Podcasts about Seliger

Es war ein feierlicher sogenannter Aufstellungsappell am Donnerstag in Vilnius. Die Panzerbrigade der Bundeswehr ist in Litauen in Dienst gestellt worden. Über die deutsche Brigade spricht Host Anna Engelke mit Marco Seliger. Für den Journalisten der NZZ und Bundeswehr-Kenner hat das eine historische Dimension. Erstmals seit dem Zweiten Weltkrieg werde deutsches Militär mit einem Kampfverband außerhalb Deutschlands dauerhaft stationiert. Dies sei „tatsächlich im wahrsten Sinne des Wortes eine Zeitenwende“. Die Brigade der Bundeswehr soll bis Ende 2027 einsatzfähig sein. Laut aktuellen Umfragen stehen bis zu 90 Prozent der Litauer der Stationierung positiv gegenüber, erklärt Seliger. In ihrer Perzeption seien die deutsche Brigade und das deutsche militärische Engagement im Rahmen der Nato ihre Existenzversicherung. Allerdings gebe es Zweifel, ob Deutschland - wenn es zum Schwur käme - sein Beistandsversprechen einhalte. Kai Küstner fasst die aktuelle Lage in der Ukraine zusammen. Auch nach dem Telefonat der Präsidenten Trump und Putin gebe es nicht das geringste Anzeichen für eine Bewegung Richtung Feuerpause. Kai spricht mit Blick auf Friedenshoffnungen von “Potemkin'scher Diplomatie” Putins, weil vieles darauf hindeutet, dass er echte Verhandlungsbereitschaft nur vortäuscht. Während die EU ein 17. Sanktionspaket verabschiedet hat, scheint US-Präsident Trump den Druck auf Moskau nicht erhöhen zu wollen. Kai erläutert auch, was hinter der Aussage Putins steckt, in der Grenzregion zur Ukraine eine Pufferzone schaffen zu wollen. Lob und Kritik, alles bitte per Mail an streitkraefte@ndr.de Alle Folgen von “Streitkräfte und Strategien” https://www.ndr.de/nachrichten/info/podcast2998.html Das ganze Interview mit Marco Seliger https://www.ndr.de/nachrichten/info/Seliger-Paradigmenwechsel-in-der-deutschen-Sicherheitspolitk,audio1879272.html NSA-Report zu russischen Cyberangriffen https://www.nsa.gov/Press-Room/Press-Releases-Statements/Press-Release-View/Article/4193749/nsa-and-others-publish-advisory-warning-of-russian-state-sponsored-cyber-campai/ Link zu neuer Staffel von “Killed In Action – Trauma Bundeswehr” https://1.ard.de/Killed_in_Action_1 Stefan Niemann über NATO-Manöver an der Ostflanke auf tagesschau24 https://www.tagesschau.de/multimedia/video/video-1469548.html

Was macht dich glücklicher, ein Geschenk zu erhalten oder ein Geschenk zu geben? Ich habe oft den Eindruck, dass die meisten Leute lieber etwas haben wollen, als etwas zu geben? Dabei meine ich natürlich nicht die kleinen Geschenke, die sozusagen die Freundschaft erhalten. Ich denke dabei mehr an die Dinge, die vielleicht keinen großen finanziellen Wert, aber doch einen Preis haben.

„Fallzahlen“ könnte fast der Medizinbegriff des Jahres 2024 werden. Aber gibt es auch andere Faktoren, welche die Unterschiede zwischen verschieden hoher postoperativer Mortalität nach Pankreasresektionen an unterschiedlichen Kliniken erklären? Viel Freude beim Hören Christoph Paasch und Sophie Heisler Gast: Prof. Dr. med. René Mantke (Brandenburg an der Havel) Moderation: Sophie Heisler (Brandenburg an der Havel) Besprochene Publikation: Mantke, Rene MD*,†; Seliger, Barbara PhD, MSc‡; Ogino, Shuji MD, PhD, MS§,‖,¶,#; Büchler, Markus W MD**,††; Hunger, Richard MSc*. Not Only Caseload but Also Patient Selection Is Predictive of Mortality After Pancreatic Resection. Annals of Surgery Open 6(1):p e536, March 2025. Unter folgendem Link können bei der Landesärztekammer Brandenburg 2 Fortbildungspunkte erworben werden. Der Kursinhalt sind stets 3 Folgen. https://lernportal.laekb.de/goto.php?target=crs_3487&client_id=laekb

Ref.: P. Gottfried Egger OFM, Brixen, Südtirol

In this final installment of the Finding the Throughline interview with James Beard Award-nominated journalist Hannah Selinger (whose book, Cellar Rat: My Life in the Restaurant Underbelly, will be released in 2025 and is available for pre-order now), we talk about what's coming up next for her as well as what she's been reading, watching, and eating, including: - The badass Martha Stewart documentary - “Health and Safety,” a memoir by Emily Witt, staff writer at “The New Yorker” - Her invention of the term #Scandivol - How “The Real Housewives” series rope you in - Her best friend who gives her major writer's envy - Her goal to get off the hamster wheel of freelance - Why she hopes her book “Cellar Rat” will piss people off - The most pleasurable books she read this year - An ode to French vanilla coffee creamer, McDonald's french fries, and the Indigo Girls Connect with Hannah at https://www.hannahselinger.net/ or on Instagram @druishamericanprincess. For full show notes with links to everything we discuss, plus bonus photos!, visit katehanley.substack.com. Thank you for listening! And thanks to this week's sponsor, Air Doctor Pro. Visit airdoctorpro.com and use code KATE to save 30% off an amazing indoor air filter *and* receive a free three-year warranty (an $84 value). Learn more about your ad choices. Visit megaphone.fm/adchoices

Heute zu Gast ist Dr. Ruth Seliger, Gründerin und Leiterin von Seliger Consulting, Mitgründerin der NGO Community for Change, Autorin u. a. von Das Dschungelbuch der Führung – Ein Navigationssystem für Führungskräfte (9. Aufl. 2023) und Einführung in Großgruppen-Methoden (4. Aufl. 2020). Ruth Seligers jüngstes Buch Systemische Beratung der Gesellschaft – Strategien für die Transformation steht erneut Patin für das zweite forum:transformieren, das von 16. - 17. Mai 2025 in Wien stattfindet und wieder gemeinsam vom Carl-Auer Verlag und der Community for Change organisiert wird. Im Zentrum steht systemisches Prozess-Know-How für Organisationen, Unternehmen, Institutionen. Im Gespräch erläutert Ruth Seliger die zentralen Punkte des zweiten Forums mit dem Titel „Demokratie zwischen Abbruch und Aufbruch“. Es ist – gerade auch für die Wirtschaft – wichtig, über Sorgen und Klagen hinauszugelangen und gemeinsam konkrete Handreichungen für die gelingende Transformation im demokratischen Gesellschaftsformat zu finden. Informationen und die Möglichkeit zur Anmeldung für das forum:transformieren gibt es auf der Webseite forumtransformieren.events. Folgen Sie auch den anderen Podcasts von Carl-Auer: autobahnuniversität www.carl-auer.de/magazin/autobahnuniversitat Blackout, Bauchweh und kein` Bock www.carl-auer.de/magazin/blackout…eh-und-kein-bock Cybernetics of Cybernetics www.carl-auer.de/magazin/cybernet…s-of-cybernetics Frauen führen besser www.carl-auer.de/magazin/frauen-fuhren-besser Formen (reloaded) Podcast www.carl-auer.de/magazin/formen-reloaded-podcast Heidelberger Systemische Interviews www.carl-auer.de/magazin/heidelbe…ische-interviews Zum Wachstum inspirieren www.carl-auer.de/magazin/zum-wachstum-inspirieren Zusammen entscheiden www.carl-auer.de/magazin/treffpunkt-entscheiden

