Podcasts about Raas

What You'll Learn:Why orchestration platforms are the future of 3PLs, and how they outperform legacy WMS systems.The real ROI of small automation solutions for 3PLs with low upfront costs.How to evaluate fulfillment tech and avoid costly pilot mistakes.What the Greenfield vs. Brownfield debate means for your automation strategy.Why incremental scaling is the best approach for implementing automation in 3PLs.How AI and robotics are transforming the supply chain and fulfillment operations.Key takeaways from Promat and other industry conferences on next-gen warehouse tech. Highlights: [00:00:00] – Introduction to the episode & guest introductions[00:06:13] – The evolution of decision-making with AI[00:10:30] – Why orchestration-first is replacing WMS in modern warehouses[00:13:52] – Evaluating fulfillment tech and avoiding common pitfalls[00:18:10] – The ROI of small-scale automation for 3PLs[00:30:00] – Greenfield vs. Brownfield for automation—where should you start?[00:34:32] – Closing thoughts on smart scaling and what's next for 3PLsQuotes: [00:06:39] “So I can spend 10%, 15% of my time compiling, and theoretically 80% of my time thinking. And that's going to be a game changer for us as an industry.” — Will O'Donnell[00:10:56] “The warehouse of the future is automation, robots, and an orchestrator. Not just a WMS.” — Erhan Musaoglu[00:19:18] “Innovation happens when you remove constraints. And a lot of constraints are self-imposed.” — Will O'Donnell[00:27:00] “Don't underestimate the simple solutions that are usually the best.” — Marv Cunningham  About the Guests: Will O'Donnell — Global Head of Corporate Development at Prologis & Managing Partner of Prologis Ventures. Will leads investment into emerging supply chain tech with a macro lens on real estate and fulfillment convergence. https://www.linkedin.com/in/will-odonnell-553aa0a/Marv Cunningham — Global Head of Operations, Essentials at Prologis. Formerly of Amazon and GXO, Marv brings deep operational expertise and a track record of warehouse optimization at scale. https://www.linkedin.com/in/marvcunningham/Erhan Musaoglu — CEO of Logiwa. A serial WMS builder, Erhan now focuses on orchestration-first fulfillment software that integrates robotics, AI, and warehouse logic. https://www.linkedin.com/in/erhanmusaoglu/ Subscribe and Keep Learning!If you're a logistics leader looking to scale sustainably, don't miss out! Subscribe for more expert strategies on tackling modern supply chain challenges.Be sure to follow and tag the eCom Logistics Podcast on LinkedIn and YouTube

In this high-yield episode Mike and Molly travel through the entire nephron—from Bowman's capsule to the collecting duct—to show how the kidneys quietly run four huge homeostatic jobs:- Water balance (ADH / vasopressin & aquaporins)- Sodium-potassium balance (aldosterone & the distal convoluted tubule)- Blood-pressure regulation (the full RAAS pathway + ACE)- Acid-base regulation (H⁺ / HCO₃⁻ handling)Along the way we connect the dots to the cardiovascular, respiratory and endocrine systems and share memory hooks, MCAT “buzz-words,” real-life examples (why alcohol makes you pee!), and pro tips for spotting kidney questions in passages.Want to learn more? Shoot us a text at 415-855-4435 or email us at podcast@jackwestin.com!

Are negative-feedback loops really the body's default setting?

Endpoint security tools worked, but the hackers worked harder for their payday.While everyone likes to know how someone else might have screwed up and what the fallout looks like, the more import elements of episodes like this one come from the in-depth conversations about new tactics and strategies that are being used by the bad guys, and simultaneously, the insight on new best practices for the good guys.So while I did enjoy diving into how the ransomware group Akira was able to use webcam access to infiltrate an organization, it was also great to discuss the evolution of these hacking groups, EDR tools, dark web monitoring and the need for better credential security with Steve Ross. He's the director of cybersecurity at S-RM, a leading provider or cyber intelligence and solutions.Watch/listen as we also discuss:Endpoint Detection and Response (EDR) tools.The rise of Akira, and the evolving symbiotic strategies used by this and other RaaS groups.Patching challenges.The growing need for dark web monitoring.The continued rise in login/credential harvesting.As a go-to podcast for our listeners, we want to help you align your brand with our expertise. By sponsoring our podcast, your brand will build trust, and your message will stand out to an audience searching for tools to assist their cybersecurity efforts. Click Here to Become a Sponsor.Promoguy Talk PillsAgency in Amsterdam dives into topics like Tech, AI, digital marketing, and more drama...Listen on: Apple Podcasts SpotifyTo catch up on past episodes, you can go to Manufacturing.net, IEN.com or MBTmag.com. You can also check Security Breach out wherever you get your podcasts, including Apple, Amazon and Overcast. If you have a cybersecurity story or topic that you'd like to have us explore on Security Breach, you can reach me at jeff@ien.com. To download our latest report on industrial cybersecurity, The Industrial Sector's New Battlefield, click here.

Ransomware has become more difficult for organizations to defend against, but easier for adversaries to deploy. The rise of ransomware-as-a-service (RaaS) — a model in which ransomware operators write the malware and affiliates pay to launch it — has lowered the barrier to entry so threat actors of all skill levels can participate and profit.   OCULAR SPIDER is one such operator. This adversary, newly named by CrowdStrike, is associated with the development of ransomware variants including Cyclops, Knight, and RansomHub. They targeted hundreds of named victims between February 2024 and March 2025, according to CrowdStrike intelligence, and they focus on industries such as professional services, technology, healthcare, and manufacturing in regions including the United States, Canada, Brazil, and some European countries.   But OCULAR SPIDER is one of many operators in the ransomware space. Adam and Cristian take listeners back to the early days of ransomware and track its evolution, variants, and key players from the mid-2010s through the launch of RansomHub in 2024. They explain how RaaS works, why it appeals to adversaries and complicates attribution, and how defenders can prepare to face today's ransomware threats.   Come for an update on Adam's adventures in bread-making; stay for a deep-dive into the RaaS evolution and the threat actors driving it.

When it comes to cybersecurity, most people think about firewalls, passwords, and antivirus software. But what about the attackers themselves? Understanding how they operate is just as important as having the right defenses in place. That's where Paul Reid comes in. As the Vice President of Adversary Research at AttackIQ, Paul and his team work to stay one step ahead of cybercriminals by thinking like them and identifying vulnerabilities before they can be exploited.   In this episode, we dive into the world of cyber threats, ransomware, and the business of hacking. Paul shares insights from his 25+ years in cybersecurity, including his experience tracking nation-state attackers, analyzing ransomware-as-a-service, and why cybercrime has become such a highly organized industry. We also talk about what businesses and individuals can do to protect themselves, from understanding threat intelligence to why testing your backups might save you from disaster. Whether you're in cybersecurity or just trying to keep your data safe, this conversation is packed with insights you won't want to miss. Show Notes: [00:58] Paul is the VP of Adversary Research at AttackIQ.  [01:30] His team wants to help their customers be more secure. [01:52] Paul has been in cybersecurity for 25 years. He began working in Novell Networks and then moved to directory services with Novell and Microsoft, Active Directory, LDAP, and more.  [02:32] He also helped design classification systems and then worked for a startup. He also ran a worldwide threat hunting team. Paul has an extensive background in networks and cybersecurity.  [03:49] Paul was drawn to AttackIQ because they do breach attack simulation. [04:22] His original goal was actually to be a banker. Then he went back to his original passion, computer science. [06:05] We learn Paul's story of being a victim of ransomware or a scam. A company he was working for almost fell for a money transfer scam. [09:12] If something seems off, definitely question it. [10:17] Ransomware is an economically driven cybercrime. Attackers try to get in through social engineering, brute force attack, password spraying, or whatever means possible. [11:13] Once they get in, they find whatever is of value and encrypt it or do something else to extort money from you. [12:14] Ransomware as a service (RaaS) has brought ransomware to the masses. [13:49] We discuss some ethics in these criminal organizations. Honest thieves? [16:24] Threats look a lot more real when you see that they have your information. [17:12] Paul shares a phishing scam story with just enough information to make the potential victim click on it.  [18:01] There was a takedown of LockBit in 2020, but they had a resurgence. It's a decentralized ransomware as a service model that allows affiliates to keep on earning, even if the main ones go down. [20:14] Many of the affiliates are smash and grab, the nation states are a little more patient.  [21:11] Attackers are branching out into other areas and increasing their attack service, targeting Linux and macOS. [22:17] The resiliency of the ransomware as a service setup and how they've distributed the risk across multiple affiliates. [23:42] There's an ever growing attack service and things are getting bigger. [25:06] AttackIQ is able to run emulations in a production environment. [26:20] Having the ability to continuously test and find new areas really makes networks more cyber resilient. [29:55] We talk about whether to pay ransoms and how to navigate these situations.  [31:05] The best solution is to do due diligence, updates, patches, and separate backups from the system.  [35:19] Dealing with ransomware is a no win situation. Everyone is different. Thanks for joining us on Easy Prey. Be sure to subscribe to our podcast on iTunes and leave a nice review.  Links and Resources: Podcast Web Page Facebook Page whatismyipaddress.com Easy Prey on Instagram Easy Prey on Twitter Easy Prey on LinkedIn Easy Prey on YouTube Easy Prey on Pinterest Paul Reid - Vice President, Adversary Research AttackIQ Paul Reid on LinkedIn AttackIQ Academy Understanding Ransomware Threat Actors: LockBit

We talk a lot about the growing complexity of hacking groups and how their tools and tactics continue to evolve. One such evolution is the ongoing specialization that runs rampant throughout the black hat community – especially when it comes to ransomware. The rise of initial access brokers, affiliate programs, spoofing domain creators, dark web communities, and more are fueling ransomware-as-a-service groups and posing new cybersecurity challenges. And while numerous reports detail the rise in ransomware attacks and the escalating amounts being paid in seeking a reprieve from denial of service, data extortion, and supply chain hacks, one recent finding really stood out. In their annual State of Ransomware Report, Blackfog stated that manufacturing had the highest number of undisclosed ransomware attacks, when compared to all other industries. So, as tough as we know the ransomware challenge is – it's actually a bit worse than we acknowledge because of the growing number of attacks that go unreported. Fortunately, we have an army of highly skilled individuals working to combat these threats. And that includes our guest for today's episode - Fortra's senior manager of domain and dark web monitoring solutions, Nick Oram. Watch/listen as we discuss:The surge of new ransomware tactics and groups, like RansomHub.The origins and continued growth of Initial Access Brokers (IABs) within the ransomware community.How affiliate programs are helping both RaaS and IAB groups increase their rate of successful attacks.Why dark web monitoring might be more important than ever for manufacturers.The ongoing "we adapt", "they adapt" dynamic.How to better educate the workforce and shift from a "As a go-to podcast for our listeners, we want to help you align your brand with our expertise. By sponsoring our podcast, your brand will build trust, and your message will stand out to an audience searching for tools to assist their cybersecurity efforts. Click Here to Become a Sponsor.Promoguy Talk PillsAgency in Amsterdam dives into topics like Tech, AI, digital marketing, and more drama...Listen on: Apple Podcasts Spotify Everyday AI: Your daily guide to grown with Generative AICan't keep up with AI? We've got you. Everyday AI helps you keep up and get ahead.Listen on: Apple Podcasts SpotifyTo catch up on past episodes, you can go to Manufacturing.net, IEN.com or MBTmag.com. You can also check Security Breach out wherever you get your podcasts, including Apple, Amazon and Overcast. If you have a cybersecurity story or topic that you'd like to have us explore on Security Breach, you can reach me at jeff@ien.com. To download our latest report on industrial cybersecurity, The Industrial Sector's New Battlefield, click here.

