Podcasts about stratified

Send us a textDr. Matt Burgess interviews genetic counsellor and researcher Dr. Sibel Saya about integrating genetic testing into primary healthcare settings, focusing on polygenic risk scores as a tool for personalizing cancer screening.• Genetic counselling principles applied in primary care settings rather than just specialist clinics• Polygenic risk scores differ from traditional genetic tests by analyzing hundreds of common variants with small individual effects• Australia and New Zealand have the highest bowel cancer rates globally, making early detection tools particularly important• Tools like CRISP help assess individual bowel cancer risk using lifestyle factors combined with genetic information• Cultural differences must be considered when implementing genetic testing in diverse communities• GPs see genetic risk assessment as within their scope despite time constraints• Risk information alone doesn't change behaviour – it's the opportunity to discuss screening that matters• Implementation research happening alongside efficacy trials to speed translation into practice• Stratified screening approaches could be widely available within 5-10 yearsIf you'd like to learn more about polygenic risk scores or risk-stratified cancer screening, visit our website or subscribe to Demystifying Genetics for future episodes on these topics.Support the showDemystifying Genetics is sponsored by TrakGenehttps://www.trakgene.com/

As Malaysia becomes more and more urbanised, stratified or strata properties are becoming increasingly commonplace, and with this progress, comes the need to ensure a harmonious way of living within such shared spaces. Lawyer, Raymond Mah, the managing partner of MahWengKwai & Associates, talk to us about what the Strata Management Act 2013 entails and tackles a listener's query as well.Image Credit: Shutterstock.com

Episode: 240 In this episode of Analyst Talk, Jason Elder sits down with Aidan Daly, a former 911 communications officer turned crime analyst. Aidan shares his career journey, insights from dispatching to full-time analysis, and his experiences with implementing the stratified policing model in Prosper, Texas. Tune in as Aidan delves into how his unique role bridges the gap between patrol officers, data analysis, and strategic policing. They discuss the challenges of institutionalizing crime analysis, creative problem-solving in law enforcement, and the importance of networking within and beyond the department. Whether you're an analyst, officer, or just interested in the world of law enforcement analysis, this episode offers valuable takeaways on teamwork, community safety, and the evolving role of crime analysts. [Note:  Description produced by ChatGPT.] This episode contains the call-in segment, Don't Be That Analyst. Rachael Songalewski (https://www.leapodcasts.com/e/atwje-rachael-songalewski-leading-with-intention/) Dr. Andrew Dasher (https://www.leapodcasts.com/e/atwje-dr-andrew-drew-dasher-%c2%a0voodoo-puzzles/)  Peter Africano (https://www.leapodcasts.com/e/atwje-peter-africano-a-novel-idea/)  Elizabeth Rodriguez (https://www.leapodcasts.com/e/atwje-elizabeth-liz-rodriguez-partner-in-crime/) Josh Todd (https://www.leapodcasts.com/e/atwje-josh-todd-the-adirondack-analyst/)  CHALLENGE: There are Easter eggs in one of the tables of the Excel chapter that Jason wrote for the IACA textbook. First-person to email us at leapodcasts@gmail.com about what the Easter eggs are will receive a $75 gift card from us. Happy hunting! *** Episode 6 of Cocktails & Crime Analysis - IACA Conference Preview - Presenters Edition https://youtu.be/FS6qqCQfcJI  *** Name Drops: Dr. Roberto Santos/Dr. Rachel Santos (00:19:28), Dawn Reeby (00:48:16) Public Service Announcements: Dr. Andrew Wheeler (https://www.leapodcasts.com/e/atwje-dr-andrew-wheeler-crime-de-coder/)  Jesus Varela (https://www.leapodcasts.com/e/atwje-jesus-varela-the-all-rise-analyst/) Related Links: https://www.amazon.com/Stratified-Policing-Organizational-Proactive-Accountability/dp/1538126567 https://www.leapodcasts.com/e/atwje-catching-up-with-dawn-what-can-analysts-do/ https://www.prospertx.gov/172/Police-Department https://www.iaca.net/conference https://www.flocksafety.com/ Association(s) Mentioned: IACA, TXLEAN Vendor(s) Mentioned:  Contact: adaily@prospertx.gov  Transcript: https://mcdn.podbean.com/mf/web/3beahx4xi6sgjh6c/AidanDaily_Transcript.pdf  Podcast Writer:   Podcast Researcher:  Theme Song: Written and Recorded by The Rough & Tumble. Find more of their music at www.theroughandtumble.com. Logo: Designed by Kyle McMullen. Please visit www.moderntype.com for any printable business forms and planners.  Podcast Email: leapodcasts@gmail.com   Podcast Webpage: www.leapodcasts.com   Podcast Twitter: @leapodcasts 00:00:17 – Introducing Aidan 00:05:52 – Fusion Center 00:19:28 – ABS:  Implementing Stratified Policing 00:31:21 – Break:  Dr. Andrew Wheeler & Jesus Varela 00:32:24 – Prosper's Objectives 00:48:16 – Analysts are a Catalyst for Change 00:52:42 – IACA Conference 00:57:32 – Don't Be That Analyst 01:05:02 – Words to the World

