 25 gauge spinal needle for such procedures. Procedure Execution and Monitoring Dr. Rosenblum continues describing the procedure, noting that the needle was advanced to the anterior border of T12-L1 under multiple imaging views. Contrast dye studies verified spread and location, with digital subtraction angiography used to check for intravascular uptake. A test dose of 1ml of 0.5% bupivacaine with epinephrine per site was administered, which Dr. Rosenblum finds interesting as he typically doesn't mix bupivacaine with epinephrine. After confirming no vascular uptake, 3-5ml of 6% aqueous phenol was injected in 1ml aliquots while communicating with the patient. The average procedure time was 16.3 minutes with minimal or no sedation. Patients remained prone for 30 minutes afterward to avoid neuroforaminal spread, as phenol is heavier and more viscous than alcohol. Post-Procedure Care and Study Evaluation Dr. Rosenblum explains that patients were monitored in recovery for one hour for adverse events and their ability to eat and void easily. They were discharged once hospital post-anesthetic criteria were met and received a follow-up call 24 hours later. Dr. Rosenblum praises the study and notes that the procedure looks similar to a lumbar sympathetic plexus block, which is also a sympathetic block. Ultrasound Considerations and Alternative Approaches Dr. Rosenblum shares his interest in ultrasound-guided celiac plexus blocks but acknowledges concerns about bowel perforation. He mentions a conversation with an interventional radiology colleague who suggested a transhepatic approach. Dr. Rosenblum recalls scanning a very thin patient where the aorta was easily visible and close to the anterior abdominal wall, making the celiac plexus potentially accessible if bowel perforation, liver bleeding, or gallbladder perforation could be avoided. He shares an experience with a patient suffering from severe pancreatitis pain who received temporary relief from a paravertebral thoracic nerve block at T8-T10, noting that paravertebral blocks provide some sympathetic spread. Conclusion and Community Resource Reminder Dr. Rosenblum concludes by recommending the article, noting its well-written analysis and graphs showing morphine consumption dropping over months following the procedure. He suggests neurolytic procedures are underutilized because they sound intimidating. He again encourages listeners to check out the community he created with separate chat rooms for regenerative medicine, regional anesthesia, and pain boards, where users can share keywords but not specific board questions. Dr. Rosenblum reminds listeners about upcoming courses and his website resources, mentions an upcoming PRP lecture, and asks for five-star reviews if listeners enjoy the podcast. The episode ends with a standard medical disclaimer. Reference https://www.painphysicianjournal.com/current/pdf?article=NTQwOA%3D%3D&journal=113