If you're in SF: Join us for the Claude Plays Pokemon hackathon this Sunday!If you're not: Fill out the 2025 State of AI Eng survey for $250 in Amazon cards!We are SO excited to share our conversation with Dharmesh Shah, co-founder of HubSpot and creator of Agent.ai.A particularly compelling concept we discussed is the idea of "hybrid teams" - the next evolution in workplace organization where human workers collaborate with AI agents as team members. Just as we previously saw hybrid teams emerge in terms of full-time vs. contract workers, or in-office vs. remote workers, Dharmesh predicts that the next frontier will be teams composed of both human and AI members. This raises interesting questions about team dynamics, trust, and how to effectively delegate tasks between human and AI team members.The discussion of business models in AI reveals an important distinction between Work as a Service (WaaS) and Results as a Service (RaaS), something Dharmesh has written extensively about. While RaaS has gained popularity, particularly in customer support applications where outcomes are easily measurable, Dharmesh argues that this model may be over-indexed. Not all AI applications have clearly definable outcomes or consistent economic value per transaction, making WaaS more appropriate in many cases. This insight is particularly relevant for businesses considering how to monetize AI capabilities.The technical challenges of implementing effective agent systems are also explored, particularly around memory and authentication. Shah emphasizes the importance of cross-agent memory sharing and the need for more granular control over data access. He envisions a future where users can selectively share parts of their data with different agents, similar to how OAuth works but with much finer control. This points to significant opportunities in developing infrastructure for secure and efficient agent-to-agent communication and data sharing.Other highlights from our conversation* The Evolution of AI-Powered Agents – Exploring how AI agents have evolved from simple chatbots to sophisticated multi-agent systems, and the role of MCPs in enabling that.* Hybrid Digital Teams and the Future of Work – How AI agents are becoming teammates rather than just tools, and what this means for business operations and knowledge work.* Memory in AI Agents – The importance of persistent memory in AI systems and how shared memory across agents could enhance collaboration and efficiency.* Business Models for AI Agents – Exploring the shift from software as a service (SaaS) to work as a service (WaaS) and results as a service (RaaS), and what this means for monetization.* The Role of Standards Like MCP – Why MCP has been widely adopted and how it enables agent collaboration, tool use, and discovery.* The Future of AI Code Generation and Software Engineering – How AI-assisted coding is changing the role of software engineers and what skills will matter most in the future.* Domain Investing and Efficient Markets – Dharmesh's approach to domain investing and how inefficiencies in digital asset markets create business opportunities.* The Philosophy of Saying No – Lessons from "Sorry, You Must Pass" and how prioritization leads to greater productivity and focus.Timestamps* 00:00 Introduction and Guest Welcome* 02:29 Dharmesh Shah's Journey into AI* 05:22 Defining AI Agents* 06:45 The Evolution and Future of AI Agents* 13:53 Graph Theory and Knowledge Representation* 20:02 Engineering Practices and Overengineering* 25:57 The Role of Junior Engineers in the AI Era* 28:20 Multi-Agent Systems and MCP Standards* 35:55 LinkedIn's Legal Battles and Data Scraping* 37:32 The Future of AI and Hybrid Teams* 39:19 Building Agent AI: A Professional Network for Agents* 40:43 Challenges and Innovations in Agent AI* 45:02 The Evolution of UI in AI Systems* 01:00:25 Business Models: Work as a Service vs. Results as a Service* 01:09:17 The Future Value of Engineers* 01:09:51 Exploring the Role of Agents* 01:10:28 The Importance of Memory in AI* 01:11:02 Challenges and Opportunities in AI Memory* 01:12:41 Selective Memory and Privacy Concerns* 01:13:27 The Evolution of AI Tools and Platforms* 01:18:23 Domain Names and AI Projects* 01:32:08 Balancing Work and Personal Life* 01:35:52 Final Thoughts and ReflectionsTranscriptAlessio [00:00:04]: Hey everyone, welcome back to the Latent Space podcast. This is Alessio, partner and CTO at Decibel Partners, and I'm joined by my co-host Swyx, founder of Small AI.swyx [00:00:12]: Hello, and today we're super excited to have Dharmesh Shah to join us. I guess your relevant title here is founder of Agent AI.Dharmesh [00:00:20]: Yeah, that's true for this. Yeah, creator of Agent.ai and co-founder of HubSpot.swyx [00:00:25]: Co-founder of HubSpot, which I followed for many years, I think 18 years now, gonna be 19 soon. And you caught, you know, people can catch up on your HubSpot story elsewhere. I should also thank Sean Puri, who I've chatted with back and forth, who's been, I guess, getting me in touch with your people. But also, I think like, just giving us a lot of context, because obviously, My First Million joined you guys, and they've been chatting with you guys a lot. So for the business side, we can talk about that, but I kind of wanted to engage your CTO, agent, engineer side of things. So how did you get agent religion?Dharmesh [00:01:00]: Let's see. So I've been working, I'll take like a half step back, a decade or so ago, even though actually more than that. So even before HubSpot, the company I was contemplating that I had named for was called Ingenisoft. And the idea behind Ingenisoft was a natural language interface to business software. Now realize this is 20 years ago, so that was a hard thing to do. But the actual use case that I had in mind was, you know, we had data sitting in business systems like a CRM or something like that. And my kind of what I thought clever at the time. Oh, what if we used email as the kind of interface to get to business software? And the motivation for using email is that it automatically works when you're offline. So imagine I'm getting on a plane or I'm on a plane. There was no internet on planes back then. It's like, oh, I'm going through business cards from an event I went to. I can just type things into an email just to have them all in the backlog. When it reconnects, it sends those emails to a processor that basically kind of parses effectively the commands and updates the software, sends you the file, whatever it is. And there was a handful of commands. I was a little bit ahead of the times in terms of what was actually possible. And I reattempted this natural language thing with a product called ChatSpot that I did back 20...swyx [00:02:12]: Yeah, this is your first post-ChatGPT project.Dharmesh [00:02:14]: I saw it come out. Yeah. And so I've always been kind of fascinated by this natural language interface to software. Because, you know, as software developers, myself included, we've always said, oh, we build intuitive, easy-to-use applications. And it's not intuitive at all, right? Because what we're doing is... We're taking the mental model that's in our head of what we're trying to accomplish with said piece of software and translating that into a series of touches and swipes and clicks and things like that. And there's nothing natural or intuitive about it. And so natural language interfaces, for the first time, you know, whatever the thought is you have in your head and expressed in whatever language that you normally use to talk to yourself in your head, you can just sort of emit that and have software do something. And I thought that was kind of a breakthrough, which it has been. And it's gone. So that's where I first started getting into the journey. I started because now it actually works, right? So once we got ChatGPT and you can take, even with a few-shot example, convert something into structured, even back in the ChatGP 3.5 days, it did a decent job in a few-shot example, convert something to structured text if you knew what kinds of intents you were going to have. And so that happened. And that ultimately became a HubSpot project. But then agents intrigued me because I'm like, okay, well, that's the next step here. So chat's great. Love Chat UX. But if we want to do something even more meaningful, it felt like the next kind of advancement is not this kind of, I'm chatting with some software in a kind of a synchronous back and forth model, is that software is going to do things for me in kind of a multi-step way to try and accomplish some goals. So, yeah, that's when I first got started. It's like, okay, what would that look like? Yeah. And I've been obsessed ever since, by the way.Alessio [00:03:55]: Which goes back to your first experience with it, which is like you're offline. Yeah. And you want to do a task. You don't need to do it right now. You just want to queue it up for somebody to do it for you. Yes. As you think about agents, like, let's start at the easy question, which is like, how do you define an agent? Maybe. You mean the hardest question in the universe? Is that what you mean?Dharmesh [00:04:12]: You said you have an irritating take. I do have an irritating take. I think, well, some number of people have been irritated, including within my own team. So I have a very broad definition for agents, which is it's AI-powered software that accomplishes a goal. Period. That's it. And what irritates people about it is like, well, that's so broad as to be completely non-useful. And I understand that. I understand the criticism. But in my mind, if you kind of fast forward months, I guess, in AI years, the implementation of it, and we're already starting to see this, and we'll talk about this, different kinds of agents, right? So I think in addition to having a usable definition, and I like yours, by the way, and we should talk more about that, that you just came out with, the classification of agents actually is also useful, which is, is it autonomous or non-autonomous? Does it have a deterministic workflow? Does it have a non-deterministic workflow? Is it working synchronously? Is it working asynchronously? Then you have the different kind of interaction modes. Is it a chat agent, kind of like a customer support agent would be? You're having this kind of back and forth. Is it a workflow agent that just does a discrete number of steps? So there's all these different flavors of agents. So if I were to draw it in a Venn diagram, I would draw a big circle that says, this is agents, and then I have a bunch of circles, some overlapping, because they're not mutually exclusive. And so I think that's what's interesting, and we're seeing development along a bunch of different paths, right? So if you look at the first implementation of agent frameworks, you look at Baby AGI and AutoGBT, I think it was, not Autogen, that's the Microsoft one. They were way ahead of their time because they assumed this level of reasoning and execution and planning capability that just did not exist, right? So it was an interesting thought experiment, which is what it was. Even the guy that, I'm an investor in Yohei's fund that did Baby AGI. It wasn't ready, but it was a sign of what was to come. And so the question then is, when is it ready? And so lots of people talk about the state of the art when it comes to agents. I'm a pragmatist, so I think of the state of the practical. It's like, okay, well, what can I actually build that has commercial value or solves actually some discrete problem with some baseline of repeatability or verifiability?swyx [00:06:22]: There was a lot, and very, very interesting. I'm not irritated by it at all. Okay. As you know, I take a... There's a lot of anthropological view or linguistics view. And in linguistics, you don't want to be prescriptive. You want to be descriptive. Yeah. So you're a goals guy. That's the key word in your thing. And other people have other definitions that might involve like delegated trust or non-deterministic work, LLM in the loop, all that stuff. The other thing I was thinking about, just the comment on Baby AGI, LGBT. Yeah. In that piece that you just read, I was able to go through our backlog and just kind of track the winter of agents and then the summer now. Yeah. And it's... We can tell the whole story as an oral history, just following that thread. And it's really just like, I think, I tried to explain the why now, right? Like I had, there's better models, of course. There's better tool use with like, they're just more reliable. Yep. Better tools with MCP and all that stuff. And I'm sure you have opinions on that too. Business model shift, which you like a lot. I just heard you talk about RAS with MFM guys. Yep. Cost is dropping a lot. Yep. Inference is getting faster. There's more model diversity. Yep. Yep. I think it's a subtle point. It means that like, you have different models with different perspectives. You don't get stuck in the basin of performance of a single model. Sure. You can just get out of it by just switching models. Yep. Multi-agent research and RL fine tuning. So I just wanted to let you respond to like any of that.Dharmesh [00:07:44]: Yeah. A couple of things. Connecting the dots on the kind of the definition side of it. So we'll get the irritation out of the way completely. I have one more, even more irritating leap on the agent definition thing. So here's the way I think about it. By the way, the kind of word agent, I looked it up, like the English dictionary definition. The old school agent, yeah. Is when you have someone or something that does something on your behalf, like a travel agent or a real estate agent acts on your behalf. It's like proxy, which is a nice kind of general definition. So the other direction I'm sort of headed, and it's going to tie back to tool calling and MCP and things like that, is if you, and I'm not a biologist by any stretch of the imagination, but we have these single-celled organisms, right? Like the simplest possible form of what one would call life. But it's still life. It just happens to be single-celled. And then you can combine cells and then cells become specialized over time. And you have much more sophisticated organisms, you know, kind of further down the spectrum. In my mind, at the most fundamental level, you can almost think of having atomic agents. What is the simplest possible thing that's an agent that can still be called an agent? What is the equivalent of a kind of single-celled organism? And the reason I think that's useful is right now we're headed down the road, which I think is very exciting around tool use, right? That says, okay, the LLMs now can be provided a set of tools that it calls to accomplish whatever it needs to accomplish in the kind of furtherance of whatever goal it's trying to get done. And I'm not overly bothered by it, but if you think about it, if you just squint a little bit and say, well, what if everything was an agent? And what if tools were actually just atomic agents? Because then it's turtles all the way down, right? Then it's like, oh, well, all that's really happening with tool use is that we have a network of agents that know about each other through something like an MMCP and can kind of decompose a particular problem and say, oh, I'm going to delegate this to this set of agents. And why do we need to draw this distinction between tools, which are functions most of the time? And an actual agent. And so I'm going to write this irritating LinkedIn post, you know, proposing this. It's like, okay. And I'm not suggesting we should call even functions, you know, call them agents. But there is a certain amount of elegance that happens when you say, oh, we can just reduce it down to one primitive, which is an agent that you can combine in complicated ways to kind of raise the level of abstraction and accomplish higher order goals. Anyway, that's my answer. I'd say that's a success. Thank you for coming to my TED Talk on agent definitions.Alessio [00:09:54]: How do you define the minimum viable agent? Do you already have a definition for, like, where you draw the line between a cell and an atom? Yeah.Dharmesh [00:10:02]: So in my mind, it has to, at some level, use AI in order for it to—otherwise, it's just software. It's like, you know, we don't need another word for that. And so that's probably where I draw the line. So then the question, you know, the counterargument would be, well, if that's true, then lots of tools themselves are actually not agents because they're just doing a database call or a REST API call or whatever it is they're doing. And that does not necessarily qualify them, which is a fair counterargument. And I accept that. It's like a good argument. I still like to think about—because we'll talk about multi-agent systems, because I think—so we've accepted, which I think is true, lots of people have said it, and you've hopefully combined some of those clips of really smart people saying this is the year of agents, and I completely agree, it is the year of agents. But then shortly after that, it's going to be the year of multi-agent systems or multi-agent networks. I think that's where it's going to be headed next year. Yeah.swyx [00:10:54]: Opening eyes already on that. Yeah. My quick philosophical engagement with you on this. I often think about kind of the other spectrum, the other end of the cell spectrum. So single cell is life, multi-cell is life, and you clump a bunch of cells together in a more complex organism, they become organs, like an eye and a liver or whatever. And then obviously we consider ourselves one life form. There's not like a lot of lives within me. I'm just one life. And now, obviously, I don't think people don't really like to anthropomorphize agents and AI. Yeah. But we are extending our consciousness and our brain and our functionality out into machines. I just saw you were a Bee. Yeah. Which is, you know, it's nice. I have a limitless pendant in my pocket.Dharmesh [00:11:37]: I got one of these boys. Yeah.swyx [00:11:39]: I'm testing it all out. You know, got to be early adopters. But like, we want to extend our personal memory into these things so that we can be good at the things that we're good at. And, you know, machines are good at it. Machines are there. So like, my definition of life is kind of like going outside of my own body now. I don't know if you've ever had like reflections on that. Like how yours. How our self is like actually being distributed outside of you. Yeah.Dharmesh [00:12:01]: I don't fancy myself a philosopher. But you went there. So yeah, I did go there. I'm fascinated by kind of graphs and graph theory and networks and have been for a long, long time. And to me, we're sort of all nodes in this kind of larger thing. It just so happens that we're looking at individual kind of life forms as they exist right now. But so the idea is when you put a podcast out there, there's these little kind of nodes you're putting out there of like, you know, conceptual ideas. Once again, you have varying kind of forms of those little nodes that are up there and are connected in varying and sundry ways. And so I just think of myself as being a node in a massive, massive network. And I'm producing more nodes as I put content or ideas. And, you know, you spend some portion of your life collecting dots, experiences, people, and some portion of your life then connecting dots from the ones that you've collected over time. And I found that really interesting things happen and you really can't know in advance how those dots are necessarily going to connect in the future. And that's, yeah. So that's my philosophical take. That's the, yes, exactly. Coming back.Alessio [00:13:04]: Yep. Do you like graph as an agent? Abstraction? That's been one of the hot topics with LandGraph and Pydantic and all that.Dharmesh [00:13:11]: I do. The thing I'm more interested in terms of use of graphs, and there's lots of work happening on that now, is graph data stores as an alternative in terms of knowledge stores and knowledge graphs. Yeah. Because, you know, so I've been in software now 30 plus years, right? So it's not 10,000 hours. It's like 100,000 hours that I've spent doing this stuff. And so I've grew up with, so back in the day, you know, I started on mainframes. There was a product called IMS from IBM, which is basically an index database, what we'd call like a key value store today. Then we've had relational databases, right? We have tables and columns and foreign key relationships. We all know that. We have document databases like MongoDB, which is sort of a nested structure keyed by a specific index. We have vector stores, vector embedding database. And graphs are interesting for a couple of reasons. One is, so it's not classically structured in a relational way. When you say structured database, to most people, they're thinking tables and columns and in relational database and set theory and all that. Graphs still have structure, but it's not the tables and columns structure. And you could wonder, and people have made this case, that they are a better representation of knowledge for LLMs and for AI generally than other things. So that's kind of thing number one conceptually, and that might be true, I think is possibly true. And the other thing that I really like about that in the context of, you know, I've been in the context of data stores for RAG is, you know, RAG, you say, oh, I have a million documents, I'm going to build the vector embeddings, I'm going to come back with the top X based on the semantic match, and that's fine. All that's very, very useful. But the reality is something gets lost in the chunking process and the, okay, well, those tend, you know, like, you don't really get the whole picture, so to speak, and maybe not even the right set of dimensions on the kind of broader picture. And it makes intuitive sense to me that if we did capture it properly in a graph form, that maybe that feeding into a RAG pipeline will actually yield better results for some use cases, I don't know, but yeah.Alessio [00:15:03]: And do you feel like at the core of it, there's this difference between imperative and declarative programs? Because if you think about HubSpot, it's like, you know, people and graph kind of goes hand in hand, you know, but I think maybe the software before was more like primary foreign key based relationship, versus now the models can traverse through the graph more easily.Dharmesh [00:15:22]: Yes. So I like that representation. There's something. It's just conceptually elegant about graphs and just from the representation of it, they're much more discoverable, you can kind of see it, there's observability to it, versus kind of embeddings, which you can't really do much with as a human. You know, once they're in there, you can't pull stuff back out. But yeah, I like that kind of idea of it. And the other thing that's kind of, because I love graphs, I've been long obsessed with PageRank from back in the early days. And, you know, one of the kind of simplest algorithms in terms of coming up, you know, with a phone, everyone's been exposed to PageRank. And the idea is that, and so I had this other idea for a project, not a company, and I have hundreds of these, called NodeRank, is to be able to take the idea of PageRank and apply it to an arbitrary graph that says, okay, I'm going to define what authority looks like and say, okay, well, that's interesting to me, because then if you say, I'm going to take my knowledge store, and maybe this person that contributed some number of chunks to the graph data store has more authority on this particular use case or prompt that's being submitted than this other one that may, or maybe this one was more. popular, or maybe this one has, whatever it is, there should be a way for us to kind of rank nodes in a graph and sort them in some, some useful way. Yeah.swyx [00:16:34]: So I think that's generally useful for, for anything. I think the, the problem, like, so even though at my conferences, GraphRag is super popular and people are getting knowledge, graph religion, and I will say like, it's getting space, getting traction in two areas, conversation memory, and then also just rag in general, like the, the, the document data. Yeah. It's like a source. Most ML practitioners would say that knowledge graph is kind of like a dirty word. The graph database, people get graph religion, everything's a graph, and then they, they go really hard into it and then they get a, they get a graph that is too complex to navigate. Yes. And so like the, the, the simple way to put it is like you at running HubSpot, you know, the power of graphs, the way that Google has pitched them for many years, but I don't suspect that HubSpot itself uses a knowledge graph. No. Yeah.Dharmesh [00:17:26]: So when is it over engineering? Basically? It's a great question. I don't know. So the question now, like in AI land, right, is the, do we necessarily need to understand? So right now, LLMs for, for the most part are somewhat black boxes, right? We sort of understand how the, you know, the algorithm itself works, but we really don't know what's going on in there and, and how things come out. So if a graph data store is able to produce the outcomes we want, it's like, here's a set of queries I want to be able to submit and then it comes out with useful content. Maybe the underlying data store is as opaque as a vector embeddings or something like that, but maybe it's fine. Maybe we don't necessarily need to understand it to get utility out of it. And so maybe if it's messy, that's okay. Um, that's, it's just another form of lossy compression. Uh, it's just lossy in a way that we just don't completely understand in terms of, because it's going to grow organically. Uh, and it's not structured. It's like, ah, we're just gonna throw a bunch of stuff in there. Let the, the equivalent of the embedding algorithm, whatever they called in graph land. Um, so the one with the best results wins. I think so. Yeah.swyx [00:18:26]: Or is this the practical side of me is like, yeah, it's, if it's useful, we don't necessarilyDharmesh [00:18:30]: need to understand it.swyx [00:18:30]: I have, I mean, I'm happy to push back as long as you want. Uh, it's not practical to evaluate like the 10 different options out there because it takes time. It takes people, it takes, you know, resources, right? Set. That's the first thing. Second thing is your evals are typically on small things and some things only work at scale. Yup. Like graphs. Yup.Dharmesh [00:18:46]: Yup. That's, yeah, no, that's fair. And I think this is one of the challenges in terms of implementation of graph databases is that the most common approach that I've seen developers do, I've done it myself, is that, oh, I've got a Postgres database or a MySQL or whatever. I can represent a graph with a very set of tables with a parent child thing or whatever. And that sort of gives me the ability, uh, why would I need anything more than that? And the answer is, well, if you don't need anything more than that, you don't need anything more than that. But there's a high chance that you're sort of missing out on the actual value that, uh, the graph representation gives you. Which is the ability to traverse the graph, uh, efficiently in ways that kind of going through the, uh, traversal in a relational database form, even though structurally you have the data, practically you're not gonna be able to pull it out in, in useful ways. Uh, so you wouldn't like represent a social graph, uh, in, in using that kind of relational table model. It just wouldn't scale. It wouldn't work.swyx [00:19:36]: Uh, yeah. Uh, I think we want to move on to MCP. Yeah. But I just want to, like, just engineering advice. Yeah. Uh, obviously you've, you've, you've run, uh, you've, you've had to do a lot of projects and run a lot of teams. Do you have a general rule for over-engineering or, you know, engineering ahead of time? You know, like, because people, we know premature engineering is the root of all evil. Yep. But also sometimes you just have to. Yep. When do you do it? Yes.Dharmesh [00:19:59]: It's a great question. This is, uh, a question as old as time almost, which is what's the right and wrong levels of abstraction. That's effectively what, uh, we're answering when we're trying to do engineering. I tend to be a pragmatist, right? So here's the thing. Um, lots of times doing something the right way. Yeah. It's like a marginal increased cost in those cases. Just do it the right way. And this is what makes a, uh, a great engineer or a good engineer better than, uh, a not so great one. It's like, okay, all things being equal. If it's going to take you, you know, roughly close to constant time anyway, might as well do it the right way. Like, so do things well, then the question is, okay, well, am I building a framework as the reusable library? To what degree, uh, what am I anticipating in terms of what's going to need to change in this thing? Uh, you know, along what dimension? And then I think like a business person in some ways, like what's the return on calories, right? So, uh, and you look at, um, energy, the expected value of it's like, okay, here are the five possible things that could happen, uh, try to assign probabilities like, okay, well, if there's a 50% chance that we're going to go down this particular path at some day, like, or one of these five things is going to happen and it costs you 10% more to engineer for that. It's basically, it's something that yields a kind of interest compounding value. Um, as you get closer to the time of, of needing that versus having to take on debt, which is when you under engineer it, you're taking on debt. You're going to have to pay off when you do get to that eventuality where something happens. One thing as a pragmatist, uh, so I would rather under engineer something than over engineer it. If I were going to err on the side of something, and here's the reason is that when you under engineer it, uh, yes, you take on tech debt, uh, but the interest rate is relatively known and payoff is very, very possible, right? Which is, oh, I took a shortcut here as a result of which now this thing that should have taken me a week is now going to take me four weeks. Fine. But if that particular thing that you thought might happen, never actually, you never have that use case transpire or just doesn't, it's like, well, you just save yourself time, right? And that has value because you were able to do other things instead of, uh, kind of slightly over-engineering it away, over-engineering it. But there's no perfect answers in art form in terms of, uh, and yeah, we'll, we'll bring kind of this layers of abstraction back on the code generation conversation, which we'll, uh, I think I have later on, butAlessio [00:22:05]: I was going to ask, we can just jump ahead quickly. Yeah. Like, as you think about vibe coding and all that, how does the. Yeah. Percentage of potential usefulness change when I feel like we over-engineering a lot of times it's like the investment in syntax, it's less about the investment in like arc exacting. Yep. Yeah. How does that change your calculus?Dharmesh [00:22:22]: A couple of things, right? One is, um, so, you know, going back to that kind of ROI or a return on calories, kind of calculus or heuristic you think through, it's like, okay, well, what is it going to cost me to put this layer of abstraction above the code that I'm writing now, uh, in anticipating kind of future needs. If the cost of fixing, uh, or doing under engineering right now. Uh, we'll trend towards zero that says, okay, well, I don't have to get it right right now because even if I get it wrong, I'll run the thing for six hours instead of 60 minutes or whatever. It doesn't really matter, right? Like, because that's going to trend towards zero to be able, the ability to refactor a code. Um, and because we're going to not that long from now, we're going to have, you know, large code bases be able to exist, uh, you know, as, as context, uh, for a code generation or a code refactoring, uh, model. So I think it's going to make it, uh, make the case for under engineering, uh, even stronger. Which is why I take on that cost. You just pay the interest when you get there, it's not, um, just go on with your life vibe coded and, uh, come back when you need to. Yeah.Alessio [00:23:18]: Sometimes I feel like there's no decision-making in some things like, uh, today I