Prof. Dr. Meinrad Walter, Freiburg, Katholische Kirche: Max Josef Metzger – von den Nazis ermordet, nun im Chor der Seligen

Im Februar 2025 startet unser nächster Zertifikatskurs in "Systemischer Organisationsgestaltung und -Führung"! Interessiert? Wir haben noch ganz wenige Plätze frei. Schreib uns an akademie@become-better.org, wenn du teilnehmen möchtest. Hier geht es zur vollständigen Episode mit Ruth Seliger: [Wie gelingt gesellschaftliche Transformation?](https://open.spotify.com/episode/4aE3chz1nzXcr8oVDTV1Vp) Mehr Infos zu unseren Gästen und alle Links zu dieser und allen anderen Folgen auf unserer Podcast-Seite: [https://become-better.org/podcast/](https://become-better.org/podcast/) Hier kannst Du Dein Buch-Exemplar von Christina Grubendorfer und Christina Ackermann bestellen: [The Real Book Of Work](https://www.amazon.de/Real-Book-Work-Organisationen-umdenken/dp/3800671549) Regelmäßig Neues von LEA erfahren?! Einfach unseren Newsletter abonnieren: [https://tinyurl.com/lea-newsletter](https://tinyurl.com/lea-newsletter) oder uns auf LinkedIn folgen: https://www.linkedin.com/company/3925422 Christina freut sich über deine Kontaktanfrage: https://www.linkedin.com/in/christina-grubendorfer/ Wenn dir der LEA Podcast gefällt, unterstütze ihn gerne: Hinterlasse eine 5-Sterne-Bewertung (z.B auf [Apple Podcasts](https://podcasts.apple.com/de/podcast/organisationen-entwickeln-der-lea-podcast-f%C3%BCr-zukunftsf%C3%A4hige/)) sowie eine Rezension und abonniere ihn.

Vom Feldgeistlichen zum Friedensaktivisten - der katholische Priester Max Josef Metzger hatte im Ersten Weltkrieg an einer der härtesten Schlachten zwischen Deutschland und Frankreich teilgenommen und wandelte sich durch seine Kriegserlebnisse zu einem der bedeutendsten Friedensaktivisten des 20. Jahrhunderts. Metzger wurde am 17. April 1944 von den Nazis hingerichtet, weil seine „Idee des Friedens“ zu gefährlich für deren Macht war. Am 17. November 2024 wird Metzger in einem feierlichen Gottesdienst im Freiburger Münster seliggesprochen und in den Kreis der „Vorbilder im Glauben“ aufgenommen. Was ihn auszeichnet und welche Positionen der Priester und Theologe vertreten hat, darüber spricht Dr. Christian Heß in der neuen Ausgabe von „Alpha und Omega – Kirche im Gespräch“. Heß ist Priester in der Kirchengemeinde March-Gottenheim. Er hat seine Doktorarbeit über Metzger geschrieben und kennt den (Mit-)Gründer von Pax Christi und der Christkönigsgesellschaft wie kein Zweiter. Moderation/Redaktion: Ralf Schöffmann

Episode #101 featuring Dr. Bryce Seliger and Dr. Tiffany Cox, two influential figures in the world of music education. Dr. Bryce Seliger has spent over a decade shaping arts administration and music education, including her role as Associate Professor of Music at Pacific University and as the Founder and Music Director of the Pacific Philharmonic. Known for her innovative approaches to community engagement, Dr. Seliger has also conducted numerous orchestras in Florida and Oregon and gained national recognition for her work in contemporary music.Dr. Tiffany Cox, a local band director at Lake Worth Community High School, brings her passion for music education to the forefront. With a PhD from Florida Atlantic University, Dr. Cox's background includes music therapy and jazz trombone from Florida State University. Since 2017, she has inspired students at Lake Worth High School and is committed to her role as band director for years to come.Listen to Alexanndra Ontra as she explores their journeys in music education, the challenges and innovations in the field, and their visions for the future of arts and orchestral performance.This Podcast is sponsored by Shufflrr. Shufflrr is AI for Presentations.

Die ideale Raumgestaltung ist nicht nur in den privaten vier Wänden sehr relevant, sondern auch in der Arbeitswelt. Das wissen Gründer und CEO der bkp GmbH Heiner Kolde und Head of New Work Marie Seliger nur zu gut. Sie schaffen Räume, die die individuellen Bedürfnisse der Mitarbeitenden berücksichtigen und auch die Unternehmenskultur widerspiegeln. Wie das in der Praxis aussieht, welchen Herausforderungen sie bereits innerhalb der Gestaltungsprozesse begegnet sind und wie die Büros in Zukunft aussehen könnten, erfahrt ihr jetzt. Viel Spaß!

Apg 20,35 Geben ist glückseliger als Nehmen! (SCH2000) Kommentar von William MacDonald (CLV) 20,33-35 Zum Schluss seiner Predigt stellte der Apostel Paulus den Ältesten noch einmal das Beispiel seines eigenen Lebens und Dienstes vor Augen. Er konnte ehrlich von sich sagen, dass er »von niemandem Silber oder Gold oder Kleidung begehrt« hatte. Es war nicht die Hoffnung auf finanziellen Gewinn, die ihn motivierte, das Werk des Herrn zu tun. Im Grunde war er ein armer Mann, was materiellen Besitz anging, doch vor Gott war er reich. Er streckte vor den Ältesten seine Hände aus und konnte sie daran erinnern, dass »diese Hände« dafür gearbeitet hatten, um die alltäglichen »Bedürfnisse« des Lebens zu befriedigen, und zwar für sich selbst und für die, »die bei« ihm »waren«. Doch er war sogar noch über das hinausgegangen. Er arbeitete als Zeltmacher, damit er genug Mittel hatte, um den »Schwachen« zu helfen – den körperlich Kranken, den »Schwachen«, die Zweifel in moralischen Fragen hatten, oder den »Schwachen« hinsichtlich geistlicher Angelegenheiten. Die Ältesten sollten sich daran erinnern und in allem das Beste der anderen zu erreichen suchen. Dabei sollten sie »die Worte des Herrn Jesus« im Gedächtnis behalten: »Geben ist seliger als Nehmen.« Interessanterweise finden sich diese Worte unseres Herrn in keinem der Evangelien. Sie stellen die Summe einer ganzen Reihe seiner Lehre dar, doch hier sind sie als inspirierte Ergänzung zu seinen Reden aus den Evangelien wiedergegeben. .:: FRAGEN::. Schreib mir! bibelverse@christliche-gewohnheiten.de .:: ANKI ::. ankisrs.net .:: DER KOSTENLOSE VIDEOKURS ::.

