POPULARITY
In episode 1836, Jack and Miles are joined by podcaster Andrew Michaan, to discuss… the Bomb Bros group chat fallout, people Ghibli-fying images of themselves with OpenAI's new image generator and much more! Eric Daugherty on X: "BREAKING: Mike Waltz announces he spoke with @ElonMusk and said tech experts are going to figure out how The Atlantic's Jeff Goldberg got into the Signal chat. "I can tell you for 100%... I don't text him, he wasn't on my phone." Goldberg Got The Scoop By Accident - Media Matters OpenAI's viral Studio Ghibli moment highlights AI copyright concerns | TechCrunch Hayao Miyazaki on the use of AI: "I am utterly disgusted" LISTEN: Keep Those Teardrops from Falling - Natalie Bergman WATCH: The Daily Zeitgeist on Youtube! L.A. Wildfire Relief: Displaced Black Families GoFund Me Directory See omnystudio.com/listener for privacy information.
In this powerful follow-up conversation, Light Watkins reconnects with Shaman Durek, now married to Princess Märtha Louise of Norway, to explore what life looks like when love meets public scrutiny — and how to stay grounded through it all.Since his last appearance on the podcast, Shaman Durek has entered into royal family life, become a bonus dad to three daughters, and stepped further into the public spotlight. He shares candidly about the media attacks, betrayal by close friends, and navigating the pressures of fame — all while learning how to protect his peace without closing his heart.This episode isn't just about headlines or spiritual theories — it's about real-life growth, hard-earned wisdom, and the daily choices we all face when life feels overwhelming. Durek opens up about setting new boundaries, how his marriage has transformed him, and the importance of creating safe space in relationships where both partners can be vulnerable without fear.He also reflects on his long-term health challenges, including dialysis treatments, and how they've deepened his commitment to living with presence and love. From redefining masculinity to holding compassion for those who hurt him, Durek's journey is one of radical accountability and spiritual maturity.Whether you're in a relationship, navigating judgment from others, or just trying to be more of yourself in a noisy world, this episode is full of grounded insight and heart. Tune in to hear how Shaman Durek is building a life of sovereignty, service, and authentic connection — even in the global spotlight.Send us a text message. We'd love to hear from you!
A relentless pursuit of perfection in science can mean that researchers are in perpetual and self-critical ‘survival mode,' forever questioning their behaviours and actions in the workplace, says clinical psychologist Desiree Dickerson.“We are not very good at taking the spotlight off ourselves, a pressure that can lead to burnout other mental health problems, adds Dickerson, who is based in Valencia, Spain.To boost workplace well-being, Ellen Wehrens describes the impact of a happiness programme that was introduced in 2019 to her lab at the Princess Máxima paediatric oncology centre in Utrecht, the Netherlands. The programme includes both a buddying system and a colour-coded index that enables individuals to signal to colleagues how they are feeling. “So green, you are doing great, yellow, not so much, and red, you are not doing well,” explains Wehrens.Ana Pineda, an ecologist who now runs I focus and write, an education and coaching business, says she began practicing yoga and meditation after feeling stressed at work. At the same time she also actively enlisted the support of friends and colleagues, describing them as “angels.” Meditation, she adds, enables her to find joy, even when faced with daunting tasks.This episode is the penultimate one in Mind Matters, an eight-part podcast series on mental health and wellbeing in academia. Hosted on Acast. See acast.com/privacy for more information.
Carmen Uscatu a publicat recent volumul autobiografic „Anul în care nu am murit” (Editura Humanitas). Carmen Uscatu este președinta și co-fondatoarea asociației „Dăruiește Viață”, ONG-ul care a construit un nou corp de clădire, dotat cu echipamente performante și tehnologie de ultimă generație, la Spitalul „Marie Curie”, doar din donații și sponsorizări de la cetățeni și firme. „Anul în care nu am murit” este o poveste cutremurătoare despre viață, moarte și renaștere. Carmen Uscatu a avut, la 24 de ani, un grav accident de mașină care i-a schimbat viața. Povestea ei, dramatică și plină de încercări, este totodată plină de speranță și încredere în umanitate. „Eu am tendința să le arăt oamenilor că se poate și altfel” scrie ea în volumul autobiografic, o frază care sintetizează întregul ei parcurs. Carmen Uscatu: „Dincolo de oamenii care m-au salvat, au fost cărțile. Ele mi-au oferit acea lume la care eu nu aveam acces în anumite momente, fie pentru că eram pe un pat de spital și tot ce vedeam erau niște pereți albi, patul, mama care mă îngrijea, medicii și asistentele din jur, fie pentru că eram blocată în mintea mea. Și-atunci cărțile erau cele care îmi ofereau fie o lume imaginară, fie lumea reală a altor oameni care au trecut prin întîmplări grele și au reușit. E o carte a recunoștinței mele pentru viața pe care o am acum.”Cum funcționează spitalul construit din donații și sponsorizări?Carmen Uscatu: „L-am finalizat în 2023. Din cauza unui război cu autoritățile am reușit să îl deschidem abia în 2024, în aprilie. Primii pacienți au fost mutați din veche clădire în noua clădire undeva în jurul datei de 15-16 aprilie. Funcționează cu aceeași echipă din vechea clădire, deși, pe oncologie ei și-au dublat numărul de pacienți de cînd s-a deschis acest spital. Asistentele au început să facă training-uri online împreună cu spitalul St. Jude din SUA, medicii au început fellowship-uri de un an, doi la clinicile cu care colaborăm, din Olanda, Princess Máxima, și din Tennessee, St. Jude. Au început să se formeze echipele multidisciplinare. (...) Accesul la experiența celor mai mari clinici din Europa și din lume ne va aduce mult mai curînd aproape de ceea ce se întîmplă la nivel mondial: e o efervescență extraordinară în a salva cît mai mulți copii bolnavi de cancer. Există realmente o mare șansă. Rata de supraviețuire în Europa este pe la 83%. Ceea ce este extraordinar este că medicii, asistentele au început să vadă acest viitor. Le-a fost greu să creadă în acest proiect dar acum lucrurile se întîmplă la o cu totul altă dimensiune decît acum un an sau doi.”Apasă PLAY pentru a asculta întregul interviu!O emisiune de Adela Greceanu și Matei Martin Un produs Radio România Cultural
Welcome to the very first episode of season 4 of A Right Royal Podcast. We're kicking off the new series with an incredible episode sharing all the details from Princess Märtha Louise of Norway and Durek Verrett's big day. Our HELLO! team were lucky to spend five days with the couple in Norway and in the new episode share all the behind-the-scenes details from their pre-wedding parties as well as their historic nuptials. Host Andrea Caamano, alongside her colleagues Sophie Vokes-Dudgeon, Jessica Callan and Sally Morgan were lucky to meet and mingle with the couple's 350 guests – and their ‘easy on the eye' security guards! They also recount incredible details such as how they flew with many Norwegian reporters and paparazzi, were chased by drones and what the couple were really like during their one-to-one interviews which have been featured in the magazine. They also talk about the incredible ceremony music that had guests in tears and the moving bible readings by Prince Haakon of Norway, Durek's sister Angelina Verrett, his nephew Lucas Byrne and the princess' former nanny Berit Tversland. Andrea also catches up with HELLO!'s royal editor, Emily Nash, who rounds up what the British royals have been up to and what their immediate plans are after a long summer break.
