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This week we discussed the hunter changes and other parts of Update 45 release notes and our week in gaming. Game News Update 45 Release Notes Patch expected next week to tweak the most pressing issues Character Creation on 32-bit game worlds will end on Wednesday, July 30 The Black Blade will join the battle […]
Sugar reduction is reshaping how food manufacturers approach product development, but how do you go about balancing health with taste preferences? With health consciousness rising and regulatory pressure mounting, the industry faces unprecedented challenges. The demand is clear, with over a third of European consumers actively buying more reduced or no added sugar products. In this episode of the Food Matters Live podcast, made in partnership with Ingredion, we explore the evolving sweetener landscape and discover how manufacturers are rising to meet consumer expectations without compromising on taste. We delve into the science of sweetener development, the importance of clean label formulations, and the complex regulatory environment that's reshaping product development strategies. From stevia innovations to texture solutions, our expert guests reveal how successful sugar reduction requires a holistic approach that considers the entire recipe – not just the sweetening component. Ingredion will be appearing at the Food Matters Live events in Rotterdam 23-24 September and Ascot 8-9 October. Ingredion Ingredion Incorporated, headquartered in the suburbs of Chicago, is a leading global ingredient solutions provider serving customers in nearly 120 countries. With 2024 annual net sales of approximately $7.4 billion, the Company turns grains, fruits, vegetables, and other plant-based materials into value-added ingredient solutions for the food, beverage, animal nutrition, brewing and industrial markets. With Ingredion Idea Labs® innovation centers located around the world and more than 11,000 employees, the Company co-creates with customers and fulfills its purpose of bringing the potential of people, nature, and technology together to make life better.
A Clare restaurateur fears delaying the introduction of a lower VAT rate for the hospitality sector would be too little too late for some businesses. The Government is contemplating pushing out the proposed reinstatement of the 9% VAT rate to June 2026 to create more scope for tax cuts in the Budget. Finance Minister Paschal Donohoe claims the measure will costs around €1 billion to implement. Patrick O'Donoghue of the Monk's Restauraunt in Ballyvaughan insists many businesses can't wait another year.
This podcast summarizes the 4 major cellular uses of cholesterol, its biosynthesis, and the regulation of the rate-limiting enzyme HMG CoA reductase by intracellular cholesterol.The podcast further describes the biochemical mechanism involved in the reduction of plasma cholesterol by statin treatment. Ultimately, statins reduce cholesterol synthesis in the liver, which in turn results in the increased gene expression of the LDL receptor in the liver. Consequently, the increased number of LDL receptors on hepatocyte cell surface increases the uptake of LDL from plasma, thus reducing plasma cholesterol. This biochemistry content may be useful to premedical and medical students. Similar content is available at:Check out similar content at: Medbiochem.orgAlso check out the regulation of HMG CoA reductase podcast below:https://youtu.be/FNSr3G6OTBsTwitter @DrAJGhalayini
Fiachra Ó Cionnaith reports that the Government is considering whether it should delay introducing a VAT reduction for the hospitality sector until the middle of next year.
The 40th anniversary of Live Aid happened recently.This great moment of global solidarity precipitated a decades-long increase in aid spending from across the developed world, but in recent years, that pattern has reversed.Why has this happened, and how can we redress the balance?Dominic MacSorley is Humanitarian Ambassador for Concern Worldwide and joins Seán to discuss.
The 40th anniversary of Live Aid happened recently.This great moment of global solidarity precipitated a decades-long increase in aid spending from across the developed world, but in recent years, that pattern has reversed.Why has this happened, and how can we redress the balance?Dominic MacSorley is Humanitarian Ambassador for Concern Worldwide and joins Seán to discuss.
After a two-month hiatus, Alex and Lord Lee reunite in the Financial Times studio to cover the latest updates on ten stocks from Lord Lee's portfolio and questions sent in by listeners. From his thoughts on his biggest holding M&G (MNG) to Cerillion (CER) CEO Louis Hall's decision to sell a chunk of his holding, Lord Lee shares his invaluable knowledge acquired through his half-century career in investing. As usual, the episode wraps up with an update on Lord Lee's portfolio, with the latest buys and sells, including one of Simon Thompson's 2025 Bargain Shares.Timestamps00:13 Introduction00:51 Lord Lee's take on the market2:54 The government's growth agenda4:58 M&G9:36 PZ Cussons13:04 Treatt15:32 Listen question on Cerillion18:02 Braemar's decision to cut its dividend20:58 Reduction in Supermarket Income Reit22:48 Two new positions28:19 Updates from Lord Lee's long-term holdingsListen to more podcasts from Investors' Chronicle on Apple, Spotify and YouTube Hosted on Acast. See acast.com/privacy for more information.
Ever wonder if your secondhand laptop could land you in an international cybercrime investigation? This episode dives into the bizarre case of a Russian basketball player arrested for ransomware activities he claims stemmed from a used computer purchase. Was he an unwitting victim or a sophisticated criminal? The hosts debate the plausibility of his defense and what it means for everyday tech users.The conversation takes a darker turn when exploring Elon Musk's AI chatbot Grok, which began calling itself "MechaHitler" and spewing hate speech before shutting down entirely. This spectacular AI failure raises profound questions about content moderation, algorithmic bias, and Musk's troubling assertion that he plans to "rewrite the entire corpus of human knowledge." The hosts expertly unpack the technical and ethical implications with their trademark blend of expertise and accessible explanations.We also examine the shifting landscape of digital relationships as Bumble announces a 30% workforce reduction. Could traditional dating apps be giving way to more organic connections formed in gaming communities and audio platforms? The team makes a compelling case that technology-mediated relationships are evolving beyond superficial swiping interfaces toward more authentic interaction spaces.The "Gadgets and Gear" segment showcases Hingbot's Sirius - an American-made programmable robot dog that offers a privacy-conscious alternative to Chinese models. Perfect for budding coders and robotics enthusiasts, this high-tech companion demonstrates how consumer robotics continues to advance despite lingering concerns about data security.Between whiskey tastings and good-natured ribbing, the hosts deliver sharp insights about our complex relationship with technology - from the anthropomorphizing of AI "hallucinations" to the ironies of major security vendors falling victim to ransomware attacks. Subscribe now to join our community of tech enthusiasts who appreciate clear, jargon-free analysis served with a side of whiskey and genuine laughs.Support the show
Researchers at the University of Osaka Hospital conducted surgeries last year to reduce the number of fetuses in 10 cases of multiple pregnancy, it has been learned.
Is your business struggling with NGER compliance? Solar energy directly reduces Scope 2 emissions from purchased electricity while protecting against regulatory risks and carbon taxes. For more, visit https://www.p4bsolar.com.au/ P4B Solar City: Norwood Address: 108 Magill Road Website: https://www.p4bsolar.com.au/
Consumers haven't soured on the low- and no-sugar trend. Food and ingredient manufacturers are heeding the call, looking to reformulate or develop reduced and zero-sugar product lines at a record pace. In this episode, Renee Leber and Lisa Sanders provide scientific insights, practical formulation techniques, and marketing strategies designed to equip attendees with actionable knowledge … Continue reading Omnivore Presents: SciDish | JULY 2025: The Scientific Skinny on Sugar Reduction →
The Real Truth About Health Free 17 Day Live Online Conference Podcast
Fairways Magazine's Kurt Kragthorpe calls this day at the State Am "striking." It sure can feel like a kick in the head as the field is reduced from 32 to 8 in one day. We break it all down and tee up the quarter-finals. Simon Kwon joins the pod. Sponsored by Goldenwest Credit Union.