Guest: Jonathan Seliger, a coach at CEO Coaching International. Jonathan is an accomplished Chief Executive Officer, Senior Advisor, and Investor with over 30 years of experience.Having lived and worked in Asia for the last 30years,Jonathan brings a global perspective to the challenges of scaling a business to BIG. Quick Background: Even if your company is global, business is always local. Your strategies for attracting and retaining customers have to be customized for each individual market. What unites your plan of attack from town to town, state to state, and country to country is the consistency of your company's values, the strength of its brand, and its ability to execute, no matter what. On today's show, Jonathan Seliger shares his strategies for expanding a brand's reach, effectively managing growth challenges, and ensuring that scaling efforts align with long-term profitability and sustainability goals that will Make BIG Happen.

Walter Klingenbeck ist ein Jugendlicher, der tief von seinem Glauben geprägt ist. Früh erlebt er den menschenverachtenden Charakter des NS-Regimes in der eigenen Kirche, durch das Abhören von "Feindsendern" glaubt er die Lügen der Propaganda nicht. Also beginnt er zu handeln, doch schon bald wird ihm die Gestapo auf die Spur kommen?.

Ever considered dropping everything to chase a wild dream? Danny Seliger, also known as Coolness, did just that, and in our latest episode, he recounts his amazing transformation from accomplished collegiate volleyball player to the VP of a leading social media agency. This isn't your average success story; it's an exploration of bold decisions, the value of real-world experience over formal education, and the power of parental support when making life-altering choices. Danny's tale is one of breaking barriers and the societal expectations that so often bind us to traditional paths.Get ready to be inspired by a journey that touches on college athletics, the leap into the uncertainties of entrepreneurship, and the thrilling world of online branding. Danny's ascent to social media stardom—with over 1.5 million followers to his name—proves that when it comes to carving out your own niche, conventional wisdom doesn't always apply. As he shares his strategies for amassing an online presence and navigating the choppy waters of crypto investments, you'll see just how much tenacity and vision can achieve when combined.Wrapping up, Danny imparts wisdom on the evolution of digital marketing, the importance of authenticity, and the necessity of aligning with those who elevate you. It's a candid look at the highs and lows of following passion over expectation, underscored by the importance of self-belief in the face of criticism. This episode isn't just a motivational talk; it's a roadmap for anyone brave enough to chase their dreams with eyes wide open. Join us for a conversation that's as enlightening as it is entertaining, with laughs, lessons, and a whole lot of Coolness.Join the What if it Did Work movement on FacebookGet the Book!www.omarmedrano.comwww.calendly.com/omarmedrano/15min

Heute zu Gast ist Dr. Ruth Seliger, erfahrene und vielgefragte Systemische Beraterin für Führung, Organisationen und Change Management. Sie ist Gründerin und Leiterin von Seliger Consulting, Mitgründerin der NGO Community for Change, Autorin u. a. von Das Dschungelbuch der Führung – Ein Navigationssystem für Führungskräfte (9. Aufl. 2023) und Einführung in Großgruppen-Methoden (4. Aufl. 2020). Ruth Seligers jüngstes Buch Systemische Beratung der Gesellschaft – Strategien für die Transformation steht Patin für ein ganz besonderes Forum, das von 12. bis 13. April 2024 in Wien stattfindet und gemeinsam vom Carl-Auer Verlag und der Community for Chance organisiert wird: das forum:transformieren. Im Zentrum steht hier systemisches Prozess-Know-How für Unternehmen, Institutionen, NGOs und Initiativen. Ein Leitgedanke dabei: Wir werden einander nicht los – also: Los! Das Angebot gelingt, und die angemeldeten Teilnehmenden kommen tatsächlich aus all diesen Kontexten und Gruppen. Wir sprechen mit Ruth Seliger über ihr Prozessmodell, die Dynamik der Transformation in Ökonomie, Ökologie und Demokratie und darüber, wie man sogenannte Common Grounds findet und gut miteinander ins Tun kommen kann. Und wir sprechen nicht zuletzt darüber, warum es dafür so wichtig und unabdingbar ist, sich zu organisieren. Informationen und die Möglichkeit zur Anmeldung für das forum:transformieren gibt es auf der Webseite forumtransformieren.events. Viel Freude beim Gespräch mit Ruth Seliger. Folgen Sie auch den anderen Podcasts von Carl-Auer: autobahnuniversität www.carl-auer.de/magazin/autobahnuniversitat Blackout, Bauchweh und kein` Bock www.carl-auer.de/magazin/blackout-bauchweh-und-kein-bock Cybernetics of Cybernetics www.carl-auer.de/magazin/cybernetics-of-cybernetics Frauen führen besser www.carl-auer.de/magazin/frauen-fuhren-besser Formen (reloaded) Podcast www.carl-auer.de/magazin/formen-reloaded-podcast Heidelberger Systemische Interviews www.carl-auer.de/magazin/heidelberger-systemische-interviews

THE NEW YORK OBSERVER—“I finally went up to Graydon and I said, ‘Hey, you know, I know you like me. I know you wanted me to be here, but I can also do covers.'”• • •That's today's guest, Mark Seliger. He's the same Mark Seliger who, at the moment of this exchange with Vanity Fair editor Graydon Carter, had already shot over 180 covers for Rolling Stone, where he was the chief photographer from 1992-2002.Seliger had been heavily recruited by GQ and Vanity Fair to move to Condé Nast. But, as he learned, the days of being Fred Woodward's go-to image maker were over. Once again, he was the new guy. And he saw an opportunity to reinvent himself.Fortunately, reinvention is Seliger's middle name. Print Is Dead (Long Live Print!) is a production of Magazeum & MO.D ©2021–2024

Die Themen dieser Folge: • Begrüßung & Themenvorstellung 00:00:00  • Rückblick #VfBRBL 00:02:04 • Transfermarkt & Turniere 00:28:13 • NLZ-News 00:37:20 • Ausblick #SCFVfB 00:43:13 • Ausblick #B04VfB 01:01:30 ────────────────────​​──────── Der MeinVfB-PodCannstatt wird präsentiert von den Stuttgarter Nachrichten und der Stuttgarter Zeitung. Hosts: Philipp Maisel, Christian Pavlic Produktion: Marian Hepp Alles rund um MeinVfB findest du hier: linktr.ee/meinvfb ────────────────────​​──────── Impressum: www.meinvfb.de/impressum.html

Das christliche Wort zum Alltag von Nicole Stark von der Katholischen Kirche, gelesen von Luisa Maurer. Den Text des SR 1 Zwischenrufs kann man auch im Internet nachlesen unter kirche-im-sr.de

In dieser Folge setzen wir uns mit dem herausfordernden Thema des Gebens auseinander, sowohl aus individueller als auch aus gesellschaftlicher Perspektive. Der zunehmende Selbstzentriertheit in unserer Welt stelle ich den biblischen Ansatz des Zehnten gegenüber. Hier der Artikel zur Untersuchung des Max-Planck-Instituts. So wird übrigens die Kirchensteuer verteilt. Apostelgeschichte 20, 35: "Stets war ich euch ein Vorbild, wie ihr durch harte Arbeit den Armen helfen könnt. Behaltet die Worte von Jesus, dem Herrn, in Erinnerung: ›Es liegt mehr Glück im Geben als im Nehmen.‹«"Bibelstelle: Neues Leben. Die Bibel © der deutschen Ausgabe 2002 / 2006 / 2017 SCM R.Brockhaus in der SCM Verlagsgruppe GmbH, Max-Eyth-Str. 41, 71088 HolzgerlingenBild: iStock/Andrii BicherAlle (Spenden-)Links zum Podcast findet ihr hier. (Podcast-Portale, Rezensionen, Einladung zum Kaffee)Oder schreibt mich direkt an: WhatsApp: +49 176 808 13 83 4Dieser Podcast wird ausschließlich mit regionalem Ökostrom produziert. Support the show