Today's Sponsor: Conquer Sales Objections, Conquer Sales Objectiveshttps://www.amazon.com/Conquer-Sales-Objections-Objectives-Questions/dp/B0DFC6GVYL Today's Rundown:Israelis erupt in protest to demand a cease-fire after 6 more hostages die in Gazahttps://apnews.com/article/israel-palestinians-gaza-hamas-war-hostages-hersh-netanyahu-29496f50a9b1740bd3905035ffd23052 Thousands of hotel workers launch strike after talks stall with top chainshttps://www.npr.org/2024/09/01/g-s1-20527/hotel-workers-strike-hyatt-hilton-marriott Court reinstates murder conviction of Adnan Syed, subject of "Serial" podcasthttps://www.cbsnews.com/news/maryland-supreme-court-reinstates-adnan-syed-murder-conviction/South Carolina women's basketball player Ashlyn Watkins charged with assault, kidnappinghttps://www.usatoday.com/story/sports/ncaaw/2024/08/31/ashlyn-watkins-charged-with-assault-kidnapping/75036050007/ Error messages and lengthy online queues greet fans scrambling to secure Oasis reunion ticketshttps://apnews.com/article/oasis-reunion-tour-tickets-sale-0ae64966bcb589faafcc5dfa28dc18bf Japanese government suspends plan to pay Tokyo women 600,000 to move away to get marrieshttps://soranews24.com/2024/08/31/japanese-government-suspends-plan-to-pay-tokyo-women-600000-to-move-away-to-get-marries/amp/ Elon Musk's X ordered to stop operations in Brazilhttps://www.businessinsider.com/brazil-judge-orders-elon-musk-x-stop-operations-2024-8 Georgia puts Cornel West, Jill Stein and Claudia De la Cruz on the state's presidential ballotshttps://apnews.com/article/georgia-president-ballot-access-cornel-west-cruz-851d3c588d2b53f76bfe19adfb33ee3b?user_email=9704f2a5e3f85dba98c827799bcbb8c6eacf1b4b967b5e04654e55ea129ba9d0&utm_medium=Afternoon_Wire&utm_source=Sailthru_AP&utm_campaign=AfternoonWire_Aug30_2024&utm_term=Afternoon%20Wire Mega Millions jackpot soars to $681 million after 25th drawing with no winnerhttps://www.cbsnews.com/news/mega-millions-jackpot-soars-drawing-no-winner/ Norway's Princess Märtha Louise marries a US man who says he's a 6th-generation shaman in a one-of-a-kind royal weddinghttps://www.businessinsider.com/princess-martha-louise-shaman-durek-verrett-controversial-wedding-netflix-deal-2024-9 Website: http://thisistheconversationproject.com Facebook: http://facebook.com/thisistheconversationproject Twitter: http://twitter.com/th_conversation TikTok: http://tiktok.com/@theconversationproject YouTube: http://thisistheconversationproject.com/youtube Podcast: http://thisistheconversationproject.com/podcasts ONE DAY OLDER ON SEPTEMBER 2:Keanu Reeves (60)Salma Hayek (58)Katt Williams (53) WHAT HAPPENED TODAY:1944: Navy pilot George H.W. Bush was shot down by Japanese forces as he completed a bombing run over the Bonin Islands. The future president was rescued by a U.S. submarine.1963: The CBS Evening News was lengthened from 15 to 30 minutes.1992: The United States and Russia agreed to build a space station. WORD OF THE DAY: halcyon [ hal-see-uhn ]https://www.dictionary.com/browse/halcyonidyllically calm and peaceful; suggesting happy tranquilityReflecting on the halcyon days of her childhood, she remembered the endless, carefree summers spent by the lake. DAILY AFFIRMATION: I Am Capable Of Overcoming Any Challenge Life Throws At Me.Enhances Self-Efficacy: This affirmation reinforces your belief in your own abilities, significantly boosting your self-efficacy. When you believe in your capacity to overcome obstacles, you're more likely to undertake challenging tasks and persist in the face of difficulties, leading to personal growth and achievement.https://www.amazon.com/100-Daily-Affirmations-Positivity-Confidence/dp/B0D2D6SS2D?source=ps-sl-shoppingads-lpcontext&ref_=fplfs&psc=1&smid=ATVPDKIKX0DER PLUS, TODAY WE CELEBRATE:Grits for Breakfast DayThe summer might be over but our September is hotter than ever. To the delight of epicurean enthusiasts everywhere, we've got quite a line-up this month…starting with September 2nd's National Grits for Breakfast Day. Who doesn't love grits in the morning? Chef Jason certainly does! So much, in fact, that he's sharing his beloved grits recipe with you! The perfect complement to that bacon & eggs kind of morning! Enjoy!https://braddocksrestaurant.com/september-2nds-national-grits-for-breakfast-day/
Known to the world as the Princess of Norway, our guest today truly transcends this title. We've formed close bonds with Märtha Louise here at Holzweiler over the years due to her strong connection to spirituality and her entrepreneurial mindset. Märtha Louise is a successful businesswoman who's sat at the helm of many companies over the years; most recently she's forayed into fashion, opening Hést, a label that's focused on creating effortless designs that are suited to modern life. Princess Märtha Louise is also the mother to three daughters, and places her family above everything else. In this episode, Susanne takes a moment with Märtha Louise to chat about how she manages to find out how she finds balance for herself throughout it all. Hosted on Acast. See acast.com/privacy for more information.