  Summary In this Pain Exam Podcast episode, Dr. David Rosenblum discusses a journal club article on low volume neurolytic retrocrural celiac plexus blocks for visceral cancer pain. The study reviewed 507 patients with severe malignancy-related abdominal pain, with data retained for 455 patients at the 5-month mark. Dr. Rosenblum explains that the procedure involves injecting 3-5ml of 6% aqueous phenol at the T12-L1 level under fluoroscopic guidance, with an average procedure time of 16.3 minutes. The study found significant pain relief lasting up to six months, reduced opioid consumption, and improved quality of life for patients with primary abdominal cancer or metastatic disease. Dr. Rosenblum shares his personal experience with celiac plexus blocks, including the trans-aortic approach he trained on, and mentions his interest in ultrasound-guided approaches. He also announces upcoming teaching engagements at ASPN, Pain Week, and other conferences, as well as CME ultrasound courses available through nrappain.org. Additionally, he mentions a new community page on the website where users can share board preparation information, though he emphasizes that remembered board questions should not be posted as he is a board question writer himself. Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights Introduction and Upcoming Events Dr. David Rosenblum introduces the Pain Exam Podcast and shares information about upcoming events. He mentions teaching ultrasound at ASPN in July, attending Pain Week in September, and participating in the Latin American Pain Society conference. Dr. Rosenblum also promotes his CME ultrasound courses available at nrappain.org and mentions he's considering organizing another regenerative medicine course in fall or winter. He offers private training for those wanting more intensive ultrasound instruction. Board Prep Community Announcement Dr. Rosenblum announces a new community page on the nrappain.org website for board preparation. He explains that registered users can access free information and keywords relevant to board exams. He emphasizes that users should not post remembered questions as this would be inappropriate, noting that he himself is a board question writer for various pain boards. Dr. Rosenblum mentions that a post about phenol in this community inspired today's podcast topic. Journal Article Overview on Celiac Plexus Block Dr. Rosenblum introduces a journal article on low volume neurolytic retrocrural celiac plexus block for visceral cancer pain, a retrospective review of 507 patients with severe malignancy-related abdominal pain. He explains that the study assessed pain relief provided by this procedure, its duration, reduction in daily opioid consumption, and quality of life improvements. The patients received neurolytic blocks without previous diagnostic blocks due to multiple comorbidities, which Dr. Rosenblum acknowledges is sometimes necessary with very sick patients despite the typical preference for diagnostic blocks before neurolysis. Dr. Rosenblum's Personal Experience with Celiac Plexus Blocks Dr. Rosenblum shares his personal training experience with trans-aortic celiac plexus blocks, where a needle is inserted through the aorta after confirming no plaques or aneurysms are present. He describes it as a safe and effective procedure despite sounding intimidating. He mentions he's only performed a handful of these procedures and doesn't do many now as an outpatient pain doctor. Study Methods and Results Dr. Rosenblum details the study methods, noting that of 507 patients studied, data for 455 was retained at the end of the review. Patients were evaluated before and after the neurolytic retrocrural celiac plexus block under fluoroscopic guidance. Assessment included procedure duration, pain scores (0-10 scale), daily opioid consumption, and quality of life improvement. Follow-up was completed six months after the procedure, showing improved pain scores, reduced opioid consumption, and better quality of life throughout the study period. Some pain returned during months 4-6 due to disease progression and the anticipated duration of the neurolytic agent. The study noted a 6.7% initial vascular contrast uptake during the procedure while using digital subtraction angiography with fluoroscopy. Study Limitations and Conclusions Dr. Rosenblum discusses the study's limitations, including the need for a larger sample size and a prospective trial with a control group, though he acknowledges this is unrealistic given the patient population. He mentions that a proven quality of life questionnaire would be beneficial, and that comparing alcohol, phenol, and RF thermocoagulation would be interesting to evaluate duration effects and side effects. The study concluded that low volume neurolytic retrocrural celiac plexus block with phenol is safe, providing up to six months of pain relief for abdominal pain due to primary malignancy or metastatic spread. Detailed Procedure Technique Dr. Rosenblum explains the detailed procedure technique used in the study. The retrocrural celiac plexus was targeted at L1 level with aim towards T12. Anterior and posterior radiographic imaging aligning the spinous process of T12-L1 junction was used with 15-20 degree oblique rotation. Local anesthetic (1% lidocaine with sodium bicarbonate) was infiltrated along the injection path. A 22 or 25 gauge 3.5-7 inch curved spinal needle was used depending on patient body habitus. Dr. Rosenblum notes he typically uses a 6-inch Chiba needle or 25 gauge spinal needle for such procedures. Procedure Execution and Monitoring Dr. Rosenblum continues describing the procedure, noting that the needle was advanced to the anterior border of T12-L1 under multiple imaging views. Contrast dye studies verified spread and location, with digital subtraction angiography used to check for intravascular uptake. A test dose of 1ml of 0.5% bupivacaine with epinephrine per site was administered, which Dr. Rosenblum finds interesting as he typically doesn't mix bupivacaine with epinephrine. After confirming no vascular uptake, 3-5ml of 6% aqueous phenol was injected in 1ml aliquots while communicating with the patient. The average procedure time was 16.3 minutes with minimal or no sedation. Patients remained prone for 30 minutes afterward to avoid neuroforaminal spread, as phenol is heavier and more viscous than alcohol. Post-Procedure Care and Study Evaluation Dr. Rosenblum explains that patients were monitored in recovery for one hour for adverse events and their ability to eat and void easily. They were discharged once hospital post-anesthetic criteria were met and received a follow-up call 24 hours later. Dr. Rosenblum praises the study and notes that the procedure looks similar to a lumbar sympathetic plexus block, which is also a sympathetic block. Ultrasound Considerations and Alternative Approaches Dr. Rosenblum shares his interest in ultrasound-guided celiac plexus blocks but acknowledges concerns about bowel perforation. He mentions a conversation with an interventional radiology colleague who suggested a transhepatic approach. Dr. Rosenblum recalls scanning a very thin patient where the aorta was easily visible and close to the anterior abdominal wall, making the celiac plexus potentially accessible if bowel perforation, liver bleeding, or gallbladder perforation could be avoided. He shares an experience with a patient suffering from severe pancreatitis pain who received temporary relief from a paravertebral thoracic nerve block at T8-T10, noting that paravertebral blocks provide some sympathetic spread. Conclusion and Community Resource Reminder Dr. Rosenblum concludes by recommending the article, noting its well-written analysis and graphs showing morphine consumption dropping over months following the procedure. He suggests neurolytic procedures are underutilized because they sound intimidating. He again encourages listeners to check out the community he created with separate chat rooms for regenerative medicine, regional anesthesia, and pain boards, where users can share keywords but not specific board questions. Dr. Rosenblum reminds listeners about upcoming courses and his website resources, mentions an upcoming PRP lecture, and asks for five-star reviews if listeners enjoy the podcast. The episode ends with a standard medical disclaimer. Reference https://www.painphysicianjournal.com/current/pdf?article=NTQwOA%3D%3D&journal=113