Katastrophenjahre sind aus der Sicht von Hilfsorganisationen „Erfolgsjahre“: Nach dem Hochwasser im Ahrtal 2021 und nach dem Beginn des Ukrainekriegs 2022 haben die Deutschen Spenden in Rekordhöhe getätigt – das hat sich in diesem Jahr mit rund fünf Milliarden Euro wieder „normalisiert“. Wir sprechen über das warme Gefühl des Gebens, über „zweierlei Maß“ beim Ermitteln des Spendenvolumens – und über bisweilen knifflige Herausforderungen beim Verteilen.

Mehr Infos zu unseren Gästen und alle Links zu dieser und allen anderen Folgen auf unserer Podcast-Seite: [https://become-better.org/podcast/](https://become-better.org/podcast/) Hier kannst Du Dein Buch-Exemplar von Christina Grubendorfer und Christina Ackermann bestellen: [The Real Book Of Work](https://www.amazon.de/Real-Book-Work-Organisationen-umdenken/dp/3800671549) Regelmäßig Neues von LEA erfahren?! Einfach unseren Newsletter abonnieren: [https://tinyurl.com/lea-newsletter](https://tinyurl.com/lea-newsletter) oder uns auf LinkedIn folgen: https://www.linkedin.com/company/3925422 Christina freut sich über deine Kontaktanfrage: https://www.linkedin.com/in/christina-grubendorfer/ Wenn dir der LEA Podcast gefällt, unterstütze ihn gerne: Hinterlasse eine 5-Sterne-Bewertung (z.B auf [Apple Podcasts](https://podcasts.apple.com/de/podcast/organisationen-entwickeln-der-lea-podcast-f%C3%BCr-zukunftsf%C3%A4hige/)) sowie eine Rezension und abonniere ihn.

Natalia Seliger is a wellness content creator who is known for her real, raw storytelling in the digital space. Natalia started posting her journey to a healthier version of herself after struggling with a toxic relationship with food. Her platforms quickly became safe space for anyone looking for a holistic and empowering approach to wellness. In this episode, Lily and Nat talk all about the power of vulnerability to create deep, lasting friendships. As a twentysomething going through a transitional season, Natalia has countless tips and tricks on how to stay grounded through the ebbs and flows of life. The pair chat about the power of authenticity in the content creation space, moving to LA (then moving back home a year later), what it means to dream big, non-negotiable morning habits, and so much more. Connect with Natalia Listen to My Monday Mood - ⁠Lily's Website⁠ Follow ⁠Lily⁠ on Instagram Follow ⁠80/20⁠ on Instagram Follow ⁠In The Twenty⁠ on Instagram Join the ⁠In The Twenty⁠ waitlist Join the ⁠Group Chat⁠ Sign up for the ⁠Newsletter⁠

Allezeit volle Genüge (2Kor 9,8)

Ryan speaks with Jake Seliger about how his cancer diagnosis and having his tongue removed have changed his perspective on life, why he is prioritizing people much more highly than work now, how he is making every single minute count, what he is trying to communicate with his recent outpouring of creativity, accepting death, and more.Jake Seliger is a writer, editor, and researcher. He has written two novels: The Hook and Asking Anna, as well as many essays covering a wide range of social and scientific subjects. Jake is also the Principal of Seliger + Associates, a grant writing and grant source service for nonprofits, public agencies and selected businesses throughout the United States. In October of 2022, Jake was diagnosed with tongue cancer, which called for the complete removal of his tongue. Despite that surgery, a later diagnosis found that the cancer had spread more quickly than expected, and tumors were found in his neck and lungs. He and his family are now raising funds to undergo the next round of treatments. Jake's own account of the surgeries and reflections on his experiences can be read here: jakeseliger.com/2023/09/09/life-swallowing-tasting-and-speaking-after-a-total-glossectomy-meaning-i-have-no-tongue. You can find Jake's work on jakeseliger.com and on Twitter @seligerj, and please do visit his GoFundMe to help pay for his cancer treatment at www.gofundme.com/f/help-the-fight-against-cancer-with-jake-s.✉️ Sign up for the Daily Stoic email: https://dailystoic.com/dailyemail

Ref.: Kpl. Norbert Purrer, Grieskirchen, ÖSTERREICH (Sendung vom 4.9.2022)

Als Pfarrer hat man spannende Begegnungen. Josias Burger bekommt immer wieder Besuch von Überraschungsgästen, die an seine Haustüre klopfen und um Hilfe ersuchen. «Geben ist seliger denn Nehmen» weiss auch Chris Strauch und hat einige Episoden parat, die er mit Bettler:innen erlebt hat. In dieser Folge geht es aber nicht nur um das Geben von materiellen Dingen, sondern auch um das Weitergeben von Werten.

All Things Monday Mood and Natalia My episode on monday mood https://open.spotify.com/episode/7EsVp140DKSWVJkWKHZDQp?si=3hp6T4N5QGSqAY-eFuzePg Follow the instagram to enter the giveaway and join the challenge: Follow Skinny Dipping Diaries the podcast page on Insta: https://www.instagram.com/skinnydippingdiaries/ Follow Kela on Insta: https://www.instagram.com/sundazedkk/ Join the Soul In Progress Community Now for accountability and exclusive resources. https://login.circle.so/checkout/soul-cial-media-community-access?request_host=soul-in-progress.circle.so Shadow Work Books and Workshops Free Shadow Work Prompt Betterhelp 10% off your first month (sponsored) Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Dr. Daniel Correa sits down with Julie and Allen Patterson to discuss the adaptive cottage they built that was featured in Southern Living to support the Parkinson's Foundation and raise awareness of Parkinson's disease. The Pattersons discuss the importance of adaptive living spaces and offer solutions to improve accessibility for people with neurologic conditions. Next, Dr. Correa talks with Dr. Glenn Seliger, acting chief medical officer and director of Traumatic Brain Injury Services at Helen Hayes Hospital in West Haverstraw, New York, and assistant professor of clinical neurology at Columbia University, as well as Ms. Beth Russo, an occupational therapist who specializes in Parkinson's disease. Dr. Seliger and Ms. Russo explain who makes up a care team and the importance of adaptive housing for people with neurologic conditions.  Additional Resources:  Parkinson's Foundation  Brain & Life: Violinist Itzhak Perlman Champions Accessibility for People with Disabilities  What is Parkinson's Disease?   Davis Phinney Foundation For Parkinson's   Helen Hayes Hospital   We want to hear from you!  Have a question or want to hear a topic featured on the Brain & Life Podcast?  Record a voicemail at 612-928-6206, or email us at BLpodcast@brainandlife.org.  Social Media:    Guest: Allen Patterson Buliders @allenpattersonbuilders (Instagram) Helen Hayes Hospital @HelenHayesHosp (Twitter)  Host: Dr. Daniel Correa @neurodrcorrea