It's Jubilee Week in Sweden as King Carl Gustaf celebrates 50 years on the throne in Stockholm, an explanation behind his regnal number and Princess Märtha Louise announces her wedding date. See more with this week's show - https://rightroyalroundup.com.au/2023/09/15/podcast-king-carl-xvi-gustaf-golden-jubilee-celebrations-royal-wedding-news/ Visit our website http://rightroyalroundup.com.au for more podcasts and other content. Like us on Facebook, follow us on Twitter, Instagram, Telegram or Pinterest --- Send in a voice message: https://podcasters.spotify.com/pod/show/right-royal-roundup/message
Jessica and Grace are back! This time we're discussing the news that Norway's controversial Princess Märtha Louise will be stepping back from royal engagements. We'll share our views on how the announcement was handled, what it means for Märtha Louise, and how it compares to similar decisions in other countries. LINKS The statement from the Norwegian royals: https://www.royalcourt.no/artikkel.html?tid=216587&sek=27287 Video statement from Märtha Louise and Durek Verrett: https://www.instagram.com/reel/CktGAI5D_7v/?utm_source=ig_web_copy_link Follow the podcast: onheirpodcast.tumblr.com/ or https://instagram.com/onheirpodcast Follow Grace: https://princesscatherinemiddleton.net/ and https://www.instagram.com/_kmiddy/ Follow Jessica: https://duchessofostergotlands.tumblr.com/ and https://www.instagram.com/howtodresslikeaprincess/
From England to Japan to Norway, members of monarchies have been ditching their royal titles in the name of love! We'll look at three of these couples who decided to go from rich fancy nobles to rich fancy nobodies: Princess Mako and lawyer Kei Komuro, Princess Märtha Louise and self-proclaimed shaman Durek Varrett, and of course everybody's favorite majestic ginger, Prince Harry and actress Meghan Markle.See omnystudio.com/listener for privacy information.
I'm blessed that our guest is my beloved fiancée, Princess Märtha Louise. In honor of our recent engagement, we take a look at our relationship journey and all the experiences we've had along the way. We discuss the energetic shift that comes with being engaged, the factors that go into building a good foundation for your relationship, the joy of catching yourself in your mistakes and learning from them, and how I found the perfect ring to represent my love. Resources: Instagram: @iam_Märthalouise Visit animamundiherbals.com and use code SHAMANDUREK for 15% off Join Wisdom Health at wisdomhealth.co/shamand or use code SHAMAND to get your first two months of membership for free Advertisers + Sponsors: Shaman School: shamandurek.com/the-shaman-school Lit Verified Store: shamandurek.com/lit-verified-shop Healing Temple: shamandurek.com/the-healing-temple Learn more about your ad choices. Visit megaphone.fm/adchoices
This episode is all about celebrating one of the most holiest weeks of the whole calendar year across religions and taking back the word princess. Let's just say a lot of things were covered in this weeks episode.
Her Highness Princess Märtha Louise was born at Rikshospitalet University Hospital in Oslo on 22 September 1971. She is the oldest child of His Majesty King Harald and Her Majesty Queen Sonja. She has one brother, His Royal Highness Crown Prince Haakon.The Princess was named after her father's mother, Crown Princess Märtha, and her great-great grandmother, Queen Louise, the mother of King Haakon VII. A constitutional amendment adopted in 1990 established the right of eldest born child to succeed to the Throne regardless of gender; however, as the amendment entered into force long after the Princess and Crown Prince were born, it was decided that males would continue to take precedence over females for children born prior to 1990.FamilyPrincess Märtha Louise became engaged to the author Mr Ari Behn on 13 December 2001. The couple were married in Nidaros Cathedral in Trondheim on 24 May 2002. Bishop Finn Wagle presided over the ceremony. In 2016 the couple decided to part ways, and they were divorced in 2017.The Princess and Mr Behn have three daughters, Miss Maud Angelica Behn, born at Rikshospitalet University Hospital in Oslo on 29 April 2003, Miss Leah Isadora Behn, born at the couple's summer home, Bloksbjerg at Hankø, on 8 April 2005 and Miss Emma Tallulah Behn born at Lommedalen on 29. September 2008.All three were christened in the Palace Chapel: Miss Maud Angelica 2 July 2003, Miss Leah Isadora 16 June 2005 and Miss Emma Tallulah 20 January 2009.The Princess lives with her daughters in Lommedalen, in Bærum outside of Oslo.Official dutiesPrincess Märtha Louise undertakes official engagements as a representative of the Royal Family in areas concerning persons with disabilities.She is also active as patron of eight organisations, and as Chair of Princess Märtha Louise's Fund. Allocations from the fund are awarded to projects that aim to benefit children with disabilities.The Princess is a member of the board of Stiftelsen Vi (the Vi Foundation), established to work on behalf of disabled people for the equal right to a meaningful life.Business enterprisePrincess Märtha Louise has long been engaged in cultural work, and especially in disseminating traditional Norwegian fairy tales to a wider audience. Among other activities, she has starred in a storytelling series on Norwegian television. The Princess is the author of several books and audiobooks, and has participated in the production of television programmes for children.The Princess established a sole proprietorship on 1 January 2002 under which she conducts her independent professional activities in the cultural sphere and as a Rosen therapist. As of that date she has been subject to Norwegian tax laws.From 2007 to 2019 The Princess ran Astarte Education/Soulspring with Ms Elisabeth Nordeng. In 2018 she established the YouTube channel Hest360 with Mr Geir Kamsvåg.