Send us a textA groundbreaking approach to equine intestinal motility takes center stage as Drs. Barbara Delvescovo and Marta Cercone join us to discuss their pioneering research on ultrasound-guided celiac plexus blocks in horses. Their remarkable findings reveal that this technique not only restores but actually enhances intestinal motility beyond baseline levels in normal horses—without causing discomfort.Post-operative ileus remains one of the most challenging conditions in equine medicine, significantly increasing mortality rates after colic surgery. Traditional treatments often fall short, requiring a multimodal approach with limited options. This innovative nerve block technique offers a promising new tool that equine practitioners with basic ultrasound skills can implement in their practice.The conversation takes fascinating turns as we explore the researchers' diverse backgrounds, from Marta's long-standing interest in neuromodulation to Barbara's clinical practice insights. Their journey reveals how mentorship and curiosity drive scientific discovery, perfectly captured in Marta's guiding principle: "True knowledge exists in knowing that you know nothing." They also share encouraging news for horse owners—contrary to common belief, many horses return to full athletic performance after colic surgery with modern management techniques. The team is now extending their research to clinical cases and inflammatory conditions, potentially transforming how we approach equine gastrointestinal disorders. For veterinarians seeking innovative solutions to challenging cases, this episode offers valuable insights into the intersection of regional anesthesia, ultrasonography, and equine medicine.AJVR open access article: https://doi.org/10.2460/ajvr.24.11.0328INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals

"Pros and Cons: The Transdiscal Approach to Celiac Plexus Block With or Without Neurolysis." From ASRA Pain Medicine News, February 2025. See the original article at www.asra.com/february25news for figures and references. This material is copyrighted.Support the show

Guest: Prajwal Ciryam, MD, PhD Traumatic brain injuries (TBIs) trigger a rapid transcriptional response in the choroid plexus, dominated by chemokines that attract neutrophils. Join Dr. Prajwal Ciryam, Assistant Professor of Neurology at the University of Maryland School of Medicine, as he explains how this early signaling may represent a critical window for modulating inflammation in the injured brain. Dr. Ciryam also spoke about this topic at the 2025 American Academy of Neurology Annual Meeting.

Guest: Prajwal Ciryam, MD, PhD Traumatic brain injuries (TBIs) trigger a rapid transcriptional response in the choroid plexus, dominated by chemokines that attract neutrophils. Join Dr. Prajwal Ciryam, Assistant Professor of Neurology at the University of Maryland School of Medicine, as he explains how this early signaling may represent a critical window for modulating inflammation in the injured brain. Dr. Ciryam also spoke about this topic at the 2025 American Academy of Neurology Annual Meeting.

Guest: Prajwal Ciryam, MD, PhD Traumatic brain injuries (TBIs) trigger a rapid transcriptional response in the choroid plexus, dominated by chemokines that attract neutrophils. Join Dr. Prajwal Ciryam, Assistant Professor of Neurology at the University of Maryland School of Medicine, as he explains how this early signaling may represent a critical window for modulating inflammation in the injured brain. Dr. Ciryam also spoke about this topic at the 2025 American Academy of Neurology Annual Meeting.

Guest: Prajwal Ciryam, MD, PhD Traumatic brain injuries (TBIs) trigger a rapid transcriptional response in the choroid plexus, dominated by chemokines that attract neutrophils. Join Dr. Prajwal Ciryam, Assistant Professor of Neurology at the University of Maryland School of Medicine, as he explains how this early signaling may represent a critical window for modulating inflammation in the injured brain. Dr. Ciryam also spoke about this topic at the 2025 American Academy of Neurology Annual Meeting.

John Veltri, Managing Director of Global Specialty Sales at SADA, hosts Kristy DeLeeuw, VP of Enterprise Transformation at Plexus, a global leader in technology solutions, to discuss Plexus's successful implementation of Google Workspace for its 20,000 employees. Kristy highlights their people-first approach, emphasizing the importance of change management, employee engagement, and continuous improvement in driving collaboration, innovation, and workforce enablement. Discover how Plexus is leveraging Google Workspace to transform its workplace and empower its employees. Join us for more content by liking, sharing, and subscribing!

The lumbosacral plexus is the anatomy of the low back and pelvis that forms the major nerves of the lower abdomen, pelvis and lower limb. It is not as susceptible to injury as the brachial plexus so clinically we understand the anatomy of this plexus a little differently, but it is important to be able to recall the spinal nerve roots of the major nerves here and the functions that will be lost if injured.