ORBITA2-Symptoms: The Symptom-Stratified Analysis of ORBITA-2

CME credits: 1.25 Valid until: 28-06-2025 Claim your CME credit at https://reachmd.com/programs/cme/program-name/26601/ Despite the advances that have been made with atypical antipsychotics indicated for the treatment of schizophrenia (SCZ), significant safety and efficacy concerns persist with these D2 blockers. Inadequate response to these treatments is common. Several emerging agents are undergoing phase 3 clinical trials. These new treatments possess unique mechanisms of action, encouraging efficacy profiles across positive, negative, and cognitive domains and favorable safety profiles that offer new hope for those living with SCZ. This educational series will cover accurately identifying individuals, including those in unique patient populations, who may benefit from switching to or augmentation with an emerging treatment option, how and when to incorporate switching or augmentation strategies, and how to integrate new therapies into current clinical practice.

Nuru Noor (University of Cambridge) discusses the PROFILE trial of biomarker-stratified treatment strategies in people with newly diagnosed Crohn's disease.Read the full article:https://www.thelancet.com/journals/langas/article/PIIS2468-1253(24)00034-7/fulltext?dgcid=buzzsprout_icw_podcast_generic_langasContinue this conversation on social!Follow us today at...https://twitter.com/thelancethttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

For Esophageal Cancer Awareness Month, Dr. Naresh Gunaratnam speaks with Dr. Srinadh Komanduri, associate chief of gastroenterology and hepatology and director of endoscopy at Northwestern Medicine, about efforts to educate the public about esophageal cancer and cutting-edge tools that are helping gastroenterologists determine which of their patients are at greatest risk of developing esophageal cancer. Esophageal cancer is preventable if high-risk patients, such as those with Barrett's Esophagus, are treated with endoscopic eradication therapy to eliminate the Barrett's tissue. Endoscopic eradication therapy is highly effective, but the challenge is identifying the high-risk patients to treat and the low-risk patients for whom long-interval surveillance may be appropriate. The Barrett's Esophagus surveillance program at Northwestern includes the TissueCypher test, which provides Dr. Komanduri and his colleagues with a personalized prediction of cancer progression risk based on molecular biomarkers that cannot be measured by traditional pathology. Join Dr. Gunaratnam and Dr. Komanduri to hear how gastroenterologists and pathologists can better identify patients who are most at-risk and provide the appropriate care to help prevent them from developing esophageal cancer. Produced by Andrew Sousa and Hayden Margolis for Steadfast Collaborative, LLC Mixed and mastered by Hayden Margolis Gastro Broadcast, Episode 56

In this episode, physiotherapist Adam Dobson discusses lumbar radiculopathy and its management. He highlights the challenges in assessing and diagnosing lumbar radiculopathy, emphasizing the importance of precise terminology and understanding mixed presentations. Dobson also explains the role of the neurological examination and the stepped-care approach in managing lumbar radiculopathy. He emphasizes the need for an economical approach to treatment, focusing on patient preferences and activities that are meaningful to them. Dobson also discusses the role of physiotherapy in supporting patients' recovery and the importance of balancing tissue-based and biopsychosocial approaches.Schmid AB, Tampin B, Baron R, et al. Recommendations for terminology and the identification of neuropathic pain in people with spine-related leg pain. Outcomes from the NeuPSIG working group. *Pain*. 2023;164(8):1693-1704. doi:[10.1097/j.pain.0000000000002919](https://doi.org/10.1097/j.pain.0000000000002919)Konstantinou K, Lewis M, Dunn KM, et al. Stratified care versus usual care for management of patients presenting with sciatica in primary care (SCOPiC): a randomised controlled trial. *Lancet Rheumatol*. 2020;2(7):e401-e411. doi:[10.1016/S2665-9913(20)30099-0](https://doi.org/10.1016/S2665-9913(20)30099-0)Stynes S, Konstantinou K, Ogollah R, Hay EM, Dunn KM. Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain. *PLoS One*. 2018;13(4):e0191852. doi:[10.1371/journal.pone.0191852](https://doi.org/10.1371/journal.pone.0191852)*********************************************************************