When a Shaman who as a boy was told he would marry the Princess of Norway, one day meets the Princess of Norway who has given up her dream of finding the love of her life and her hope of truly being seen, this is when Shaman Durek and Princess Märtha met. The rest is history (in the making). With an unwavering commitment to social change and an unbreakable bond tested and proven, Durek and Märtha not only talk the talk, but walk it with pride and passion. The story of a Shaman and a Princess isn't one you hear everyday - especially when it's this Shaman and this Princess. This is a story we are honored to share and proud to support. Featured in: ‘The Origin Edition' of AwareNow Magazine Topic: Spirituality, Humanity Produced by: Awareness Ties & KNEKT TV Featuring: Shaman Durek & Princess Märtha Interviewed by: Allié McGuire
A princess who leads by example, empowering others simply by living her own truth, Princess Märtha Louise of Norway doesn't bow to standard protocol or societal norms. Rather, she stands for what she believes, unafraid and unapologetic of her authentic self. As opposed to being defined by her title, she boldly defines the title in terms of her own as an agent for change. Featured in: ‘The Origin Edition' of AwareNow Magazine Topic: Spirituality, Humanity Produced by: Awareness Ties & KNEKT TV Featuring: Princess Märtha Interviewed by: Allié McGuire
In this episode, sponsored by Bio-Techne, Drs. Hans Clevers and Kai Kretschmar join the podcast to talk broadly about the role of adult stem cells in tissue maintenance and repair. Specifically, they will focus on the expression and function of Troy and stem cells in the development and homeostasis of the epidermis, the outermost layer of the skin, that functions as a protective mechanical and biological barrier against injuries, pathogens and the loss of heat and water.GuestsHans Clevers, MD, PhD, is group leader at the Hubrecht Institute for Developmental Biology and Stem Cell Research and at the Princess Máxima Center for Pediatric Oncology. He is also University Professor at the University Utrecht and Oncode Investigator. Both in the Netherlands. Kai Kretzschmar, PhD, is junior group leader at the MSNZ University Hospital Würzburg, Germany HostMartin Pera, PhD – Editor-in-Chief, Stem Cell Reports and The Jackson LaboratoryTwitter: @martinperaJAXSupporting DocumentsTroy/Tnfrsf19 marks epidermal cells that govern interfollicular epidermal renewal and cornificationAbout Stem Cell ReportsStem Cell Reports is the Open Access journal of the International Society for Stem Cell Research (ISSCR) for communicating basic discoveries in stem cell research, in addition to translational and clinical studies. Stem Cell Reports focuses on original research with conceptual or practical advances that are of broad interest to stem cell biologists and clinicians.Twitter: @StemCellReportsAbout ISSCRWith nearly 4,000 members from more than 65 countries, the International Society for Stem Cell Research is the preeminent global, cross-disciplinary, science-based organization dedicated to stem cell research and its translation to the clinic. The ISSCR mission is to promote excellence in stem cell science and applications to human health.Twitter: @ISSCRAcknowledgementsISSCR StaffKeith Alm, Chief Executive OfficerBethany Almon, Senior Manager of Integrated MarketingYvonne Fisher, Managing Editor, Stem Cell ReportsKym Kilbourne, Director of Media and Strategic CommunicationsJack Mosher, Scientific AdvisorVoice WorkBen SnitkoffMusic@Konovalov
Holy Crap is going International! This week we have an incredible guest with us - Hollywood's favourite Shaman - Shaman Durek! We have followed this man’s work for years and it feels almost surreal that he is now guesting our podcast. For those of you who are new to him, he’s an American, 6th generation Shaman, author of best selling book 'Spirit Hacking' and frequent guest on American TV shows. He's also best friends with Gwyneth Paltrow and boyfriend to Princess Märta Louise of Norway. In this interview, we share a deep and profound conversation about many of our favourite topics, and learn so many new things. And so will you, we promise. At the end of the interview, Durek channels a beautiful message to all of you in this community. IN THIS EPISODE: - How Shaman Durek and Princess Märta Louise met - The end of the Guru era and why it’s time we reclaim our power - Durek's connection to Stockholm - The energetics of Scandinavia - What Spirit Hacking means + and a live shamanic session on Mathilda - The story of Atlantis - What ’The Matrix’ is all about - Why we see numbers 111, 222 etc - Durek channels a beautiful message to Holy Crap Community More information about Shaman Durek: https://shamandurek.com/ Visit @holycrappodcast for behind the scenes shots from the interview and join our spiritual community Holy Crap Community on Facebook. Lots of love, Amanda & Mathilda
Warning: This episode contains spoilers for Episode Two of Atlantic Crossing. Norwegian Crown Princess Märtha was born in Sweden, but Swedish actor Sofia Helin didn't know her story until she signed on to play the quiet Royal in Atlantic Crossing. But after coming on board the miniseries, Helin helped shape the story of the little-known Princess, bringing a surprising light to her powerful story. Helin talks royalty, FDR, and Saga Noren of Broen in a new interview.
Britská zpěvačka a kytaristka Nilüfer Yanya nás od loňské debutové nahrávky nepřestala bavit, naopak přichází s více groovy zvukem než kdy jindy. Mezi hudebními novinkami prvního listopadového týdne nechybí ani rapperka Rico Nasty, známá pro svůj unikátní projev, kterou na novince Don’t Like Me doplnili Don Toliver a trapová legenda Gucci Mane. Síly spojili také experimentátoři Daniel O’Sullivan a Richard Youngs.