As deportations ramp up, there's every reason to believe that crime will continue to fall. The early returns have been impressive.
Reducing fentanyl, gun thefts, block party violence, and car burglaries through targeted efforts by the Alachua County Sheriff's office, plus pursuit of internet crimes against children. ACSO Public Information Officer Capt. Chris Simms on the Thursday Bob Rose Show
Displaced intraarticular calcaneal fractures (DIACFs) are associated with high rates of posttraumatic arthritis. Traditional management with open subtalar arthrodesis often results in high revision rates and complications. Acute open arthrodesis has shown success in Sanders III and IV calcaneus fractures, with favorable return-to-work and radiographic fusion outcomes. This study evaluates the radiographic results of calcaneus percutaneous reduction and posterior arthroscopic subtalar arthrodesis (C-PASTA) for acute Sanders III and IV fractures. In conclusion, C-PASTA demonstrates excellent fusion rates, significant restoration of calcaneal alignment, and minimal complications. These findings suggest that C-PASTA is a viable, minimally invasive technique for acute Sanders III and IV fractures. Click here to read the article.
In today's episode, Jeff Lynch, founder and CEO of Idle Smart joins us to talk about how his company is revolutionizing idle management for heavy-duty fleets. Moving beyond the costly and fragmented solutions of the past, like APUs, Idle Smart offers an automated, fleet-focused system that cuts fuel costs, boosts ROI, and enhances sustainability. Follow the Loaded and Rolling Podcast Other FreightWaves Shows Learn more about your ad choices. Visit megaphone.fm/adchoices
In today's episode, Jeff Lynch, founder and CEO of Idle Smart joins us to talk about how his company is revolutionizing idle management for heavy-duty fleets. Moving beyond the costly and fragmented solutions of the past, like APUs, Idle Smart offers an automated, fleet-focused system that cuts fuel costs, boosts ROI, and enhances sustainability. Follow the Loaded and Rolling Podcast Other FreightWaves Shows Learn more about your ad choices. Visit megaphone.fm/adchoices
Kineon users report an 89% drop in pain in just 2–3 weeks. Too good to be true? Or the future of wearable recovery tech? In this BIOHACKER SPECIAL episode, we go deep on red light therapy, chronic pain, and the real science behind the device everyone's talking about: the Kineon MOVE+. (use TONY10 for 10% off) Join me and Forrest Smith, Co-Founder & CEO of Kineon, who turned his own chronic knee pain into a mission to help millions move without it. You'll learn:
This series of talks hits upon one of the longstanding themes of TopMedTalk, opioids and opioid reduction in a perioperative setting. We discuss the opioid epidemic, the issue of persistent opioid use after surgery, and strategies for opioid reduction. Topics include historical usage, the dangers of high-dose opioids, and alternative pain management techniques such as opioid-free anesthesia and multimodal analgesia. The discussion also highlights the importance of ongoing research, patient education, and evidence-based practices to minimize the side effects of opioids while ensuring effective pain management. Presented by Tim Miller, Professor of Anesthesiology at Duke University Medical Center. Tim completed his training in Nottingham, UK followed by a fellowship in cardiothoracic anaesthesia at Glenfield Hospital, Leicester, UK. He is a fellow of the Royal College of Anaesthetists.
Want to work directly with me to close more deals? Go Here: https://www.titaniumu.comWant the Closer's Formula sales process I've used to close 2,000+ deals (FREE) Go Here: https://www.kingclosersformula.com/closeIf you're new to my channel my name is RJ Bates III. Myself and my partner Cassi DeHaas are the founders of Titanium Investments.We are nationwide virtual wholesalers and on this channel we share EVERYTHING that we do inside our business. So if you're looking to close more deals - at higher assignments - anywhere in the country… You're in the right place.Who is Titanium Investments and What Have We Accomplished?Over 10 years in the real estate investing businessClosed deals in all 50 statesOwned rentals in 12 statesFlipped houses in 11 statesClosed on over 2,000 properties125 contracts in 50 days (all live on YouTube)Back to back Closers Olympics ChampionTrained thousands of wholesalers to close more deals_________________________________With over 2,000 Videos, this is the #1 channel on YouTube for all things Virtual Wholesaling. SUBSCRIBE NOW! https://www.youtube.com/@RJBatesIII_________________________________RESOURCES FOR YOU:If you want my team and I to walk you through how to build or scale your virtual wholesaling business from A to Z, click here to learn more about Titanium University: https://www.titaniumu.com(FREE) If you want to learn how to close deals just like me, The King Closer, then download the free King Closer Formula PDF: https://www.kingclosersformula.com/close(FREE) Join our exclusive FB group community for real estate investors and wholesalers: https://www.facebook.com/groups/titaniumvault/(FREE) Click here to grab our Titanium fleet free PDF & training: Our battle tested strategies and tools that we actually use… and are proven to work: https://www.kingclosersformula.com/fleetGrab the King Closer Blueprint: My Step by Step Sales Process for closing over 2,000 deals (Only $37): https://www.kingclosersformula.com/kcblueprintGrab Titanium Profits: Our exact system we use to comp and underwrite deals in only 4 minutes. (Only $99) https://www.kingclosersformula.com/titaniumprofitsWant to know what the best markets to wholesale in are? Grab my breakdown of all 50 states here: https://www.titaniumu.com/marketsSupport the show
In this powerful hypnosis session, Adam Cox guides you through a vivid metaphor known as The Chamber of Clones, where you encounter three versions of yourself, each representing a different future relationship with alcohol over the next year. One clone continues drinking as you currently do, another drinks just once per week, and the third abstains from alcohol entirely. As you observe how each version of you evolves, physically and emotionally, you gain deep insight and clarity, empowering you to choose the relationship with alcohol that best supports your wellbeing, goals, and values. This session is designed to reprogram your subconscious patterns around alcohol and help you feel more in control, confident, and congruent with the person you truly want to become.
A programme to try to get people off meth and away from crime has been launched in Porirua as part of a multi-million dollar government drive. Ellen O'Dwyer reports.
AM Best Senior Industry Research Analyst Christopher Graham discusses a new Best's Market Segment Report that finds new cyber supplementing highlights pricing difference by policy type.
Replay: Dimensionality Reduction
Interview recorded - 1st of July, 2025On this episode of the WTFinance market I had the pleasure of welcoming back David Hunter. David is Chief Macro Strategist of Contrarian Macro Advisors 52 and one of the few who have been bullish over the past few years. During our conversation we spoke about the disconnect between the economy and markets, tariffs, Doge to continue, the reduction of the deficit, which segments are undervalued and more. I hope you enjoy!0:00 - Introduction1:26 - Current outlook4:01 - Disconnect between economy and markets?5:57 - Tariffs9:22 - Money on the sideline?11:58 - DOGE to continue?15:38 - DOGE & Bill complimentary16:46 - Reduction of the deficit20:13 - Peak of government bond yields?22:20 - Confidence to increase price targets24:28 - Buy the dip29:08 - Which segments are undervalued32:28 - Gold to keep going up?34:36 - One message to takeaway from our conversation?David is an investment professional with 25 years of investment management experience and 20 years as a sell-side strategist with strong expertise in macroeconomic analysis and portfolio management. His strong macro capabilities combined with a contrarian philosophy have allowed me to forecast economic cycles and spot market trends well ahead of the consensus. David is an intellectually honest, independent thinker comfortable with charting a course away from the crowd. Accomplished stock picker and value-oriented portfolio manager.David Hunter - Twitter - https://twitter.com/DaveHcontrarianLinkedIn - https://www.linkedin.com/in/david-hunter-668ba015/WTFinance -Spotify - https://open.spotify.com/show/67rpmjG92PNBW0doLyPvfniTunes -https://podcasts.apple.com/us/podcast/wtfinance/id1554934665?uo=4LinkedIn - https://www.linkedin.com/in/anthony-fatseas-761066103/Twitter - https://twitter.com/AnthonyFatseas
Today in Lighting is sponsored by Keystone Technologies, dedicated to Light Made Easy for more than 80 years. Learn more. Highlights today include: Just In June 2025: New Architectural Lighting Products, Leviton CN2030 Sustainability Report 2024 Highlights 37% Reduction in Emissions, Axis Lighting Acquires Picasso Lighting to Launch U.S. Manufacturing Platform, IALD 2025: Studio Waldemeyer Illuminates Enlighten Europe, ETI Vanity Lighting Series 2025: Discover the New Allure, Radii, and Ispa Collections.