In this episode of the Conscious Design Podcast, host Ian Peterman talks with Manuel Jiménez García, co-founder and CEO of Nagami, to explore the cutting-edge world of 3D printing technology and recycled plastics. Learn how Nagami turns plastic waste into high-tech 3D printed architecture!. Manuel shares the inspiring origin story of Nagami, the challenges of scaling large-scale 3D printing, and their mission to promote the circular economy. If you're curious about eco-friendly design, reducing plastic waste, or the future of sustainable manufacturing, this episode is for you! Notable Moments: 00:00 - Guest Introduction 00:38 - The Origin Story of Nagami 02:18 - From Research to Real-World Impact 15:01 - Scaling and Exploring New Materials 25:02 - Sustainable and Personalized 3D Printing 35:48 - Future Goals and Architectural Innovations About Manuel Jiménez García and Nagami Manuel Jiménez García is the co-founder and CEO of the robotic 3D printing and design brand Nagami, based in Ávila, Spain. He is also the co-founder of Automated Architecture Ltd (AuAr), a design-tech company specializing in robotically assembled housing based in London, and the founder and principal of madMdesign, a computational design practice also based in London. For over a decade, Manuel has developed a wide variety of projects focused on computational design, automation, and sustainable building methods, particularly large-scale 3D printing using recycled plastics. His work is part of the permanent collection at the Centre Pompidou (Paris) and has been exhibited worldwide in venues such as the Victoria & Albert Museum (London), Canada's Design Museum (Toronto), The Design Museum (London), the Royal Academy of Arts (London), the Zaha Hadid Design Gallery (London), and the Philadelphia Museum of Art. In addition to his practice, Manuel is an Associate Professor of Architecture at The Bartlett School of Architecture, UCL (London). He serves as the Programme Director of the MSc/MRes Architectural Computation (AC) and is the Unit Master of AD-RC4, both part of The Bartlett B-Pro. He is also the co-founder of UCL AUAR Labs and curator of Plexus, a multidisciplinary lecture series focused on computational design. Nagami was founded in 2006 by Manuel Jiménez García, Miguel Ángel Jiménez García, and Ignacio Veguera Ochoa. The company works closely with its partners to meticulously craft every detail, from early ideation through design, development, and production, with boldness and innovation at the core of every creation. The team at Nagami comprises architects, engineers, designers, researchers, and professionals from various fields specializing in technology, robotics, and sustainability. Together, they work daily to push the boundaries of imagination into uncharted territories. Nagami is a multidisciplinary team of brilliant minds with a shared goal: to create a new reality through 3D printing. Learn More about Manuel Jiménez García and Nagami Linkedin: https://www.linkedin.com/company/nagami-design/ Facebook: https://www.facebook.com/Nagami.DesignInstagram: https://www.instagram.com/nagami.design Youtube: https://www.youtube.com/channel/UCaDv9GWjlV9H6hk-RLIomSg Website: https://nagami.design/es/ YouTube Channel: http://bit.ly/3sG7VEi Blog: https://bit.ly/3kltV6s Conscious Design Book: https://www.amazon.com/dp/B09KNMN9BT Join our Newsletter: https://bit.ly/2U8IlMS Visit our website: https://www.petermanfirm.com/ We created this content so that creative entrepreneurs like you can integrate social and environmental responsibility into your brand's DNA through #ConsciousDesign. Ian Peterman, the leading expert in Conscious Design, hosts the Conscious Design podcast and is the co-author of the book "Conscious Design." If you enjoyed this episode, give it a thumbs up, subscribe to our channel, and share it with your network! Let us know in the comments what excites you most about sustainable 3D printing.

If you're a network marketer looking to build a legacy business with depth and stability, this episode is for you. Rebekah puts Melissa in the hot seat as a leader who has mastered the art of developing leaders and creating lasting success through the Star Diamond Program at Plexus.     Melissa shares the ups and downs of her journey, why leadership development is the key to long-term security, and how investing in others has created both business momentum and personal reward. Plus, hear about her unforgettable reward trip to New York City with her daughter—complete with Christmas magic and a $1,000 shopping spree!     Tune in for insight, inspiration, and vision-casting for building a business that lasts!     The Ambition Coalition Instagram: https://www.instagram.com/the.ambition.coalition/     Follow Rebekah on Instagram: https://www.instagram.com/rebekahfowlkes/     Follow Melissa on Instagram: https://www.instagram.com/melissaeickenhorst     Podcast Produced by clantoncreative.com

Buy: https://overview.fanlink.tv/OVR099-Kyrist Overview Music presents the debut full EP from the one and only Kyrist on the label, featuring equally celebrated Drum & Bass artist InsideInfo. Out 29.11 Kyrist https://www.instagram.com/kyrist_/ https://www.facebook.com/kyristdnb https://soundcloud.com/kyristdnb Overview Music https://overviewmusic.co.uk https://patreon.com/overview https://facebook.com/overviewuk https://instagram.com/overviewuk https://twitter.com/overviewuk https://soundcloud.com/overviewuk