Als Oster-Special präsentieren wir Dir heute eine etwas ungewöhnliche Predigt von Basti. Die Predigt ist Teil der Predigt-Reihe "Jesus. Genügsames Leben" aus der Chapel Fürth. =========================== SHOWNOTES: Chapel Fürth: https://www.chapel-fuerth.de ⁠⁠Facebook-Gruppe von BibelFinanz⁠⁠: ⁠⁠https://www.facebook.com/groups/bibelfinanz ⁠⁠ ⁠⁠Online-Akademie von BibelFinanz:⁠⁠ ⁠⁠https://bibelfinanz.de/online-akademie⁠⁠ =========================== Wenn Dir die Folge gefallen hat, abonniere gerne unseren Podcast und (sofern Dein Podcast-Anbieter das zulässt) gib uns "5 Sterne" oder einen "Daumen hoch" als Bewertung! Wie jede Woche freuen wir uns über Deine Kommentare, Rückfragen und Anregungen. Auch über Vorschläge für neue Finanzthemen, die Dich aus Sicht der Bibel interessieren, danken wir Dir schon jetzt! Sei mächtig gesegnet! Dein Team von BibelFinanz

#chapel #fürth #finanzen bibelfinanz.de Podcast-Empfehlung: 'Oh, du heiliges Geld' by Bibelfinanz

Laserschwert für alle Fälle - von Ramón Seliger

Ref.: Dr. med. Dagmar Amling, Fachärztin für Allgemeinmed. und Psychopädin nach Dr. Udo Derbolowsky, Mod.: Sabine Böhler

This week we have a very special guest!! Welcome Nats!! Nats is a health & wellness content creator that shares her transformation and journey on becoming her best self. I absolutely loved and connected a lot with her during this episode, it felt like having a chat with that one friend that uplifts you and leaves you feeling inspired and full of energy. In this episode we covered: - her ultimate glow up guide (habits, routines...) - how your thoughts can create your reality - dropping out of college to follow your dreams Hope you enjoy this episode as much as we enjoyed recording it! Links: Nats IG: https://www.instagram.com/natsneatteats/ Nats podcast: https://www.instagram.com/mondayymoodpod/ Carola's IG: https://www.instagram.com/carolaagomez/ Carola's Podcast: https://www.instagram.com/lifewithcarola/

In today's episode Natalia and I talk about being single in your 20s, taking yourself on dates, our best/worst date stories and more! Natalia's Instagram - https://instagram.com/natsneatteats?igshid=YmMyMTA2M2Y=Natalia's YouTube - https://youtube.com/c/NataliaSeligerNatalia's Tik Tok - https://www.tiktok.com/@nataliaaseliger?_t=8XKpUZhLKDC&_r=1 --- Support this podcast: https://anchor.fm/lindsay-rae/support

Das ist Folge 730 Willkommen zu Unternehmerwissen in 15 Minuten. SMART das Kurzformat. Mein Name ist Rayk Hahne, Ex-Profisportler und Unternehmensberater. Wir starten sofort mit dem Training. Wenn Dir die Folge gefällt teile Sie mit Deinen Freunden unter dem Link  raykhahne.de/730 Dich erwarten heute die 5 Unternehmerwahrheiten von dem Speaker und Autor Dieter Lange . Wichtigster Punkt aus dem heutigen Training? Wie erreichst du Glückseligkeit. Die Folge teilst Du mit dem Link: raykhahne.de/730 . Bevor wir gleich mit der Folge starten, habe ich noch eine Empfehlung für Dich.Der Partner dieser Folge sind die Volksbanken-Raifeisenbanken. „Woran willst Du denken, wenn Du an Banken denkst? An Aktionäre, die auf ihre eigene Profitmaximierung aus sind? Oder lieber an eine Institution, die Deine Interessen immer vor ihre eigenen stellt…? Die Volksbanken Raiffeisenbanken sind Genossenschaftsbanken, die allein ihren  Mitgliedern gehören. Ganz nach der Devise: Mitwissen. Mitbestimmen. Mitverdienen. Das bedeutet konkret: Als Mitglied hast Du jederzeit das Recht auf maximale Transparenz darüber, was mit  Deinem Vermögen passiert.  Aber mehr noch: In den jährlichen Mitgliederversammlungen bestimmst Du sogar aktiv mit,  wo es mit Deiner Bank langgeht. Und als wären diese beiden Vorteile nicht genug, kannst Du bei den Volksbanken Raiffeisenbanken sogar am Erfolg Deiner Bank mitverdienen. Und zwar in Form von Dividenden, die in der Regel einmal jährlich auf Deine Geschäftsanteile ausgezahlt werden. Klingt gut?  Dann gehe jetzt auf vr.de/mitglied und erfahre mehr. Dieter kennst du bereits aus der Folge de/716 dann lass uns loslegen mit den 5 Unternehmerwahrheiten von Dieter   Geben ist Seliger denn nehmen. Definiere Deine Aufgaben als Führungskraft. Prüfe dein Charakteristikum als Führungskraft. Hebe Dich von den Top-CEO's ab. Schaffe eine geniale Storyline.   die Shownotes zu dieser Folge findest Du unter de/730 alle Links habe ich Dir dort aufbereitet und Du kannst die Inhalte der Folge noch einmal nachlesen   Dir hat die Folge gefallen und Du konntest sofort etwas umsetzen? Dann sei ein Held für jemanden und teile diese Folge.: Erst den Podcast abonnieren unter raykhahne.de/podcast , oder folge mir bei Facebook, Instagram, LinkedIn oder YouTube; denn ich bin hier, um Dich als Unternehmer noch besser zu machen. Danke das Du die Zeit mit uns verbracht hast. Das Training ist vorbei, jetzt liegt es an Dir. Viel Spaß mit der Umsetzung.  

today we're sharing the 10 ways we show up for ourselves every single day with my close friend, @natsneatteats, one of my first social media friends turned real life besties. she's one of the most intentional, uplifting & inspiring persons I know—you simply don't want to miss her point of view on wellness!! TW: Body image, ED, Nutrition/Food & Fitness. If any of these topics are triggering to you, please skip this episode. love you so much! Journal prompt: my lifestyle nonnegotiables See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

hot girl summer is out...and HEALTHY girl summer is in. this summer we're working on removing the guilt we have around this time of year. we are all too hard on ourselves to look a certain way, but it's time to realize that health is how you FEEL. not how you look. join britt & nat as they talk about all things healthy girl summer, tips, affirmations and positive self talk, favorite recipes, grocery staples and more!Train with Britt on her new app: https://brittanylupton.appFollow the podcast@funandgains.podcastFollow NataliaTiktok: @nataliaaseliger Instagram: @natsneatteatsYoutube: Natalia SeligerFollow Brittinsta // @_brittanyluptonyoutube // Brittany Luptontiktok // brittanyluptonContact Ushello@funandgainspodcast.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Der Pop-Zirkus läuft wieder an, doch die Herausforderungen seien gewaltig, meint Branchenkenner und Publizist Berthold Seliger: bessere Absicherung für Musiker und Musikerinnen und die Menschen Backstage, mehr Fairness gegenüber den Fans. Er hofft, dass die Menschen weiter freiwillig Masken tragen. Denn Seliger blickt sorgenvoll auf das Jahresende.Siniawski, Adalbertwww.deutschlandfunk.de, KulturfragenDirekter Link zur Audiodatei