This podcast describes a study addressing the use of dexrazoxane as a cardioprotectant in a cohort of more than 1,000 pediatric acute myeloid leukemia patients. Transcript This JCO Podcast provides observations and commentary on the JCO article “Effect of Dexrazoxane on Left Ventricular Systolic Function and Treatment Outcomes in Patients with Acute Myeloid Leukemia: A Report From the Children’s Oncology Group” by Getz et al. My name is Elvira van Dalen, and I am an epidemiologist at the Princess Máxima Center for Pediatric Oncology in Utrecht, The Netherlands and a Coordinating Editor of Cochrane Childhood Cancer. My oncologic specialties are cardiotoxicity and systematic reviews and guidelines in the field of pediatric oncology. I have nothing to disclose. Anthracyclines are widely used in pediatric oncology. Unfortunately, one of their most serious adverse effects is cardiotoxicity, which can occur during or shortly after treatment, but also decades later. In the Dutch LATER Childhood Cancer study, we found a 10.5% cumulative incidence of symptomatic heart failure 40 years after cancer diagnosis in survivors treated with cardiotoxic chemotherapy. The Childhood Cancer Survivor Study and St Jude LIFE show similar results. Siblings report significantly less congestive heart failure than survivors. These are high risks, especially in this young patient population. Cardiotoxicity impairs quality of life and can lead to premature death. Prevention is thus very important. Extensive research has been devoted to the identification of possible cardioprotective interventions, like liposomal anthracyclines, increasing the anthracycline infusion duration and reducing the cumulative anthracycline dose. Concerning the cumulative anthracycline dose, it should be kept in mind that there is no safe dose. Another option is the use of cardioprotective agents like dexrazoxane. As shown in our Cochrane systematic review published in 2011 which is currently being updated, it prevents cardiac damage. But unfortunately, the majority of the evidence comes from studies addressing adult patients with breast cancer and these data cannot be extrapolated to children. In children as of yet only a few randomized trials have been performed, none including acute myeloid leukemia patients. In these pediatric studies, for clinical heart failure there were no significant differences between dexrazoxane and control groups, while results for asymptomatic cardiotoxicity varied with the outcome definition used. All studies were relatively short-term, and we don’t know how longer follow-up will influence these results. Thus far only a few small non-randomized studies including 50 children or less evaluated dexrazoxane in pediatric acute myeloid leukemia, all with limitations. The article by Getz and colleagues that accompanies this podcast adds important new information to the current knowledge of the use of dexrazoxane in pediatric acute myeloid leukemia patients and pediatric patients in general. It presents the results from the Children’s Oncology Group AAML1031 trial investigating the use of dexrazoxane during frontline treatment of pediatric acute myeloid leukemia. Between 2011 and 2016, patients younger than 30 years at diagnosis were enrolled. Almost 98% were younger than 21 years. The analyses included 1014 patients, of which 10% received dexrazoxane consistently at every anthracycline course and 90% were never exposed to dexrazoxane. Anthracycline treatment involved both daunorubicin and mitoxantrone. Low risk patients received a cumulative anthracycline dose of 444 mg/m2, while high risk patients received 294 mg/m2 assuming the daunorubicin equivalency conversion employed by the Children’s Oncology Group at the time of this protocol. Patients were followed for a median of 3.5 years, with an interquartile range of 2.5 to 4.7 years. Cardiac function was assessed using either echocardiography or multigated acquisition scans which were performed at regular intervals. Compliance with cardiac monitoring was more than 90% on-protocol, but less than 60% off-protocol. Left ventricular systolic dysfunction was primarily defined as a shortening fraction of less than 28% or an ejection fraction of less than 55%. In the report by Getz and colleagues that accompanies this podcast, 26.5% of patients consistently treated with dexrazoxane and 42.2% of patients that never received any dexrazoxane developed left ventricular systolic dysfunction. The hazard ratio was 0.55 with a 95% confidence interval of 0.36 to 0.86. There was a trend towards a worse grade of left ventricular systolic dysfunction without dexrazoxane. Some evidence pointed to recovery of systolic function, but as this was based on mean values instead of number of patients below the cut-off value it is possible that patients with good and bad values balanced each other out resulting in an adequate mean value. This can give the impression that there is no problem, while for some patients this might not be true. It is important to note that this was not a randomized trial, which would have provided the highest level of evidence to answer this type of question. Dexrazoxane was administered at the discretion of treating physicians. However, characteristics like sex, age, risk group, treatment arm, compliance with cardiac monitoring and follow-up were similar in both groups. Unfortunately, cumulative anthracycline dose was not reported for both groups, but it was stated that patients completed a median of 4 courses regardless of dexrazoxane exposure. An important question regarding any cardioprotective intervention is whether it can reduce cardiotoxicity without negative effects on anti-tumor efficacy and non-cardiac toxicities. At the moment, despite its clear cardioprotective effects, at least in adults, dexrazoxane is not routinely used in clinical practice. This might be explained by the suspicion of interference with anti-tumor efficacy and the occurrence of secondary malignancies. However, as shown in our Cochrane systematic review no significant differences between treatment groups were identified, which is in line with more recently published randomized trials. Studies often do not report data on anti-tumor efficacy and non-cardiac toxicities, but fortunately Getz and colleagues did. This is important as extrapolation of many of these data to other types of malignancies is difficult. Survival and relapse risk were comparable between groups. And even though this study did report on only a few non-cardiac toxicities, those that were reported were similar. Despite the relatively short follow-up period, four secondary malignancies occurred, three in the non-dexrazoxane group. This was not statistically significant different. None of the secondary malignancies was acute myeloid leukemia, but it might have been difficult to distinguish a secondary malignancy from a relapse. In summary, although this is not a randomized trial, this large study provides new knowledge on the use of dexrazoxane in pediatric acute myeloid leukemia patients with regard to cardiac function, anti-tumor efficacy and non-cardiac toxicities. Overall, dexrazoxane seems to be cardioprotective, at least within the relatively short follow-up period of maximal 4 years, without negative effects on anti-tumor efficacy and non-cardiac toxicities including secondary malignancies. Hopefully the authors will continue to follow these patients for long-term results. Even though this study does have limitations, it definitely adds to the knowledge of the use of dexrazoxane in children. It can help to inform the development of a much-needed evidence-based clinical practice guideline that is currently being developed by the International Late Effects of Childhood Cancer Guideline Harmonization Group. This concludes this JCO Podcast. Thank you for listening.
Here we go! In this very first solo episode I talk about my experience at the divinity tour in Norway with Shaman Durek and Princess Märtha Louise. Host: @iselinmork www.iselinmork.com @onpoint.podcast https://www.facebook.com/iselinmorkcom/ Themesong: "It's only a matter of time" by Linn Kathrin Taklo.