Welcome to Raw. Real. Redeemed! Just when you think Amy ran out of lists she has the longest one yet! NINE areas you can lean into your physical health and a brief overview of some of her favorite products that help in these nine specific ways. If you are interested in any of the Plexus products mentioned in this episode, please visit: www.shopmyplexus.com/rachaelanderson Have questions or comments for us? We love to hear from our listeners! You can e mail us at hello@rawrealredeemed.com

Uncover the path to digital transformation in electronics manufacturing with Andrew Scheuermann, Cofounder and CEO from Arch Systems. Andrew shares invaluable insights into how Arch, with 85 professionals in 13 countries, is partnering with major EMS players like Flex, Jabil, and Plexus to redefine efficiency. Learn how their innovative Action Manager tool is revolutionizing the transition from  data to intelligent actions that significantly boost KPIs. Discover the strategic approach behind scaling from proof-of-concept projects across multiple facilities, and why large EMS companies are cautiously embracing digital change to stay ahead in the competitive landscape.Be inspired by the transformative power of AI in manufacturing. Imagine harnessing generative models like GPT to automate complex tasks such as downtime analysis, retaining expert knowledge, and driving the fourth industrial revolution. Andrew walks us through Arch's ambitious plans to expand capabilities from SMT lines to box would and to new industries like semiconductor advanced packaging and injection molding. By collaborating with MES providers such as Aegis Software, Arch aims to unlock untapped efficiencies in less optimized sectors. Join Andrew amd I as we explore a future that promise to reshape manufacturing and the exciting innovations that lie ahead.For more information about Arch Systems visit https://archsys.io/Listen to Andrew's own podcast "Manufacturing Intelligence" at https://archsys.io/blog/introducing-the-manufacturing-intelligence-podcast/Like every episode of EMS@C-Level, this one was sponsored by global inspection leader Koh Young (https://www.kohyoung.com) and Adaptable Automation Specialist Launchpad.build (https://launchpad.build).You can see video versions of all of the EMS@C-Level pods on our YouTube playlist.

Welcome to Raw. Real. Redeemed! Part 3 of Amy's Leveling up Lists! Today...Four healthy habits you can choose from to start right away! If you are interested in any of the Plexus products mentioned in this or the following episode please visit: www.shopmyplexus.com/rachaelanderson Have questions or comments for us? We love to hear from our listeners! You can e mail us at hello@rawrealredeemed.com

In this episode, we review the high-yield topic of⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Lumbosacral Plexus ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Anatomy section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

Welcome back to your two favorite girlies and the deep dive episode of the month! Today we are diving into Plexus Healthy Living Co. We cover what plexus is, what products are being sold, career opportunities, and 2 reality tv stars as brand ambassadors? Resources for this deep dive were taken directly from plexus website as well as an article written by Brittany Morgan (linked below) https://www.brittanymorgon.com/blog/plexus-slim-the-great-pink-drink-scam All claims in this video are alleged and for educational purposes  You can find Ali on instagram: https://www.instagram.com/theantioverwhelmcoach?igsh=OHAyZ3lwcXBoY3c3 You can find Maddy on Instagram: https://www.instagram.com/maddy.nourishandlift?igsh=M3djYWY5YWltYzE%3D&utm_source=qr If you want to catch one of our favorite deep dives, check out the influencer who scammed women: https://open.spotify.com/episode/3BgyyYBc9vqvUMtUn9oKrv?si=vVjzfyqzQPm-Mm0ZqXh4rg (episode 34)  Make sure to subscribe so you don't miss an episode and send us your health / relationship / life / just need advice on, questions to kindahotpod@gmail.com to have us answer your questions on the show. Find us on all streaming platforms here, including the full video experience on our YouTube channel

Send Kiona a Text Message!Support the showThank you so much for tuning in to this episode! If you like this podcast, don't hesitate to share it and leave a review so it can bring the podcast to the attention of others. If you want to share your own birth story or experience on the Birth As We Know It™️ Podcast, head over to https://birthasweknowitpodcast.com/ or fill out this Guest Request Form. Support the podcast and become a part of the BAWKI™️ Community by becoming a Patron on the Birth As We Know It Patreon Page! And don't forget to join in on the fun in the Private Facebook Group!