Is happiness freedom from pain? Then Jesus is the unhappiest person in the universe. Many of us come to Christ, get what we want (temporary relief) and stop digging into the deeper things of Jesus. But we must meet the Man of Sorrows or we will never experience the best things about Him…. A life saved is worth everything. This is Venue Church, based in the Calgary area of Canada and led by Pastor Corey Kope. For more information or how to connect please visit VenueChurch.ca using the link below. https://www.youtube.com/c/TheVenueChurchTV Staying Connected Website: https://venuechurch.ca/ Venue Church Facebook: https://www.facebook.com/venuechvrch/ Venue Church Instagram: https://www.instagram.com/venue.church/

Fredrik is joined by Eric Normand for a discussion of debugging your ideas through domain modeling, using Eric's concept of lenses to find more good questions to ask. Eric is writing a book about domain modeling and has developed the concept of lenses - ways to look at various aspects of your domain, model, and code in order to better consider various solutions and questions. Why? Because design is needed, but is easily lost in the modern urge to be fast and agile. There's a lot you can and need do on the way to a working system. Eric pushes for design which is an integral part, perferably right in the code, rather than a separate one which can become outdated and separated without anyone noticing. Just spend a little more time on it. Tricks for seeing your domain with fresher eyes. Change is not always maximal and unpredictable! But thinking it is can lead to a lot of indirection and abstraction where a single if-statement could have sufficed for years. Refactoring as a way of finding the seams in your model. What is the code actually supposed to do? How does it actually fit with the domain? Recorded during Øredev 2023, where Eric gave two presentations about the topics discussed: Better software design with domain modeling and Stratified design and functional architecture. Thank you Cloudnet for sponsoring our VPS! Comments, questions or tips? We are @kodsnack, @tobiashieta, @oferlundand @bjoreman on Twitter, have a page on Facebook and can be emailed at info@kodsnack.se if you want to write longer. We read everything we receive. If you enjoy Kodsnack we would love a review in iTunes! You can also support the podcast by buying us a coffee (or two!) through Ko-fi. Links Eric Eric's Øredev 2023 presentations: Better software design with domain modeling *Stratified design and functional architecture Eric has his own podcast Grokking simplicity - Eric's book on functional programming Domain modeling Waterfall UML Clojure REPL - Red-evaluate-print loop Kodsnack 294 - the episode where Dan Lebrero gave Fredrik a feel for REPL-driven development Domain modeling lenses Drawing on the right side of the brain The “keynote yesterday” - Na'Tosha Bard about code outliving you (see also episode 558) Then a miracle occurs Titles I'm really on to something Anti-design trend In a waterfall world On the way to code Experimentation in code Not about moving your hand I don't want rules Yes, that's the right question! Take five minutes Spending more time on it Code lets me play with ideas I'm happy working on a whiteboard Debug your ideas Server babysitters

Fredrik is joined by Eric Normand for a discussion of debugging your ideas through domain modeling, using Eric’s concept of lenses to find more good questions to ask. Eric is writing a book about domain modeling and has developed the concept of lenses - ways to look at various aspects of your domain, model, and code in order to better consider various solutions and questions. Why? Because design is needed, but is easily lost in the modern urge to be fast and agile. There’s a lot you can and need do on the way to a working system. Eric pushes for design which is an integral part, perferably right in the code, rather than a separate one which can become outdated and separated without anyone noticing. Just spend a little more time on it. Tricks for seeing your domain with fresher eyes. Change is not always maximal and unpredictable! But thinking it is can lead to a lot of indirection and abstraction where a single if-statement could have sufficed for years. Refactoring as a way of finding the seams in your model. What is the code actually supposed to do? How does it actually fit with the domain? Recorded during Øredev 2023, where Eric gave two presentations about the topics discussed: Better software design with domain modeling and Stratified design and functional architecture. Thank you Cloudnet for sponsoring our VPS! Comments, questions or tips? We are @kodsnack, @tobiashieta, @oferlund and @bjoreman on Twitter, have a page on Facebook and can be emailed at info@kodsnack.se if you want to write longer. We read everything we receive. If you enjoy Kodsnack we would love a review in iTunes! You can also support the podcast by buying us a coffee (or two!) through Ko-fi. Links Eric Eric’s Øredev 2023 presentations: Better software design with domain modeling *Stratified design and functional architecture Eric has his own podcast Grokking simplicity - Eric’s book on functional programming Domain modeling Waterfall UML Clojure REPL - Red-evaluate-print loop Kodsnack 294 - the episode where Dan Lebrero gave Fredrik a feel for REPL-driven development Domain modeling lenses Drawing on the right side of the brain The “keynote yesterday” - Na’Tosha Bard about code outliving you (see also episode 558) Then a miracle occurs Titles I’m really on to something Anti-design trend In a waterfall world On the way to code Experimentation in code Not about moving your hand I don’t want rules Yes, that’s the right question! Take five minutes Spending more time on it Code lets me play with ideas I’m happy working on a whiteboard Debug your ideas Server babysitters