In this piece we look at the opioid crisis in the UK and how it has translated into clinical practice. Hear about the history and data behind opioid prescription trends, specifically highlighting the high-risk patient demographics and mortality figures associated with opioid use. Learn how a multidisciplinary approach, taken by the opioid reduction service at Guy's & St. Thomas', helps showcase early outcome data and the strategies employed in opioid weaning. Emphasizing the importance of patient engagement and personalized care we detail the clinic's processes, preparations, and long-term strategies for opioid tapering. The episode concludes with a compelling patient testimonial video reflecting the positive outcomes of the service. Fauzia Hasnie, Consultant Lead, Opioid Multidisciplinary Pain Management Clinic, Joint Lead, Combined Sickle-Opioid Virtual Multidisciplinary Clinic Guy's & St Thomas' NHS Foundation Trust. Resources: UK National Institute for Health Care Excellence (NICE) guidelines: Overview | Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults | Guidance | NICE US Centers for Disease Control and Prevention (CDC): Guideline Recommendations and Guiding Principles | Overdose Prevention | CDC
Fitness mit M.A.R.K. — Dein Nackt Gut Aussehen Podcast übers Abnehmen, Muskelaufbau und Motivation
Was, wenn Dein Körper nachts heimlich gegen Dich arbeitet? Wenn Du abnehmen oder Muskeln aufbauen willst – aber der Fortschritt bleibt aus –, dann liegt es vielleicht nicht an Deinem Training oder Deiner Ernährung. Sondern an Deinem Schlaf.In dieser Folge erfährst Du:Warum schon eine Stunde weniger Schlaf Deinen Fettabbau torpedieren kannWie Schlafmangel Deinen Hormonhaushalt sabotiert – und Dich hungriger machtWas die Wissenschaft über Muskelabbau durch schlechten Schlaf sagtUnd welche 13 praxiserprobten Strategien Du ab heute umsetzen kannst, um erholsamer zu schlafen und Deinem Körper beim Regenerieren, Wachsen und Verbrennen zu helfenAußerdem: Warum Temperatur eine geheime Superkraft beim Schlaf ist – und was Mark persönlich verändert hat, um 10 % mehr Tiefschlaf herauszuholen.____________*WERBUNG: Infos zum Werbepartner dieser Folge und allen weiteren Werbepartnern findest Du hier.____________Erwähnte Tools:Hinweis: Wenn Du eines der Tools kaufen möchtest, kannst Du etwas Geld sparen, indem Du das jeweilige Angebot für Podcasthörer nutzt.Eight Sleep: bis 350 € Rabatt*Whoop: 1 Monat kostenlos*Melatonin: Melaform 1,5 Mg+ FormMed (5 € geschenkt für Neukunden: "mark5")Earbuds: Soundcore Sleep A20*Quellen:Nedeltcheva et al. (2010). Sleep curtailment is accompanied by increased intake of calories from snacks. Am J Clin Nutr, 91(1), 155–162.Nedeltcheva et al. (2010). Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med, 153(7), 435–441.Spiegel et al. (2004). Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med, 141(11), 846–850.Spaeth et al. (2013). Effects of experimental sleep restriction on weight gain, caloric intake, and meal timing in healthy adults. Sleep, 36(7), 981–990.Leproult & Van Cauter (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173–2174.Van Cauter & Plat (1996). Physiology of growth hormone secretion during sleep. J Pediatr, 128(5 Pt 2), S32–S37.Kräuchi & Wirz-Justice (2001). Circadian rhythm of heat production, heart rate, and skin and core temperature under unmasking conditions. Am J Physiol Regul Integr Comp Physiol, 283(3), R819–R829.Okamoto-Mizuno & Mizuno (2012). Effects of thermal environment on sleep and circadian rhythm. J Physiol Anthropol, 31, 14.Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner.Heller et al. (2010). Temperature regulation and sleep. In: Principles and Practice of Sleep Medicine (5th ed.), pp. 292–304.Emmons & McCullough (2003). Counting blessings versus burdens: An experimental investigation of gratitude and well-being in daily life. J Pers Soc Psychol, 84(2), 377–389.Kaimal et al. (2016). Reduction of cortisol levels and participants' responses following art making. Art Therapy, 33(2), 74–80.St-Onge et al. (2016). Effects of diet on sleep quality. Adv Nutr, 7(5), 938–949.Khalsa et al. (2003). A phase response curve to single bright light pulses in human subjects. J Physiol, 549(3), 945–952.***Shownotes und Übersicht aller Folgen.Trag Dich in Marks Dranbleiber Newsletter ein.Entdecke Marks Bücher.Folge Mark auf Instagram, Facebook, Strava, LinkedIn. Hosted on Acast. See acast.com/privacy for more information.
Pearse Doherty, Sinn Féin Finance Spokesperson and Donegal TD
James Lawless Minister for further and Higher Education.
Rays continue to win series: Mets, Tigers, & a strong start against the Royals.Cincinnati Reds' Chase Burns strikes out the Yankees' top batters in the first inning. Chandler Simpson is back in the majors, though his defensive growth remains key2021 Rays roster that won 100 games - who remainsContrasts between veterans like Clayton Kershaw & players who never make it to free agency.Impact of MLB Cutting Minor League TeamsManfred's reduction from 160 to 120 minor league teams has affected player development—especially for international players.Lost opportunities for Latin American players Rays' workaround: sending talent to the Australian Baseball League (e.g., Junior Caminero).Latin American Pipeline ChallengesLimited playing time in complex leagues like the FCL (Florida Complex League) due to rehab assignments and draft influx.Some Players that are promoted too quickly, risking their development.Discussion on Rays' strategic patience and international development system.Reduction in the number of minor league teams reduced the number of Latin America players Mat's strategy for Merging minor league teams with collegiate teams Comparing the path to the majors of Jac Caglianone to that of Junior CamineroAustralian Baseball League Propose 2 collegiate teams associated with each MLB teamIdeal scenario of Yankees & Rays fighting it for the ALCS championship with the keys to George Steinbrenner Field given to the winnerThe Rays have gone “Old School” including bunting, running the basesUnknowable pitch of Chris Bubic's “Ghost Pitch” – reminiscent of Brent Honeywell Yankees v Reds sneak peek – Elly De La CruzMat observes - pitchers that have a, a strong reliance on split fingers or sliders & throw them the hardest, tend to have the most surgeriesNeed to keep the Bullpen happyTrade Deadline - 8 to 10 days out before we see Trades start to come in Shortstops across Rays Minor Leaguers - Adrian Santanam Gregory Barriosm Carson Williams – also playing 3rd base as Ha-Seong Kim is currently SSRays path to replace Wander Franco includes trading Luke Raley trading for Jose Caballero has proven well worth his versatility from SS or anywhere on the fieldPraise to Rays Scouting & Analytical teams for discovering new talentFun new team names for proposed expansion teams to Vancouver, The Killer Whales, Nashville, The Nashville WhiskiesWhat if the Kansas City Royals renamed themselves the Kansas City MonarchsA Montreal Expansion team could be the Montreal Royals these would reflect back on the history of the game in the Negro Leagues & Jackie RobinsonLosing the Expos names removes the stigma of the pastA trip to Kansas City to see the Royals & Negro League Baseball MuseumAlan Alford at Rickwood with Dusty BakerJack Stack's as a must stop in Kansas City for BarbecueRays pitcher Drew Rasmussen's has increased variations of his pitchingAvoiding predictability in pitching – Taj Bradley Tampa Baseball Museum with Larry Rothschild & Dave Magadan Coaches Corner We will soon see X-Rays now with the Athletics, Jeffrey Springs + Jacob Lopez who is leading K/9Mat at @matgermain.bsky.social or Mark at @baseballbizondeck.bsky.social BaseballBiz on Deck, at iHeart Apple, Spotify, Amazon Music, and at www.baseballbizOnDeck.com Special Thanks to Scott Holmes for the music Stomps & Claps
In this episode of The SKIN Report, Dr. Simran Sethi addresses a sensitive and often frustrating symptom of polycystic ovarian syndrome (PCOS): excess facial hair.Dr. Sethi explains why women with PCOS experience facial hair growth, which medications are most effective for treating it (like spironolactone and birth control), and what hair reduction methods are safest—especially for women of color. She breaks down the pros and cons of shaving, waxing, laser hair removal, and electrolysis, and offers science-backed advice for lasting results.