Today I have a special treat for you — a summertime throwback, if you will! We’re kicking off a series of podcasts you’ll find sprinkled through summer here, sharing a few of the most potent interviews I've ever done. Today I have two very special guests on the show, Princess Märtha Louise of Norway and Elisabeth Nordeng. If you’ve ever wondered if you’re the only ‘crazy’ one out there talking to angels and playing with your aura energy — this episode is for you! Are you ready to tap into the FREE support of the angels and the crystalline path to ascension? I’m showing a lush group of divine women how to raise their vibration and ascend to Crystalline Goddess status in my FREE community The Crystalline Goddess, and I’d love for you to join us! https://www.facebook.com/groups/crystallinegoddess/ If you enjoy this episode and it inspires you in some way, I’d love to hear about your biggest takeaway. You can leave a review in iTunes, which is always appreciated, or head over to the Facebook group and share your ‘Aha!’ moments with us there. In this interview, we’ll be covering: How angel sisters meet even when the odds are stacked against them [5:21] Childhood clairvoyance, motherhood activations, and the blossoming of two spiritual teachers [7:27] How a princess becomes a spiritual goddess through trials and public judgment [16:06] More about the angel school in Norway and Märtha and Elisabeth’s bestselling book, The Spiritual Password [25:14] The scoop on the most important spiritual tool Märtha and Elisabeth have found in their work together [27:19] Keys to listening to the heart as the secret to your spiritual energy flow [37:42] Discover if you (or your children) are indigo or crystal children...and what that means for your dream life [38.49] SHOW LINKS: The Spiritual Password bestselling book is available now on Amazon: https://www.amazon.com/Spiritual-Password-Learn-Unlock-Power/dp/178180267X/ref=sr_1_1?keywords=Spiritual+Password&qid=1561550397&s=gateway&sr=8-1 I look forward to seeing you in The Crystalline Goddess group where I’ll be sharing free pop-up healing sessions, angelic rituals, and Atlantean education. You’ll also enjoy access to a sacred sisterhood of women who are on their own healing journey and are eager to cheer you on and celebrate your arrival. Join the community here: https://www.facebook.com/groups/crystallinegoddess/
Fun fact: Ginnifer Goodwin's birth name is Jennifer Michelle. Another one? She carries an iPhone AND a flip phone in her bag. What else is in this episode? Updates on Eurovision (Who won?), James Charles v. Tati v. Jeffree Star (Who won?) and the Game of Thrones finale (Who won?) The inappropriate gift Future gave his son, (Baby) Future. A Coca Cola bottling heir's private plane gets caught with 5,000 cannabis plants and Jonathan Rhys Meyers. And why the media is not quite getting that Princess Märtha Louise of Norway and her new Shaman boyfriend are a match made in heaven. Plus, Rita's in Cannes! Call 619.WHO.THEM and we might play your call on an upcoming episode! Want more stuff? Go join our Patreon for bonus content—like a weekly newsletter and exclusive bonus episodes. You can also support us by checking out today's sponsor Dunkin.
The Duchess of Cambridge's new garden, Princess Märtha Louise controversial relationship, Denmark's Crown Prince Couple's 15th Wedding Anniversary and discovery at Winchester Cathedral?See more in this week's show.Become a patron today https://www.patreon.com/join/rightroyalroundup?Visit our website http://rightroyalroundup.com.au.Like us on Facebook https://www.facebook.com/RightRoyalRoundup, follow us on Twitter @RightRoyalRound and Instagram @rightroyalroundup.
Princess Märtha Louise står frem med ny kjæreste, en sjaman fra California. Partiet Rødt fortsetter den lange marsjen mot det kommunistiske paradis. Med Anders Giæver, Astrid Meland og Hans Petter Sjøli. Produsent Magne Antonsen. See acast.com/privacy for privacy and opt-out information.
If you enjoyed this podcast, make sure to subscribe for more weekly education content from ASCO University. We truly value your feedback and suggestions, so please take a moment to leave a review. If you are an oncology professional and interested in contributing to the ASCO University Weekly Podcast, email ascou@asco.org for more information. TRANSCRIPT 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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] Hello and welcome to the ASCO Guidelines podcast series. My name is Shannon McKernin and today I'm interviewing Dr. Valerie de Haas from Princess Máxima Center for Pediatric Oncology in the Netherlands, lead author on "Initial Diagnostic Workup of Acute Leukemia: ASCO Clinical Practice Guideline Endorsement of the CAP and ASH Guideline.” Thank you for being here today, Dr. de Haas. Thank you. So first, can you give us a general overview of what this guideline covers? Well, yes. The laboratory evaluation of patients who are suspected of having acute leukemia is very complex, and it has evolved significantly with the incorporation of advanced laboratory techniques. The traditional backbone of initial workup of AL, of acute leukemia, is composed of ctyomorphology, cytochemistry, immunophenotyping, and molecular cytogenetics. These techniques are the backbone of the initial diagnostic workup of acute leukemia. This is leading to risk stratification and fine tuning of the therapy by molecular signatures. The advanced molecular diagnostics, such as next-generation sequencing, has become more important in the diagnosis and in the risk stratification of acute leukemia. This guideline is meant for both pediatric and adult patients, and it was initially published in 2017. This year, we reviewed this guideline, and we have taken into account two important developments. First, since 2017, we've seen that there are major advances in molecular techniques and also that we can identify and validate new molecular markers. And those two events have contribute to a better risk stratification. And the second development is the effect that the WHO classification was revised in 2017 which also has led to new risk recoveries and refined subclassifications. So what are the key recommendations of this guideline? Well, in total, we have reviewed 27 guideline statements by the ASCO endorsement expert panelists. And discussion points are used to summarize issues that were identified from the updated literature. The ASCO expert panel determined that the recommendations from the guideline as published in 2016 are clear, thorough, and they are based upon the most relevant scientific evidences. We fully endorse the CAP-ASH guideline on initial diagnostic workup of acute leukemia. And we decided to include some discussion points according to clinical practice and according to the updated literature. In fact, we identified four categories of key recommendations. The first one is the initial diagnostics focusing on basic diagnostics and determination of risk parameters. This concerns, in total, about 11 guideline recommendations, and they give an overview of the initial workup varying from the collection of the clinical history of the patient to initial basic diagnostics by cytomorphology, flow cytometry and molecular cytogenetic analysis of peripheral blood, bone marrow, and cerebrospinal fluids. Secondly, the second category were molecular markers and MRD detection, and they were addressed