Dr. Banu Arun and Dr. Sana Al Sukhun share recommendations from the newest ASCO resource-stratified guideline on systemic treatment for patients with metastatic breast cancer. They describe the importance of this new guideline, the four-tier resource setting approach, key recommendations, and implementation considerations. Recommendations are discussed for systemic therapy for HER2-positive, triple-negative, and hormone receptor-positive metastatic breast cancer, across Basic, Limited, and Enhanced resource settings. Drs. Arun and Al Sukhun highlight the importance of this guideline for clinicians and patients in regions with limited resources to optimize cancer care. Read the full guideline “Systemic Treatment of Patients with Metastatic Breast Cancer: ASCO Resource-Stratified Guideline” at www.asco.org/resource-stratified-guidelines." TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/resource-stratified-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest disclosures in the JCO Global Oncology, https://ascopubs.org/doi/10.1200/GO.23.00285  Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Banu Arun from the University of Texas MD Anderson Cancer Center in Houston, Texas, and Dr. Sana Al Sukhun from Al Hayat Oncology Practice in Amman, Jordan, co-chairs on “Systemic Treatment of Patients with Metastatic Breast Cancer: ASCO Resource-Stratified Guideline.”  Thank you for being here, Dr. Arun and Dr. Al Sukhun. Dr. Banu Arun: Thank you for having us.  Dr. Sana Al Sukhun: Thank you. Pleasure to join you. Brittany Harvey: And before we discuss this guideline, I'd just like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including the guests who have joined us today on this episode, are available online with the publication of the guideline in the JCO Global Oncology, which is linked in the show notes.   Then, to jump into the content of this guideline, Dr. Al Sukhun, can you first provide an overview of the scope and the purpose of this guideline?  Dr. Sana Al Sukhun: Sure. And again, thank you, Brittany. Pleasure to join you. This guideline is really interesting and very important. It addresses the care and treatment of the most common cancer worldwide, particularly metastatic breast cancer, taking into consideration different availability of resources, particularly in countries with limited resources. As you know, most of us are aware of the importance of clinical practice guidelines improving outcomes for patients in medicine, not only in oncology, but most of those guidelines are developed in countries that are highly resourced. So their applicability in countries of limited resources that lack infrastructure and resources is definitely limited because they cannot really adopt and adapt to those guidelines, which makes resource adapted or resource stratified guidelines quite important and helpful. First, to clinicians caring for patients so that they can properly allocate resources, prioritize how to use therapy for patients, but also even policymakers to allocate resources and plan graduated implementation of science to improve outcomes for their patients according to the progressive availability of resources.  So we're talking about breast cancer, the most common cancer worldwide. And not only is it the most common cancer worldwide, but also more than two-thirds of new cases are diagnosed in countries of limited resources. Unfortunately, they also carry the burden of more than 70% of the mortality attributed to breast cancer. Another challenge is that the median age for the patients affected with breast cancer in countries of limited resources is indeed at least a decade younger than Western societies, which adds to the burden, not only the social, but also the economic burden of cancer. And unfortunately, presentation in these countries is mostly locally advanced, metastatic breast cancer, therefore comes the focus on helping our colleagues in countries of limited resources to care for patients according to the resources available, not only in countries of limited resources, even colleagues practicing in less fortunate areas within countries that are highly resourced. Brittany Harvey: Excellent. Thank you for providing that background information for this guideline.  So then you've just described how many countries and areas have different resources. So, Dr. Arun, could you describe the four-tier resource setting approach that this expert panel used? Dr. Banu Arun: Yeah, Brittany, that's a good question. I think it's important to know where we started and what infrastructure we used. So for developing resource stratified guidelines, ASCO has adopted its framework from the four-tier resource setting approach, which was actually developed by the Breast Health Global Initiative, and we employed modifications to that framework based on the disease control priorities. What this framework emphasizes is also that variations can be present not only between countries, but actually within countries with disparities, for example, differences between rural and urban areas within one country.   So the four settings are obviously basic, limited, enhanced, and maximal settings. The basic setting includes core resources or fundamental services that are really absolutely necessary for any public health, primary health care system to function at all. These include services that are typically applied in a single clinical interaction. For example, vaccination is feasible for highest need populations.   