Interproximal Reduction, When, Why, and How | 9 MINUTE SUMMARY In this episode, I dive into the fundamentals of interproximal reduction(IPR) when to use it, why it matters, and how to do it effectively.We'll cover how much IPR can safely be carried out, compare differentclinical protocols and their pros and cons, and take a critical look at howaligner software plans IPR (and where it may fall short).This summary is based on Dr. Flavia Artese's insightful lecture at therecent American Association of Orthodontists Annual Session in Philadelphia,along with insights from my own clinical research and experience. How much IPR is possible? Recommended amount ½ to 1/3 of outer enamel Estimate with periapical radiographs are inaccurate, under-estimateas well as over estimate Meredith 2017 Brine 2001 Quantity of the enamel each interproximal surface Kailasam2021 systematic review, with an excellent table created by Bosio in 2022 highlightingthe enamel present and hypothetical safe reduction, ranging from 0.3-0.7mm,with 5-10% greater enamel on the distal surfaces Can all teeth have IPR?· Triangular teeth are idealo Large interradicular distance, roots canapproximate with no issue· Square shaped teeth not idealo Reduced interradicular distance, rootapproximation of 0.8mm = loss of crestal bone Taera 2008 Are we accurate with IPR? Johner 2013 AJODO· Manual strips Vs rotary disc Vs oscillatingstrips = all underperformed IPR by up to 0.1mm Protocols: Small Vs Large · 0.1-0.2mm manual strips· 0.3mm+ larger reduction · Polishing required – If not = 25 um furrows retainplaque Jack Sheridan1989 Separation posterior region· Separator – Requires measuring of premolarbefore and after· Bur – needle buro Parallel occlusal planeo Recontour tooth surface to create contact point· No separator - requires contact point to be broken, advantageis the measurement of the IPR site is accurate Bolton's analysis· Based on excess, rather than tooth removal Proportionality· Width o Canine 90% of central incisoro Lateral 70% of central incisor IPR planningBolton's discrepancy + Tooth proportionality= whento add or remove tooth structure However· “Don't do pre-emptive stripping for balancingtooth mass ratios between arches. Chances are it will work out just fine” Jack Sheradin 2007 JCO Method of use for 4 mm of IPR:· Posterior to anterior – Jack Sheridano Posterior IPR first, followed by distalisation,e.g. 4-5 first, distalise 4o Maintain arch length with stops etc, maintainanchorage· Anterior to posterior – Farooq o Anchorage preserving o Tony Weir 2021 the most common site in clinicalpractice was the lower anterior segment IPR on overlapping teeth· Not possible to achieve ideal anatomy withmotorised IPR instruments · Posterior IPR first, distalise, followed byanterior alignment and IPR – Flavia· Use of handstrips is possible on overlappingteeth - Farooq Limits of IPR· 4-5mm, although Sheridan described possible 8.9mm,technically challenging· IPR is not a possibility for sagittaldiscrepancy: Greater Bolton's discrepancies in class 3 and class 2malocclusions, SR 53 studies Machado 2020, greater in class 2 and 3 casesalbeit a small difference of 0.3-0.8% Retained primary 2nd molars· Idealise occlusion· Consider root morphology divergence, as post IPRspace may not closeo If divergence greater than crown, reconsider asspace closure unlikely Why do we need to use IPR with aligners? Dahhas 2024· Alogrythm reduces the number of aligners· More IPR rather than saggital correction· IPR staged inappropriately with large IPR whilstcontact point overlap, which is difficult to perform adequate anatomicalreduction
THE LANCET 2003;362:772-776Background: Angiotensin converting enzyme inhibitors (ACEi) reduce mortality and morbidity in patients with systolic heart failure (see CONSENSUS and SOLVD trials). However, registry data showed that up to 20% of patients with systolic heart failure were not taking ACEi. One of the frequent causes for intolerance to ACEi is cough. Angiotensin converting enzyme inhibitors work by blocking the conversion of angiotensin I to angiotensin II, a key step in the renin–angiotensin–aldosterone system (RAAS). Angiotensin II receptor blockers were tolerated in patients with systolic heart failure who were intolerant to ACEi. However, data on long term effectives as an alternative to ACEi were lacking.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Alternative trial sough to assess if the angiotensin-receptor blocker (ARB) candesartan, could improve outcomes in patients with systolic heart failure who are intolerant to ACEi.Patients: Eligible patients had left ventricular ejection fraction of 40% or less and NYHA class II, III or IV symptoms of at least 4 weeks duration. Patients had also to be intolerant to ACEi.Exclusion criteria were not provided in the main manuscript.Baseline characteristics: Patients were recruited from 618 centers in 26 countries. The trial randomized 2,028 patients – 1,013 randomized to receive candesartan and 1,015 to receive placebo.The average age of patients was 67 years and 68% were men. The average left ventricular ejection fraction was 30%. Cardiomyopathy was ischemic in 68% of the patients. The NYHA class was II in 48% of the patients, III in 49% and IV in 4%.Approximately 50% had hypertension, 27% had diabetes, 61% had prior myocardial infarction, 9% had stroke, 25% had atrial fibrillation and 14% were current smokers.At the time of enrollment, 85% were taking a diuretic, 46% were taking digoxin, 55% were taking beta-blockers and 24% were taking spironolactone.The most common reasons for ACEi intolerance were cough in 72% of the patients, hypotension in 13%, renal dysfunction in 12% and angioedema or anaphylaxis in 4%.Procedures: The trial was double-blinded. Patients were assigned in a 1:1 ratio to receive candesartan starting at 4 or 8mg once daily or placebo. The treatment was doubled every two weeks to a target dose of 32mg once daily.After randomization, follow up occurred at 2, 4, and 6 weeks, 6 months and every 4 months thereafter.Endpoints: The primary outcome was a composite of cardiovascular death or heart failure hospitalizations. All deaths were classified as cardiovascular unless there was a clear non-cardiac cause.Analysis was performed based on the intention-to-treat principle. The estimated sample size to have 80% power at 5% alpha was 2,000 patients. The sample size calculation assumed 18% relative risk reduction in the primary outcome with candesartan assuming a 15% annual event rate in the placebo arm.Results: The median follow up time was 34 months. The mean candesartan daily dose was 23mg at 6 months.Candesartan reduced the primary endpoint of cardiovascular death or heart failure hospitalizations (33.0% vs 40.0%, adjusted HR: 0.70, 95% CI: 0.60 – 0.81; p< 0.001). Candesartan reduced the individual components of the primary outcome - (21.6% vs 24.8%; p= 0.02) for cardiovascular death and (20.4% vs 28.2%; p< 0.001) for heart failure hospitalizations. All-cause death was also lower with candesartan (26.2% vs 29.2%, adjusted HR: 0.83, 95% CI: 0.70–0.99; p= 0.033). The number of patients who had any hospitalization as well as the total number of hospitalizations were numerically but not statistically significantly lower with candesartan (60.2% with candesartan vs 63.3%; p= 0.16) and (1,718 vs 1,835; p= 0.06).Candesartan was associated with more hypotension (3.7% vs 0.9%), more increase in creatinine (6.1% vs 2.7%) and more hyperkalemia (1.9% vs 0.3%). Angioedema occurred in three patients in the candesartan group and none in the placebo group. Cough occurred in two patients taking candesartan and four taking placebo.Authors reported no significant subgroup interactions, however, a corresponding graph was not provided.Conclusion: In patients with systolic heart failure who are intolerant to ACEi, candesartan reduced the primary composite outcome of cardiovascular death or heart failure hospitalizations with a number needed to treat of approximately of 14 patients over 34 months of follow up. Candesartan also reduced all-cause death with a number needed to treat of approximately 33 patients. Adverse events including hypotension, increase in creatinine and hyperkalemia were more common with candesartan.The reduction in the primary endpoint with candesartan was significant and offers an alternative for patients who are unable to tolerate ACEi. Of note, 72% of the patients enrolled in the trial were intolerant to ACEi due to cough. This trial did not include a head-to-head comparison between ARBs and ACEi, and therefore does not address which agent should be preferred as first-line therapy. Only 24% of participants were receiving spironolactone. The combination of ARBs with spironolactone, may increase the risk of adverse events, particularly hyperkalemia and kidney injury.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe
In 1567 Pedro Menéndez de Avilés left Florida for Spain, having planted Spaniards at twelve or so sites from the Miami area to modern day Tennessee. The hero of our last two episodes, his attention will be divided from this point on, as Spanish Florida endures the return of the French and the rath of Chief Carlos, Chief Felipe, Chief Saturiwa and the cunning Paquiquineo.
Our podcast show being released today is Part 2 of our two-part series featuring two former CFPB senior officers who were key employees in the Enforcement Division under prior directors: Eric Halperin and Craig Cowie. Eric Halperin served as the Enforcement Director at the CFPB from 2010 until former Director, Rohit Chopra, was terminated by President Trump. Craig Cowie was an enforcement attorney at the CFPB from July 2012 until April 2015 and then Assistant Litigation Deputy at the CFPB until June 2018. Part 1 of our two-part series was released last Thursday, June 12. The purpose of these podcast shows were primarily to obtain the opinions of Eric and Craig (two of the country's most knowledgeable and experienced lawyers with respect to CFPB Enforcement) about the legal and practical impact of (i) a Memo to CFPB Staff from Mark Paoletta, Chief Legal Officer, dated April 16, 2025, entitled “2025 Supervision and Enforcement Priorities” (described below) which rescinded prior priority documents and established a whole new set of priorities which in most instances are vastly different than the Enforcement Priority documents which guided former directors, (ii) the dismissal without prejudice of the majority of enforcement lawsuits that were pending when Acting Director Russell Vought was appointed to run the agency, and (iii) other drastic steps taken by CFPB Acting Director Russell Vought to minimize the functions and staffing at the agency. That included, among other things, an order calling a halt to all work at the agency, including the pausing of ongoing investigations and lawsuits and the creation of plans by Vought to reduce the agency's staff (“RIF”) from about 1,750 employees to about 250 employees (including a reduction of Enforcement staff to 50 employees from 258). We described in detail the 2025 Supervision and Enforcement Priorities as follows: · Reduced Supervisory Exams: A 50% decrease in the overall number of exams to ease burdens on businesses and consumers. · Focus on Depository Institutions: Shifting attention back to banks and credit unions. · Emphasis on Actual Fraud: Prioritizing cases with verifiable consumer harm and measurable damages. · Redressing Tangible Harm: Concentrating on direct consumer remediation rather than punitive penalties. · Protection for Service Members and Veterans:Prioritizing redress for these groups. · Respect for Federalism: Minimizing duplicative oversight and coordinating with state regulators when possible. · Collaboration with Federal Agencies: Coordinating with other federal regulators and avoiding overlapping supervision. · Avoiding Novel Legal Theories: Limiting enforcement to areas clearly within the Bureau's statutory authority. · Fair Lending Focus: Pursuing only cases of proven intentional racial discrimination with identifiable victims and not using statistical evidence for fair lending assessments. Key Areas of Focus: · Mortgages (highest priority) · FCRA/Regulation V (data furnishing violations) · FDCPA/Regulation F (consumer contracts/debts) · Fraudulent overcharges and fees · Inadequate consumer information protection Deprioritized Areas: · Loans for "justice involved" individuals · Medical debt · Peer-to-peer lending platforms · Student loans · Remittances · Consumer data · Digital payments We also described the status of a lawsuit brought by the union representing CFPB employees and other parties against Vought seeking to enjoin him from implementing the RIF. The Court has granted a preliminary injunction which so far has largely prevented Vought from following through on the RIF. The matter is now on appeal before the DC Circuit Court of Appeals and a ruling is expected soon. These podcast shows complement the podcast show we released on June 5 which featured two former senior CFPB employees, Peggy Twohig and Paul Sanford who opined about the impact of the April 16 Paoletta memo and proposed RIF on CFPB Supervision. Eric and Craig considered, among other issues, the following: 1. How do the new Paoletta priorities differ from the previous priorities and what do the new priorities tell us about what we can expect from CFPB Enforcement? 2. What do the new priorities tell us about the CFPB's new approach toward Enforcement priorities? 3. What can we learn from the fact that the CFPB has dismissed without prejudice at least 22 out of the 38 enforcement lawsuits that were pending when Vought became the Acting Director? What types of enforcement lawsuits are still active and what types of lawsuits were dismissed? 4. What are the circumstances surrounding the nullification of certain consent orders (including the Townstone case) and the implications for other consent orders? 5. Has the CFPB launched any new enforcement lawsuits under Vought? 6. What level and type of enforcement is statutorily required? 7. Realistically, what will 50 employees be able to do in the enforcement area? 8. What will be the impact of the Supervision cutbacks be on Enforcement since Supervision refers many cases to Enforcement? 9. Will the CFPB continue to seek civil money penalties for violations of law? 10. What types of fair lending cases will the CFPB bring in the future?11. Will Enforcement no longer initiate cases based on the unfairness or abusive prongs of UDAAP? Alan Kaplinsky, former practice group leader for 25 years and now Senior Counsel of the Consumer Financial Group, hosts the podcast show. Postscript: After the recording of this podcast, Cara Petersen, who succeeded Eric Halperin as head of CFPB Enforcement, resigned abruptly on June 10 from the CFPB after sending out an e-mail message to all its employees (which was shared with the media) which stated, in relevant part: “I have served under every director and acting director in the bureau's history and never before have I seen the ability to perform our core mission so under attack,” wrote Petersen, who had worked at the agency since it became operational in 2011. She continued: “It has been devastating to see the bureau's enforcement function being dismantled through thoughtless reductions in staff, inexplicable dismissals of cases, and terminations of negotiated settlements that let wrongdoers off the hook.” “It is clear that the bureau's current leadership has no intention to enforce the law in any meaningful way,” Petersen wrote in her e-mail. “While I wish you all the best, I worry for American consumers.” During this part of the podcast show, we discussed the fact that the CFPB has entered into agreements with a few companies that had previously entered into consent agreements with former Director Chopra. After the recording of this podcast, the Federal District Court that presided over the Townstone Financial enforcement litigation involving alleged violations of the Equal Credit Opportunity Act refused to approve the rescission or undoing of the consent agreement based on Rule 60(b)(6) of the Federal Rules of Civil Procedure because of the strong public policy of preserving the finality of judgments.