built a autosave for like our internal notes platform and I literally just ask them cursor. Can you add autosave? Yeah. I don't know if it's over under engineer. Yep. I just vibe coded it. Yep. And I feel like at some point we're going to get to the point where the models kindDharmesh [00:23:36]: of decide where the right line is, but this is where the, like the, in my mind, the danger is, right? So there's two sides to this. One is the cost of kind of development and coding and things like that stuff that, you know, we talk about. But then like in your example, you know, one of the risks that we have is that because adding a feature, uh, like a save or whatever the feature might be to a product as that price tends towards zero, are we going to be less discriminant about what features we add as a result of making more product products more complicated, which has a negative impact on the user and navigate negative impact on the business. Um, and so that's the thing I worry about if it starts to become too easy, are we going to be. Too promiscuous in our, uh, kind of extension, adding product extensions and things like that. It's like, ah, why not add X, Y, Z or whatever back then it was like, oh, we only have so many engineering hours or story points or however you measure things. Uh, that least kept us in check a little bit. Yeah.Alessio [00:24:22]: And then over engineering, you're like, yeah, it's kind of like you're putting that on yourself. Yeah. Like now it's like the models don't understand that if they add too much complexity, it's going to come back to bite them later. Yep. So they just do whatever they want to do. Yeah. And I'm curious where in the workflow that's going to be, where it's like, Hey, this is like the amount of complexity and over-engineering you can do before you got to ask me if we should actually do it versus like do something else.Dharmesh [00:24:45]: So you know, we've already, let's like, we're leaving this, uh, in the code generation world, this kind of compressed, um, cycle time. Right. It's like, okay, we went from auto-complete, uh, in the GitHub co-pilot to like, oh, finish this particular thing and hit tab to a, oh, I sort of know your file or whatever. I can write out a full function to you to now I can like hold a bunch of the context in my head. Uh, so we can do app generation, which we have now with lovable and bolt and repletage. Yeah. Association and other things. So then the question is, okay, well, where does it naturally go from here? So we're going to generate products. Make sense. We might be able to generate platforms as though I want a platform for ERP that does this, whatever. And that includes the API's includes the product and the UI, and all the things that make for a platform. There's no nothing that says we would stop like, okay, can you generate an entire software company someday? Right. Uh, with the platform and the monetization and the go-to-market and the whatever. And you know, that that's interesting to me in terms of, uh, you know, what, when you take it to almost ludicrous levels. of abstract.swyx [00:25:39]: It's like, okay, turn it to 11. You mentioned vibe coding, so I have to, this is a blog post I haven't written, but I'm kind of exploring it. Is the junior engineer dead?Dharmesh [00:25:49]: I don't think so. I think what will happen is that the junior engineer will be able to, if all they're bringing to the table is the fact that they are a junior engineer, then yes, they're likely dead. But hopefully if they can communicate with carbon-based life forms, they can interact with product, if they're willing to talk to customers, they can take their kind of basic understanding of engineering and how kind of software works. I think that has value. So I have a 14-year-old right now who's taking Python programming class, and some people ask me, it's like, why is he learning coding? And my answer is, is because it's not about the syntax, it's not about the coding. What he's learning is like the fundamental thing of like how things work. And there's value in that. I think there's going to be timeless value in systems thinking and abstractions and what that means. And whether functions manifested as math, which he's going to get exposed to regardless, or there are some core primitives to the universe, I think, that the more you understand them, those are what I would kind of think of as like really large dots in your life that will have a higher gravitational pull and value to them that you'll then be able to. So I want him to collect those dots, and he's not resisting. So it's like, okay, while he's still listening to me, I'm going to have him do things that I think will be useful.swyx [00:26:59]: You know, part of one of the pitches that I evaluated for AI engineer is a term. And the term is that maybe the traditional interview path or career path of software engineer goes away, which is because what's the point of lead code? Yeah. And, you know, it actually matters more that you know how to work with AI and to implement the things that you want. Yep.Dharmesh [00:27:16]: That's one of the like interesting things that's happened with generative AI. You know, you go from machine learning and the models and just that underlying form, which is like true engineering, right? Like the actual, what I call real engineering. I don't think of myself as a real engineer, actually. I'm a developer. But now with generative AI. We call it AI and it's obviously got its roots in machine learning, but it just feels like fundamentally different to me. Like you have the vibe. It's like, okay, well, this is just a whole different approach to software development to so many different things. And so I'm wondering now, it's like an AI engineer is like, if you were like to draw the Venn diagram, it's interesting because the cross between like AI things, generative AI and what the tools are capable of, what the models do, and this whole new kind of body of knowledge that we're still building out, it's still very young, intersected with kind of classic engineering, software engineering. Yeah.swyx [00:28:04]: I just described the overlap as it separates out eventually until it's its own thing, but it's starting out as a software. Yeah.Alessio [00:28:11]: That makes sense. So to close the vibe coding loop, the other big hype now is MCPs. Obviously, I would say Cloud Desktop and Cursor are like the two main drivers of MCP usage. I would say my favorite is the Sentry MCP. I can pull in errors and then you can just put the context in Cursor. How do you think about that abstraction layer? Does it feel... Does it feel almost too magical in a way? Do you think it's like you get enough? Because you don't really see how the server itself is then kind of like repackaging theDharmesh [00:28:41]: information for you? I think MCP as a standard is one of the better things that's happened in the world of AI because a standard needed to exist and absent a standard, there was a set of things that just weren't possible. Now, we can argue whether it's the best possible manifestation of a standard or not. Does it do too much? Does it do too little? I get that, but it's just simple enough to both be useful and unobtrusive. It's understandable and adoptable by mere mortals, right? It's not overly complicated. You know, a reasonable engineer can put a stand up an MCP server relatively easily. The thing that has me excited about it is like, so I'm a big believer in multi-agent systems. And so that's going back to our kind of this idea of an atomic agent. So imagine the MCP server, like obviously it calls tools, but the way I think about it, so I'm working on my current passion project is agent.ai. And we'll talk more about that in a little bit. More about the, I think we should, because I think it's interesting not to promote the project at all, but there's some interesting ideas in there. One of which is around, we're going to need a mechanism for, if agents are going to collaborate and be able to delegate, there's going to need to be some form of discovery and we're going to need some standard way. It's like, okay, well, I just need to know what this thing over here is capable of. We're going to need a registry, which Anthropic's working on. I'm sure others will and have been doing directories of, and there's going to be a standard around that too. How do you build out a directory of MCP servers? I think that's going to unlock so many things just because, and we're already starting to see it. So I think MCP or something like it is going to be the next major unlock because it allows systems that don't know about each other, don't need to, it's that kind of decoupling of like Sentry and whatever tools someone else was building. And it's not just about, you know, Cloud Desktop or things like, even on the client side, I think we're going to see very interesting consumers of MCP, MCP clients versus just the chat body kind of things. Like, you know, Cloud Desktop and Cursor and things like that. But yeah, I'm very excited about MCP in that general direction.swyx [00:30:39]: I think the typical cynical developer take, it's like, we have OpenAPI. Yeah. What's the new thing? I don't know if you have a, do you have a quick MCP versus everything else? Yeah.Dharmesh [00:30:49]: So it's, so I like OpenAPI, right? So just a descriptive thing. It's OpenAPI. OpenAPI. Yes, that's what I meant. So it's basically a self-documenting thing. We can do machine-generated, lots of things from that output. It's a structured definition of an API. I get that, love it. But MCPs sort of are kind of use case specific. They're perfect for exactly what we're trying to use them for around LLMs in terms of discovery. It's like, okay, I don't necessarily need to know kind of all this detail. And so right now we have, we'll talk more about like MCP server implementations, but We will? I think, I don't know. Maybe we won't. At least it's in my head. It's like a back processor. But I do think MCP adds value above OpenAPI. It's, yeah, just because it solves this particular thing. And if we had come to the world, which we have, like, it's like, hey, we already have OpenAPI. It's like, if that were good enough for the universe, the universe would have adopted it already. There's a reason why MCP is taking office because marginally adds something that was missing before and doesn't go too far. And so that's why the kind of rate of adoption, you folks have written about this and talked about it. Yeah, why MCP won. Yeah. And it won because the universe decided that this was useful and maybe it gets supplanted by something else. Yeah. And maybe we discover, oh, maybe OpenAPI was good enough the whole time. I doubt that.swyx [00:32:09]: The meta lesson, this is, I mean, he's an investor in DevTools companies. I work in developer experience at DevRel in DevTools companies. Yep. Everyone wants to own the standard. Yeah. I'm sure you guys have tried to launch your own standards. Actually, it's Houseplant known for a standard, you know, obviously inbound marketing. But is there a standard or protocol that you ever tried to push? No.Dharmesh [00:32:30]: And there's a reason for this. Yeah. Is that? And I don't mean, need to mean, speak for the people of HubSpot, but I personally. You kind of do. I'm not smart enough. That's not the, like, I think I have a. You're smart. Not enough for that. I'm much better off understanding the standards that are out there. And I'm more on the composability side. Let's, like, take the pieces of technology that exist out there, combine them in creative, unique ways. And I like to consume standards. I don't like to, and that's not that I don't like to create them. I just don't think I have the, both the raw wattage or the credibility. It's like, okay, well, who the heck is Dharmesh, and why should we adopt a standard he created?swyx [00:33:07]: Yeah, I mean, there are people who don't monetize standards, like OpenTelemetry is a big standard, and LightStep never capitalized on that.Dharmesh [00:33:15]: So, okay, so if I were to do a standard, there's two things that have been in my head in the past. I was one around, a very, very basic one around, I don't even have the domain, I have a domain for everything, for open marketing. Because the issue we had in HubSpot grew up in the marketing space. There we go. There was no standard around data formats and things like that. It doesn't go anywhere. But the other one, and I did not mean to go here, but I'm going to go here. It's called OpenGraph. I know the term was already taken, but it hasn't been used for like 15 years now for its original purpose. But what I think should exist in the world is right now, our information, all of us, nodes are in the social graph at Meta or the professional graph at LinkedIn. Both of which are actually relatively closed in actually very annoying ways. Like very, very closed, right? Especially LinkedIn. Especially LinkedIn. I personally believe that if it's my data, and if I would get utility out of it being open, I should be able to make my data open or publish it in whatever forms that I choose, as long as I have control over it as opt-in. So the idea is around OpenGraph that says, here's a standard, here's a way to publish it. I should be able to go to OpenGraph.org slash Dharmesh dot JSON and get it back. And it's like, here's your stuff, right? And I can choose along the way and people can write to it and I can prove. And there can be an entire system. And if I were to do that, I would do it as a... Like a public benefit, non-profit-y kind of thing, as this is a contribution to society. I wouldn't try to commercialize that. Have you looked at AdProto? What's that? AdProto.swyx [00:34:43]: It's the protocol behind Blue Sky. Okay. My good friend, Dan Abramov, who was the face of React for many, many years, now works there. And he actually did a talk that I can send you, which basically kind of tries to articulate what you just said. But he does, he loves doing these like really great analogies, which I think you'll like. Like, you know, a lot of our data is behind a handle, behind a domain. Yep. So he's like, all right, what if we flip that? What if it was like our handle and then the domain? Yep. So, and that's really like your data should belong to you. Yep. And I should not have to wait 30 days for my Twitter data to export. Yep.Dharmesh [00:35:19]: you should be able to at least be able to automate it or do like, yes, I should be able to plug it into an agentic thing. Yeah. Yes. I think we're... Because so much of our data is... Locked up. I think the trick here isn't that standard. It is getting the normies to care.swyx [00:35:37]: Yeah. Because normies don't care.Dharmesh [00:35:38]: That's true. But building on that, normies don't care. So, you know, privacy is a really hot topic and an easy word to use, but it's not a binary thing. Like there are use cases where, and we make these choices all the time, that I will trade, not all privacy, but I will trade some privacy for some productivity gain or some benefit to me that says, oh, I don't care about that particular data being online if it gives me this in return, or I don't mind sharing this information with this company.Alessio [00:36:02]: If I'm getting, you know, this in return, but that sort of should be my option. I think now with computer use, you can actually automate some of the exports. Yes. Like something we've been doing internally is like everybody exports their LinkedIn connections. Yep. And then internally, we kind of merge them together to see how we can connect our companies to customers or things like that.Dharmesh [00:36:21]: And not to pick on LinkedIn, but since we're talking about it, but they feel strongly enough on the, you know, do not take LinkedIn data that they will block even browser use kind of things or whatever. They go to great, great lengths, even to see patterns of usage. And it says, oh, there's no way you could have, you know, gotten that particular thing or whatever without, and it's, so it's, there's...swyx [00:36:42]: Wasn't there a Supreme Court case that they lost? Yeah.Dharmesh [00:36:45]: So the one they lost was around someone that was scraping public data that was on the public internet. And that particular company had not signed any terms of service or whatever. It's like, oh, I'm just taking data that's on, there was no, and so that's why they won. But now, you know, the question is around, can LinkedIn... I think they can. Like, when you use, as a user, you use LinkedIn, you are signing up for their terms of service. And if they say, well, this kind of use of your LinkedIn account that violates our terms of service, they can shut your account down, right? They can. And they, yeah, so, you know, we don't need to make this a discussion. By the way, I love the company, don't get me wrong. I'm an avid user of the product. You know, I've got... Yeah, I mean, you've got over a million followers on LinkedIn, I think. Yeah, I do. And I've known people there for a long, long time, right? And I have lots of respect. And I understand even where the mindset originally came from of this kind of members-first approach to, you know, a privacy-first. I sort of get that. But sometimes you sort of have to wonder, it's like, okay, well, that was 15, 20 years ago. There's likely some controlled ways to expose some data on some member's behalf and not just completely be a binary. It's like, no, thou shalt not have the data.swyx [00:37:54]: Well, just pay for sales navigator.Alessio [00:37:57]: Before we move to the next layer of instruction, anything else on MCP you mentioned? Let's move back and then I'll tie it back to MCPs.Dharmesh [00:38:05]: So I think the... Open this with agent. Okay, so I'll start with... Here's my kind of running thesis, is that as AI and agents evolve, which they're doing very, very quickly, we're going to look at them more and more. I don't like to anthropomorphize. We'll talk about why this is not that. Less as just like raw tools and more like teammates. They'll still be software. They should self-disclose as being software. I'm totally cool with that. But I think what's going to happen is that in the same way you might collaborate with a team member on Slack or Teams or whatever you use, you can imagine a series of agents that do specific things just like a team member might do, that you can delegate things to. You can collaborate. You can say, hey, can you take a look at this? Can you proofread that? Can you try this? You can... Whatever it happens to be. So I think it is... I will go so far as to say it's inevitable that we're going to have hybrid teams someday. And what I mean by hybrid teams... So back in the day, hybrid teams were, oh, well, you have some full-time employees and some contractors. Then it was like hybrid teams are some people that are in the office and some that are remote. That's the kind of form of hybrid. The next form of hybrid is like the carbon-based life forms and agents and AI and some form of software. So let's say we temporarily stipulate that I'm right about that over some time horizon that eventually we're going to have these kind of digitally hybrid teams. So if that's true, then the question you sort of ask yourself is that then what needs to exist in order for us to get the full value of that new model? It's like, okay, well... You sort of need to... It's like, okay, well, how do I... If I'm building a digital team, like, how do I... Just in the same way, if I'm interviewing for an engineer or a designer or a PM, whatever, it's like, well, that's why we have professional networks, right? It's like, oh, they have a presence on likely LinkedIn. I can go through that semi-structured, structured form, and I can see the experience of whatever, you know, self-disclosed. But, okay, well, agents are going to need that someday. And so I'm like, okay, well, this seems like a thread that's worth pulling on. That says, okay. So I... So agent.ai is out there. And it's LinkedIn for agents. It's LinkedIn for agents. It's a professional network for agents. And the more I pull on that thread, it's like, okay, well, if that's true, like, what happens, right? It's like, oh, well, they have a profile just like anyone else, just like a human would. It's going to be a graph underneath, just like a professional network would be. It's just that... And you can have its, you know, connections and follows, and agents should be able to post. That's maybe how they do release notes. Like, oh, I have this new version. Whatever they decide to post, it should just be able to... Behave as a node on the network of a professional network. As it turns out, the more I think about that and pull on that thread, the more and more things, like, start to make sense to me. So it may be more than just a pure professional network. So my original thought was, okay, well, it's a professional network and agents as they exist out there, which I think there's going to be more and more of, will kind of exist on this network and have the profile. But then, and this is always dangerous, I'm like, okay, I want to see a world where thousands of agents are out there in order for the... Because those digital employees, the digital workers don't exist yet in any meaningful way. And so then I'm like, oh, can I make that easier for, like... And so I have, as one does, it's like, oh, I'll build a low-code platform for building agents. How hard could that be, right? Like, very hard, as it turns out. But it's been fun. So now, agent.ai has 1.3 million users. 3,000 people have actually, you know, built some variation of an agent, sometimes just for their own personal productivity. About 1,000 of which have been published. And the reason this comes back to MCP for me, so imagine that and other networks, since I know agent.ai. So right now, we have an MCP server for agent.ai that exposes all the internally built agents that we have that do, like, super useful things. Like, you know, I have access to a Twitter API that I can subsidize the cost. And I can say, you know, if you're looking to build something for social media, these kinds of things, with a single API key, and it's all completely free right now, I'm funding it. That's a useful way for it to work. And then we have a developer to say, oh, I have this idea. I don't have to worry about open AI. I don't have to worry about, now, you know, this particular model is better. It has access to all the models with one key. And we proxy it kind of behind the scenes. And then expose it. So then we get this kind of community effect, right? That says, oh, well, someone else may have built an agent to do X. Like, I have an agent right now that I built for myself to do domain valuation for website domains because I'm obsessed with domains, right? And, like, there's no efficient market for domains. There's no Zillow for domains right now that tells you, oh, here are what houses in your neighborhood sold for. It's like, well, why doesn't that exist? We should be able to solve that problem. And, yes, you're still guessing. Fine. There should be some simple heuristic. So I built that. It's like, okay, well, let me go look for past transactions. You say, okay, I'm going to type in agent.ai, agent.com, whatever domain. What's it actually worth? I'm looking at buying it. It can go and say, oh, which is what it does. It's like, I'm going to go look at are there any published domain transactions recently that are similar, either use the same word, same top-level domain, whatever it is. And it comes back with an approximate value, and it comes back with its kind of rationale for why it picked the value and comparable transactions. Oh, by the way, this domain sold for published. Okay. So that agent now, let's say, existed on the web, on agent.ai. Then imagine someone else says, oh, you know, I want to build a brand-building agent for startups and entrepreneurs to come up with names for their startup. Like a common problem, every startup is like, ah, I don't know what to call it. And so they type in five random words that kind of define whatever their startup is. And you can do all manner of things, one of which is like, oh, well, I need to find the domain for it. What are possible choices? Now it's like, okay, well, it would be nice to know if there's an aftermarket price for it, if it's listed for sale. Awesome. Then imagine calling this valuation agent. It's like, okay, well, I want to find where the arbitrage is, where the agent valuation tool says this thing is worth $25,000. It's listed on GoDaddy for $5,000. It's close enough. Let's go do that. Right? And that's a kind of composition use case that in my future state. Thousands of agents on the network, all discoverable through something like MCP. And then you as a developer of agents have access to all these kind of Lego building blocks based on what you're trying to solve. Then you blend in orchestration, which is getting better and better with the reasoning models now. Just describe the problem that you have. Now, the next layer that we're all contending with is that how many tools can you actually give an LLM before the LLM breaks? That number used to be like 15 or 20 before you kind of started to vary dramatically. And so that's the thing I'm thinking about now. It's like, okay, if I want to... If I want to expose 1,000 of these agents to a given LLM, obviously I can't give it all 1,000. Is there some intermediate layer that says, based on your prompt, I'm going to make a best guess at which agents might be able to be helpful for this particular thing? Yeah.Alessio [00:44:37]: Yeah, like RAG for tools. Yep. I did build the Latent Space Researcher on agent.ai. Okay. Nice. Yeah, that seems like, you know, then there's going to be a Latent Space Scheduler. And then once I schedule a research, you know, and you build all of these things. By the way, my apologies for the user experience. You realize I'm an engineer. It's pretty good.swyx [00:44:56]: I think it's a normie-friendly thing. Yeah. That's your magic. HubSpot does the same thing.Alessio [00:45:01]: Yeah, just to like quickly run through it. You can basically create all these different steps. And these steps are like, you know, static versus like variable-driven things. How did you decide between this kind of like low-code-ish versus doing, you know, low-code with code backend versus like not exposing that at all? Any fun design decisions? Yeah. And this is, I think...Dharmesh [00:45:22]: I think lots of people are likely sitting in exactly my position right now, coming through the choosing between deterministic. Like if you're like in a business or building, you know, some sort of agentic thing, do you decide to do a deterministic thing? Or do you go non-deterministic and just let the alum handle it, right, with the reasoning models? The original idea and the reason I took the low-code stepwise, a very deterministic approach. A, the reasoning models did not exist at that time. That's thing number one. Thing number two is if you can get... If you know in your head... If you know in your head what the actual steps are to accomplish whatever goal, why would you leave that to chance? There's no upside. There's literally no upside. Just tell me, like, what steps do you need executed? So right now what I'm playing with... So one thing we haven't talked about yet, and people don't talk about UI and agents. Right now, the primary interaction model... Or they don't talk enough about it. I know some people have. But it's like, okay, so we're used to the chatbot back and forth. Fine. I get that. But I think we're going to move to a blend of... Some of those things are going to be synchronous as they are now. But some are going to be... Some are going to be async. It's just going to put it in a queue, just like... And this goes back to my... Man, I talk fast. But I have this... I only have one other speed. It's even faster. So imagine it's like if you're working... So back to my, oh, we're going to have these hybrid digital teams. Like, you would not go to a co-worker and say, I'm going to ask you to do this thing, and then sit there and wait for them to go do it. Like, that's not how the world works. So it's nice to be able to just, like, hand something off to someone. It's like, okay, well, maybe I expect a response in an hour or a day or something like that.Dharmesh [00:46:52]: In terms of when things need to happen. So the UI around agents. So if you look at the output of agent.ai agents right now, they are the simplest possible manifestation of a UI, right? That says, oh, we have inputs of, like, four different types. Like, we've got a dropdown, we've got multi-select, all the things. It's like back in HTML, the original HTML 1.0 days, right? Like, you're the smallest possible set of primitives for a UI. And it just says, okay, because we need to collect some information from the user, and then we go do steps and do things. And generate some output in HTML or markup are the two primary examples. So the thing I've been asking myself, if I keep going down that path. So people ask me, I get requests all the time. It's like, oh, can you make the UI sort of boring? I need to be able to do this, right? And if I keep pulling on that, it's like, okay, well, now I've built an entire UI builder thing. Where does this end? And so I think the right answer, and this is what I'm going to be backcoding once I get done here, is around injecting a code generation UI generation into, the agent.ai flow, right? As a builder, you're like, okay, I'm going to describe the thing that I want, much like you would do in a vibe coding world. But instead of generating the entire app, it's going to generate the UI that exists at some point in either that deterministic flow or something like that. It says, oh, here's the thing I'm trying to do. Go generate the UI for me. And I can go through some iterations. And what I think of it as a, so it's like, I'm going to generate the code, generate the code, tweak it, go through this kind of prompt style, like we do with vibe coding now. And at some point, I'm going to be happy with it. And I'm going to hit save. And that's going to become the action in that particular step. It's like a caching of the generated code that I can then, like incur any inference time costs. It's just the actual code at that point.Alessio [00:48:29]: Yeah, I invested in a company called E2B, which does code sandbox. And they powered the LM arena web arena. So it's basically the, just like you do LMS, like text to text, they do the same for like UI generation. So if you're asking a model, how do you do it? But yeah, I think that's kind of where.Dharmesh [00:48:45]: That's the thing I'm really fascinated by. So the early LLM, you know, we're understandably, but laughably bad at simple arithmetic, right? That's the thing like my wife, Normies would ask us, like, you call this AI, like it can't, my son would be like, it's just stupid. It can't even do like simple arithmetic. And then like we've discovered over time that, and there's a reason for this, right? It's like, it's a large, there's, you know, the word language is in there for a reason in terms of what it's been trained on. It's not meant to do math, but now it's like, okay, well, the fact that it has access to a Python interpreter that I can actually call at runtime, that solves an entire body of problems that it wasn't trained to do. And it's basically a form of delegation. And so the thought that's kind of rattling around in my head is that that's great. So it's, it's like took the arithmetic problem and took it first. Now, like anything that's solvable through a relatively concrete Python program, it's able to do a bunch of things that I couldn't do before. Can we get to the same place with UI? I don't know what the future of UI looks like in a agentic AI world, but maybe let the LLM handle it, but not in the classic sense. Maybe it generates it on the fly, or maybe we go through some iterations and hit cache or something like that. So it's a little bit more predictable. Uh, I don't know, but yeah.Alessio [00:49:48]: And especially when is the human supposed to intervene? So, especially if you're composing them, most of them should not have a UI because then they're just web hooking to somewhere else. I just want to touch back. I don't know if you have more comments on this.swyx [00:50:01]: I was just going to ask when you, you said you got, you're going to go back to code. What