The next tier would be the limited setting. That includes countries or settings with second-tier resources or services that are intended to produce major improvements in outcomes, such as incidences and cost effectiveness. Unlike the basic setting, it can involve single or multiple interactions with providers or healthcare services. Then the third tier is the enhanced setting, where the services are optional but important, and these services should ideally produce further improvements in outcome and increase the number of quality of options and also individual choices, maybe countries having the ability to track patients and links to registries.  And then the last one is of course, the maximal setting that includes high-level, state-of-art resources and services that are available in some high-resource countries. Brittany Harvey: Thank you for describing that framework and the approach that the panel used. So then I'd like to move on and talk about the key high-level recommendations of this guideline for systemic therapy for metastatic breast cancer across those three lower tiered resource settings - the basic, limited, and enhanced resource settings. So, Dr. Al Sukhun, could you start with the recommendations across these settings focusing on HER2-positive breast cancer?  Dr. Sana Al Sukhun: Sure. You know, HER2-positive metastatic breast cancer is one of the most aggressive subtypes of breast cancer. However, its outcome has been transformed with the introduction of HER2-targeted therapy. So, apart from patients who suffer from congestive heart failure or limited compromised ejection fraction, which can be evaluated on a case-by-case basis, patients are candidates for HER2 targeted therapy. When we made the recommendations according to the availability of resources, we started in a gradual approach. So, in a maximal setting, you treat patients with HER2-positive metastatic breast cancer in the frontline setting using the combination of trastuzumab, pertuzumab, and taxanes or endocrine therapy if patients have limited disease burden, or if they have the recurrence after a long disease-free interval. Usually, the combination of trastuzumab and pertuzumab with taxane is used. But then again, clinicians can use navelbine, considering good data from the HERNATA trial about its efficacy as compared to taxanes and even also, we recommended platinum therapy according to availability.   However, if pertuzumab is not available, you go to the next level where we recommend offering, again, chemotherapy, be it taxane, navelbine, platinum, with trastuzumab, or even without trastuzumab if trastuzumab is not available. So, something to keep in mind, chemotherapy is not without efficacy in this aggressive subtype. It is not as good as when you use the combination with HER2-targeted therapy, but it still works. Patients and clinicians in this era of biologic therapy immunotherapy tend to think only pricey medications are the ones that can be used for treatment and improving outcome. However, definitely adding help with targeted therapy is great whenever it's available. But if it's not available, chemotherapy still could be used in a sequential manner. We listed all possible chemotherapeutic options starting with taxanes, navelbine, platinums, even CMF, capecitabine.   When it comes to second-line therapy, including those patients who relapse within 12 months of adjuvant therapy, the optimal line of treatment would be trastuzumab deruxtecan. However, if it's not available, we recommend to be offered with successive or progressive preference, if it's not available, T-DM1 could be used. If it's not available, capecitabine and lapatinib could be used. If it's not available, trastuzumab with chemotherapy could be used. If it's not available, we go back to the sequential use of chemotherapy, including adriamycin, taxanes, platinums, capecitabine, or even CMF.  Brittany Harvey: I appreciate you reviewing those recommendations for HER2-positive breast cancer.  So then, moving along, Dr. Arun, what are the recommendations for patients with metastatic triple-negative breast cancer? Dr. Banu Arun: Thank you, Brittany. Triple-negative breast cancer, of course, is one of the serious subgroups of breast cancer. About 10 to 15% of patients have triple-negative breast cancer. What I will do is I will divide it into the three-tier settings as well as first-, second-, and third-line therapies.  For patients with triple-negative PD-L-negative metastatic breast cancer in the limited settings and even enhanced settings, single-agent chemotherapy rather than combination chemotherapy should be recommended as the first-line. However, if patients are symptomatic or have immediate life-threatening disease, combination chemotherapy can be offered.  For patients with triple-negative breast cancer that are PD-L1 positive, they may be offered in addition to chemotherapy, an immune checkpoint inhibitor, as first-line therapy, most probably in enhanced settings and in basic and limited, of course, chemotherapy. When you move on to the second-line for metastatic breast cancer in patients with or without previous PD-L1 checkpoint inhibitors, clinicians can offer palliative or best supportive care in the basic setting. In the limited setting, chemotherapy with anthracyclines, taxanes, platinums are options. And in the enhanced setting if sacituzumab govitecan is not available, chemotherapy would be an option. Now, when we move on to the third-line setting for triple-negative breast cancer, clinicians can actually offer chemotherapy and/or palliative care, depending really on the status of the patient. Brittany Harvey: Excellent. Thank you for providing those recommendations for triple-negative breast cancer. As you mentioned, it's one of the rarer forms of breast cancer. So then, Dr. Al Sukhun, I'd like to move into the last section of patients, actually the most common, but hormone receptor-positive breast cancer. What are those recommendations?  