Mark Seliger was born in Amarillo, Texas. He was Rolling Stones chief photographer for 20 years, where he shot over 150 covers silica shoots frequently for Vanity Fair, GQ, Italian Vogue, Harper's Bazaar, L, and other magazines. His advertising work includes projects for Adidas, Anheuser-Busch, Levi's, Netflix and Ralph Lauren. Seliger received the Alfred Eisenstadt Award, Clio Grand Prix, the C Award, Cannes Lions Grand Prix, The One Show, ASME, SPG and the Texas Medal of Arts were exhibited in museums and galleries around the world. His photographs are in the permanent collections at the National Portrait Gallery at the Smithsonian, the Museum of Fine Arts in Houston and the National Portrait Gallery in London. · markseliger.com · www.creativeprocess.info

20220215 afternoon Moderator: Donna Seliger (IA), RSVA® Secretary and Sagebrush Committee RANDOLPH-SHEPPARD VENDORS OF AMERICA® Celebrating Over fifty years of achievement and advocacy RSVA® SAGEBRUSH 2022 NATIONAL BUSINESS ENTERPRISE PROGRAM TRAINING CONFERENCE Sagebrush 2022: The future Unmasked and Reset 20220215 afternoon Moderator: Donna Seliger (IA), RSVA® Secretary and Sagebrush Committee o USI innovations & Full service (National Vending) BEP lease program: Bob Daubach (IA), USI Midwest Regional Sales Manager Samantha Hadden, National Vending ZEBRA SPONSOR o How to compete for business outside the RS priority: Ed Manley (FL), Ed Manley and Associates This session highlighted effective certifications for developing skills for businesses outside the RS Program. Participants also learned the importance of knowing current food service requirements. Questions and Answers o How to More Successfully Use the New RS15 Form: Kathy Roat (IA), BEP Administrator for the Iowa Department for the Blind Nathan Pullen (AZ), BEP Program Manager for Arizona Rehabilitation Services This session uncovered even more details of this annual form which had changes in 2021. Correct information in this form can assist the particular state BEP program in moving forward. Questions and Answers o What are Microtronic Cashless Solutions?: Terri Starnes-Bryant, Microtronic Cashless Solutions, Inc. Questions and Answers Find out more at https://acb-events.pinecast.co

Mark Seliger was born in Amarillo, Texas. He was Rolling Stones chief photographer for 20 years, where he shot over 150 covers silica shoots frequently for Vanity Fair, GQ, Italian Vogue, Harper's Bazaar, L, and other magazines. His advertising work includes projects for Adidas, Anheuser-Busch, Levi's, Netflix and Ralph Lauren. Seliger received the Alfred Eisenstadt Award, Clio Grand Prix, the C Award, Cannes Lions Grand Prix, The One Show, ASME, SPG and the Texas Medal of Arts were exhibited in museums and galleries around the world. His photographs are in the permanent collections at the National Portrait Gallery at the Smithsonian, the Museum of Fine Arts in Houston and the National Portrait Gallery in London. · markseliger.com · www.creativeprocess.info

Mark Seliger was born in Amarillo, Texas. He was Rolling Stones chief photographer for 20 years, where he shot over 150 covers silica shoots frequently for Vanity Fair, GQ, Italian Vogue, Harper's Bazaar, L, and other magazines. His advertising work includes projects for Adidas, Anheuser-Busch, Levi's, Netflix and Ralph Lauren. Seliger received the Alfred Eisenstadt Award, Clio Grand Prix, the C Award, Cannes Lions Grand Prix, The One Show, ASME, SPG and the Texas Medal of Arts were exhibited in museums and galleries around the world. His photographs are in the permanent collections at the National Portrait Gallery at the Smithsonian, the Museum of Fine Arts in Houston and the National Portrait Gallery in London. · markseliger.com · www.creativeprocess.info

*tw: eating disorders, restriction* i talk to the beautiful soul that is natalia seliger. we discuss her health journey, including a past history of disordered eating, intuitive eating/exercise, how to build confidence, self-love, social media, and so much more. you will leave this episode feeling inspired to live intuitively. -- find natalia: @natsneatteats on ig, @nataliaaseliger on tik tok, and natalia seliger on youtube. my ig: @her.healthful

Die Themen dieser Folge: • Rückblick #BFCVfB 01:45 • Borna Sosa überzeugt als Kapitän 05:46 • Der VfB im großen Liga-Vergleich 14:55 • NLZ-Newsflash mit Nico Willig 50:48 • Ausblick #VfBSGF mit Taktikanalyse 55:11 ────────────────────​​──────── Der MeinVfB-PodCannstatt wird präsentiert von den Stuttgarter Nachrichten und der Stuttgarter Zeitung. Hosts: Philipp Maisel, Christian Pavlic Produktion: Marian Hepp Alles rund um MeinVfB findest du hier: https://linktr.ee/meinvfb ────────────────────​​──────── Impressum: https://www.meinvfb.de/impressum.html

Hola, maricoper. Trump, Texas, Newsom y Percy.Bienvenido al maricoffee, un repaso de titulares relevantes y temas que dan para reflexionar un rato mientras te tomas el primer café de la semana.¡Podcast premium! Puedes añadir el podcast de hoy a tu plataforma favorita haciendo click en el botón “Listen in podcast app” que aparece justo debajo del reproductor de ahí arriba. Con eso ya deberías recibir todas las actualizaciones privadas como lector premium.Test de actualidad. Como cada lunes, la mejor forma de poner a prueba lo pendiente que has estado de los titulares en la última semana. Aquí el enlace.¡ÚNETE A NUESTRO DISCORD! Puedes sumarte al Discord de La Wikly a través de este formulario. Nuestro compañero Luis Galindo te echará un cable.Es puto marzo de nuevo. Bienvenido a La Wikly.

Die Themen dieser Folge: •  Rückblick #TSGVfB 4:12  •  Die Diskrepanz zwischen den Halbzeiten 5:40  •  Der Datenblick des Instituts für Spielanalyse 9:30  •  Warum zu wenig über Kempf gesprochen wird 18:25  • Verlängerung mit Gonzalez 24:00  • Die Woche der Comebacks 31:35  • Blick auf den Maschinenraum 33:42  • Vorschau #VfBFCB 40:28  • Warum das Spiel zur rechten Zeit kommt 43:03  • Kontern als Mittel gegen die Bayern? 47:35  • Gegen Kimmich an der Playsi 54:54 ────────────────────​​──────── Der MeinVfB-PodCannstatt wird präsentiert von den Stuttgarter Nachrichten und der Stuttgarter Zeitung. Hosts: Philipp Maisel, Christian Pavlic Produktion: Marian Hepp Alles rund um MeinVfB findest du hier: https://linktr.ee/meinvfb ────────────────────​​──────── Impressum: https://www.meinvfb.de/impressum.html