Referências do EpisódioWeaver Ant, the Web Shell Whisperer: Tracking a Live China-nexus OperationVanHelsing, new RaaS in TownOracle denies breach after hacker claims theft of 6 million data recordsSérie de tweets da Microsoft sobre nova campanha do LatrodectusRoteiro e apresentação: Carlos Cabral e Bianca OliveiraEdição de áudio: Paulo ArruzzoNarração de encerramento: Bianca Garcia

On this episode the guys talk DD Born Again, The Electric State, dumb things people are doing, and much more. Enjoy.

This episode also covers recent ransomware as a service (RaaS) trends, including the rise of SpearWing and Akira groups, advanced ransomware techniques exploiting IoT vulnerabilities, and issues with the ESP32 microcontroller's hidden commands. Additionally, Signal President Meredith Whitaker warns about privacy risks in agentic AI systems. Tune in for in-depth cybersecurity updates and more. 00:00 The Talk: Supporting Our Podcast 01:37 Cybersecurity Today: Ransomware as a Service 04:57 Akira Ransomware: Exploiting IoT Devices 06:50 ESP32 Microcontroller Vulnerabilities 08:21 AI Agents: Privacy and Security Risks 09:56 Conclusion and Contact Information

Best Wishes plots their next path, saying goodbye to Taywin, and making a stop over at Temple Felinis before returning to Miri's old stomping grounds...Featuring Tim (he/him) as our illustrious DM, Em (fae/she) as Shy, Triton Sun Soul Monk; Jannes (he/him) as Thistle Longbranch, Orc Circle of the Moon Druid; Adam (he/him) as Esper Declan, Hexblood Phantom Rogue; Sean (he/him) as Mark Dwyler, Human Aberrant Mind Sorcerer; and Jess (she/her) as Mirielle Fiamma, Fire Genasi Trickery Cleric! Huge thanks to our special guests Kelli Ogmundson (she/her) as Blueberry, Half-Elf Celestial Warlock, and Jamie King (they/them) as Raas, Elf Ancestral Guardian Barbarian! We're so grateful to send them off in an awesome way!Come join us live for our Main Campaign episodes every Monday at 8pm PST at twitch.tv/blackwaterdnd. Consider following or subscribing on Twitch, and come join us over on Patreon for tons of extra content to sink your teeth into. Our episodes are available as VOD on Twitch, then posted on Youtube on Fridays at noon. Our Podcast episodes release Monday at noon, one week after the live broadcast. Music and Soundscapes by Syrinscape and Epidemic Sound. Character art by Tiana Kovacevic.

Ever wonder what really happens inside the body during shock? This week, Chris Cebollero and Kelly Grayson dive into the renin angiotensin aldosterone system (RAAS).  From vasoconstriction to fluid retention, they break down this complex topic with real-life examples, a sprinkle of humor and practical tips for how EMS providers can apply this knowledge in the field. Kelly shares the importance of understanding the “why” behind shock presentations, from recognizing when fluids won't work to knowing when vasopressors are the answer. With anecdotes like treating a sepsis patient on ACE inhibitors and using pulse ox waveforms for clues, this episode blends science with field-tested wisdom. Whether you're an EMT, paramedic, or just an anatomy nerd, you'll walk away with a clearer picture of how the RAAS keeps us alive – and how we, as EMS professionals, can work smarter alongside it. Memorable quotes “It's called, ‘The Renan Angiotensin Aldosterone System – not just a planetary belt in Star Wars'”. — Kelly Grayson “So, the kidneys now say, ‘We're not getting enough blood. Here's this renin that we're gonna send out because we've gotta fix this problem.' What the body doesn't know is that Chris Cebollero and Kelly Grayson and you are out there trying to fix it. So it's trying to fix itself.” — Chris Cebollero Related resources: Understanding push dose pressors Understanding prehospital vasopressors: Dopamine, epinephrine or norepinephrine? A basic overview of shock for EMS Compensated vs. decompensated shock: what you need to know ABOUT THE SPONSOR Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. Pulsara scales to meet your dynamic communication needs. From routine patient alerts to managing large-scale emergencies, every responder and clinician connects seamlessly. Familiar yet powerful, Pulsara streamlines your response, from routine transfers to regional disasters. One tool. Every day. Regardless of event. Discover more at Pulsara.com. RATE & REVIEW Catch a new episode of the Inside EMS podcast every Friday. Enjoying the show? Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or let us know if you'd like to join us as a guest.

During this presentation, Donald DiPette, MD, FACP, FAHA, on behalf Robert M. Carey, MD, reviews the role of the RAAS in normal blood pressure and salt and water homeostasis. In addition, Dr. DiPette discusses the role of the RAAS in the pathophysiology of cardiovascular disease, diabetes mellitus, and kidney disease, and he also details the pharmacologic inhibition/blockade of the RAAS.

The party attempts a heist(?) while Tim(?) puts them through a gauntlet at the Veytoma Academy...Welcome to BlackwaterDnD's Main Campaign, DM'd by our special guest DM, The GM Tim!Featuring Tim (he/him) as our illustrious DM, Em (fae/she) as Shy, Triton Sun Soul Monk; Jannes (he/him) as Thistle Longbranch, Orc Circle of the Moon Druid; Adam (he/him) as Esper Declan, Hexblood Phantom Rogue; Sean (he/him) as Mark Dwyler, Human Aberrant Mind Sorcerer; and Jess (she/her) as Mirielle Fiamma, Fire Genasi Trickery Cleric! Welcoming guests Kelli Ogmundson (she/her) as Blueberry, Half-Elf Celestial Warlock, and Jamie King (they/them) as Raas, Elf Ancestral Guardian Barbarian!Come join us live for our Main Campaign episodes every Monday at 8pm PST at twitch.tv/blackwaterdnd. Consider following or subscribing on Twitch, and come join us over on Patreon for tons of extra content to sink your teeth into. Our episodes are available as VOD on Twitch, then posted on Youtube on Fridays at noon. Our Podcast episodes release Monday at noon, one week after the live broadcast. Music and Soundscapes by Syrinscape and Epidemic Sound. Character art by Tiana Kovacevic 

Julie and Eric spend some time recapping PAX Unplugged before all of us take a look at the year that was 2024. What was the easiest game to teach? The game that you'd best set aside a day to play? The Hoopiest Hula Hoop? All will be revealed, dear listener! 01:00 - PAX Unplugged Recap 14:03 - The Quiet House 16:49 - Star Trek TNG VCR Game 20:41 - 2024 as a Whole 29:25 - Best to Play at a Convention: Ito, Rock Hard 1977, Duck & Cover 31:40 - Best Theme: Rock Hard 1977, Mistwind, Kelp: Shark vs. Octopus 34:43 - Most Likely to be Gifted: Muppets Clue, Wicked 38:00 - Best Traveling Game: Seaside, Smug Owl, Ito 40:25 - Best Set Aside a Day For It Game: Tidal Blades 2, El Burro, Wandering Galaxy 45:13 - Easiest Teach/Learn: Cat Horror Costumes, Pixies, Ito 46:50 - Bonus Heavy Euro: Civolution 47:16 - Wanted to Play but Didn't: Power Grid Outpost, Quacks of Quedlinburg: The Duel, Paella Park, Pagan: Fate of Roanoke, Daitoshi 50:18 - Hoopiest Hula Hoop: Ziggurat, Slay the Spire, Panda Panda 53:51 - Sharpest Thorn: I Am Done, Clash of Galiformes, Unlock Kids 57:31 - Rosiest Rose: Star Wars Unlimited, Wyrmspan, The 7th Continent 59:22 - Anticipated for 2025 - Raas, Azul Duel, All My Books, The Elder Scrolls, Galactic Cruise Next Episode: January 14th, 2025 Tales of Horror? Questions? tom@dicetower.com

One of the most limited blockchain resources is blockspace. From Bitcoin's Blocksize Wars to Ethereum's scaling roadmap, a common denominator seems to have emerged in the form of rollups. Advancements in zero knowledge proofs have enabled trustless bridges, which are a cornerstone to onboarding liquidity to any blockchain. Furthermore, Celestia's modular approach to blockchain architecture and their recent commitment to gigabyte blocks of data availability marked the beginning of commoditization for rollups. Abundance is the first rollup-as-a-service platform that is able to scale to 1 gigagas/second throughput, finally bringing off-chain applications, on-chain.Topics covered in this episode:Gelato's pivot to rollup-as-a-service platformSovereign rollupsEnshrined bridges and settlement proofsAbundance and 1 Gigagas/second rollupsModularitySecurity assumptionsSequencer (de)centralisationSocial consensusCelestia's DA layer bandwidthEthereum native rollupsDecentralisation and censorship-resistanceEpisode links:Hilmar Orth on XGelato Network on XAbundance on XSponsors:Gnosis: Gnosis builds decentralized infrastructure for the Ethereum ecosystem, since 2015. This year marks the launch of Gnosis Pay— the world's first Decentralized Payment Network. Get started today at - gnosis.ioChorus1: Chorus1 is one of the largest node operators worldwide, supporting more than 100,000 delegators, across 45 networks. The recently launched OPUS allows staking up to 8,000 ETH in a single transaction. Enjoy the highest yields and institutional grade security at - chorus.oneThis episode is hosted by Friederike Ernst.

We sincerely apologize! During the livestream recording, we experienced some technical difficulties between 07:15 to 08:50. Thanks for your patience and understanding.Learn more about becoming an Insider on our website: https://www.benbikman.comDuring The Metabolic Classroom lecture this week, Dr. Bikman dives into the intricate relationship between salt- and water-regulating hormones and metabolic health.Starting with a discussion of the renin-angiotensin-aldosterone system (RAAS), he explains how hormones like angiotensin II, aldosterone, and antidiuretic hormone (ADH) are not only critical for regulating blood pressure but also significantly impact insulin sensitivity and fat cell dynamics. Angiotensin II promotes insulin resistance by increasing ceramide production, which blocks insulin signaling, while also enlarging fat cells and inhibiting their breakdown. Similarly, aldosterone exacerbates insulin resistance by enhancing ceramide levels and promotes both the growth and multiplication of fat cells. ADH complements these effects, particularly by inhibiting fat breakdown through its action on specific receptors.Ben emphasizes the counterintuitive finding that salt restriction, often prescribed to manage hypertension, can worsen insulin resistance, particularly in individuals with metabolic vulnerabilities. Studies highlight that reducing salt intake leads to increased fasting insulin levels, impaired glucose metabolism, and unfavorable lipid changes, such as reduced HDL cholesterol. Additionally, he warns that dehydration, much like salt restriction, activates these same hormonal pathways, compounding their metabolic effects.Dr. Bikman concludes with a reminder that interventions aimed at improving blood pressure should consider their broader metabolic implications, particularly for individuals predisposed to insulin resistance.Show Notes/References:For complete show notes and references referred to in this episode, we invite you to become a Ben Bikman Insider subscriber. As a subscriber, you'll enjoy real-time, livestream Metabolic Classroom access which includes live Q&A with Ben, ad-free Metabolic Classroom Podcast episodes, show notes and references, Ben's Research Reviews Podcast, and a searchable archive that includes all Metabolic Classroom episodes and Research Reviews. Learn more about becoming an Insider on our website: https://www.benbikman.comTimestamps: (approximate)(01:13) Overview of Salt- and Water-Regulating Hormones(02:22) How Angiotensin II Influences Blood Pressure and Insulin Resistance(06:37) The Metabolic Effects of Angiotensin II on Fat Cells(11:22) Aldosterone's Role in Insulin Resistance and Fat Cell Growth(15:57) Metabolic Impacts of Antidiuretic Hormone (ADH)(29:02) The Counterintuitive Effects of Salt Restriction on Metabolic Health(33:13) The Role of Dehydration in Activating Metabolic Hormones(34:51) Conclusion: How Blood Pressure Hormones Influence Metabolic Health#MetabolicHealth #InsulinResistance #Hypertension #SaltAndHealth #BloodPressure #HormonesAndHealth #DrBenBikman #MetabolicSyndrome #LowCarbLife #Type2Diabetes #KetoLife #HealthyLifestyle #NutritionScience #MetabolismMatters #HealthEducation #FatCellBiology #InsulinSensitivity #SaltIntake #Dehydration #HealthTips Hosted on Acast. See acast.com/privacy for more information.

Best Wishes spends a night recovering after the Cardic Gemini in their new abode in Taywin...Welcome to BlackwaterDnD's Main Campaign!Featuring Tim (he/him) as our illustrious DM, Em (fae/she) as Shy, Triton Sun Soul Monk; Jannes (he/him) as Thistle Longbranch, Orc Circle of the Moon Druid; Adam (he/him) as Esper Declan, Hexblood Phantom Rogue; Sean (he/him) as Mark Dwyler, Human Aberrant Mind Sorcerer; and Jess (she/her) as Mirielle Fiamma, Fire Genasi Trickery Cleric! Welcoming guests Kelli Ogmundson (she/her) as Blueberry, Half-Elf Celestial Warlock, and Jamie King (they/them) as Raas, Elf Ancestral Guardian Barbarian!Come join us live for our Main Campaign episodes every Monday at 8pm PST at twitch.tv/blackwaterdnd. Consider following or subscribing on Twitch, and come join us over on Patreon for tons of extra content to sink your teeth into. Our episodes are available as VOD on Twitch, then posted on Youtube on Fridays at noon. Our Podcast episodes release Monday at noon, one week after the live broadcast. Music and Soundscapes by Syrinscape and Epidemic Sound. Character art by Tiana Kovacevic 

A tense standoff atop the caldera of Asari as Best Wishes struggles to resolve the Cardic Gemini...Welcome to BlackwaterDnD's Main Campaign!Featuring Tim (he/him) as our illustrious DM, Em (fae/she) as Shy, Triton Sun Soul Monk; Jannes (he/him) as Thistle Longbranch, Orc Circle of the Moon Druid; Adam (he/him) as Esper Declan, Hexblood Phantom Rogue; Sean (he/him) as Mark Dwyler, Human Aberrant Mind Sorcerer; and Jess (she/her) as Mirielle Fiamma, Fire Genasi Trickery Cleric! Welcoming guests Kelli Ogmundson (she/her) as Blueberry, Half-Elf Celestial Warlock, and Jamie King (they/them) as Raas, Elf Ancestral Guardian Barbarian!Come join us live for our Main Campaign episodes every Monday at 8pm PST at twitch.tv/blackwaterdnd. Consider following or subscribing on Twitch, and come join us over on Patreon for tons of extra content to sink your teeth into. Our episodes are available as VOD on Twitch, then posted on Youtube on Fridays at noon. Our Podcast episodes release Monday at noon, one week after the live broadcast. Music and Soundscapes by Syrinscape and Epidemic Sound. Character art by Tiana Kovacevic 

In this episode, Luis, founder of Gelato and Abundance, presents a compelling argument for sovereign rollups while challenging composability. We explore how traditional L2 bridge designs may be holding back scalability, diving deep into Abundance's achievement of 1 giga gas throughput through a sovereign rollup approach. Luis makes the controversial case that liquidity fragmentation is a "skill issue" rather than a technical problem, and examines why the future of scaling may not require the complex bridge architecture common in today's L2s. We close out by diving into the evolving relationship between rollup frameworks and RaaS providers. Thanks for tuning in! - - Follow Luis: https://x.com/luis_0x Follow Mike: https://x.com/MikeIppolito_ Follow Expansion: https://x.com/ExpansionPod_ Subscribe on YouTube: https://www.youtube.com/@expansionpod Subscribe on Apple: http://apple.co/4bGKYYM Subscribe on Spotify: http://spoti.fi/3Vaubq1 Get top market insights and the latest in crypto news. Subscribe to Blockworks Daily Newsletter: https://blockworks.co/newsletter/ -- Timestamps: (00:00) Introduction (02:39) Abundance Overview (08:26) What is Actually a Rollup? (12:17) Benefits of Sovereign Rollup (30:19) Giga Gas Production Ready (33:47) Abundant Blockspace Thesis (41:05) Rollup Framework Business Model (47:29) Benefit of Interop (54:51) RaaS vs Framework (1:02:14) Convergence of Solutions - - Disclaimer Expansion was kickstarted by a grant from the Celestia Foundation. Nothing said on Expansion is a recommendation to buy or sell securities or tokens. This podcast is for informational purposes only, and any views expressed by anyone on the show are solely our opinions, not financial advice. Rex, Jon, and our guests may hold positions in the companies, funds, or projects discussed.

The Cardic Gemini is upon us, and the harrowing battle for the state of magic in the world of Teris begins...Welcome to BlackwaterDnD's Main Campaign!Featuring Tim (he/him) as our illustrious DM, Em (fae/she) as Shy, Triton Sun Soul Monk; Jannes (he/him) as Thistle Longbranch, Piney Circle of the Moon Druid; Adam (he/him) as Esper Declan, Hexblood Phantom Rogue; Sean (he/him) as Mark Dwyler, Human Aberrant Mind Sorcerer; and Jess (she/her) as Mirielle Fiamma, Fire Genasi Trickery Cleric! Welcoming guests Kelli Ogmundson (she/her) as Blueberry, Half-Elf Celestial Warlock, and Jamie King (they/them) as Raas, Elf Ancestral Guardian Barbarian!Come join us live for our Main Campaign episodes every Monday at 8pm PST at twitch.tv/blackwaterdnd. Consider following or subscribing on Twitch, and come join us over on Patreon for tons of extra content to sink your teeth into. Our episodes are available as VOD on Twitch, then posted on Youtube on Fridays at noon. Our Podcast episodes release Monday at noon, one week after the live broadcast. Music and Soundscapes by Syrinscape and Epidemic Sound. Character art by Tiana Kovacevic 

Best Wishes finds Blueberry's sibling, Raas, and time ticks down to the Gemini as the volcano Asari gets unstable...Welcome to BlackwaterDnD's Main Campaign!Featuring Tim (he/him) as our illustrious DM, Em (fae/she) as Shy, Triton Sun Soul Monk; Jannes (he/him) as Thistle Longbranch, Piney Circle of the Moon Druid; Adam (he/him) as Esper Declan, Hexblood Phantom Rogue; Sean (he/him) as Mark Dwyler, Human Aberrant Mind Sorcerer; and Jess (she/her) as Mirielle Fiamma, Fire Genasi Trickery Cleric! Welcoming guests Kelli Ogmundson (she/her) as Blueberry, Half-Elf Celestial Warlock, and Jamie King (they/them) as Raas, Elf Ancestral Guardian Barbarian!Come join us live for our Main Campaign episodes every Monday at 8pm PST at twitch.tv/blackwaterdnd. Consider following or subscribing on Twitch, and come join us over on Patreon for tons of extra content to sink your teeth into. Our episodes are available as VOD on Twitch, then posted on Youtube on Fridays at noon. Our Podcast episodes release Monday at noon, one week after the live broadcast. Music and Soundscapes by Syrinscape and Epidemic Sound. Character art by Tiana Kovacevic 

From humble beginnings building boats for his father in South Africa to championing Leopard and now Aquila power cats, it's safe to call Lex Raas a cat lover. Editor-in-Chief Dan Harding sits down with Lex to discuss his life with power cats and why he thinks they're poised to continue to grow in popularity. Learn more at pmymag.com Subscribe to Power & Motoryacht magazine at pmymag.com/subscribe Subscribe to our FREE newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, we dive deep into the world of ransomware with two of 2024's most talked-about threats: Phobos and Helldown. Learn how the Phobos ransomware operation managed to dominate 11% of the market, generating $16 million in ransom payments, and the shocking details of its admin's extradition to the U.S. We also explore the rise of Helldown ransomware, its exploitation of VPN vulnerabilities, and how these attacks are reshaping cybersecurity globally. If you're curious about how ransomware works, the evolution of cybercrime, and what it means for businesses and individuals, this video is packed with insights. Don't forget to like, subscribe, and hit the notification bell to stay updated on the latest cybersecurity trends. Key Topics Covered: What is ransomware-as-a-service (RaaS)? How Phobos became a major player in 2024. Helldown ransomware's exploitation of undisclosed VPN vulnerabilities. Tips to secure your network and stay ahead of cybercriminals. Join the discussion in the comments! What's your biggest takeaway from these cases? #Ransomware #PhobosRansomware #HelldownRansomware #Cybersecurity #CyberCrime #RansomwareExplained #Hacking #DataBreach #VPNSecurity #TechNews #PhobosAdmin #HelldownExploits #CyberThreats #ZeroDay #NationStateHacks #DigitalCrime #CybersecurityAwareness #OnlineSafety #RansomwareAttack #TechExplained #2024Trends #DataSecurity #NetworkSecurity #Hackers #CyberAttack #VPNVulnerabilities #DataProtection #TechTalks #CyberDefense #SecurityTips #PhobosVsHelldown

Welcome back Rounds Table Listeners!We are back today with our Classic Rapid Fire Podcast!This week, Drs. Mike Fralick and Justin Boyle discuss two recent papers exploring the effect of sitting time reduction on blood pressure and the discontinuation of RAAS inhibition perioperatively. Two papers, here we go!Sitting Time Reduction and Blood Pressure in Older Adults (0:00 – 11:35).Discontinuation versus continuation of renin-angiotensin system inhibition before non-cardiac surgery: the SPACE trial (11:35 – 21:32).And for the Good Stuff:Summer McIntosh becomes 1st Canadian to win 3 gold medals at a single Olympic Games (21:32 – 22:37).One-Pagers for the Wards by Dr. Mike Fralick! (22:37 – 24:13)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