Dr. Sana Al Sukhun: Thank you, Brittany. As you mentioned, it's the most common subtype worldwide. The rule of the thumb is sequential hormonal therapy, depending on availability. So, whatever you have hormonal therapy, sequential hormonal therapy unless pending visceral crisis or symptomatic disease, it's recommended that you offer sequential single-agent chemotherapy, unless it's a real visceral crisis, where we recommend combination chemotherapy. That's a classic in all our guidelines.  When considering frontline hormonal therapy, again, I will start from the maximal level and gradually recommend according to availability. So in enhanced levels in many countries now, we have generic CDK4/6 inhibitors, which increase their availability. So we do recommend hormonal therapy with CDK4/6 inhibitors. Upon progression or when they are not available, on progression, you move to the second line of hormonal therapy. If you have liquid biopsy, check for PIK3CA mutation. Sometimes you do have the liquid biopsy, but you do not have alpelisib to offer to your patients with hormonal therapy, then it's okay, you still can move to second-line fulvestrant with everolimus. Sequentially, you can move forward to fulvestrant by itself if you do not have everolimus. And even you can sequence tamoxifen until your patient stops responding to hormonal therapy then you can offer sequential single-agent chemotherapy.  Brittany Harvey: Thank you, Dr. Al Sukhun for providing those recommendations.  So then, Dr. Arun, what should clinicians do when we do not have access to receptor assessment? What is recommended for best practices for management of those patients? Dr. Banu Arun: So, Brittany, that's an important question. There are some basic settings where unfortunately, immunohistochemistry for ER/PR HER2neu determination is not available. Our group really recommends in these cases that clinicians may presume hormonal receptor positivity and offer tamoxifen in most cases. It is expected that IHC would be available in limited and, of course, enhanced settings. Brittany Harvey: Great. Thank you for providing that information.  So further, what else should clinicians know as they implement these recommendations, Dr. Arun?  Dr. Banu Arun: It's very important that we, all healthcare provider clinicians, really know the data. I think reading the guidelines or knowing about first and second line therapies is obviously important, but the devil is in the details. And I think knowing the publications and subgroup analyses, if needed, because every patient is different and sometimes the recommendations cannot go by the books. You really need to do an assessment of the patient and see in which setting you are and then make the most of the guidelines that are recommended. It's to guide. The name is guidelines. It's to guide. And ultimately, it's the clinician's responsibility to find the best available therapy for the patient. And sometimes that includes no treatment and supportive care. Dr. Sana Al Sukhun: Totally agree with Dr. Arun. They are there to support the clinician decision. After all, the clinician is the one who sees the patient, who can evaluate the patient from all aspects — social aspect, physical aspect, the tumor aspect. So it's not just about the tumor, it's about the patient and the environment where the clinician is treating the patient. However, I believe there is support to the clinician not only in treating the patient, but also on addressing priorities for research to improve outcomes for patients in different resource settings. There is also support for the clinicians to help them advocate for improving care for patients in a strategic way, where they prioritize resource allocation. So they are there to support the clinician at all levels, not only when treating patients, but when advocating for patients, when helping patients to make decisions, when they're discussing with their health officials and policymakers.   Brittany Harvey: Absolutely. Those are excellent points that you both made about individualizing patient care for the specific person in front of you. So then, finally, Dr. Al Sukhun, how will these guideline recommendations impact patients with metastatic breast cancer globally?  Dr. Sana Al Sukhun: The ultimate goal for anything we do, including guidelines, is to improve outcomes for patients worldwide. They are there to support clinician decisions, empower clinicians to optimize care for their patients, to advocate for improving outcomes for patients by strategically allocating resources according to the most impactful strategy. They help clinicians to identify areas for research that are needed according to the resources available to them. They are there to guide policymakers, again, also implementing strategies to implement science that could improve outcomes in an efficient way for their societies. So hopefully, all these, with our research, with our advocacy, with our health policy, with our treatment decisions, hopefully all these will improve outcomes for breast cancer patients and ultimately reduce mortality, particularly in less fortunate, limited resource settings for patients everywhere. Brittany Harvey: Absolutely. We hope that these guidelines improve outcomes and quality of life for patients worldwide.  So I want to thank you both so much for your work to develop this guideline. There's certainly a large amount of recommendations, so I encourage our listeners to read the full guideline, which is linked in the show notes. And I want to thank you so much for your time today, Dr. Al Sukhun and Dr. Arun. Dr. Sana Al Sukhun: Thank you for having us. Dr. Banu Arun: Thank you, Brittany. Brittany Harvey: And thank you to all of our listeners for tuning into the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/resource-stratified-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    