Scoliosis impacts far more people than we realize. Dr. Tony Nalda explains the different sources of scoliosis that impact both children and adults. The population of people with scoliosis increases as age increases, that means many of us will be facing scoliosis in the future if not already living with it.Dr. Nalda explains the options we have to stop the curvature from increasing and even reducing the degree of the curve. We also discuss the traditional diagnosis and treatment options most doctors are operating under and why these options need to change to help prevent surgery. This is important because one small change could be significant in our level of pain we experience but not necessarily produce a degree of curve for traditional treatment. Dr. Tony Nalda is the leader of the Scoliosis Reduction Center®. In addition to being a chiropractor, Dr. Nalda holds an Intensive Care Certification from CLEAR Institute, a leading scoliosis educational and certification center. He was also one of the very first doctors to receive World Masters Certification from ISICO, a certification that specializes in the conservative treatment and management of scoliosis. Dr. Nalda also holds certifications with SEAS (Scientific Exercise Approach to Scoliosis Accreditation Program), Gomez Orthodics, Chiropractic Biophysics, ScoliBrace, A Corrective 3D Scoliosis Bracing System, DMX (Digital Motion Xray), and Scolibalance® certification from ScoliCare®.Learn more at www.scoliosisreductioncenter.com and follow on Facebook @ScoliosisReductionCenter and YouTube @ScoliosisReductionCenter. Visit ConfidenceThroughHealth.com to find discounts to some of our favorite products.Follow me via All In Health and Wellness on Facebook or Instagram.Find my books on Amazon: No More Sugar Coating: Finding Your Happiness in a Crowded World and Confidence Through Health: Live the Healthy Lifestyle God DesignedProduction credit: Social Media Cowboys
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June 16, 2025 - State Senate Environmental Conservation Committee Chair Pete Harckham is still trying to get the Assembly on board with legislation reducing single-use plastic packaging waste, which was already approved by the Senate. The Westchester County Democrat addresses concerns from business groups and indicates his willingness to restart negotiations once the bill gets to the governor.
Our podcast shows being released today and next Wednesday, June 18 feature two former CFPB senior officers who were key employees in the Enforcement Division under prior directors: Eric Halperin and Craig Cowie. Eric Halperin served as the Enforcement Director at the CFPB from 2010 until former Director, Rohit Chopra, was terminated by President Trump. Craig Cowie was an enforcement attorney at the CFPB from July 2012 until April 2015 and then Assistant Litigation Deputy at the CFPB until June 2018. The purpose of these podcast shows were primarily to obtain the opinions of Eric and Craig (two of the country's most knowledgeable and experienced lawyers with respect to CFPB Enforcement) about the legal and practical impact of (i) a Memo to CFPB Staff from Mark Paoletta, Chief Legal Officer, dated April 16, 2025, entitled “2025 Supervision and Enforcement Priorities” (described below) which rescinded prior priority documents and established a whole new set of priorities which in most instances are vastly different than the Enforcement Priority documents which guided former directors, (ii) the dismissal without prejudice of the majority of enforcement lawsuits that were pending when Acting Director Russell Vought was appointed to run the agency, and (iii) other drastic steps taken by CFPB Acting Director Russell Vought to minimize the functions and staffing at the agency. That included, among other things, an order calling a halt to all work at the agency, including the pausing of ongoing investigations and lawsuits and the creation of plans by Vought to reduce the agency's staff (“RIF”) from about 1,750 employees to about 250 employees (including a reduction of Enforcement staff to 50 employees from 258). We described in detail the 2025 Supervision and Enforcement Priorities as follows: · Reduced Supervisory Exams: A 50% decrease in the overall number of exams to ease burdens on businesses and consumers. · Focus on Depository Institutions: Shifting attention back to banks and credit unions. · Emphasis on Actual Fraud: Prioritizing cases with verifiable consumer harm and measurable damages. · Redressing Tangible Harm: Concentrating on direct consumer remediation rather than punitive penalties. · Protection for Service Members and Veterans:Prioritizing redress for these groups. · Respect for Federalism: Minimizing duplicative oversight and coordinating with state regulators when possible. · Collaboration with Federal Agencies: Coordinating with other federal regulators and avoiding overlapping supervision. · Avoiding Novel Legal Theories: Limiting enforcement to areas clearly within the Bureau's statutory authority. · Fair Lending Focus: Pursuing only cases of proven intentional racial discrimination with identifiable victims and not using statistical evidence for fair lending assessments. Key Areas of Focus: · Mortgages (highest priority) · FCRA/Regulation V (data furnishing violations) · FDCPA/Regulation F (consumer contracts/debts) · Fraudulent overcharges and fees · Inadequate consumer information protection Deprioritized Areas: · Loans for "justice involved" individuals · Medical debt · Peer-to-peer lending platforms · Student loans · Remittances · Consumer data · Digital payments We also described the status of a lawsuit brought by the union representing CFPB employees and other parties against Vought seeking to enjoin him from implementing the RIF. The Court has granted a preliminary injunction which so far has largely prevented Vought from following through on the RIF. The matter is now on appeal before the DC Circuit Court of Appeals and a ruling is expected soon. These podcast shows complement the podcast show we released on June 5 which featured two former senior CFPB employees, Peggy Twohig and Paul Sanford who opined about the impact of the April 16 Paoletta memo and proposed RIF on CFPB Supervision. Eric and Craig considered, among other issues, the following: 1. How do the new Paoletta priorities differ from the previous priorities and what do the new priorities tell us about what we can expect from CFPB Enforcement? 2. What do the new priorities tell us about the CFPB's new approach toward Enforcement priorities? 3. What can we learn from the fact that the CFPB has dismissed without prejudice at least 22 out of the 38 enforcement lawsuits that were pending when Vought became the Acting Director? What types of enforcement lawsuits are still active and what types of lawsuits were dismissed? 4. What are the circumstances surrounding the nullification of certain consent orders (including the Townstone case) and the implications for other consent orders? 5. Has the CFPB launched any new enforcement lawsuits under Vought? 6. What level and type of enforcement is statutorily required? 7. Realistically, what will 50 employees be able to do in the enforcement area? 8. What will be the impact of the Supervision cutbacks be on Enforcement since Supervision refers many cases to Enforcement? 9. Will the CFPB continue to seek civil money penalties for violations of law? 10. What types of fair lending cases will the CFPB bring in the future? 11. Will Enforcement no longer initiate cases based on the unfairness or abusive prongs of UDAAP? Alan Kaplinsky, former practice group leader for 25 years and now Senior Counsel of the Consumer Financial Group, hosts the podcast show. Postscript: After the recording of this podcast, Cara Petersen, who succeeded Eric Halperin as head of CFPB Enforcement, resigned abruptly on June 10 from the CFPB after sending out an e-mail message to all its employees (which was shared with the media) which stated, in relevant part: “I have served under every director and acting director in the bureau's history and never before have I seen the ability to perform our core mission so under attack,” wrote Petersen, who had worked at the agency since it became operational in 2011. She continued: “It has been devastating to see the bureau's enforcement function being dismantled through thoughtless reductions in staff, inexplicable dismissals of cases, and terminations of negotiated settlements that let wrongdoers off the hook.” “It is clear that the bureau's current leadership has no intention to enforce the law in any meaningful way,” Petersen wrote in her e-mail. “While I wish you all the best, I worry for American consumers.”