I'm not a financial advisor; Superpowers for Good should not be considered investment advice. Seek counsel before making investment decisions.Watch the show on television by downloading the e360tv channel app to your Roku, AppleTV or AmazonFireTV. You can also see it on YouTube.When you purchase an item, launch a campaign or create an investment account after clicking a link here, we may earn a fee. Engage to support our work.Devin: What is your superpower? Logan: I think one of the superpowers I like to think I have is the ability to just keep getting back up.Graze Robotics is making waves by tackling environmental challenges and reshaping labor dynamics in commercial landscaping. At the helm of this pioneering company is Logan Fahey Franz, who's raised nearly $25 million from everyday investors to scale the company's eco-friendly, fully autonomous electric lawnmowers. These robots are purpose-built for large-scale sites, including golf courses, solar fields, and municipal properties, where they deliver precision and efficiency at a lower cost than traditional methods.“Being a fully electric solution is important to us,” Logan explained during our conversation. “But you think about the Graze unit—the tractor holds all of the autonomy. We're not just solving mowing; we have attachments for collecting golf balls on driving ranges and upcoming attachments to clean cart paths.” His passion for environmental solutions shines as he discusses how Graze Robotics' technology responds to noise restrictions and emissions bans, increasingly common at local and state levels.The company has mastered unique capabilities like night mowing, which is ideal for solar fields since panels lie flat after sunset. Graze's approach is both forward-thinking and practical. In Logan's words, “Operating at night is a unique element... mowing at night is really the most efficient because the panels are set to flat.”As Graze Robotics continues to grow, Logan and his team aim to scale their impact with a projected 150 robotic units rolling out in early 2025. With tens of thousands of potential deployments on the horizon, Graze is poised to meet the ever-growing demand for sustainable, automated lawn care.tl;dr:* In today's episode, Logan Fahey Franz shares insights into Graze Robotics' eco-friendly, autonomous robotic mowers, which are transforming large-scale landscaping for golf courses, solar fields, and municipalities.* Logan highlights Graze Robotics' unique night-mowing capability, which increases efficiency for solar fields, where mowing during the day would interfere with panel orientation toward the sun.* Addressing labor shortages and rising environmental standards, Logan emphasizes how Graze's robots reduce costs, enable workforce reallocation to higher-value tasks and comply with local noise and emissions regulations.* Logan's journey from nonprofit social enterprises to leading a high-tech robotics company demonstrates his passion for integrating sustainability and social good with business, especially through innovative, scalable solutions.* For those interested in impact investing, Logan invites potential investors to explore Graze Robotics' offerings, which remain accessible to both traditional and crowd investors through ongoing investment opportunities.How to Develop Resilience As a SuperpowerLogan's superpower lies in his resilience—his ability to “keep getting back up” after failures and setbacks. From early challenges in starting businesses to public defeat in a political campaign, Logan has consistently shown that he can recover and forge ahead with renewed purpose and determination.One of the most impactful examples of Logan's resilience came after he ran for city council in Cleveland and lost by a significant margin. Rather than letting the public loss dissuade him, he used this setback as a springboard to create Fay Group, rallying investors—including former campaign donors—to support his vision. Through this experience, he gained invaluable lessons in facing rejection and staying committed to his goals, which he has applied to his leadership at Graze Robotics and other ventures.Tips for Developing Resilience:* Embrace Failure as a Learning Tool – Understand that setbacks are part of the process and provide valuable lessons for growth.* Seek External Advisors – Lean on mentors and experienced professionals for guidance, particularly when evaluating when to pivot or persist.* Set Personal Goals – Know what you want to accomplish so that internal motivation can fuel your resilience during tough times.* Build a Supportive Network – Surround yourself with people who can offer perspective and encouragement, helping you see past temporary defeats.By following Logan's example and advice, you can make resilience a skill. With practice and effort, you could make it a superpower that enables you to do more good in the world.Remember, however, that research into success suggests that building on your own superpowers is more important than creating new ones or overcoming weaknesses. You do you!Guest ProfileLogan Fahey Franz (he/him):Chief Executive Officer, Graze RoboticsAbout Graze Robotics: Graze is a full-stack automation, robotics, and AI company focused on enabling the service industry to do more with less. We are more than just a developer of autonomous commercial lawnmowers; we are architects of progress. With each stride we make, we move closer to simplifying maintenance across diverse landscapes. From airports to golf courses and government properties to solar fields, we're redefining how maintenance is approached through intelligent, eco-friendly, autonomous tools.Website: www.grazemowing.comX/Twitter Handle: @grazemowingCompany Facebook Page: fb.com/grazemowingLinkedin: linkedin.com/company/graze-mowingOther URL: www.invest.grazerobotics.comBiographical Information: Logan Fahey is the current President and CEO of Graze Robotics - a developer of fully commercial autonomous mowers for airports, golf courses and solar fields.With experience ranging from running a family office to social enterprise to disrupting markets through technology innovation, Logan has built a unique and successful career as an entrepreneur and visionary. In a variety of roles with for-profit and not-for-profit organizations, Logan has headed effective teams and met ambitious goals through strategic innovation, always with a diligent focus on managing the bottom line.Logan started his career in 2012, managing the family office for PartsSource, the world's largest medical parts provider. He also headed the PartsSource foundation and ran the company's real-estate venture capital program, New Vista Ventures.Building on relationships developed during his time with Towards Employment (former venture), Logan assembled the board of directors for Fahey Group, a holdings company that he founded in 2016. Fahey Group's acquisitions include Landmark Lawn and Garden Supply, a northeast Ohio wholesale supplier and retail center that was in the red.At Landmark, Logan and the new management team overhauled the business by consolidating its stores, improving its supply chain, reducing costs, expanding net margins, and increasing net income. Landmark's successes also included launching an e-commerce business that generated $30+ million in increased revenue, recreating its brand for the direct-to-consumer and direct-to-business markets, and selling its locations, providing a significant return to shareholders.The next venture was Robin Autopilot, a robotic lawn care company based in Dallas-Fort Worth. Fahey Group acquired Robin in 2019 as a distressed asset backed by MTD Holdings (now Stanley Black and Decker). As Robin's new CEO, Logan hired a new management team and repositioned the company as a RaaS firm with a Software-as-a-Service component (including multi-manufacturer fleet management solutions). Robin later became a Husqvarna Venture.Logan lives in Dallas with his husband, Luke, who is a land-use attorney with Leeward and Associates, an alternative energy company. Logan and Luke enjoy traveling, skiing, and spending time with their English Bulldog, Benji.Board Activity- Strategic advisor to the Board of Sensori Robotics, a RaaS start-up based in Dallas-Fort Worth- Board member, governance chair, and executive committee member of the National Social Enterprise Alliance- Board member and chair of the Robin Autopilot Holdings boardX/Twitter Handle: @loganefaheyPersonal Facebook Profile: fb.com/logan.fahey.9Instagram Handle: @GrazeMowingSupport Our SponsorsOur generous sponsors make our work possible, serving impact investors, social entrepreneurs, community builders and diverse founders. Today's advertisers include FundingHope, Honeycomb Credit and the SuperCrowd Mastermind. Learn more about advertising with us here.Max-Impact MembersThe following Max-Impact Members provide valuable financial support to keep us operating:Carol Fineagan, Independent Consultant | Lory Moore, Lory Moore Law | Marcia Brinton, High Desert Gear | Paul Lovejoy, Stakeholder Enterprise | Ralf Mandt, Next Pitch | Add Your Name HereUpcoming SuperCrowd Event CalendarIf a location is not noted, the events below are virtual.* SuperCrowd Mastermind Group, twice monthly on the 1st and 3rd Thursdays at noon Eastern. This group is for entrepreneurs and small business owners interested in raising money from the crowd. Attend your first meeting free!* Impact Cherub Club Meeting hosted by The Super Crowd, Inc., a public benefit corporation, on November 19, 2024, at 1:00 PM Eastern. Each month, the Club meets to review new offerings for investment consideration and to conduct due diligence on previously screened deals. To join the Impact Cherub Club, become an Impact Member of the SuperCrowd.* Superpowers for Good Televised Live Pitch, November 13, 9:00 PM Eastern during primetime. At the event, judges will select their pick, and the audience will select the SuperCrowd Award recipient. Put the date on your calendar to watch it live!* SuperCrowdHour, November 20, 2024, at 1:00 PM Eastern. Each month, we host a value-laden webinar for aspiring impact investors or social entrepreneurs. At November's SuperCrowdHour, Devin will explain six common investment types you need to understand before you can invest like a pro. Free to attend.Community Event Calendar* Successful Funding with Karl Dakin, Tuesdays at 10:00 AM ET - Click on Events* Community Revitalization, Thursdays, 10:00 AM Eastern.* Crowdfunding Unlocked, WorldTree, Thursday, November 14 at 3:00 ET/Noon PT. Devin Thorpe, Léa Bouhelier-Gautreau and Cathy Key.* Main Street Skowhegan and NC3 Entrepreneur Finance Workshop Series, September 17 - November 19, 2023.* 2025 Earthshot Prize Application window is open through November 15, 2024. Apply today!* Asheville Neighborhood Economics, date TBD following impact of Helene.If you would like to submit an event for us to share with the 8,000+ members of the SuperCrowd, click here.We use AI to help us write compelling recaps of each episode. Get full access to Superpowers for Good at www.superpowers4good.com/subscribe

Caddy Robotics is a company specializing in AI solutions for businesses, focusing on autonomous service robots designed to enhance operational efficiency and customer experience. On this episode of The Wednesday Match Play Podcast powered by Epic Golf Club, Travis shares the journey of how Caddy Robotics got started, taking us behind the scenes of the video featured on their website, and giving us a rundown on their impressive lineup of robots. He breaks down what RaaS means and shares some exciting news about their plans for a showroom. He also details their onboarding process and explains how members are embracing these innovative machines. This was a fascinating technological conversation, and it was an honor to have Travis on the show. Let's tee off.

NamPol adjunk-kommissaris Kauna Shikwambi het onlangs die belangrikheid van openbare nakoming van die Drankwet se regulasies beklemtoon. Met skole wat vroeër as gewoonlik vir die verkiesings gesluit het, het sy sjebiens, kroeë en kerke aangemoedig om geraas tot die minimum te beperk om te verhoed dat leerders en studente wat vir nasionale eksamens voorberei, ontwrig word. Hierdie oproep het ten doel om 'n gunstige studie-omgewing gedurende hierdie kritieke tyd te verseker. Kosmos 94.1 Nuus het met adjunk-kommissaris Kauna Shikwambi gepraat wat haar punte uit die mediaverklaring herhaal het en bygevoeg dat die polisiemag die land op die hart dra terwyl die Namibiese verkiesing nader kom.

The Rubicon Centre at Munster Technological University (MTU) has announced the commencement of Enterprise Ireland's New Frontiers Phase 2 Programme. This year, 15 promising start-ups, spanning various industries from sustainable packaging to AI-driven platforms, have been selected to participate in this highly competitive programme. According to the Rubicon Centre, the 2024 cohort is not only remarkable for the breadth of its business ideas but also for its near gender parity, with 7 of the 15 being female founders. The Rubicon Centre is part of Innovation and Enterprise at MTU. Meet the 2024 Cohort: A Glimpse into the Future of Business The businesses selected for this year's programme represent a wide array of industries, each bringing a fresh and innovative approach to solving contemporary challenges. Here's a look at the dynamic ventures from this year's cohort: 1. ROWTEIC LIMITED (Founder: Sam O'Neill) - A biomechanics software platform transforming the sport of rowing by providing insights into technique and performance. 2. Cookease (Founder: Aoife Goulding) - Leveraging air fryer technology to make home baking mess-free and stress-free for modern consumers. 3. Quartz (Founder: Iarla Crewe) - Offering a crypto bank account that allows users to earn yield, manage transfers, and access funds with a debit card, all while maintaining custody of their crypto assets. 4. Product Otter (Founder: Mairead Maher) - An AI-driven RAAS platform that delivers real-time competitive intelligence and future insights to elevate product development and strategic decision-making. 5. All You Knead (Founder: Lucy Lehane) - A service providing pre-weighed, locally sourced ingredients to schools for Home Economics, supporting food literacy education. 6. a.chara (Founder: Reece Hogan) - A supportive app designed for healthcare professionals and caregivers of dementia patients, focusing on chronic pain management and well-being. 7. Zhy Biotechnologies Ltd (Founder: Zuhri Ajibola) - Developing microbiome-friendly bio-fermented ingredients for food, beverage, and personal care industries, targeting individuals with sensitive gut and skin. 8. Natural Vet Co. (Founder: Sinéad Mellett) - A veterinary supplement company providing novel formulations for cats and dogs, created by a vet and herbalist. 9. Nooneering (Founder: Michael Noonan) - Introducing Noonan's Control Method, an innovation that reduces variance in stepper motor performance, improving efficiency. 10. Alternative Christmas Pudding (Bia Bona Dea) (Founder: Sadhbh Cosgrove) - A line of alternative Christmas puddings made with Belgian chocolate and liqueurs, offering a vegan and gluten-free option. 11. Vappa (Founder: Marc O'Donovan-Wyatt) - A loyalty rewards app that encourages positive daily habits through a rewards system. 12. Mindful Maker (Founder: Paul Murphy) - A business creating handmade, heritage-led furniture, homeware, and gifts from sustainably sourced Irish timbers. 13. Enertech Ltd. (Founder: Diarmuid Duggan) - A virtual power plant platform that aggregates electricity micro-generation and demand response to sell energy at optimal times. 14. Tower Watch (Founder: Robin Thankachan) - A building energy monitoring and management platform designed to optimize efficiency, offering features like predictive maintenance and sustainability goal tracking. 15. Eco Root (Founder: Lavanya Bhandaria) - Innovating in sustainable packaging by creating compostable materials from mycelium, contributing to eco-friendly alternatives for various industries. New Frontiers Phase 2: A Launchpad for Innovation Enterprise Ireland's New Frontiers programme is designed to support early-stage entrepreneurs in transforming their innovative ideas into successful, scalable businesses. The Phase 2 programme, hosted by The Rubicon Centre at MTU, provides participants with a comprehensive six-month programme that includes practical mentoring, financial support, and access to vital resources. It equips entrep...

The rise of Retail as a Service (RaaS) has opened up transformative opportunities for retailers, but it also poses serious challenges. In this episode, join Oliver Banks to dive deep into the evolving RaaS landscape and explore the key factors that are shaping its future. From data privacy concerns to expansion into new categories, we'll dissect the pros, cons, and potential pitfalls of this new business model. Whether you're considering RaaS for your business or are curious about the changing dynamics of retail, this episode offers fresh insights and perspectives on what's to come. Listen to this episode now to:Understand how RaaS is both levelling the playing field and empowering major retailers.Explore the 5 emerging factors which are shaping the future of RaaS.Discover how non-retail companies are entering the RaaS space and what that means for the future.Show notes are at www.obandco.uk/317.

Retail-as-a-Service (RaaS) is a fast evolving segment of retail which offers new profit streams or the ability to quickly scale a new business or channel. Today, we're exploring how this model is reshaping the retail landscape. From the growth of global giants like Amazon, Ocado and THG to the rise of supply chain innovators like Shein, we unpack the key drivers behind this trend and what it means for retailers of all sizes. Whether you're considering adopting RaaS, already a provider, or wondering about the challenges and opportunities that this shift means for your business, this episode will offer valuable insights into the RaaS opportunity. Show notes are at www.obandco.uk/316.