Commentary by Associate Editor Sean Pinney

In this episode, I introduce the stratified design lens, which talks about how and why we split things into layers.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.22.533592v1?rss=1 Authors: Yu, X., Yuan, H., Yang, Y., Zheng, W., Zheng, X., Lu, S.-H., Jiang, W., Yu, X. Abstract: Self-renewing, damage-repair and differentiation of mammalian stratified squamous epithelia are subject to tissue homeostasis, but the regulation mechanisms remain elusive. Here, we investigate the esophageal squamous epithelial tissue homeostasis in vitro and in vivo. We establish a rat esophageal organoid (rEO) in vitro system and show that the landscapes of rEO formation, development and maturation trajectories can mimic those of rat esophageal epithelia in vivo. Single-cell RNA sequencing (scRNA-seq), snap-shot immunostaining and functional analyses of stratified "matured" rEOs define that the epithelial pluripotent stem-cell determinants, p63 and Sox2, play crucial but distinctive roles for regulating mammalian esophageal tissue homeostasis. We identify two cell populations, p63+Sox2+ and p63-Sox2+, of which the p63+Sox2+ population presented at the basal layer is the cells of origin required for esophageal epithelial stemness maintenance and proliferation whereas the p63-Sox2+ population presented at the suprabasal layers is the cells of origin having a dual role for esophageal epithelial differentiation (differentiation-prone fate) and rapid tissue damage-repair responses (proliferation-prone fate). Given the fact that p63 and Sox2 are developmental lineage oncogenes and commonly overexpressed in ESCC tissues, p63-Sox2+ population could not be detected in organoids formed by esophageal squamous cell carcinoma (ESCC) cell lines. Taken together, these findings reveal that the tissue homeostasis is maintained distinctively by p63 and/or Sox2 dependent cell lineage populations required for the tissue renewing, damage-repair and protection of carcinogenesis in mammalian esophagi. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Layer formation in a stably-stratified fluid cooled from above Towards an analog for Jupiter and other gas giants by J. R. Fuentes et al. on Tuesday 29 November In 1D evolution models of gas giant planets, an outer convection zone advances into the interior as the surface cools, and multiple convective layers form beneath that convective front. To study layer formation below an outer convection zone in a similar scenario, we investigate the evolution of a stably-stratified fluid with a linear composition gradient that is constantly being cooled from above. We use the Boussinesq approximation in a series of 2D simulations at low and high Prandtl numbers ($mathrm{Pr} = 0.5$ and 7), initialized with constant temperature everywhere, and cooled at different rates. We find that multiple convective layers form at $mathrm{Pr} = 7$, {as the result of an instability in the} diffusive thermal boundary layer below the outer convection zone. At low Pr, layers do not form because the temperature gradient within the boundary layer is much smaller than at large Pr and, consequently, is not large enough to overcome the stabilizing effect of the composition gradient. For the stratification used in this study, on the long-term the composition gradient is an ineffective barrier against the propagation of the outer convection zone and the entire fluid becomes fully-mixed, whether layers form or not. Our results challenge 1D evolutionary models of gas giant planets, which predict that layers are long-lived and that the outer convective envelope stops advancing inwards. We discuss what is needed for future work to build more realistic models. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2204.12643v3