*Trigger Warnung: Geburtsschäden und -Verletzungen. Wenn man Janina googelt kommt als einer der ersten Vorschläge das Stichwort “Arm”. Die Frage zu ihrem rechten Arm begleitet sie seit Jahren - bisher ist sie in der Öffentlichkeit immer unbeantwortet geblieben. Heute spricht Janina zum ersten Mal ausführlich über ihre Plexus Parese und wie sie trotz Handicap, ihren Alltag unbeschwert meistert. Gemeinsam taucht sie mit Patricia in ihre Vergangenheit ein und erzählt von starken und auch schwachen Momenten. Und ob ihre eigene traumatische Geburt, die Vorbereitung auf ihr erstes Kind beeinflusst hat.   Weitere Informationen rund um den Podcast findet Ihr auf: www.instagram.com/unterunsmoms Und mehr Informationen zum Thema Plexus Parese findet ihr hier: https://plexuskinder.de/

In the latest episode of Direct Approach, Wayne talks with Plexus CEO Gene Tipps. Gene brings over 25 years of experience in the direct selling space, encompassing a diverse range of leadership roles across startups and multimillion-dollar organizations. With a proven track record in operational excellence and strategic oversight, his transition to CEO at Plexus offers a wealth of knowledge that will resonate with aspiring and current leaders. 

How do you begin your morning? My morning ritual is a non-negotiable. In this episode, I share my daily rituals and some of the products I use. It's taken me years to create a lifestyle that works for my body AND my Soul, and one that keeps my nervous system more balanced than at any other point in my life. In this episode I share:The downside of rigid routinesThe importance of slowly waking your body up - and how to do it The Illuminated Woman way"How" to listen to your body as you awakenMy approach to choosing the right supplements that will support your bodyThe importance of grounding outside in the early morningThe variety of rituals I choose from each morning (mixing it up is key for maintaining a morning routine!)Self-care essentialsMy mindful eating practicesWhy it's so important to limit technology, and how I do itThe importance of balanced days, and what I include in mineAn evening wind-down to complete the day in a way that sets a foundation for restful sleepHere are some of the products I mentioned in the episode:Ryze Mushroom Coffee - get 15% off your first purchase with this linkLankato Monk FruitNaples Soap CompanydoTerra's Hydrating Body Mist (email me if you'd like to purchase this through doTerra)Laura Geller's Mineral BlushRiseWell ToothpasteJoyome by Plexus morning and evening moisturizer (email me if you'd like to purchase this through Plexus)Castor Eye Serum by Heritage StoreDo you have your copy of my free guide, 4 Steps to Connect with Your Higher Self? If not, get yours here!

Jaycee Vallier was diagnosed with Chloroid Plexus Carcinoma, a form of Pediatric Brain Cancer on January 30th of 2020. This cancer has both limited options and a very poor outlook upon diagnosis. Unfortunately, as Jaycee's parents Curtis and Trish tell their story, these conclusions turned out to be accurate and despite going through so much for over 500 days, Jaycee lost her battle on July 3rd of 2021. Curtis and Trish will talk about their beloved daughter plus their non-profit- Battlecorn Care Packages, which they started while Jaycee was still alive and was able to help other pediatric cancer patients.  

Was ist das für ein Rekord-Fund an Kokain, den die Behörden da in Hamburg sichergestellt haben? Gerade eben läuft in Düsseldorf eine Pressekonferenz, auf der Einzelheiten bekannt gegeben werden. Der Fall wurde ja am Freitag bekannt, aber DIE Details über die 35 Tonnen Kokain im Wert von mehreren Milliarden Euro eben NICHT. Manuela Rid aus dem SWR3-Aktuell-Team hat die Pressekonferenz verfolgt.

After the Plexus AI Conference in Frankfurt last week, we discuss where AI is taking us and reflect on its impact on our lives. An insightful group of speakers enlightened us last week with facts about recent developments and the status quo of Artificial Intelligence, it's impact on our society, what it has do do with our brains, where challenges and chances lie and how AI is implemented in Asset Management. Günter Jäger and Aurelia Rauch chat about their main take-aways. DISCLAIMER This publication is for information- and marketing purposes only. The provided information is not legally binding and neither constitutes a financial analysis, nor an offer for investment-transactions or an investment advice and does not substitute any legal, tax or financial advice. Bergos AG does not accept any liability for the accuracy, correctness or completeness of the information. Bergos AG excludes any liability for the realisation of forecasts or other statements contained in the publication. The reproduction in part or in full without prior written permission of Bergos is not permitted.