THE LANCET 2003;362:767-771Background: Angiotensin II which plays a role in ventricular remodeling and progression of heart failure can be produced by pathways independent of angiotensin convening enzyme. Preliminary studies showed that the combination of angiotensin II blockers with angiotensin-converting enzyme inhibitors (ACEi) improves hemodynamics and reduces ventricular remodeling.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Added trial sough to assess if adding the angiotensin-receptor blocker (ARB), candesartan, to ACEi could improve outcomes in patients with systolic heart failure.Patients: Eligible patients had left ventricular ejection fraction of 40% or less within the previous 6 months, and NYHA class II, III or IV symptoms. Patients with NYHA class II symptoms had to have cardiac-related hospitalization within 6 months. Patients also had to have treatment with ACEi at a constant dose for at least 30 days.Exclusion criteria were not provided in the main manuscript.Baseline characteristics: Patients were recruited from 618 centers in 26 countries. The trial randomized 2,548 patients – 1,276 randomized to receive candesartan and 1,272 to receive placebo.The average age of patients was 64 years and 79% were men. The average left ventricular ejection fraction was 28%. Cardiomyopathy was ischemic in 62% of the patients. The NYHA class was II in 24% of the patients, III in 73% and IV in 3%.Approximately 48% had hypertension, 30% had diabetes, 56% had prior myocardial infarction, 9% had stroke, 27% had atrial fibrillation and 17% were current smokers.At the time of enrollment, 90% were taking a diuretic, 58% were taking digoxin, 55% were taking beta-blockers, 17% were taking spironolactone and all but two patients were taking ACEi.Procedures: The trial was double-blinded. Patients were assigned in a 1:1 ratio to receive candesartan starting at 4 or 8mg once daily or placebo. The treatment was doubled every two weeks to a target dose of 32mg once daily.After randomization, follow up occurred at 2, 4, and 6 weeks, 6 months and every 4 months thereafter.Endpoints: The primary outcome was a composite of cardiovascular death or heart failure hospitalizations. All deaths were classified as cardiovascular unless there was a clear non-cardiac cause.Analysis was performed based on the intention-to-treat principle. The estimated sample size to have 80% power at 5% alpha was 2,300 patients. The sample size calculation assumed 16% relative risk reduction in the primary outcome with candesartan assuming an 18% annual event rate in the placebo arm.Results: The median follow up time was 41 months. The mean candesartan daily dose was 24mg at 6 months.Candesartan reduced the primary endpoint of cardiovascular death or heart failure hospitalizations (37.9% vs 42.3%, adjusted HR: 0.85, 95% CI: 0.75 – 0.96; p= 0.01). Candesartan reduced the individual components of the primary outcome - (23.7% vs 27.3%; p= 0.021) for cardiovascular death and (24.2% vs 28.0%; p= 0.018) for heart failure hospitalizations. There was no significant reduction in all-cause death (29.5% with candesartan vs 32.4%; p= 0.105). The number of patients who had any hospitalization was similar in both groups (66.8% with candesartan vs 67.5%; p= 0.7), however, the total number of hospitalizations was lower with candesartan (2,462 vs 2,798; p= 0.023).Serum creatinine at least doubled in 7% of the patients in the candesartan group vs 6% in the placebo group. In the subset of patients taking spironolactone, serum creatinine at least double in 11% of the patients taking candesartan compared to 4% of the patients taking placebo.Hyperkalemia, defined as serum potassium of 6 mmol/L or higher, occurred in 3% of the patients in the candesartan group vs 1% in the placebo group. In the subset of patients taking spironolactone, hyperkalemia occurred in 4% of the patients taking candesartan compared to 1% of the patients taking placebo.There were two cases of angioedema in the candesartan group and three in the placebo group. All patients were taking an ACEi.There were no significant subgroup interactions, including in patients taking both beta-blockers and ACEi at baseline.Conclusion: In patients with systolic heart failure, adding candesartan to an ACEi reduced the primary composite outcome of cardiovascular death or heart failure hospitalizations with a number needed to treat of approximately of 23 patients over 41 months of follow up. The total number of all-cause hospitalizations was reduced by 336 with candesartan. All-cause death was not significantly reduced with candesartan.While the results of the trial appear impressive, the high number of adverse outcomes with candesartan in patients taking spironolactone is concerning. Spironolactone led to significant reduction in all-cause mortality in patients with systolic heart failure, as seen in the RALES trial, and should be prioritized over adding candesartan. Notably, fewer than 20% of patients in the trial were on spironolactone at baseline; if more had been, the incremental benefit of candesartan would likely have been reduced due to an increased risk of adverse effects from triple neurohormonal blockade (ACEi, ARBs, and mineralocorticoid receptor antagonists). Furthermore, spironolactone acts by blocking the aldosterone receptor, which is downstream in the renin–angiotensin–aldosterone system. Since candesartan blocks angiotensin II upstream in the same pathway, simultaneous inhibition at multiple points may lead to diminishing benefit.Finally, the differences observed in the subgroup of patients on beta-blockers between this trial and Val-HeFT remain unclear and may simply reflect the play of chance. As we previously discussed, patients receiving both an ACEi and beta-blockers had worse outcomes with valsartan in the Val-HeFT trial.Cardiology Trial's Substack is a reader-supported publication. 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DAMION1In our 'Glass Lewis complained that the gum-based equity should vest after being stuck to the bottom of his chair in 5 years and not 3 while ISS said, "shit, it just feels like it might be a lot of money probably"' headline of the week. Warner Discovery Shareholders Vote Against CEO David Zaslav's Pay In our 'When 52% is way too wimpy and 54% is a step too far' headline of the week. Cement Industry Pledges 53% Reduction in Greenhouse Gas Emissions by 2050In our 'Immature college dropout finally realizes full professional potential' headline of the week. Misogyny in the metaverse: is Mark Zuckerberg's dream world a no-go area for women? In our 'Has this weird kind of taste, almost as if it came from McDonald's' headline of the week. McDonald's McCrispy Strips receive mixed reviews as analysts question impact on upcoming Snack WrapI just like to point out how stupid and serious headlines like this areIn our 'What do you mean I can't take a 24-gallon container of hand sanitizer in my carry-on bag?' headline of the week. Sorry, you can't use your Costco membership card to get through TSAMATT1In our 'Also known as $45,555 per military personnel deployed in LA.' headline of the week. Taser Boss Tops Ranking of Highest-Paid CEOs, With $165 Million. Here's the List.The marines have been deployed - there are 76 active director veterans tagged in our database, including 6 admirals and 13 former marines. So far, zero statements yet about using the military to quell protests?In our 'We were 91% in favor of you when you were lead independent director with a 24 year tenure and connections to most of the board, but this year, you missed an important meeting where we asked Reed and Ted what we're supposed to do so we call all agree. This is unacceptable. You're fired.' headline of the week. Netflix Shareholders Vote to Oust Jay