by 10 of the recommendations. And these recommendations give a structural overview of the molecular and cytogenetic workup for acute lymphoblastic leukemia versus acute myeloid leukemia identifying different prognostic markers. Also, the detection of MRD is taken into account in this recommendation. There is a major difference between children and adults, and this part is given most attention in the discussion part as the developments have been major during the past few years. The third one is the context of referral to another institution with expertise in the management of acute leukemia. This is addressed by four recommendations, emphasizing the point that referral to an institution with specific expertise is of major importance for the central workup of acute leukemia. And finally, the final reporting and report keeping is reflected in three recommendations, mainly supporting conclusions from 2017 which were describing the fact that the complete report with basic diagnostics in one central report should be available within 48 to 72 hours. And this should be followed by complete, final, comprehensive report in one or two weeks. So can you tell us about those discussion points that were made and why the panel decided to include these? The discussion points include mostly issues regarding diagnostics that involve flow cytometry and molecular techniques as addressed in part one and two of the guidelines. We think that the cytomorphologic assessment is essential for initial diagnosis of acute leukemia. Multicolor flow cytometry using 8 to 10 colors has led to a better distinction between myeloids, lymphoid, and mixed lineage blast origin. Even when the number of cells are limited, for instance in CNS involvement, fine needle aspirate of extramedullary leukemic infiltration, or skin biopsy for leukemic cutis. Also, it was suggested to better assess the central nervous system involved in leukemia. The expert panel recommends the immunophenotyping studies as an additional detection technique next to the cytomorphological examination of cytospins and particularly for those with a low level involvement of acute leukemia that cannot be well addressed by a morphologic examination only. The TDT immunohistochemistry staining of cytospins has alternatively been used for detection of CNS disease in AML and evaluation of CSF by multicolor flow cytometry has been recently adopted in some centers. Flow cytometry, using at least six, but we now use in some laboratories, even 8 to 10 colors has led to a much more specific in tentative diagnosis. And this has improved the detection of CNS involvement. The use of molecular tools, for instance, polymerase change reaction, PCR, NGS for low-level CSF involvement is still under study, and therefore, we did not recommend this in our discussion. Regarding the molecular markers and MRD detection, the discussion here was mainly based upon the results of translational research supported by better molecular detection techniques. And those molecular diagnoses have been developing in the past few years with the inclusion of many more molecular markers. And they included one of the key diagnostic criteria in the revised WHO classification, which was revised in 2017. And we made substantial changes that have been made in the ASH-CAP guidelines concerning molecular diagnostics. Those newly identified targets by advanced molecular techniques give possibilities for better risk stratification. Some examples of better molecular characterization of acute lymphoblastic leukemia are, for instance, additional testing for MLL translocations. Furthermore, we can look in patients with T-ALL for NOTCH1, and FBXW7 mutations. The Ikaros family zinc finger gene, the IKZF1 gene is frequently deleted in adults as well in children with B-ALL. And it was shown to have an independent prognostic significance and was also associated with poor clinical outcome. In the current text of the current risk that the protocols IKZF1 should be regularly included in the screening panels for all ALL patients. If we look for examples for better characterization of AML, acute myeloid leukemia, we have found an increasing number of additional cytogenetic aberrations, like for instance FLT3 ITD which is associated with poor outcome. Another example is appropriate mutational analysis for kids, which can be detected both in adult patient as pediatric patients with a confirmed core binding factor acute myeloid leukemia. So this is myeloid leukemia with a translocation A21, RUNX1, or inversion 16. This recommendation is very strong in adults, whereas in children, this prognostic fact impact remains unclear. So there have been proven several publications which refer to a similar prognosis for children and others who refer to a poor prognosis in comparison to known mutated genes. So we suggest to test for this mutation in adults, especially, but also in children to learn from it. Finally, emerging evidence supports molecular studies as principle test for monitoring minimal residual disease of acute leukemia. And there are several key molecular markers that are included in the initial workup, which will be carried on for monitoring MRD, for instance, PML- RAR-alpha, RUNX1-RUNXT1, CBFB-MYH11, and NPM1, CEBP-alpha and others. Beside those aforementioned markers, it's very important to screen for other molecular markers that have predictive or prognostic value in the individual. And it is possible to use them for MRD. We have found a recent consensus from the European Leukemia Net MRD Working Group, who was proposing that for detection of molecular MRD, and they refer the RT PCR platform to NGS and digital PCR platforms. Although all those molecular techniques have been developed very quickly and it is very tempting to use them for initial diagnostics, currently, not all laboratories will have all those techniques available. So the expert panel strongly advises understanding to make distinction between diagnostic that are needed in the first phase to start treatment and subsequently, treatment stratification, in contrast to the usual dose findings in a broader research. For instance, available karyotyping, FISH, PCR techniques, if possible, NGS can be used in the initial start of treatment, whereas techniques like whole exome sequencing, whole genome sequencing, RNA sequencing, and epigenomic studies are meant for a broader research. And finally, how will these guideline recommendations affect patients? Well, in the end, the patients will receive better and especially, more personalized treatment. If we have results available within two weeks from diagnosis, it will be possible to better identify which basis will better benefit from more intensified and more personalized treatment, whereas others may need less intensive treatment with less toxicity. If you use traditional techniques to do this supported by molecular techniques like karyotyping, FISH, and PCR techniques, and in the end, following MRD to see which patients are responding to treatment, MRD detection will help to identify these patients and stratify them finally to the best treatment. Great. Thank you for your work on this important guideline, and thank you for your time today, Dr. de Haas. OK. Thanks a lot. And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast series. If you've enjoyed what you've heard today, please rate and review the podcast and refer this show to a colleague.