This special student-hosted episode of the Weinberg in the World Podcast features a conversation with Sonia Punjabi '21 who graduated from Northwestern with a Biological Studies Major and a Art Theory & Practice Minor.  Student host Smera Dwivedi, a rising sophomore majoring in chemistry, interviews Sonia Punjabi, a third-year Doctorate of Physical Therapy student at the University of Miami. Sonia shares her journey from Northwestern University, where she explored various fields before finding her passion in physical therapy. She highlights the impact of being a peer advisor on her personal and professional development, emphasizing the importance of interpersonal skills and diversity training. Sonia also discusses her current clinical rotations and the challenges she faced along the way. https://www.linkedin.com/in/sonia-punjabi/ Transcript: Smera Dwivedi: Welcome to the Weinberg in the World Podcast, featuring stories of interdisciplinary thinking in today's environment. My name is Smera, and I'm your student host of this special episode of this podcast. I'm a rising sophomore and I have an intended major in chemistry on the premedical path, although I'm not that sure about that, but I'm very excited to learn about physical therapy and your career. Today, I'm excited to be speaking with Ms. Sonia Punjabi, who is, I'm not sure I asked you where you're working or the title of company or anything. Sonia Punjabi: Totally fine. We can get to that when we start. Smera Dwivedi: Okay. Well, good to know. If you'd like to introduce yourself, thank you so much for speaking with me. Sonia Punjabi: Yeah, of course. So I'm Sonia, she/her/hers pronouns, and I'm currently in Miami, Florida. I am in the third year, third and final year of the Doctorate of Physical Therapy program at the University of Miami, which I never thought I would be doing for multiple reasons. It's really cool. We'll get into that. But because I'm in the final year of the doctorate, we have clinical rotations, which means I'll be at different places until I am fully licensed and practicing on my own. So for now, just UMPT, but I love it here, and when there's a job opportunity, I'll let you know. Smera Dwivedi: Oh, good to know, good to know. So how was your Northwestern undergrad shaped how where you are now? Sonia Punjabi: Oh, I loved Northwestern. I adored it there. I came in not knowing what was going on, which I think is normal. I came in thinking maybe I would do math because I had done well in my math classes in high school. I had excelled in the APs. They offered me the MENU course. I don't know if it's so called MENU. So I was like, "Oh, this is kind of neat." It wasn't quite what I was looking for because I didn't know what I was looking for, so I thought, "Oh, architecture, I like art and math. Maybe journalism. Maybe I should switch to McCormick or potentially SESP." I kid you not, I looked at so many things when I was in Northwestern, but the things that stood out to me and made me who I am were being a peer advisor for two years. I was a peer advisor for the class of 2023 and the class of 2024, which is happy tears since they've graduated, if they stuck with that graduation year, and the fact that I took advantage of Weinberg because it's arts and sciences, I took a bajillion English courses, some short of a minor. I probably could have done a minor in English literature, and I did a minor in art theory and practice, and those highly influenced how I am as a person today, both personally and professionally, but we'll get into that. I don't want to talk your ear off immediately. Smera Dwivedi: You're so good. You're completely good. So what about being specifically a peer advisor made you realize something about yourself or something about your interests or something along those lines? Sonia Punjabi: I think the peer advisor course, the way that they prepare students to be peer advisors is phenomenal. It's so well done. I'm still hoping to encourage my current institution and future institutions to utilize some of the same training techniques where we learn about diversity in ourselves, we learn about identity in ourselves, we learn about how to dialogue, and those are essential skills for humans that interact with other humans, but also for healthcare providers that support other humans in health. So that was huge. That was my 101 and how to talk to people and also who am I. I loved it. I loved it. I gained so many incredible interpersonal skills from being a peer advisor that I probably still use at this moment to this day. They've just been honed as I've entered the doctorate program. Smera Dwivedi: Okay. Good. So what was the hardest part about where you are now? What was the hardest part, whether it was undergrad or something else? Sonia Punjabi: Good question. I think not to be too pithy here, there are ebbs and flows in every stage of life. In undergrad, maybe early undergrad, it was that I didn't know. I was confused about my path, which is the way it's supposed to be. I didn't know if I was even in the right school, right major. I had no idea. So I was a biological sciences major, inevitably, confusingly, begrudgingly pre-med, not that that's not a wonderful track, but it didn't quite fit and I wasn't sure why. And I kid you not, I was thinking about preparing for the MCAT and preparing for applying to medical school until the last quarter I was at Northwestern, the final one. I changed my mind. I think it must've been February 2021 and I graduated in June 2021. So I decided really late that I wanted to go into PT school. So maybe in the beginning it was that uncertainty and that feeling that I hadn't found quite the right fit. I knew what I liked, I loved the art theory and practice classes, I loved being a peer advisor, I loved writing and talking, but I didn't know how that would translate. Smera Dwivedi: So I kind of relate to ... I'm in the pre-med path, but I'm not sure if that's something I want to do. So what made you realize that physical therapy was what you wanted to do or what made you finally decide to get off the medical school path? Sonia Punjabi: Sure, and again, I do want to emphasize that I have some lovely friends in the pre-med, well, now medical school world. They're deep in medical school now, and it's a great path. It's amazing. I don't want anyone to feel like, "Oh, this is wrong," because it's a great path. It just wasn't my path. For me, it was that I had a history of my own PT journey as a patient with dance. I danced at Northwestern. I was one of the first years who auditioned for Ahana when it was formed in 2017. So I was on Ahana, I had auditioned for the Bhangra team, and I realized I couldn't do everything I wanted to do, and that was tough. I hadn't found the right kind of PT for myself either. I didn't know what I was looking for. Finally, we get to February 2021, and in my brain, I've already kind of thought about and entertained physical medicine and rehabilitation. It's called PM&R for short, you may have heard of it, and it is a specialty in medicine in which physicians intervene pain management with rehabilitation, either mildly invasively, moderately invasively, noninvasively. There are a ton of ways that physicians can intervene in PM&R, but I thought that was really attractive to me. I was like, "Oh, there's a physician at Shirley Ryan that takes care of performing artists," and I met her. This was right before the pandemic. I kid you not, it was maybe the week or the week of, week before or week of. I go downtown. I have a meeting with one of these physicians who was nice enough to greet me, and we chat about the differences between the physician track and the physical therapy track because they work closely together for rehab. And she was very honest about it. She said, "Yeah, well, I think as a physician, you get to make decisions about medications if that's applicable, about surgical interventions if that's applicable, but you spend less time with your patients compared to a clinician in physical therapy who might see someone two to three times a week for an hour each, depending on the setting they're in. So you have different relationships with your patients and you accomplish different things together." And I was like, "That's interesting," Smera Dwivedi: Absolutely. Sonia Punjabi: I started entertaining that track during the pandemic when everyone was making sourdough and banana bread. We made a lot of banana bread. I was also- Smera Dwivedi: I forget the [inaudible 00:07:43] Sonia Punjabi: A lot of banana bread and a lot of podcasts. I was listening to podcasts by dance trainers working in the rehab world. I was listening to podcasts and looking at online resources from PTs who did a different kind of PT than I'd ever seen. They did strength-based PT. So I started educating myself and applying some of these skills and I was like, "Well, this is pretty cool." Finally, when I was juggling PM&R, PT, PM&R, PT, I made the decision to do PT because the lifestyle of the educational trajectory made sense to me. I got to be a clinician earlier and for longer time with patients, and that's what I really liked. Smera Dwivedi: Okay. Very nice. A podcast, so I need to start listening to podcasts. Got it. Got it. Sonia Punjabi: You don't have to. It just happened to be- Smera Dwivedi: It's like another avenue to explore to see what I want to do. It's very nice because- Sonia Punjabi: I was exploring on Instagram. There are clinicians that show you how they treat knee pain with certain exercises. Again, be careful, it's the internet. They might be like, "Hang upside down from a tree," and that's obviously not going to ... Well, it might, but it might not be the right thing, but I was exploring resources to understand the variety of people not only in rehab, meaning doctors and PTs and OTs and other folks that help with the rehab world, but also styles of rehab within physical therapy. So this was all on my own accord. Northwestern has a wonderful PT program, but I don't think the undergrads get a lot of exposure to what that is. Smera Dwivedi: Okay. That makes sense. So you looked at you said Instagram. Did you ever shadow a lot of doctors? Did that help or anything of sort? Sonia Punjabi: Yeah, good question. Again, because times were a little different, when COVID picked up, I had just started entertaining that idea, and that's why I met with some of the folks at Shirley Ryan. So I'd been to Shirley Ryan a couple times before the pandemic, and I had seen their space, which is really interesting. They overlap their engineers and their PTs and their physicians all in the same space in the same floor. So I got to speak to an engineer there, I got to speak to this performing arts physician and PM&R physician there, and I probably would've continued doing that with the children's hospital I applied for a position, et cetera. But when the pandemic happened, the resources available to me were Spotify or Instagram were folks that were posting information, again, beware, but information that you could learn bite-size pieces about how they treat, and a lot of folks are doing that, especially in this day and age. So it's a wonderful way to explore. It's not the only one. It just happened to be one of mine. We have a family friend who I also was able to speak to on the phone who is at Hopkins Rehabilitation now and specializes in triathletes and runners. I got to speak to him about his experience. So that's also definitely an option. If you have connects in certain areas and they're willing to speak, ask some questions. Smera Dwivedi: Makes sense. Do you have any advice for somebody who's going through something similar or doesn't know what to do or something? Sonia Punjabi: Of course. So I think Northwestern kids are often certain personalities. They often are extremely high achieving, very bright. There's a reason that we're all in this cool place or we're in this cool place. We really like what we're doing and we're good at things that we're doing, and we want to continue to learn and excel. I also feel that sometimes the perfectionism can mask our abilities to see, "Hey, I have all these really cool things going on," and I might not be where that person is, but I've learned how to speak Mandarin. I've learned how to oil paint in Kresge. I've learned how to code, and I'm a history major. Sometimes it's okay to do something purely out of interest and fun, even if it doesn't feel like, "Oh, this is going to be something on my resume or it's going to take me to this future degree," whether it's a medical degree or a law degree or whatever that may be. It doesn't necessarily have to make sense. I think explore and be okay with making mistakes and being lighthearted about it. I will be totally honest, I think my art theory and practice minor and all of my English classes greatly influenced how I am as a future clinician. I think it's made me really well-rounded, and it's something I love. Typically with the pre-medical track, they may not be like, "Go take an art class." They might give you time, but don't feel like that's not the right thing if you're interested in it. Certainly, there's volunteering, there's health related courses, you have to take all of the prerequisites. Those are a given, but give yourself some space to make mistakes, to be lighthearted, to not be too hard on yourself and to explore. Smera Dwivedi: Well, that's really good advice because I feel like a lot of times I think of the longterm value in all the classes I take and if they're going to benefit my career or resume, so that's- Sonia Punjabi: It's not a bad thought. It's not a bad thought at all, but the pressure can feel like a lot sometimes with that. Smera Dwivedi: So along the same lines, do you regret doing something like that? Do you regret something like in undergrad that you wish you'd done differently? Sonia Punjabi: I think I can say the only thing I regret is being too hard on myself, genuinely. I think you are meant to explore and change your path. They know you're going to do that. If you don't, something's wrong. You are meant to explore, make mistakes and grow and change course. So if you're doing that, you're doing the right thing. So I wouldn't regret anything. I think I had a wonderful time. I explored and I did a lot of really unique things that made my Northwestern experience. Smera Dwivedi: That's reassuring to hear, for sure. So I'm worried I'm going to regret doing certain things or taking certain classes. Sonia Punjabi: I took, like I said, a bunch of art courses for the art minor, and I took English courses for fun because based on my Weinberg credits, I didn't need them, based on my premedical requisites I didn't need them, but I remember them maybe the most, and that's super cool to me. Smera Dwivedi: So other than your classes, and you talked a little bit about social media and how that influenced your decision, other than that, were there any extracurriculars that pushed you towards your career or any that you were like, "Oh, wow, I like this a lot. This is something I want to do in the future," or something like that? Sonia Punjabi: Let me think. Well, I did touch on the dance scene at Northwestern, which is lovely, amazing, super cool. There's a wonderful performing arts scene, as you know. The fact that I loved it so much but had some hurdles on my own participating in it, that was a big hole. I was like, "Gosh. If only I could wholeheartedly with my whole musculoskeletal system participate in this, that would be amazing." And I still did, but just at my own pace since I hadn't found the clinician that was right for me yet. I think that is often a common story in my fields. A lot of my classmates in my cohort, they have their ACL history or they have their shoulder labrums or their hockey injuries, and that is a common segue into the field, but not the only one. Some people come from advertising degrees, business degrees, they have kids, they come from serving in the military, in the Navy. So a lot of paths can lead to this, and much like any other career, many paths can lead to a law degree. Many paths can lead back to medicine if you pursue medical school. I don't want people to think that there's one path to get here. I think I deviated from your question a little bit, so we might need to come back to that. Smera Dwivedi: Totally okay, just whatever you'd like to say. I did want to ask, Ahana, is that the Bollywood dance group or is that the one with the Danyas or which one? Sonia Punjabi: Good question. So I think I auditioned for pretty much all of them when I was a freshman, a first year. Ahana is the noncompetitive, as far as I'm aware, still noncompetitive Bollywood dance, like a film fusion dancing. I remember exploring the Raas team exploring the Bhangra team, exploring TONIK Tap, which I thought was super cool, legendary, such interesting performing artists, the TONIK Tap. I was familiar with Refresh. I hope that there's still a large participation in the dance scene at Northwestern, and I would hope that in the fields in physical therapy, there is more tension given to performing artists now than before because I think that's been a developing part of the field where performing artists have a very unique sense of sport, of what they have to do, demands in the sport, and they haven't always been treated as such. So I think getting proper treatment and having clinicians that understand that is so [inaudible 00:16:36] because then it takes people years to figure out who they need because it's not common knowledge. So little mini plug for all of our dancers out there. If something's not right, don't be afraid to get second opinions and look for clinician that makes sense to you and that treats you to your sport and to your needs. Smera Dwivedi: So did you continue doing Ahana all four years? Sonia Punjabi: I did Ahana for a year-ish, a year-ish. I remember I had to say goodbye to the team my sophomore year, I believe, my second year because of my PT journey. I hadn't found what I needed yet. It was getting tougher to participate in dance, but I think life has a funny way of showing you what you need when you need it. So I've found some really amazing resources, clinicians, worlds of PT that lend themselves back to what I was doing in Ahana like, "Oh, that thing I wanted to do, that's why it was so hard because I hadn't had this training, this treatment, this person." I mean, life is kind of funny like that. Smera Dwivedi: So was it the balance, was it a lot of time commitment, which is why you had to just let it go or were you just like, "I need to be more career-oriented," and some extracurriculars can't be balanced well? What was the driving- Sonia Punjabi: It was actually the physical pain injury stuff. I was having trouble with that, and yeah, it's a tough journey for any athlete for any performing artist when you have to take a break because of that, but I'm really glad my life went the way that it did because I don't know if I would be here if it hadn't. Smera Dwivedi: Do you have any role models growing up or just whenever? Sonia Punjabi: Yeah. So currently, a few of my role models here in the Miami area are the women who work in the subspecialty of PT called pelvic floor therapy. It's a therapy that you might not recognize applies to more than just pregnant folk because, certainly, that's a population that needs pelvic floor PT at times, but there are subspecialty of PT that works with stability, strength, integrity and function of the pelvis and the things in the pelvis. So this is bladder and bowel function, this is sexual health, and this is pain, injury, et cetera. They're so cool. I have a wonderful mentor in the Delray, Boca Raton area who has her own clinic, and she's always available for me to ask questions, for me to come in and say like, "Hey, can I participate as a shadow? Can I see who you're treating today?" if they're comfortable with it. She's wonderful. And then I have my own clinicians here, actually, that have treated me, that have seen me throughout my own journey who are so smart, so interesting, such fun individuals to provide support. They show me that being a colorful human is not only allowed but also encouraged in a field where you're treating humans. So I think if we handle ourselves with imperfect grace, that's great. That's going to be a wonderful way to connect with people when you show them like you're doing your best and you are acknowledging when things get a little twisted and continuing on. So definitely my role models in pelvic PT, my parents and my brother who are all Northwestern alum. We are a very purple family. They are definitely a big support system to me. There are so many other people on the list, my sister-in-Law, my brother's wife and the cat outside. Essentially, your support system cheers you on, and the mentors and the role models I have are often one and the same, so to keep it light. Smera Dwivedi: Right. Good to know. It's also nice to have a support system, for sure. Sonia Punjabi: Absolutely. Oh, I should probably mention, if you do another degree after Northwestern, all of the faculty, all of the clinicians, all the people who are teaching you become amazing role models and support systems. A little shout out to the faculty and staff at the University of Miami Physical Therapy Program. They're a family. That's why I came. They are like a bonafide family. They will care for you. They will help you to the point of texting you when something's wrong or you texting them when something's wrong and they'll respond to you. They are available by email. They're available to meet with you. They're honestly available to give life advice. I have a faculty member's book sitting in my bookcase right now. So if you're open to being vulnerable, which is a huge part of what peer advisor training teaches you, people will help. Smera Dwivedi: Okay. So you talked a little bit about your post post-grad struggles. Sonia Punjabi: So again, every chapter is going to have its own flavor of ups and downs. When I graduated from Northwestern, so bittersweet, amazing, very exciting. I started a gap year position at a Miami-based gym and physical therapy clinic. I was doing their photography, their media, their patient and client interactions. It was amazing because I got to learn all these wonderful things from people who were already doing it ahead in this part of the career, but it was tough because I didn't have any peers and I felt a little bit like an island. So that can be a little isolating when you have a new chapter and you feel like you're on your own footing and you would benefit maybe from seeing where some of your classmates are or having a peer that's just at the same stage of life. So it was helpful when someone else came in at that position who was applying to med school, and so we had that commonality of life chapter. Smera Dwivedi: That's nice that you were able to navigate through that. So your two years post ... You said you graduated in 2021? Sonia Punjabi: I did, yes, in June 2021. Smera Dwivedi: So you mentioned your doctorate program that you have to get back to. What is that? Sonia Punjabi: Yes. So the PT program, typically in the United States now, are three-year programs and they're doctorates. So when you graduate, you have a doctorate of physical therapy, and then you take the licensing exam to practice. So okay, you have the doctorate, you're knowledgeable, now you're allowed to practice. So that is where I am. I'm in the third year and I'm finishing classwork in October, and then October through May for our program, we have three clinicals in a row where we get to have hands-on experience with a clinical instructor who will oversee you and you'll treat people in the hospital, you'll treat pediatrics if you're into that. For me, I'm going to be treating pelvic in March. So this termination of the program is really hands-on practical work. Smera Dwivedi: Got it. Okay. Is there anything else you'd like to say or, I don't know, speak about, give advice for anything? Sonia Punjabi: Open-ended. I have silly versions of this answer and I have serious versions. Do you want both? Silly versions. Still, they hold weight, go check out Bookends and Beginnings. It's, I think, still in the alley at where the box is. You know where the campus gear store is? Smera Dwivedi: Yeah. Sonia Punjabi: There's an alley, there's a bookstore in there. They also have a book front, which is beautiful, if I'm remembering correctly, on Sherman. I think it's on Sherman. Go check it out. It was my little lifeline during PT or not PT school, during my Northwestern undergrad experience. And if the fourth floor of North still exists- Smera Dwivedi: Yeah. They're doing some construction with North, but it's like they're adding a pub of something. Sonia Punjabi: Interesting. Smera Dwivedi: There's still like a third and fourth floor. Yes. Sonia Punjabi: I think it's the fourth floor and people don't know about it. If you take a staircase, go check that out if nobody knows about that yet. Smera Dwivedi: It's nice and quiet up there, for sure. Sonia Punjabi: Oh, yes. Oh, yes. I think I have a few about the library. Do they still take out the Mario Kart Wii during reading week? Smera Dwivedi: Yes, of course. Sonia Punjabi: Okay. Good. Play a lot of that. Do a lot of that. Participate in every primal screen you can. Smera Dwivedi: Haven't done that yet, actually. Sonia Punjabi: Yeah, you should. I think it's 9:00 PM. Is it the Sunday before finals? Smera Dwivedi: Yeah, I believe so, around that time. Sonia Punjabi: Do that. If you're feeling adventurous, go take a look at Blick, the art store near where the movie theater used to be. Smera Dwivedi: There's still a movie theater there, the AMC. Sonia Punjabi: Oh, surprising. I'm sure more fun, silly ones will come to mind, but my gist here is just explore just a cool place. Evanston's a great place. Northwestern's a great community. Don't be afraid to strike up conversations with people you haven't really crossed paths with. Serious ones would be don't be afraid of change. Change is the only constant. It's that very famous saying or phrase. Don't be afraid of change with anything, with undergrad, with your personal life, with post-grad. Don't be resistant to change. It will often make you better. Smera Dwivedi: No, good to know. I do. Sonia Punjabi: Yeah, of course. Smera Dwivedi: Well, I mean, that was really helpful for me to consider. Thank you so much for your advice and for talking about your career and personal stuff about your life and [inaudible 00:25:50] I appreciate it. Sonia Punjabi: If anyone has questions about the physical therapy world, I'm more than happy to chat, to get on a video call, phone call. It's a really cool place. I think a lot of health leaning undergrads may not know this is an option for them or what it even looks like. There are a million different things you could do in PT. You can help folks post-stroke walk again. You can help folks post-spinal cord injury participate in leisure, in recreation. For me, I can help folks during pregnancy or if you just want to rehab ankles and pediatrics who play soccer, do that. It's a cool field. Consider it, and I'm here for questions. Smera Dwivedi: Okay. Thank you. Sonia Punjabi: Yeah, of course. Smera Dwivedi: We appreciate you tuning into the special edition of the podcast, Weinberg in the World. Go Cats. We hope you have an amazing day.

This week on Security Squawk, dive deep into the world of Ransomware-as-a-Service with a focus on the recent RansomHub attack that targeted Halliburton, causing significant disruption to their operations. We'll explore the intricacies of the attack, its implications for the oil and gas industry, and how RansomHub has become a major player in the ransomware landscape. Host Bryan Hornung leads the conversation on how businesses can navigate the escalating threats posed by RaaS groups and fortify their defenses against these sophisticated cyber attacks. Don't miss this critical episode packed with expert analysis and actionable insights.

AKI Tips and Tricks from Joel Topf MD, Kashlak's Chief of Nephrology Get a grip on acute kidney injury (AKI) with Dr. Joel Topf (AKA @kidney_boy), Kashlak's Chief of Nephrology! We've put together an AKI highlight reel - focusing on practical tips and tricks to help you identify, diagnose and manage AKI, plus how to recognize AIN and random myths and musings on vancomycin, NSAIDS, contrast nephropathy, and the risk of NSF from gadolinium. Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode's release date).  Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written (including CME questions) and Produced by: Cyrus Askin, MD Infographic by: Cyrus Askin, MD Cover Art: Kate Grant MBChb, MRCGP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com Guest: Joel Topf, MD Time Stamps 00:00 Sponsors - VCU Health CE and Pediatrics On Call podcast by APP 00:30 Intro, disclaimer, guest bio 03:00 Guest one-liner, Picks of the Week*: Zoe Keating albums (Cellist); Mrs. America (TV series) on FX; The Last of Us (Videogame); 08:45 Sponsor - Pediatrics On Call podcast by APP 09:15 Definition of acute kidney injury (AKI) and fundamentals 11:00 Cardiorenal syndrome 12:24 Schema for AKI 17:30 Establish an etiology, determine urine output and address electrolyte abnormalities 21:22 AKI in the otherwise-healthy patient; 32:20 Rhabdomyolysis
38:21 Vancomycin 41:43 Acute interstitial nephritis (AIN) 44:52 Contrast induced nephropathy (CIN) 50:37 Gadolinium in AKI and/or CKD 52:53 Timing of dialysis 
 56:37 AKI in the out-patient setting and how to handle home meds e.g. TMP-SMX, RAAS inhibitors; 62:01 Is Ultrasound necessary in AKI
 64:58 Dr. Topf's take home points and Plug for Seminars in Nephrology 68:45 Outro and Sponsor - VCU Health CE Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Panacea Financial If you're ready to join the thousands of doctors who have declared independence from traditional banks, visit panaceafinancial.com today. Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts.

CardioNerds Dr. Rick Ferraro, Dr. Gurleen Kaur, and Dr. Maryam Barkhordarian discuss the evidence and data supporting SGLT inhibition for cardiovascular and kidney health outcomes with expert faculty Dr. Muthu Vaduganathan. They discuss the role of SGLT inhibitors in different populations, including those with diabetes mellitus, heart failure, CKD, and myocardial infarction. Show notes and audio editing by CardioNerds Academy Fellow Dr. Maryam Barkhordarian. This episode was produced in collaboration with the American Society of Preventive Cardiology (ASPC) with independent medical education grant support from Lexicon Pharmaceuticals. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - The Data Supporting SGLT Inhibition with Dr. Muthiah Vaduganathan The benefit of SGLT inhibition extends beyond diabetes, and improves cardiovascular and kidney health outcomes independent of diabetes in appropriate patient populations. SGLT inhibition decreases cardiovascular mortality and heart failure hospitalization independent of left ventricular ejection fraction. SGLT inhibitors reduce clinically relevant events such as dialysis and transplantation in CKD patients irrespective of etiology and are now a cornerstone for the prevention of CKD progression. The introduction of polypills in heart failure can simplify GDMT implementation. Show notes - The Data Supporting SGLT Inhibition with Dr. Muthiah Vaduganathan How did SGLT inhibitors transition from “diabetes medication” to guideline-directed cardiovascular medicine? Most therapies in cardiology were developed for a particular purpose and ended up being indicated for a vastly different reason. The SGLT-2 inhibitors are no different. Cardiovascular safety concerns about diabetes medications led to a mandate to conduct cardiovascular outcomes trials for all novel diabetes medications. This federal requirement shed light on the cardiovascular benefits of SGLT inhibitors in patients with diabetes. These initial trials showed that not only are these medications safe but also, surprisingly, proved their role in preventing heart failure and delaying progression of chronic kidney disease. What are the mechanisms of action of SGLT-2 and SGLT-1/2 inhibitors? The central mechanism(s) of how these medications confer health outcomes benefits patients is/are not well understood. The main organ involved in the action of SGLT-2 inhibitors is the kidney at the level of the proximal tubule, impacting the cardiovascular system by handling salt and water and improving kidney efficiency. Conversely, SGLT-1/2 inhibitors also act at the level of the gut, the predominant location of the SGLT-1 cotransporter. Their effects on the cardiovascular system are secondary, given there is no SGLT-1 or -2 cotransporters in the myocardium. These secondary effects can be impacted through blood pressure reduction, volume regulation, improved glycemic control, etc. to overall improve cardiovascular status. Whatever the underlying mechanisms, the empirical data for their use is strong and growing. What is the role of SGLT inhibitors in preventing CKD progression? RAAS inhibitors (ACE inhibitors and ARBs) have been the cornerstone of CKD management for the past two to three decades. SGLT inhibitors have been the first add-on to this background therapy. Four trials, DAPA-CKD, EMPA-CKD, CREDENCE, and the SCORED, investigated the effects of SGLT-2 and SGLT-1/2 inhibitors in patients with CKD with or without diabetes. The outcomes of these trials include modifying the course of CKD and reducing events such as dialysis initiation and transplantation. These effects were regardless of participants' diabetic status, CKD etiology, or individual patient profile.