Nach der Plexus AI Konferenz in Frankfurt letzte Woche diskutieren wir darüber, wohin uns die KI führt und reflektieren über ihre Auswirkungen auf unser Leben. Eine aufschlussreiche Gruppe von Referenten hat uns letzte Woche mit Fakten über die jüngsten Entwicklungen und den Status Quo der Künstlichen Intelligenz aufgeklärt, ihre Auswirkungen auf unsere Gesellschaft, was sie mit unseren Gehirnen zu tun hat, wo die Herausforderungen und Chancen liegen und wie KI in der Vermögensverwaltung eingesetzt wird. Günter Jäger und Aurelia Rauch sprechen über ihre wichtigsten Erkenntnisse. DISCLAIMER Diese Publikation dient ausschliesslich Informations- und Marketingzwecken. Die bereitgestellten Informationen sind nicht rechtsverbindlich und stellen weder Finanzanalysen, noch ein Angebot für Investmenttransaktionen oder eine Anlageberatung dar und ersetzen keine rechtliche, steuerliche oder finanzielle Beratung. Bergos übernimmt keine Gewähr für die Aktualität, Richtigkeit oder Vollständigkeit der Informationen. Für den Eintritt der in der Publikation enthaltenen Prognosen oder sonstige Aussagen schliesst Bergos jegliche Haftung aus. Ohne schriftliche Zustimmung von Bergos dürfen die vorliegenden Information weder auszugsweise noch vollständig vervielfältigt werden.

In a collaboration of medical fads and brands, Dr. Sydnee and Justin dive into the confusing MLM called Plexus. The company started as a seller of the Breast Chek [sic] Kit but has since branched out into wellness and weight management products that it encourages its Ambassadors to recruit others to sell. Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

In this episode, we review the high-yield topic of⁠ ⁠⁠⁠⁠Myenteric Nerve Plexus⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Gastrointestinal section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message

In this episode, we review the high-yield topic of⁠ ⁠Submucosal Nerve Plexus ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Gastrointestinal section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message

Each of us are born with a talent that we can either see openly or we don't know the talent exist. That is what exactly happened with Brittney Howard! Her talent is leading a team of women who have an amazing mission. On this week of the Women Inspiring Women podcast, Melanie is interviewing Top Earner of Plexus, Brittney Howard! Brittney and Melanie chat about leadership, serving, and building up a team with passion. Brittney talks about her start of direct sales with the journey that has brought her to where she is in life and business. BOOK MENTIONED: 21 Laws Of Leadership https://amzn.to/3xtECMT 5 Levels Of Leadership https://amzn.to/43JgfXN Good Leaders Ask Great Questions https://amzn.to/3U20vMr Reserve your spot for The Blitz here: https://blitz.chicinfluencer.com/ Connect with Brittney Howard here: Subscribe here: LeadHERship Podcast Follow Brittney @BrittneyDHoward

Amit and Jeff continue their tour of the upper limb, focusing on blocking the distal branches around the elbow, forearm and wrist. Also in this episode: discussion of listener questions about LAST, sharing of failed block stories, and somehow, weirdly, a reference to Paris Hilton.

In this episode of Investors & Operators, Jordan sits down with Chris Antonello, Owner and Operating Partner at Plexus Capital to discuss the different aspects of deal creation, offering his insights and advice to those looking to either secure capital or structure deals. Together, they discuss:Types of Operating PartnersProfessionalizing a CompanyValue Creation After a Deal...and so much more.Top TakeawaysWhere am I going? Where do I want to be? When talking about the key questions all business owners should be asking themselves, Chris encourages them to reflect on where they currently stand and identify strategies for increasing their businesses' value. He emphasizes the significance of not only working on the day-to-day task, but taking time to step back and evaluate the business' worth and growth potential. “You can't throw the ball where the guy is. You've got to throw the ball where the guy is going to be.” Chris uses an analogy of a quarterback throwing the ball to where the receiver will be, stressing forward-thinking in organizational setup for future success and growth. Highlighting middle market buyers expectations, Chris shows the importance of professionalizing your company and teams to boost its EBITDA and overall value.Chasing the American Dream. Chris shares the joy he finds in seeing the hard work and value creation of entrepreneurs and being able to partner with them to scale their businesses. He spotlights the importance of shared values in these partnerships and highlights the satisfaction Plexus feels from seeing the growth and success from these partnerships.

Title: Shunting vs. ETV/Choroid Plexus Fulguration for Hydrocephalus Guest Faculty: Michael G. DeCuypere, MD, PhD Hosts: Rushna Ali, MD and Seth F. Oliveria, MD PhD In this episode we will speak with Dr. Michael DeCuypere about the use of endoscopic techniques including endoscopic third ventriculostomy and/or choroid plexus coagulation in the management of pediatric hydrocephalus.