Die Themen dieser Folge: • „Tag X“ ist gekommen • Einschätzung der Gesamtlage • Warum jedes Spiel ein Finale ist • Achillessehnenriss bei Awoudja • Wie es für den VfB II weitergeht • Vorschau #SVWWVfB • Taktikanalyse • Tiki-Taka mit Marco Seliger ────────────────────​​──────── Der MeinVfB-PodCannstatt wird präsentiert von den Stuttgarter Nachrichten und der Stuttgarter Zeitung. Hosts: Philipp Maisel, Christian Pavlic Produktion: Marian Hepp Alles rund um MeinVfB findest du hier: https://linktr.ee/meinvfb ────────────────────​​──────── Impressum: https://www.meinvfb.de/impressum.html

Dr. Carolyn Lam:               Welcome to Circulation On The Run. Your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore.                                                 In just a moment, we are going to be discussing the diagnostic conundrum of elevated high sensitivity cardiac troponin levels in a patient with renal disease, but also suspected of acute coronary syndrome. Aha! I bet I caught your attention. A very, very familiar diagnostic dilemma. So stay tuned right after these summaries.                                                 Cardiac allograft vasculopathy is the leading cause of death in patients more than five years post cardiac transplantation. It has been hypothesized that cardiac allograft vasculopathy results from interrupted lymphatic drainage post surgery. Since the donor lymphatic vessels are not inesthimozed to that of the recipient during transplantation, thus the lymphatic system may play a crucial role in the alloimmune response.                                                 Well, these hypothesis are addressed in the first paper in today's journal from first author Dr. Edwards, corresponding author Dr. Wong and colleagues from Kings College, London. These authors use spect CT lymphoscintigraphy in a pre-clinical model. And therefore provided objective quantification of lymphatic flow following transplantation and showed that this correlated to cardiac allograft vasculopathy. They demonstrated that cardiac lymphatic remodeling and lymphatic transport dysfunction post transplant was associated with cardiac allograft vasculopathy and transplant rejection.                                                 They further showed that lymphatic flow was increased during chronic rejection. This in turn may have resulted in enhanced trafficking of antigen presenting cells to the local draining lymph nodes in an augmented alloimmune response. Now although the cause and effect of this phenomenon could not be fully established, these data provided the impetus for the investigation of lymphangiogenesis inhibition as a means to dampen chronic rejection.                                                 The absorb bioresorbable vascular scaffold is known to completely resolve within three years after coronary artery implantation. However, what is the safety and effectiveness of these bioresorbable scaffolds during this critical three year period. First author Dr. Ali, corresponding author Dr. Stone and colleagues from Columbia University Medical Center performed an individual patient level meta analysis of the four randomized absorb trial and demonstrated that compared with metallic everolimus eluting stents, the bioresorbable vascular scaffold had higher rates of target lesion failure and device thrombosis cumulatively to three years and between one and three years. Multi-variable analysis identified the number of treated lesions, current tobacco use and previous cardiac interventions as independent predictors of three year target lesion failure. Whereas diabetes was predictive of three year device thrombosis in bioresorbable vascular scaffold treated patients.                                                 The next paper reported the three year follow up of the FAME 2 trial, which compared PCI guided bi-fractional flow reserve with best medical therapy in patients with stable coronary artery disease to assess clinical outcomes and cost effectiveness. First and corresponding author Dr. Fearon and colleagues from Stanford cardiovascular institute showed that major adverse cardiac events at three years were significantly lower in the PCI group, compared with the medical treatment group. This difference was primarily as a result of a lower rate of urgent revascularization. Mean initial costs were higher in the PCI group, but by three years, were similar between the two groups. The incremental cost effectiveness ratio for PCI compared to medical therapy was more than $17,000 per quality adjusted life year at two years and $1,600 per quality adjusted life year at three years. Thus the authors concluded that percutaneous coronary intervention in patients with stable coronary artery disease and at normal fractional flow reserve may be advantages compared to with medical therapy alone, because it results in improved clinical outcomes and quality of life at no increased cost by the end of three years follow up.                                                 The next study shows for the first time, that pioglitazone may prevent stroke as a single stand-alone outcome. Today's paper by first author Dr. Yaghi, corresponding author Dr. Kernan from Yale School of Medicine and colleagues was a secondary analysis of the iris trial, which showed that pioglitazone reduced the risk for a composite outcome of stroke on myocardial infarction among non-diabetic patients with insulin resistant and a recent stroke or transient ischemic attack. Now, the current planned secondary analysis used updated American Heart Association 2013 consensus criteria for ischemic stroke to examine the effect of pioglitazone on stroke outcomes. The study found that pioglitazone reduced the risk by 25% by five years, with absolute rates of 8% with pioglitazone versus 10.7% with placebo. Pioglitazone reduced the risk for ischemic strokes, but had no effect on the risk of hemorrhagic events. These findings add to the evidence that pioglitazone may be a potent therapy for vascular disease risk reduction and may help inform shared decision making by providers and patients for the use of pioglitazone after ischemic stroke or transient ischemic attack.                                                 Well, that ends it for our summaries. Now for a feature discussion.                                                 The cardiac troponins have really revolutionized cardiology. We use them in of course the diagnosis of myocardial infarction and in fact the recent European Society of Cardiology recommendations say that the rapid zero and one hour triage algorithm for rule in or rule out of non STEMI should use high sensitivity troponins and interestingly irrespective of renal function. Now this latter point has caused some confusion, some questions, since we all know that patients with chronic kidney disease frequently have higher or increased levels of cardiac troponins, especially since we now can detect them with the high sensitivity essays. And this is even in the absence of an acute coronary syndrome.                                                 Well, this week's journal contains two papers that address this topic so well. And I am delighted to have with us the corresponding author of the first paper, Dr. Christian Mueller from University Hospital Basel in Switzerland and the author of the second paper, Dr. Nicholas Mills from University of Edinburgh in Scotland. For the more, we have Dr. Torbjorn Omland, associate editor from University of Oslo in Norway.                                                 Lot's to talk about. Christian, could I start with you? Could you say in your own words the rationale for looking at this vulnerable population and then perhaps describe what you did in your study? Dr. Christian Mueller:     I'm very thankful that Circulation shed a lot of light on the population of patients with renal dysfunction, because both as a clinician and as a researcher, I'm definitely convinced that they merit a lot of our attention for several reasons.                                                 So first, it's important to be aware that the incidents of acute myocardial infarction among patients presenting with acute chest pain is much higher in patients with renal dysfunction, as compared to patients with normal renal function. And second, atypical clinical presentations also are more frequent in patients with renal dysfunction. Then possibly third, the ECG of course also a mandatory tool in our assessment is more often showing unspecific signs that may mimic or obscure the presence of myocardial infarctions and most of them are related to left ventricular hypertrophy. And in addition, patients with renal dysfunction are more prone to adverse events, both related to cardiovascular medication. For example, anticoagulation as well as our cardiovascular procedures, including PCI. Now again, as both papers have a strong focus on troponin, also cardiac troponin is a bit more difficult to interpret in patients with renal dysfunction related to exactly as you mentioned chronic elevations of cardiac troponin, TNI related to chronic cardiovascular disease.                                                 And I think that's so important to stress, any troponin signal in a patient with renal dysfunction is real and should not be incorrectly attributed to just a problem of impaired secretion by the kidneys. Dr. Carolyn Lam:               So definitely an even greater need to diagnose myocardial infarction accurately in this very high risk population. So tell us what you did. Dr. Christian Mueller:     We assessed this challenging sub group within the APACE study. So APACE is a large international prospective diagnostic study that is run in five countries with 12 centers. And we actually enroll consecutive patients presenting with suspected myocardial infarction. And then all patients get a very detailed workup and then adjudicated final diagnosis. And the adjudicated file diagnosis is done by two independent cardiologists and is based on two enormous extensive sets of data. The clinical data set that has been obtained at the local site and of course includes cardiac imaging and standard troponin testing, ECG data.                                                 