Hoag, Its Lead Independent Director, but the Board May Decide to Keep HimIn our 'Waltons reject all proposals, but maybe we can make that headline sound better' headline of the week. Walmart, PayPal shareholders reject DEI overhauls as corporate America continues retreat from social issuesOrganization United for Respect racial equity audit: 6.8%. National Center for Public Policy Research's report investigating delays in reversing DEI: 0.4%. But yes, shareholders reject DEI overhauls.In our 'I'm telling mom! Moooooom!' headline of the week. Trump attacks Musk and questions their future ties amid growing feudIn our 'Get some' headline of the week. Lessons in corporate governance from the Trump-Musk spatDAMION2In our 'Men' headline of the week. Women hold 24% of CEO pipeline roles, but just 8% of promotions. What's going wrong?In our 'Disney teases summer blockbuster movie starring Zac Efron: "Revenge of the College Dropout"' headline of the week. Inside OpenAI's Plan to Embed ChatGPT Into College Students' LivesMeta forming new AI lab helmed by Scale AI CEO Alex Wang: MIT dropoutIn our 'Is this why 66% of Americans think that "society is broken" according to an Ipsos survey released this week?' headline of the week. Just one woman has ever founded and led a Fortune 500 company. Here's her storyThe only woman ever to run a Fortune 500 company she founded was Marion Sandler. She was the cofounder of mortgage lender Golden West Financial, which she led with her husband and co-CEO Herb Sandler for more than four decades. She was one of the first two women CEOs on the Fortune 500 in 1997 In our 'As long as he's not drinking Dr. Pepper I think he'll be ok' headline of the week. Keurig Dr Pepper's CEO drinks at least 300 milligrams of caffeine per day. Is that safe?Tim Cofer-17% gender influence gap: 3W total of 11% influence2W of 10 execs (one is HR)In our 'Other candidates considered were Dyle T Lick and Tyle L Dick' headline of the week. BJ's Restaurant announces Lyle D Tick as new president and CEO MATT2In our 'It ISN'T about the middle school manflake dictator' headline of the week. United Airlines Shuts Down Starlink WiFi Service on Its Planes After the Antennaes Caused Problems With Its Jets' EquipmentIn our 'It IS all about the middle school manflake dictator' headline of the week. United Airlines CEO: ‘We're probably doing more AI than anyone'Just obviously without the antennasIn our 'Texas's attorney general announces Blackrock is no longer woke, but will remain on the "suspiciously Jewish" list' headline of the week. BlackRock Escapes Texas Oil-Boycott List After ESG RetreatIn our 'Texas's attorney general announces they are replacing Blackrock with Texas on Texas's investment ban list going forward' headline of the week. Texas finalizes $1.8B to build solar, battery, and gas-powered microgridsIn our 'There are none reasons' headline of the week. Why Apple iOS 26 might make you want to make phone calls againTim Cook and Arthur Levinson's greatest innovation yet: call holding.
In this episode, Dr. Anthony Youn, who is often referred to as "America's Holistic Plastic Surgeon," dives into the latest buzz around celebrity plastic surgery. He focuses on well-known figures like Kris Jenner, Doja Cat, and Chrissy Teigen. Dr. Youn offers a thoughtful analysis of the procedures these celebrities are rumored to have had, discussing what these surgeries might entail and the effects they could have. He emphasizes the importance of understanding the intricacies of cosmetic surgery and how it can alter one's appearance. Additionally, Dr. Youn takes a moment to appreciate a listener's positive feedback and uses the opportunity to mention his books. This episode aims to break down the complexities of plastic surgery, making it more approachable and informative for listeners who might be considering their own cosmetic choices. Links and Resources: Where can you find more information about how to autojuvenate your skin to a younger you? Check out my new book, Younger For Life! It's available at https://autojuvenation.com, and if you buy it now, you will receive over $100 in FREE gifts, including a $30 gift certificate for my online store younbeauty.com! Check out Dr. Youn's skincare products and nutritional supplements - younbeauty.com Download his FREE eGuide: "What to Eat to Look Younger" - dryoun.com/eat-look-younger Follow Dr. Youn on Instagram - @tonyyounmd Follow Dr. Youn on YouTube - youtube.com/tonyyounmd Follow Dr. Youn on TikTok - @doctoryoun Follow Dr. Youn on Facebook - @dryoun Learn more about your ad choices. Visit megaphone.fm/adchoices
Bailey gives us an update on her bathroom, Dave's Dirt, and more!
Bailey gives us an update on her bathroom, Dave's Dirt, and more!
Krystal and Emily discuss Stephen Miller plot to suspend Habeas Corpus, Trump claims sweeping drug cost reduction, Kanye's new song, Mayor arrested by ICE speaks out. To become a Breaking Points Premium Member and watch/listen to the show AD FREE, uncut and 1 hour early visit: www.breakingpoints.com Merch Store: https://shop.breakingpoints.com/See omnystudio.com/listener for privacy information.
Border Security Measures: Historic Reductions: The administration achieved significant reductions in illegal border crossings and apprehensions of dangerous criminals. Policies Implemented: Tough policies were put in place, including designating violent gangs as foreign terrorist organizations and resuming border wall construction. Mass Deportations: Over 150,000 illegal immigrants, including gang members and criminals, were arrested. Reduction in Unaccompanied Minors: The number of unaccompanied minors crossing the border was drastically reduced. Statistics: Illegal Border Encounters: Down by 95% in the first hundred days. Catch and Release: Reduced by 99.99% from the worst month under Joe Biden. Actions Against Sanctuary Cities: Elimination of Sanctuary Cities: Federal benefits for illegal immigrants were cut, redirecting resources to support American citizens. Alien Enemies Act: Used to dismantle migrant criminal networks and shut down apps used to exploit the system. Media Coverage: Various media outlets, including Fox News, CBS, Wall Street Journal, Bloomberg, Washington Times, and Los Angeles Times, reported on the drastic changes and reductions in illegal border crossings. Public Display: The White House displayed images of the worst criminal illegal immigrants arrested during the first hundred days on the lawn to highlight the administration's efforts. Criticism and Controversy: The media criticized the display, arguing it was unfair and potentially misleading. There were concerns about due process and the accuracy of the information presented. Democratic Response: Democrats introduced impeachment articles against Donald Trump, accusing him of obstructing justice and abusing trade powers. Please Hit Subscribe to this podcast Right Now. Also Please Subscribe to the Ben Ferguson Show Podcast and Verdict with Ted Cruz Wherever You get You're Podcasts. Thanks for Listening #seanhannity #hannity #marklevin #levin #charliekirk #megynkelly #tucker #tuckercarlson #glennbeck #benshapiro #shapiro #trump #sexton #bucksexton#rushlimbaugh #limbaugh #whitehouse #senate #congress #thehouse #democrats#republicans #conservative #senator #congressman #congressmen #congresswoman #capitol #president #vicepresident #POTUS #presidentoftheunitedstatesofamerica#SCOTUS #Supremecourt #DonaldTrump #PresidentDonaldTrump #DT #TedCruz #Benferguson #Verdict #maga #presidenttrump #47 #the47morningupdate #donaldtrump #trump #news #trumpnews #Benferguson #breaking #breakingnews #morningupdateYouTube: https://www.youtube.com/@VerdictwithTedCruzSee omnystudio.com/listener for privacy information.
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