Davey Morse  is the founder of Plexus. Plexus is the first online space where we've seen people share, not just finished thoughts, but unresolved thinking. No followers, no likes, no broadcasting, and no public profiles; just the feeling that is in your body or on your mind, a space to express it, and technology that pulls, to you, the people who get it. ★ Support this podcast ★

In a world filled with untapped possibilities, discovering the keys to personal and professional growth not only empowers you to fully embrace your potential but also equips you with the tools to inspire your team, enabling them to unlock their potential as well.Listen in for an insightful conversation that will leave you inspired and empowered to embrace your creative potential! Panelists:Doretha Bailey, VP of HR, Turf Masters BrandsBrady Young, Principal Coach & Consultant, Thrive Coaching and Consulting, LLCMarissa Andrada, Culture Master & Kindness Catalyst, Board Director, Krispy KremeModerated by: Derek Lundsten, President & Chief Culture Officer, LifeGuidesChapters:00:00 Introductions07:24 Being a Rebel: cultivated or innate?16:51 How have you handled recent massive shifts?23:30 Personalization over standardization27:07 The importance of grace30:05 Innovation, creativity, and mobility in HR36:43 Being a voice for the unheard41:20 What are you doing to develop yourselves?BIOS:Brady is a savvy business and HR leader who understands the levers of a business and builds people operations that support exceeding its goals. His superior skills in communication and relationship-building make it possible to gain trust rapidly so that he can get organizations to the next level of success through their people. Additionally, Brady is highly trusted and valued for his ability to coach and mentor leaders. Brady has 20 years of experience in HR at TGen, Plexus, CVS, Intel and Raytheon and has created cutting-edge HR and TA functions in a number of startups. Currently, Brady is Principal Coach and Consultant at Thrive Coaching and Consulting, LLC.Doretha Bailey, MBA is the VP of People & Culture for Turf Masters Brands.  As VP, she is responsible for providing strategic guidance and leadership to all aspects of the human resources functions and operations. She possesses 20+ years in human resources, organizational development, and leadership. Her career spans over several industries including telecommunications, defense, manufacturing, faith-base, military, pharmaceutical, franchising and now turfgrass.Marissa Andrada is a master of activating organizational hyper-growth and turnaround through the transformation and creation of dynamic, diverse and inclusive cultures. With over 25 years of experience of integrating people and leadership capability into the foundation of business strategies, she has energized brands to codify their purpose and values while accelerating company growth and industry-wide change, inspiring a movement for employee well-being and opportunity. Marissa has been the key catalyst in transforming cultures and driving performance at a multitude of consumer brands, most recently as the first chief people officer at Chipotle Mexican Grill. She is currently serving as an independent board director at Krispy Kreme, Inc. where she is also the chair of the Remuneration and Nomination Committee.Follow Brady on LI: https://www.linkedin.com/in/brady-young-hrexec/Follow Doretha on LI: https://www.linkedin.com/in/doretha-bailey/Follow Marissa on LI: https://www.linkedin.com/in/marissaandrada/

Author : Derrick Boden Narrator : Valerie Valdes Host : Mur Lafferty Audio Producer : Summer Brooks This story originally appeared in the August 2022 issue of Clarkesworld. Migratory Patterns of the Modern American Skyscraper by Derrick Boden They call it the pinnacle of architectural innovation. An affordable housing revolution. They call it Plexus, and […] Source

On today's show, we are talking about lack versus abundance when it comes to attracting clients, the mindset around that and how to, even when you feel like you're in a lack mindset, how to shift into abundance. So we're gonna just like dive right into it.We will touch on:Lack mentality vs abundance mentality.How to get out of a lack mindset.Focus on what is actually working and who is working.The importance of high-ticket offers.Why you need to get your body in motion.The importance of self-sabotage awareness.The importance of being mindful of blocks and patterns.Building digital assets first.Today's podcast sponsor is Alisa Terry - Plexus Worldwide -Offering health, hope and happiness!!Hello Ladies...I share Plexus! So what is Plexus, you say? Plexus Worldwide offers science-based health and wellness products that fill in the nutritional gaps to help your body heal naturally! Our mission is to help consumers live healthier and happier lives by balancing your blood sugars and gut bacteria, reducing inflammation in the body and helping sustain your energy levels without that afternoon crash!! Samples of the pink drink and clean energy drinks are available upon request.Connect with Alisa with Plexus:www.plexusworldwide.com/alisakterry

This week Anthony is joined by Katie!! Katie and Anthony talk about taking back your life, being ok with putting yourself first, doing what makes you happy, Plexus and gut health, and a lot more!! The Keep Moving Forward Podcast Episode 274 Bonus Episode www.patreon.com/kmfpodcast Instagram: @ComicAnthonyD @KMFPodcast Twitter: @ComicAnthonyD Intro / Outro music by Hollow, lyrics by Nick Graystone. Check out his new band DemonScar Long Island, for the best sandwiches go to Finn's Deli, www.finnsdeli.com Sail Away Coffee use code WWBro10 www.sailawaycoffee.com Built Bars use code WWBroPodcast www.builtbar.com Keep Moving Forward Merch teechip.com/stores/kmfpodcast --- Send in a voice message: https://podcasters.spotify.com/pod/show/kmfpodcast/message