In the second set of data that includes the study specific data sets, including serial measurements with high sensitivity carry troponin essay and a lot of details characterization of patients and patient follow up. So this is the reference standard against which the one hour algorithm the European Society of Cardiology evaluated. And the one hour algorithm has been derived and previously validated in overall population. Mainly patients with normal renal function. And so we tried to evaluate the performance of this predefined algorithm specifically in patients with renal dysfunctions.                                                 So among a bit more than 3,000 patients, the prevalence of patients with renal dysfunction was 15%. So we had about 500 patients with renal dysfunction. And the interesting finding from our work is that first the prevalence of N-STEMI was nearly threefold in patients with renal dysfunction as compared to patients with normal renal function. And, fortunately the rule out part of the algorithm regarding sensitivity still works very well. It is, however, the efficacy of rule out that is lower in patients with renal dysfunction, simply because fewer patients really have very low troponin concentration and are therefore ineligible for rule out.                                                 However, as a clinician, the main concern with troponin and renal dysfunction is the rule in part, and specificity. And as you would think, specificity of the one hour algorithm was in fact significantly lower in patients with renal dysfunction. It was still appropriate for therapeutic consequences, but it was lower as compared to patients with normal renal function, so the specificity was 89% in patients with renal dysfunction, as compared to 96.5% in normal renal function.                                                 So the overall efficacy of the algorithm was lower in patients with renal dysfunction, however then when trying to create and derive optimized cut off levels, so all cut off levels optimized for use in renal dysfunction, we didn't really find alternative cut offs that would do a much better job than the official cut off levels recommended in the guidelines. So our conclusion is that in patients with renal dysfunction, the safety of the one hour algorithm still is very high, however the specificity of rule in and overall efficacy are decreased. Dr. Carolyn Lam:               Right. That's beautifully summarized. And also that different cut offs didn't really help to increase the efficacy of this algorithm. And just to clarify to our listeners, I believe you defined renal dysfunction as an estimated GFR of less than 60, which is so beautiful because it's perfectly consistent with the second paper.                                                 Nick, could you please tell us about your study and your take home messages as well. Dr. Nicholas Mills:            So high stakes is our clinical trial that we're conducting across hospitals in Scotland to evaluate the best way to use high levels of cardiac troponin in clinical practice. One of the areas of uncertainty is whether these assets really add any additional value for patients with chronic kidney disease, where troponin concentrations tend to be higher. And the premise of a high sensitive test is that we can measure lower concentrations and improve the sensitivity. But is this just going to create uncertainty for clinicians?                                                 So we evaluated 5,000 consecutive patients for performance of high sensitivity cardiac to put in testing. And those with and without renal impairment. And based upon what Christian, we identified that patients with renal impairment are less likely to have very low concentrations, but that you can rule out myocardial infarction safely in patients with renal impairment. And similarly that those with renal impairment are more likely to have an abnormal troponin concentration at presentation. Around about 40% of all patients have troponins above the upper reference limit. And whilst the specificity for myocardial infarction is lower, type one myocardial infarction or myocardial infarction due to plaque rupture or cardiac thrombosis remains the most common diagnosis in this group.                                                 Finally we looked at one year outcomes. And this is really critical. Because we found that patients with renal impairment were two to threefold more likely to die from cardiovascular disease one year following their presentation than those without renal impairment. And I think that my general experience during these tests in clinical practice is that troponin elevations in patients with kidney disease are often ignored and there's a concern about what they mean, and therefore these patients don't get access to the fantastic treatments we have for coronary heart disease. So our take home message is that high sets of troponin testing in patients with renal disease does have value, it's useful for identifying low risk patients although there are fewer of them, and it performs well as a diagnostic test, highlighting in particular a group of patients that really have poor clinical outcomes.                                                 As a cardiological community, we need to do better. Dr. Carolyn Lam:               What I really love about both or your papers is the consistency in the messages. Torbjorn, I want to bring you in on this. You managed both papers. Such a lovely pair of papers that we're so proud to be publishing and you had also invited an editorial by Dr. deFilippi and Seliger. Would you like to comment on your perspective and perhaps the clinical take home message to our audience? Dr. Torbjørn Omland:     Yes, I think this has been pointed very well out by both Christian and Nick. And I think it's worth recapitulating that renal dysfunction is a major problem that clinicians often try to explain by just lack of renal filtration. But that the closest probably are increased production and underlying cardiac disease. So in the editorial Dr. deFilippi Filippi and Dr. Seliger points also out in these things. Moreover they try to look forward and have made comments to recent studies that showed that in patients with renal dysfunction have different troponin fragments than patients with acute myocardial infarctions. Dr. Carolyn Lam:               I find that so fascinating. And it really, really relates to the field of heart failure and what we are also talking and thinking about with natriuretic peptides and their different fragments and the possible different meanings. And how different essays maybe non specific for different fragments.                                                 Christian, you think a lot about these things. I'm curious, what are your thoughts on this and areas of future work that are very urgent? Dr. Christian Mueller:     I think Torbjorn very nicely addressed this. So the current high sensitivity essays for T and I that we use in clinical practice, they are designed kind of to detect everything in blood that looks like troponin, either T or I, including various fragments. And I think it's a fantastic new avenue of research, trying to find out that the biochemical signatures can be further differentiated and exactly that perhaps different troponin fragments or tricordinate products more prominent in patients having ischemic injuries like treat myocardial infarction, as compared to for example other modes of injuries. So I think that's very nice hypothesis and some early data. But at least from my perspectives and to the best of my knowledge until now, the diagnostic algorithms that we have other ways to approach this in clinical practice. And so it's the higher the blood concentration in patients with acute chest pain, the more likely it's acute myocardial infarction. It's not any chronic disease and again the higher the change from presentation to one hour or two hours, the more likely it's acute as a dynamic disorder resulting in an acute increase in cardiac troponin, as compared to the chronic release patterns typically seen in patients with renal dysfunction. Dr. Carolyn Lam:               Yeah. That's just so fascinating. Nick, we sadly are running out of time, but I do want to give you the last word. The clinical take home message, once again. What do you think listeners should take home that may change their practice, after listening to this podcast? Dr. Nicholas Mills:            I think the key message for clinicians, is that in a patient with suspected acute coronary syndrome and has renal impairment and elevated troponin concentration, serial testing is mandatory to differentiate between those that have chronic myocardial injury due to subclinical heart disease and those that are having acute myocardial injury as a consequence of a presumed acute coronary syndrome. Field testing is critical to inform which treatment path and what investigations we recommend for our patients. Dr. Carolyn Lam:               Wonderful. And to take any elevations seriously, because this is a high risk population.                                                 Well, audience you heard it right here on Circulation On The Run. I'm sure you've enjoyed this. I certainly have. Don't forget to tune in again next week.