When Shree Krishna descended on Earth 5000 years ago, he bestowed the highest bliss to the Gopis through the Raas Leela or Maha Raas, the Divine Dance. Why Did Shree Krishna test the Gopis' before the Raas Leela? What happened during the Maha Raas? What are the key lessons from Raas Leela? Listen more to learn as Swami Mukundananda explains them in detail in this 38th episode of the Srimad Bhagavatam. Stay tuned for the next episode.

After an epic announcement of a series A raise as well as a rebrand yesterday, Caldera is positioning itself as the go-to modular vending machine for launching new chains. Does that sound funny? Well, we came up with this analogy minutes before the show and are starting to lean into it. Vending machines allow you to pick any snack to cure your hunger. RaaS providers similarly allow you to pick from a variety of modular infra to build a new chain. Developers can access everything needed to build and scale their blockchains—from rollup frameworks like OP, Arbitrum, and ZK Sync to data availability layers such as Celestia and EigenDA. We ended up talking about the core issue Caldera is trying to solve with their recent metalayer developments, which is fragmentation. The technical complexity involved in connecting separate modules can be difficult, let alone connecting chains itself in a friendly way for users. We asked Matt how he plans to handle this... He mentioned by focusing on asynchronous composability over the more challenging synchronous composability is his ideal outcome, for now. We discussed what it actually looks like to provide RaaS services for projects, who their customers are, their marketing strategy, and the technicals behind their metalayer. We also asked if RaaS is going to zero via commoditization and if RaaS is really needed in a world of abundant shared sequencers (which can fulfill a similar role to a RaaS, in a sense). Matt had good answers. We really enjoyed this episode and hope you do as well. Website: https://therollup.co/ Spotify: https://open.spotify.com/show/1P6ZeYd.. Podcast: https://therollup.co/category/podcast Follow us on X: https://www.x.com/therollupco Follow Rob on X: https://www.x.com/robbie_rollup Follow Andy on X: https://www.x.com/ayyyeandy Join our TG group: https://t.me/+8ARkR_YZixE5YjBh The Rollup Disclosures: https://therollup.co/the-rollup-discl

Message our hosts, Kieran and Jose.We all learned about the renin-angiotensin-aldosterone system in school... Or did we? This fantastic, in-depth interview on our current understanding of the RAAS will provide a revolutionary new perspective on how we may be able to harness the maladaptive systems that are activated in heart failure for positive purposes in our patients. Join Jose and Kieran as The Animal Heartbeat welcomes Professor Marisa Ames, Board-certified veterinary cardiologist and expert on the RAAS in dogs and cats.Please check out https://www.trigdocs.com/ to find out more about The Translational RAAS Interest Group, Dr Ames' collective of interested clinicians and researchers from the fields of veterinary and human medicine.

In this episode of The Cybersecurity Defenders Podcast, we discuss some cutting-edge intel coming out of LimaCharlie's community Slack channel.Likely the biggest password leak ever: nearly 10 billion credentials exposed.Eldorado is a newly discovered ransomware-as-a-service operation targeting both Windows and Linux systems. OVHcloud has reported mitigating a record-breaking distributed denial-of-service attack that peaked at 840 million packets per second.Cisco has issued a warning about a critical remote code execution vulnerability named "regreSSHion," tracked as CVE-2024-6387, affecting OpenSSH on glibc-based Linux systems. In the first half of 2024, cryptocurrency thefts amounted to $1.4 billion, significantly driven by rising crypto prices and a few large-scale attacks.

Water From Thin Air Hit me up: mylesdhillon@gmail.com And please share this pod with friend. ## Humanoid Robots Enter the Warehouse- GXO Logistics signs multi-year deal with Agility Robotics to deploy Digit humanoid robots- Digit robots are 5'9" tall, can lift 35 lbs, and assist with repetitive tasks like moving totes- First commercial Robots-as-a-Service (RaaS) deployment of humanoid robots- Managed through Agility Arc cloud platform for easy integration- RaaS model lowers barriers for companies to adopt advanced robotics- Marks significant milestone for warehouse automation and human-robot collaboration## Harvesting Water from Air- New technology uses adsorbent fins to extract water from air more efficiently - Can harvest water even in low humidity (10% relative humidity)- Compact design with fins 2mm apart collects up to 1.3L water/day at 30% humidity- 2-5x more efficient than similar devices- Uses heat to release collected water- Addresses water scarcity concerns, tapping into atmospheric water vapor- Prototype tested successfully, research published in ACS Energy Letters## 3D Printing Corneas - Researchers developing 3D printed personalized corneas to treat blindness/disorders- Key benefits: customization, reduced donor dependence, lower rejection risk- Uses bioink from patient's stem cells or modified collagen fibers- Showing promise in lab/animal testing, moving towards human trials - Could help millions with corneal blindness- Challenges remain in scaling production and further testing- Multiple research groups working on the technology- Seen as promising solution to cornea shortages for aging populationCitations:[1] https://retailtechinnovationhub.com/home/2024/6/28/gxo-logistics-lays-claim-to-an-industry-first-as-it-inks-multi-year-agreement-with-agility-robotics[2] https://science4data.com/gxo-logistics-and-agility-robotics-deploy-digit-humanoid-robots/[3] https://www.logisticsmatters.co.uk/Humanoid-robot-to-deploy[4] https://gxo.com/news_article/gxo-signs-industry-first-multi-year-agreement-with-agility-robotics/[5] https://www.therobotreport.com/agility-robotics-digit-humanoid-lands-first-official-job/Get intouch with Myles at mylesdhillon@gmail.com

In this episode we meet Finola Burke, the managing director of RaaS Group, to delve into financial modelling and price discovery of company value. Finola explains how her team searches for mispriced companies to create sound research. RaaS Group specialises in providing independent equities research, particularly focusing on small and micro-cap companies. These companies often fly under the radar but can offer significant growth potential. If you are looking for an investing platform, Moomoo is a great brokerage suitable for both investors and traders, offering CHESS-sponsored ASX and US stocks starting from just $3AUD and $0.99USD. Sign up and deposit today to get 10 FREE stocks and 6.8% on your uninvested cash. T&Cs apply. https://j.moomoo.com/00GywLHere's a link to the blog post: https://www.sharesforbeginners.com/blog/Finola-Burke-RaaSDisclosure: The links provided are affiliate links. I will be paid a commission if you use this link to make a purchase. You will receive a discount by using these links/coupon codes. I only recommend products and services that I use and trust myself or where I have interviewed and/or met the founders and have assured myself that they're offering something of value.Shares for Beginners is a production of Finpods Pty Ltd. The advice shared on Shares for Beginners is general in nature and does not consider your individual circumstances. Shares for Beginners exists purely for educational and entertainment purposes and should not be relied upon to make an investment or financial decision. If you do choose to buy a financial product, read the PDS, TMD and obtain appropriate financial advice tailored towards your needs. Philip Muscatello and Finpods Pty Ltd are authorised representatives of Money Sherpa PTY LTD ABN - 321649 27708, AFSL - 451289. Hosted on Acast. See acast.com/privacy for more information.

In today's episode, we look into the recent compromise of celebrity TikTok accounts through a zero-click attack and discuss the exploited vulnerabilities. We then explore the potential security pitfalls of Microsoft's Windows Recall feature, highlighting totalrecall.py by ethical hacker Alexander Hagenah. Finally, we examine the ransomware attacks executed by the Russian-speaking Qilin group on NHS medical services in London. For more details, check out these sources: https://thehackernews.com/2024/06/celebrity-tiktok-accounts-compromised.html https://github.com/xaitax/TotalRecall https://www.group-ib.com/blog/qilin-ransomware/ https://www.google.com/search?q=why+should+people+delete+tiktok&oq=why+should+people+delete+tiktok Thanks to Jered Jones for providing the music for this episode. https://www.jeredjones.com/ Logo Design by https://www.zackgraber.com/ 00:00 Introduction 01:18 TikTok's Troubling History of Security Flaws 04:58 Exploring Microsoft's Controversial Recall Feature 07:46 Quillin Ransomware: A Deep Dive Tags: Zero-click attack, TikTok, hackers, vulnerability, ethical hacker, TotalRecall, Windows Recall, vulnerabilities, Qilin, ransomware, defend, security measures, sensitive data, critical sectors, Russian-speaking gang, NHS hospitals, cybersecurity, celebrity accounts, platform security Search Phrases: How TikTok handles zero-click attacks Vulnerabilities in TikTok security Protecting TikTok accounts from hackers Ethical hacking and TotalRecall demonstration Securing data against Windows Recall threats Defending against Qilin ransomware Russian ransomware gang Qilin explained Health sector ransomware attacks prevention Cybersecurity tips for TikTok users Windows Recall vulnerabilities and precautions https://thehackernews.com/2024/06/celebrity-tiktok-accounts-compromised.html ---`Flash Briefing: Celebrity TikTok Accounts Compromised Using Zero-Click Attack via DMs Zero-Click Attack on TikTok: Threat actors have exploited a zero-click vulnerability in TikTok, allowing them to take over high-profile accounts via direct messages without user interaction. (Source: Semafor, Forbes) Actionable Insight: Stay vigilant even if you don't interact with suspicious messages. Update your app regularly to ensure you have the latest security patches. Scope of the Compromise: TikTok has not disclosed the exact number of affected users but claims that only a "very small" number of accounts were compromised. Engagement: Ask listeners, “Have you noticed any unusual activity on your social media accounts lately? Share your experiences with us.” Response and Mitigation: TikTok has implemented preventive measures to stop the attack and is working directly with impacted users to restore account access. Actionable Insight: If you suspect your account has been compromised, contact TikTok support immediately and follow their guidance for recovery. Historical Context of TikTok Security Issues: January 2021: Check Point identified a flaw allowing attackers to build a user database with associated phone numbers. (Source: Check Point) September 2022: Microsoft found a one-click exploit in TikTok's Android app that could take over accounts via a crafted link. (Source: Microsoft) Turkey Compromise: 700,000 accounts were compromised via intercepted SMS messages. (Source: Report) Invisible Challenge: Attackers used a viral challenge to spread information-stealing malware. Global Concerns and Actions: China Ties: Concerns about TikTok's Chinese ownership have led to proposed and enacted bans in several countries, including the U.S., U.K., Canada, and Australia on government devices. Legal Actions: TikTok has filed a lawsuit in the U.S. challenging a proposed ban,` TotalRecall shows how easily data collected by Windows Recall can be stolen https://github.com/xaitax/TotalRecall ---`- TotalRecall Tool: Ethical hacker Alexander Hagenah developed the TotalRecall tool to highlight security vulnerabilities in Windows' newly announced Recall feature. This tool can easily extract and expose sensitive data collected by Recall. Actionable Insight: Be vigilant when using new features and tools that collect data, as they may have hidden security risks. Recall Feature Overview: Microsoft announced the Recall feature on May 20, 2024, as part of the Copilot+ line of Windows 11-powered PCs. Recall takes screen snapshots every few seconds, uses OCR to extract information, and stores this data in an unencrypted SQLite database. Actionable Insight: Encrypt sensitive data locally and regularly audit new features for potential security risks. Security Pitfalls: Security researcher Kevin Beaumont demonstrated that exfiltration of Recall databases can be automated, making it easy for malware and hackers to access the data. He criticized Microsoft for enabling Recall by default and allowing it to be reactivated without user knowledge. Actionable Insight: Immediately disable features that pose security risks and monitor for unauthorized reactivation. TotalRecall Functionality: The tool copies Recall databases, extracts information like passwords and search terms, and summarizes this data. Hagenah does not plan to update the tool further, leaving its functionality as a proof of concept. Actionable Insight: Regularly review and understand the tools being used within your system to prevent potential data breaches. Microsoft's Response: Although Microsoft has emphasized security, their implementation of Recall falls short. The feature stores data locally in an unencrypted format, making it accessible to malware and unauthorized users. Actionable Insight: Push for vendors to improve security measures and hold them accountable for defaults that put user data at risk. Upcoming Release: Recall is` ---`scheduled for release on June 18, 2024. Security professionals hope Microsoft addresses the highlighted issues before the launch. Actionable Insight: Stay updated on new releases and security patches to ensure vulnerabilities are addressed before widespread adoption. Disabling Recall: Recall is enabled by default on Copilot+ devices, but users can disable it during initial setup or via Group Policy in enterprise environments. Actionable Insight: Ensure that all team members are aware of how to disable potentially risky features and implement these changes as part of security best practices. Engagement Suggestion: "Have you ever encountered a new feature that seemed more risky than beneficial? Share your experiences with us and let's discuss how to navigate these challenges together!"` Who are Qilin, the cybercriminals thought behind the London hospitals hack? https://www.group-ib.com/blog/qilin-ransomware/ ---`Flash Briefing: Qilin Ransomware Group NHS Attack: Cybercriminal group Qilin, a Russian-speaking ransomware gang, attacked NHS medical services provider Synnovis, disrupting hospital trusts and GPs across London. If based in Russia, British law enforcement faces challenges due to Russia's non-extradition policy and lack of cooperation on cybersecurity matters post-Ukraine invasion. [Source: The Guardian] Ransomware as a Service (RaaS): Qilin operates on a RaaS model, providing tools and infrastructure to independent hackers for a cut of the ransom, typically 15-20%. They demand ransoms ranging from $50,000 to $800,000, often using spear phishing for initial network access. [Source: Group-IB] Past Attacks: Since October 2022, Qilin has attacked over 50 organizations, including Robert Bernard in France and Dialog in Australia. Notable incidents include the Big Issue publisher attack, with 500GB of data leaked after a refused ransom. [Source: Group-IB] Rust and Go Languages: Qilin leverages Rust and Go programming languages for their ransomware, making it harder to detect and analyze. This allows them to customize attacks for different operating systems like Windows and Linux. [Source: Group-IB] Double Extortion Technique: Qilin uses double extortion, encrypting data and exfiltrating sensitive information to pressure victims into paying the ransom. They have a proprietary Dark Leak Site (DLS) for publishing stolen data. [Source: Group-IB] Affiliate Management: Qilin's affiliate panel includes sections for managing targets, creating ransomware samples, and coordinating attacks. Affiliates get 80-85% of the ransom, depending on the amount. [Source: Group-IB] Security Recommendations: Multi-Factor Authentication (MFA): Implement MFA and credential-based access solutions. Regular Backups: Conduct regular data backups. Email Protection: Use tools like Group-IB's Business Email Protection to [---]()counter phishing. Advanced Detection: Employ AI-based solutions for real-time intrusion detection. Patch Management: Regularly update and apply security patches. Employee Training: Educate employees about cybersecurity risks and phishing signs. Incident Response: Contact experts immediately if attacked; avoid paying ransoms. [Source: Group-IB] Listener Engagement: Question for Listeners: Have you ever encountered a phishing email at work? How did you handle it? Stay vigilant and keep your systems secure!`

This episode of the Metabolic Classroom is sponsored by Redmond Real Salt. Use code BEN15 to get 15% off of their products: https://redmond.lifeSummary:In this lecture, Professor Ben Bikman explores the cardiometabolic effects of salt intake, detailing its role in electrolyte balance, fluid regulation, nerve function, muscle contractions, acid-base balance, and nutrient absorption. He explains the renin-angiotensin-aldosterone system (RAAS) and its response to low blood pressure or sodium levels, leading to sodium retention and water reabsorption in the kidneys. Dr. Bikman discusses how insulin influences salt handling by stimulating sodium reabsorption and increasing aldosterone production. He warns against the unintended consequences of salt restriction, such as elevated insulin levels and resistance, exacerbating metabolic syndrome and cardiovascular risk.Shifting focus to fat cells, Dr. Bikman explains how aldosterone and angiotensin II affect fat cell growth and differentiation, promoting lipogenesis, inflammation, and fibrosis. He suggests salt restriction may contribute to obesity and insulin resistance. Discussing potential anti-obesity effects, he mentions angiotensin receptor blockers inhibiting angiotensin II signaling in fat cells.Dr. Bikman stresses the complex interplay between salt, insulin, and fat cell biology, cautioning against oversimplified dietary recommendations. He encourages critical thinking about salt intake's impact on metabolic health and body composition, advocating for deeper understanding and knowledge sharing to improve health outcomes.01:52: Importance of Salt in the Body - Overview of the essential role of salt, particularly sodium, in electrolyte balance, fluid regulation, nerve function, muscle contractions, acid-base balance, and nutrient absorption.06:00: Biochemical Pathways of Salt Regulation - Detailed explanation of the RAAS cascade, involving renin, angiotensinogen, angiotensin-converting enzyme, angiotensin I and II, and aldosterone. Discussion of the physiological effects of angiotensin II, including vasoconstriction, thirst stimulation, and stimulation of aldosterone production.09:48: Interaction Between Salt Regulation and Insulin - Exploration of the interaction between salt regulation pathways and insulin, including insulin's direct effect on sodium reabsorption in the kidneys and its modulation of the RAAS. Explanation of how salt restriction can lead to increased insulin levels and insulin resistance.13:44: Consequences of Salt Restriction - Discussion of the negative health consequences of salt restriction, including increased insulin resistance and metabolic syndrome. Reference to studies showing the association between salt restriction and adverse metabolic outcomes.17:58: Hypertension and Cardiovascular Health - Summary of the relationship between salt restriction, hypertension, and cardiovascular disease. Mention of anti-hypertensive medications targeting the RAAS, such as ACE inhibitors and angiotensin receptor blockers.20:59: Metabolic Effects on Fat Cells - Transition to discussing the metabolic effects of salt-regulating pathways on fat cells. Explanation of how aldosterone and angiotensin II promote fat cell growth, differentiation, lipogenesis, inflammation, and fibrosis.27:53: Conclusion and Takeaways - Recap of the lecture's key points, emphasizing the complex interplay between salt intake, insulin, and fat cell biology. Call to action for critical thinking about dietary recommendations and sharing of knowledge for informed decision-making.Learn more at: https://www.insuliniq.com Hosted on Acast. See acast.com/privacy for more information.

Bankless Friday Weekly Rollup Last Week Of April ------

Global Head of Essentials Operations Marv Cunningham, as Prologis' Global Head of Operating Essentials and Global Head of Workforce Solutions, oversees all aspects of Prologis' Workforce Programs and Community Relations division, as well as Essentials platform delivering the next generation of solutions to address some of the most critical challenges fulfillment centers face today building into your business the resilience you need to innovate, grow, and thrive, encompasses the company's Community Workforce Initiative (CWI). CWI is building a talent pipeline for customers, with an emphasis on revitalizing career pathways and creating economic opportunities in the communities where the company operates. Within Operating Essentials, Marv is centered at the core of successful fulfillment – from move-in services to forklifts and racking systems and encompassing fully automated warehouse solutions. Learn more about CWI here and more about Operations Essentials here Mr. Cunningham joined Prologis in 2023 and has 15-plus years of experience in Supply Chain and Logistics throughout the United States and Europe. Prior to joining Prologis. Mr. Cunningham was the COO/CIO for GXO, Logistics, the Chief Supply Chain Officer for Saks, Saks Off 5th & Hudson Bay, the Chief Supply Chain Officer for Rent the Runway, Vice President of Target Supply Chain, and multiple roles at Amazon. Mr. Cunningham has an MBA from Carnegie Mellon and a Bachelor of Science in nuclear engineering from Oregon State University which he completed in 3 years. He loves to ride his Harley-Davidson motorcycles on the weekend and plays basketball any chance he can. SHOW SUMMARYIn this episode of eCom Logistics Podcast, Marv Cunningham discusses the Prologis Essentials program and its mission to provide comprehensive solutions for e-commerce logistics challenges. He shares his extensive experience in the industry, including his time at Amazon and Target, and highlights the importance of standardization, scalability, and culture in warehouse operations. Marv also emphasizes the growing role of automation and robotics in improving efficiency and reducing labor costs. Overall, this episode offers valuable insights into the evolving landscape of e-commerce logistics and how to address industry challenges.HIGHLIGHTS[00:00:43] The advantages of 3PLs in operating systems and driving economies of scale.[00:13:11] Integration of AI and machine learning in providing real-time feedback for operational improvements.[00:19:14] Factors indicating the right time for adopting automation in warehouses.[00:23:58] Marv's four P's approach: People, Process, Performance, and Price. QUOTES[00:00:27] "They can help you with either financing or RaaS. They can set up the system, they can operate it for you. You get the economy to scale and the savings base in automation."[00:04:03] "What we're trying to do at Prologis Essentials is we're trying to also do anything inside and outside of the building. So anything from racking to fork trucks to full solution automation, to networking capacity planning."[00:13:30] "Instead of just giving you a solution, they're giving you a solution that then starts thinking about ‘how did we do today' and ‘what can I make a recommendation?'"[00:19:14] "If you have a labor problem, if you're growing, and then if you really believe that you're trying to either write process units faster or in a shorter period of time with less shifts, both of those are the right time for automation." Find out more about Marv Cunningham and his company in the link below:https://www.linkedin.com/in/marvcunningham/https://www.prologis.com/essentials-solutions/ This episode is sponsored by G&P Construction. If you're in need of top notch, all-inclusive Material handling solutions for logistics and commercial real estate, look no further than G&P Construction. Be sure to visit www.gandpconstruction.com to discover your one-stop shop for turnkey MHE integrations.

Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volume depletion Albumin repletes volume stores and reduces renal impairment Albumin binds inflammatory cytokines and expands plasma volume Reduced all-cause mortality if IV albumin is given with antibiotics Hepatorenal syndrome Cirrhosis of the liver causes the release of endogenous vasodilators The renin-angiotensin-aldosterone system (RAAS) fails systemically but maintains vasoconstriction at the kidneys, leading to decreased renal perfusion IV albumin expands plasma volume and prevents failure of the RAAS Large volume paracentesis Large-volume removal may lead to circulatory dysfunction IV albumin is associated with a reduced risk of paracentesis-associated circulatory dysfunction There are many other FDA-approved conditions for which to use exogenous albumin but the data are conflicted about the benefits on mortality References 1. Arroyo V, Fernandez J. Pathophysiological basis of albumin use in cirrhosis. Ann Hepatol. 2011;10(SUPPL. 1):S6-S14. doi:10.1016/s1665-2681(19)31600-x 2. Bai Z, Wang L, Wang R, et al. Use of human albumin infusion in cirrhotic patients: a systematic review and meta-analysis of randomized controlled trials. Hepatol Int. 2022;16(6):1468-1483. doi:10.1007/s12072-022-10374-z 3. Batool S, Waheed MD, Vuthaluru K, et al. Efficacy of Intravenous Albumin for Spontaneous Bacterial Peritonitis Infection Among Patients With Cirrhosis: A Meta-Analysis of Randomized Control Trials. Cureus. 2022;14(12). doi:10.7759/cureus.33124 4. Kwok CS, Krupa L, Mahtani A, et al. Albumin reduces paracentesis-induced circulatory dysfunction and reduces death and renal impairment among patients with cirrhosis and infection: A systematic review and meta-analysis. Biomed Res Int. 2013;2013. doi:10.1155/2013/295153 5. Sort P, Navasa M, Arroyo V, et al. Effect of Intravenous Albumin on Renal Impairment and Mortality in Patients with Cirrhosis and Spontaneous Bacterial Peritonitis. N Engl J Med. 1999;341(6):403-409. Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit  

OutlineChapter 14- Hypovolemic States- Etiology - True volume depletion occurs when fluid is lost from from the extracellular fluid at a rate exceeding intake - Can come the GI tract - Lungs - Urine - Sequestration in the body in a “third space” that is not in equilibrium with the extracellular fluid. - When losses occur two responses ameliorate them - Our intake of Na and fluid is way above basal needs - This is not the case with anorexia or vomiting - The kidney responds by minimizing further urinary losses - This adaptive response is why diuretics do not cause progressive volume depletion - Initial volume loss stimulates RAAS, and possibly other compensatory mechanisms, resulting increased proximal and collecting tubule Na reabsorption. - This balances the diuretic effect resulting in a new steady state in 1-2weeks - New steady state means Na in = Na out - GI Losses - Stomach, pancreas, GB, and intestines secretes 3-6 liters a day. - Almost all is reabsorbed with only loss of 100-200 ml in stool a day - Volume depletion can result from surgical drainage or failure of reabsorption - Acid base disturbances with GI losses - Stomach losses cause metabolic alkalosis - Intestinal, pancreatic and biliary secretions are alkalotic so losing them causes metabolic acidosis - Fistulas, laxative abuse, diarrhea, ostomies, tube drainage - High content of potassium so associated with hypokalemia - [This is a mistake for stomach losses] - Bleeding from the GI tract can also cause volume depletion - No electrolyte disorders from this unless lactic acidosis - Renal losses - 130-180 liters filtered every day - 98-99% reabsorbed - Urine output of 1-2 liters - A small 1-2% decrease in reabsorption can lead to 2-4 liter increase in Na and Water excretion - 4 liters of urine output is the goal of therapeutic diuresis which means a reduction of fluid reabsorption of only 2% - Diuretics - Osmotic diuretics - Severe hyperglycemia can contribute to a fluid deficit of 8-10 Iiters - CKD with GFR < 25 are poor Na conservers - Obligate sodium losses of 10 to 40 mEq/day - Normal people can reduce obligate Na losses down to 5 mEq/day - Usually not a problem because most people eat way more than 10-40 mEq of Na a day. - Salt wasting nephropathies - Water losses of 2 liters a day - 100 mEq of Na a day - Tubular and interstitial diseases - Medullary cystic kidney - Mechanism - Increased urea can be an osmotic diuretic - Damage to tubular epithelium can make it aldo resistant - Inability to shut off natriuretic hormone (ANP?) - The decreased nephro number means they need to be able to decrease sodium reabsorption per nephron. This may not be able to be shut down acutely. - Experiment, salt wasters can stay in balance if sodium intake is slowly decreased. (Think weeks) - Talks about post obstruction diuresis - Says it is usually appropriate rather than inappropriate physiology. - Usually catch up solute and water clearance after releasing obstruction - Recommends 50-75/hr of half normal saline - Talks briefly about DI - Skin and respiratory losses - 700-1000 ml of water lost daily by evaporation, insensible losses (not sweat) - Can rise to 1-2 liters per hour in dry hot climate - 30-50 mEq/L Na - Thirst is primary compensation for this - Sweat sodium losses can result in hypovolemia - Burns and exudative skin losses changes the nature of fluid losses resulting in fluid losses more similar to plasma with a variable amount of protein - Bronchorrhea - Sequestration into a third space - Volume Deficiency produced by the loss of interstitial and intravascular fluid into a third space that is not in equilibrium with the extracellular fluid. - Hip fracture 1500-2000 into tissues adjacent to fxr - Intestinal obstruction, severe pancreatitis, crush injury, bleeding, peritonitis, obstruction of a major venous system - Difference between 3rd space and cirrhosis ascities - Rate of accumulation, if the rate is slow enough there is time for renal sodium and water compensation to maintain balance. - So cirrhotics get edema from salt retension and do not act as hypovolemia - Hemodynamic response to volume depletion - Initial volume deficit reduced venous return to heart - Detected by cardiopulmonary receptors in atria and pulmonary veins leading to sympathetic vasoconstriction in skin and skeletal muscle. - More marked depletion will result in decreased cardiac output and decrease in BP - This drop in BP is now detected by carotid and aortic arch baroreceptors resulting in splanchnic and renal circulation vasoconstriction - This maintains cardiac and cerebral circulation - Returns BP toward normal - Increase in BP due to increased venous return - Increased cardiac contractility and heart rate - Increased vascular resistance - Sympathetic tone - Renin leading to Ang2 - These can compensate for 500 ml of blood loss (10%) - Unless there is autonomic dysfunction - With 16-25% loss this will not compensate for BP when patient upright - Postural dizziness - Symptoms - Three sets of symptoms can occur in hypovolemic patients - Those related to the manner in which the fluid loss occurs - Vomiting - Diarrhea - Polyuria - Those due to volume depletion - Those due to the electrode and acid base disorders that can accompany volume depletion - The symptoms of volume depletion are primarily related to the decrease in tissue perfusion - Early symptoms - Lassitude - Fatiguability - Thirst - Muscle cramps - Postural dizziness - As it gets more severe - Abdominal pain - Chest pain - Lethargy - Confusion - Symptomatic hypovolemia is most common with isosmotic Na and water depletion - In contrast pure water loss, causes hypernatremia, which results in movement of water from the intracellular compartment to the extracellular compartment, so that 2/3s of volume loss comes from the intracellular compartment, which minimizes the decrease in perfusion - Electrolyte disorders and symptoms - Muscle weakness from hypokalemia - Polyuria/poly dips is from hyperglycemia and hypokalemia - Lethargy, confusion, Seizures, coma from hyponatremia, hypernatremia, hyperglycemia - Extreme salt craving is unique to adrenal insufficiency - Eating salt off hands ref 18 - Evaluation of the hypovolemic patient - Know that if the losses are insensible then the sodium should rise - Volume depletion refers to extracellular volume depletion of any cause, while dehydration refers to the presence of hypernatremia due to pure water loss. Such patients are also hypovolemic. - Physical exam is insensitive and nonspecific - Finding most sensitive and specific finding for bleeding is postural changes in blood pressure - I don't find this very specific at all! - Recommends laboratory confirmation regardless of physical exam - Skin and mucous membranes - Should return too shape quickly - Elastic property is called Turgur - Not reliable is patients older than 55 to 60 - Dry axilla - Dry mucus membranes - Dark skin in Addison's disease Frim increased ACTH - Arterial BP - As volume goes down so does arterial BP - Marked fluid loss leads to quiet korotkoff signs - Interpret BP in terms of the patients “normal BP” - Venous pressure - Best done by looking at the JVP - Right atrial and left atrial pressure - LV EDP is RAP + 5 mmHg - Be careful if valvular disease, right heart failure, cor pulmonare, - Figure 14-2 - Shock - 30% blood loss - Lab Data - Urine Na concentration - Should be less than 25 mmol/L, can go as low as 1 mmol/L - Metabolic alkalosis can throw this off - Look to the urine chloride - Figure 14-3 - Renal artery stenosis can throw this off - FENa - Mentions that it doesn't work so well at high GFR - Urine osmolality - Indicates ADH - Volume depletion often associated with urine osm > 450 - Impaired by - Renal disease - Osmotic diuretic - Diuretics - DI - Mentions that severe volume depletion and hypokalemia impairs urea retension in renal medulla - Points out that isotonic urine does not rule out hypovolemia - Mentions specific gravity - BUN and Cr concentration - Normal ratio is 10:1 - Volume depletion this goes to 20:1 - Serum Na - Talks about diarrhea - Difference between secretory diarrhea which is isotonic and just causes hypovolemia - And osmotic which results in a lower electrolyte content and development of hypernatremia - Talks about hyperglycemia - Also can cause the sodium to rise from the low electrolyte content of the urine - But the pseudohyponatraemia can protect against this - Plasma potassium - Treatment - Both oral and IV treatment can be used for volume replacement - The goal of therapy are to restore normovolemia - And to correct associated acid-base and electrolyte disorders - Oral Therapy - Usually can be accomplished with increased water and dietary sodium - May use salt tablets - Glucose often added to resuscitation fluids - Provides calories - Promotes intestinal Na reabsorption since there is coupled Na and Glucose similar to that seen in the proximal tubule - Rice based solutions provide more calories and amino acids which also promote sodium reabsorption - 80g/L of glucose with rice vs 20 g/L with glucose alone - IV therapy - Dextrose solutions - Physiologically equivalent to water - For correcting hypernatremia - For covering insensible losses - Watch for hyperglycemia - Footnote warns against giving sterile water - Saline solutions - Most hypovolemic patients have a water and a sodium deficit - Isotonic saline has a Na concentration of 154, similar to that of plasma see page 000 - Half-isotonic saline is equivalent to 550 ml of isotonic saline and 500 of free water. Is that a typo? - 3% is a liter of hypertonic saline and 359 extra mEq of Na - Dextrose in saline solutions - Give a small amount of calories, otherwise useless - Alkalinizing solutions - 7.5% NaHCO3 in 50 ml ampules 44 mEq of Na and 44 mEq of HCO3 - Treat metabolic acidosis or hyperkalemia - Why 44 mEq and not 50? - Do not give with calcium will form insoluble CaCO3 - Polyionic solutions - Ringers contains physiologic K and Ca - Lactated Ringers adds 28 mEq of lactate - Spreads myth of LR in lactic acidosis - Potassium chloride - Available as 2 mEq/mL - Do not give as a bolus as it can cause fatal hyperkalemia - Plasma volume expanders - Albumin, polygelastins, hetastarch are restricted to vascular space - 25% albumin can pull fluid into the vascular space - 25% albumin is an albumin concentration of 25 g/dL compare to physiologic 4 g/dL - Says it pulls in several times its own volume - 5% albumin is like giving plasma - Blood - Which fluid? - Look at osmolality, give hypotonic fluids to people with high osmolality - Must include all electrolytes - Example of adding 77 mEw of K to 0.45 NS and making it isotonic - DI can be replaced with dextrose solutions, pure water deficit - Case 14-3 - Diarrhea with metabolic acidosis - He chooses 0.25 NS with 44 mEq of NaCl and 44 NaHCO3 - Talks about blood and trauma - Some studies advocate delaying saline until penetrating trauma is corrected APR about to. Keep BP low to prevent bleeding. Worry about diluting coagulation factors - Only do this if the OR is quickly available - Volume deficit - Provides formula for water deficit and sodium deficit - Do not work for isotonic losses - Provides a table to adjust fluid loss based on changes in Hgb or HCTZ - Says difficult to estimate it from lab findings and calculations - Follow serial exams - Serial urine Na - Rate of replacement - Goal is not to give fluid but to induce a positive balance - Suggests 50-100 ml/hr over what is coming out of the body - Urine - Insensibles 30-50 - Diarrhea - Tubes - Hypovolemic shock - Due to bleeding - Sequesting in third space - Why shock? - Progressive volume depletion leads to - Increased sympathetic NS - Increased Ang 2 - Initially this maintains BP, cerebral and coronary circulation - But this can decrease splanchnic, renal and mucocutaneous perfusion - This leads to lactic acicosis - This can result in intracellular contents moving into circulation or translocation of gut bacteria - Early therapy to prevent irreversible shock - In dogs need to treat with in 2 hours - In humans may need more than 4 hours - Irreversible shock associated with pooling of blood in capillaries - Vasomotor paralysis - Hyperpolarization of vascular smooth muscle as depletion of ATP allows K to flowing out from K channels opening. Ca flows out too leading to vasodilation - Glyburide is an K-ATP channel inhibitor (?) caused increased vasoconstriction and BP - Pluggin of capillaries by neutrophils - Cerebral ischemia - Increased NO generation - Which Fluids? - Think of what is lost and replace that. - Bleeding think blood - Raise the hct but not above 35 - Acellular blood substitutes, looked bad at the time of this writing - Di aspirin cross linked hemoglobin had increased 2 and 28 day mortality vs saline - Colloids sound great but they fail in RCTs - SAFE - FEAST - Points out that saline replaces the interstitial losses why do we think those losses are unimportant - Pulmonary circulation issue - Pulmonary circulation is more leaky so oncotic pressure less effective there - Talks about the lungs be naturally protected from pulmonary edema - Rate of fluid - 1-2 liters in first hour - Suggests CVP or capillary wedge pressure during resuscitation - No refs in the rate of fluid administration section - Lactic acidosis - Points out that HCO can impair lactate utilization - Also states that arterial pH does not point out what is happening at the tissue level. Suggests mixed-venous sample.ReferencesJCI - Phenotypic and pharmacogenetic evaluation of patients with thiazide-induced hyponatremia and a nice review of this topic: Altered Prostaglandin Signaling as a Cause of Thiazide-Induced HyponatremiaThe electrolyte concentration of human gastric secretion. https://physoc.onlinelibrary.wiley.com/doi/10.1113/expphysiol.1960.sp001428A classic by Danovitch and Bricker: Reversibility of the “Salt-Losing” Tendency of Chronic Renal Failure | NEJMOsmotic Diuresis Due to Retained Urea after Release of Obstructive Uropathy | NEJMIs This Patient Hypovolemic? | Cardiology | JAMAAnd by the same author, a textbook: Steven McGee. 5th edition. Evidence-Based Physical Diagnosis Elsevier Philadelphia 2022. ISBN-13: 978-0323754835The clinical course and pathophysiological investigation of adolescent gestational diabetes insipidus: a case report | BMC Endocrine DisordersSensitivity and specificity of clinical signs for assessment of dehydration in endurance athletes | British Journal of Sports MedicineDiagnostic performance of serum blood urea nitrogen to creatinine ratio for distinguishing prerenal from intrinsic acute kidney injury in the emergency department | BMC NephrologyThe meaning of the blood urea nitrogen/creatinine ratio in acute kidney injury - PMCLanguage guiding therapy: the case for dehydration vs volume depletion https://www.acpjournals.org/doi/10.7326/0003-4819-127-9-199711010-00020?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmedValidation of a noninvasive monitor to continuously trend individual responses to hypovolemiaReferences for Anna's voice of God on Third Spacing : Shires Paper from 1964 (The ‘third space' – fact or fiction? )References for melanie's VOG:1. Appraising the Preclinical Evidence of the Role of the Renin-Angiotensin-Aldosterone System in Antenatal Programming of Maternal and Offspring Cardiovascular Health Across the Life Course: Moving the Field Forward: A Scientific Statement From the American Heart Association2. excellent review of RAAS in pregnancy: The enigma of continual plasma volume expansion in pregnancy: critical role of the renin-angiotensin-aldosterone systemhttps://journals-physiology-org.ezp-prod1.hul.harvard.edu/doi/full/10.1152/ajprenal.00129.20163. 10.1172/JCI107462- classic study in JCI of AngII responsiveness during pregnancy4. William's Obstetrics 26th edition!5. Feto-maternal osmotic balance at term. A prospective observational study

"In The War For Talent, There Is No Second Place!" You can get ready for top tips if you need help in the attraction phase, recruiting, or retention phases with Gerry Gadoury.Host Vincent A. Lanci is excited to bring on a book-coaching client turned friend to celebrate the release of his new book, Destination Employer. You can grab this value-filled book here. If you enjoy this week's show,  please click the subscribe button to stay current.About his company: RedBeard Solutions is an SBA-certified Service Disabled Veteran Professional services firm with a strong focus on Cybersecurity and tech. Our passion is ensuring that our Member firms enjoy an unfair advantage in attracting, recruiting, and retaining the best CyberSecurity and tech talent in their Marketplace. How do we do that?-Cybersecurity & Technology focused RaaS Platform-Destination Employer Roadmap (Assessment/Guide) - How does your firm stack up?-Employer Brand creation, expansion, and protection-Consistent, efficient, and cost-effective Recruitment-Talent Retention StrategiesAbout the book: Attract. Recruit. Retain.If you can't grow your team, you can't grow your business.If you are a Founder, CEO, CIO, CISO, this is the biggest part of your job. Fullstop.Regardless of overall labor-market conditions, in-demand talent will have options. It is up to you to gain their attention, convince them to join your team, and keep them with you. How do you do that? How do market leaders like Google, Harvard, and Apple consistently achieve this outcome? They cultivate a reputation for being “the place” to grow your career. Potential employees know that if they join those firms they can 10X their career. Said differently, they become Destination Employers.In this hands-on book, we break down the Destination Employer Methodology into twelve key elements that you can implement within your organization. This is done in an actionable, step-by-step format so you can not only match the industry leader's strategy but beat them at the game of building world-changing teams.This will transform how you do business and give you an unfair competitive advantage that will maximize the likelihood of your company crushing growth goals and becoming a Unicorn.Would you be interested in connecting with the host or guest? Email Danica at PodcastsByLanci@Gmail.com to get started.Music Credits: Adventure by MusicbyAden | https://soundcloud.com/musicbyadenIf you enjoyed this week's show,  click the subscribe button to stay current!Support the showIf you enjoyed this week's show, click the subscribe button to stay current.Listen to A Mental Health Break Episodes hereTune into Writing with Authors here

Welcome to another exciting episode of Straight A Nursing! I'm your host, Nurse Mo, and today we'll be diving into a fascinating topic: the relationship between congestive heart failure (CHF) and anemia. Have you ever wondered why so many patients with CHF also have anemia? Well, I certainly have, and today we're going to explore the pathophysiology behind this intriguing connection. So, let's get started and unravel the complexities of CHF and anemia together. In this episode you'll learn why iron deficiency, decreased erythropoietin levels, chronic inflammation, and activation of the RAAS pathway are all possible causes of anemia in CHF. Plus, we'll also explore the consequences of anemia in heart failure and the treatment options available. Get ready for a knowledge-packed episode that will empower you as a nursing professional. Press play to jump right in! ___________________ Full Transcript - Read the article and view references FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh! Med Surg Solution - Are you looking for a more effective way to learn Med Surg? Enroll in Med Surg Solution and get lessons on 57 key topics and out-of-this-world study guides.