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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] Hello and welcome to the ASCO Guidelines podcast series. My name is Shannon McKernin and today I'm interviewing Dr. Valerie de Haas from Princess Máxima Center for Pediatric Oncology in the Netherlands, lead author on "Initial Diagnostic Workup of Acute Leukemia: ASCO Clinical Practice Guideline Endorsement of the CAP and ASH Guideline.” Thank you for being here today, Dr. de Haas. Thank you. So first, can you give us a general overview of what this guideline covers? Well, yes. The laboratory evaluation of patients who are suspected of having acute leukemia is very complex, and it has evolved significantly with the incorporation of advanced laboratory techniques. The traditional backbone of initial workup of AL, of acute leukemia, is composed of ctyomorphology, cytochemistry, immunophenotyping, and molecular cytogenetics. These techniques are the backbone of the initial diagnostic workup of acute leukemia. This is leading to risk stratification and fine tuning of the therapy by molecular signatures. The advanced molecular diagnostics, such as next-generation sequencing, has become more important in the diagnosis and in the risk stratification of acute leukemia. This guideline is meant for both pediatric and adult patients, and it was initially published in 2017. This year, we reviewed this guideline, and we have taken into account two important developments. First, since 2017, we've seen that there are major advances in molecular techniques and also that we can identify and validate new molecular markers. And those two events have contribute to a better risk stratification. And the second development is the effect that the WHO classification was revised in 2017 which also has led to new risk recoveries and refined subclassifications. So what are the key recommendations of this guideline? Well, in total, we have reviewed 27 guideline statements by the ASCO endorsement expert panelists. And discussion points are used to summarize issues that were identified from the updated literature. The ASCO expert panel determined that the recommendations from the guideline as published in 2016 are clear, thorough, and they are based upon the most relevant scientific evidences. We fully endorse the CAP-ASH guideline on initial diagnostic workup of acute leukemia. And we decided to include some discussion points according to clinical practice and according to the updated literature. In fact, we identified four categories of key recommendations. The first one is the initial diagnostics focusing on basic diagnostics and determination of risk parameters. This concerns, in total, about 11 guideline recommendations, and they give an overview of the initial workup varying from the collection of the clinical history of the patient to initial basic diagnostics by cytomorphology, flow cytometry and molecular cytogenetic analysis of peripheral blood, bone marrow, and cerebrospinal fluids. Secondly, the second category were molecular markers and MRD detection, and they were addressed by 10 of the recommendations. And these recommendations give a structural overview of the molecular and cytogenetic workup for acute lymphoblastic leukemia versus acute myeloid leukemia identifying different prognostic markers. Also, the detection of MRD is taken into account in this recommendation. There is a major difference between children and adults, and this part is given most attention in the discussion part as the developments have been major during the past few years. The third one is the context of referral to another institution with expertise in the management of acute leukemia. This is addressed by four recommendations, emphasizing the point that referral to an institution with specific expertise is of major importance for the central workup of acute leukemia. And finally, the final reporting and report keeping is reflected in three recommendations, mainly supporting conclusions from 2017 which were describing the fact that the complete report with basic diagnostics in one central report should be available within 48 to 72 hours. And this should be followed by complete, final, comprehensive report in one or two weeks. So can you tell us about those discussion points that were made and why the panel decided to include these? The discussion points include mostly issues regarding diagnostics that involve flow cytometry and molecular techniques as addressed in part one and two of the guidelines. We think that the cytomorphologic assessment is essential for initial diagnosis of acute leukemia. Multicolor flow cytometry using 8 to 10 colors has led to a better distinction between myeloids, lymphoid, and mixed lineage blast origin. Even when the number of cells are limited, for instance in CNS involvement, fine needle aspirate of extramedullary leukemic infiltration, or skin biopsy for leukemic cutis. Also, it was suggested to better assess the central nervous system involved in leukemia. The expert panel recommends the immunophenotyping studies as an additional detection technique next to the cytomorphological examination of cytospins and particularly for those with a low level involvement of acute leukemia that cannot be well addressed by a morphologic examination only. The TDT immunohistochemistry staining of cytospins has alternatively been used for detection of CNS disease in AML and evaluation of CSF by multicolor flow cytometry has been recently adopted in some centers. Flow cytometry, using at least six, but we now use in some laboratories, even 8 to 10 colors has led to a much more specific in tentative diagnosis. And this has improved the detection of CNS involvement. The use of molecular tools, for instance, polymerase change reaction, PCR, NGS for low-level CSF involvement is still under study, and therefore, we did not recommend this in our discussion. Regarding the molecular markers and MRD detection, the discussion here was mainly based upon the results of translational research supported by better molecular detection techniques. And those molecular diagnoses have been developing in the past few years with the inclusion of many more molecular markers. And they included one of the key diagnostic criteria in the revised WHO classification, which was revised in 2017. And we made substantial changes that have been made in the ASH-CAP guidelines concerning molecular diagnostics. Those newly identified targets by advanced molecular techniques give possibilities for better risk stratification. Some examples of better molecular characterization of acute lymphoblastic leukemia are, for instance, additional testing for MLL translocations. Furthermore, we can look in patients with T-ALL for NOTCH1, and FBXW7 mutations. The Ikaros family zinc finger gene, the IKZF1 gene is frequently deleted in adults as well in children with B-ALL. And it was shown to have an independent prognostic significance and was also associated with poor clinical outcome. In the current text of the current risk that the protocols IKZF1 should be regularly included in the screening panels for all ALL patients. If we look for examples for better characterization of AML, acute myeloid leukemia, we have found an increasing number of additional cytogenetic aberrations, like for instance FLT3 ITD which is associated with poor outcome. Another example is appropriate mutational analysis for kids, which can be detected both in adult patient as pediatric patients with a confirmed core binding factor acute myeloid leukemia. So this is myeloid leukemia with a translocation A21, RUNX1, or inversion 16. This recommendation is very strong in adults, whereas in children, this prognostic fact impact remains unclear. So there have been proven several publications which refer to a similar prognosis for children and others who refer to a poor prognosis in comparison to known mutated genes. So we suggest to test for this mutation in adults, especially, but also in children to learn from it. Finally, emerging evidence supports molecular studies as principle test for monitoring minimal residual disease of acute leukemia. And there are several key molecular markers that are included in the initial workup, which will be carried on for monitoring MRD, for instance, PML- RAR-alpha, RUNX1-RUNXT1, CBFB-MYH11, and NPM1, CEBP-alpha and others. Beside those aforementioned markers, it's very important to screen for other molecular markers that have predictive or prognostic value in the individual. And it is possible to use them for MRD. We have found a recent consensus from the European Leukemia Net MRD Working Group, who was proposing that for detection of molecular MRD, and they refer the RT PCR platform to NGS and digital PCR platforms. Although all those molecular techniques have been developed very quickly and it is very tempting to use them for initial diagnostics, currently, not all laboratories will have all those techniques available. So the expert panel strongly advises understanding to make distinction between diagnostic that are needed in the first phase to start treatment and subsequently, treatment stratification, in contrast to the usual dose findings in a broader research. For instance, available karyotyping, FISH, PCR techniques, if possible, NGS can be used in the initial start of treatment, whereas techniques like whole exome sequencing, whole genome sequencing, RNA sequencing, and epigenomic studies are meant for a broader research. And finally, how will these guideline recommendations affect patients? Well, in the end, the patients will receive better and especially, more personalized treatment. If we have results available within two weeks from diagnosis, it will be possible to better identify which basis will better benefit from more intensified and more personalized treatment, whereas others may need less intensive treatment with less toxicity. If you use traditional techniques to do this supported by molecular techniques like karyotyping, FISH, and PCR techniques, and in the end, following MRD to see which patients are responding to treatment, MRD detection will help to identify these patients and stratify them finally to the best treatment. Great. Thank you for your work on this important guideline, and thank you for your time today, Dr. de Haas. OK. Thanks a lot. And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast series. If you've enjoyed what you've heard today, please rate and review the podcast and refer this show to a colleague.