Layer formation in a stably-stratified fluid cooled from above Towards an analog for Jupiter and other gas giants by J. R. Fuentes et al. on Tuesday 29 November In 1D evolution models of gas giant planets, an outer convection zone advances into the interior as the surface cools, and multiple convective layers form beneath that convective front. To study layer formation below an outer convection zone in a similar scenario, we investigate the evolution of a stably-stratified fluid with a linear composition gradient that is constantly being cooled from above. We use the Boussinesq approximation in a series of 2D simulations at low and high Prandtl numbers ($mathrm{Pr} = 0.5$ and 7), initialized with constant temperature everywhere, and cooled at different rates. We find that multiple convective layers form at $mathrm{Pr} = 7$, {as the result of an instability in the} diffusive thermal boundary layer below the outer convection zone. At low Pr, layers do not form because the temperature gradient within the boundary layer is much smaller than at large Pr and, consequently, is not large enough to overcome the stabilizing effect of the composition gradient. For the stratification used in this study, on the long-term the composition gradient is an ineffective barrier against the propagation of the outer convection zone and the entire fluid becomes fully-mixed, whether layers form or not. Our results challenge 1D evolutionary models of gas giant planets, which predict that layers are long-lived and that the outer convective envelope stops advancing inwards. We discuss what is needed for future work to build more realistic models. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2204.12643v3

Polarization From A Radially Stratified Off-Axis GRB Outflow by A. C. Caligula do E. S. Pedreira et al. on Thursday 24 November While the dominant radiation mechanism gamma-ray bursts (GRBs) remains a question of debate, synchrotron emission is one of the foremost candidates to describe the multi-wavelength afterglow observations. As such, it is expected that GRBs should present some degree of polarization across their evolution - presenting a feasible means of probing these bursts' energetic and angular properties. Although obtaining polarization data is difficult due to the inherent complexities regarding GRB observations, advances are being made, and theoretical modeling of synchrotron polarization is now more relevant than ever. In this manuscript, we present the polarization for a fiduciary model where the synchrotron forward-shock emission evolving in the radiative-adiabatic regime is described by a radially stratified off-axis outflow. This is parameterized with a power-law velocity distribution and decelerated in a constant-density and wind-like external environment. We apply this theoretical polarization model for selected bursts presenting evidence of off-axis afterglow emission, including the nearest orphan GRB candidates observed by the Neil Gehrels Swift Observatory and a few Gravitational Wave (GWs) events that could generate electromagnetic emission. In the case of GRB 170817A, we require the available polarimetric upper limits in radio wavelengths to constrain its magnetic field geometry. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2211.12477v1

Polarization From A Radially Stratified Off-Axis GRB Outflow by A. C. Caligula do E. S. Pedreira et al. on Wednesday 23 November While the dominant radiation mechanism gamma-ray bursts (GRBs) remains a question of debate, synchrotron emission is one of the foremost candidates to describe the multi-wavelength afterglow observations. As such, it is expected that GRBs should present some degree of polarization across their evolution - presenting a feasible means of probing these bursts' energetic and angular properties. Although obtaining polarization data is difficult due to the inherent complexities regarding GRB observations, advances are being made, and theoretical modeling of synchrotron polarization is now more relevant than ever. In this manuscript, we present the polarization for a fiduciary model where the synchrotron forward-shock emission evolving in the radiative-adiabatic regime is described by a radially stratified off-axis outflow. This is parameterized with a power-law velocity distribution and decelerated in a constant-density and wind-like external environment. We apply this theoretical polarization model for selected bursts presenting evidence of off-axis afterglow emission, including the nearest orphan GRB candidates observed by the Neil Gehrels Swift Observatory and a few Gravitational Wave (GWs) events that could generate electromagnetic emission. In the case of GRB 170817A, we require the available polarimetric upper limits in radio wavelengths to constrain its magnetic field geometry. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2211.12477v1

Polarization From A Radially Stratified Off-Axis GRB Outflow by A. C. Caligula do E. S. Pedreira et al. on Wednesday 23 November While the dominant radiation mechanism gamma-ray bursts (GRBs) remains a question of debate, synchrotron emission is one of the foremost candidates to describe the multi-wavelength afterglow observations. As such, it is expected that GRBs should present some degree of polarization across their evolution - presenting a feasible means of probing these bursts' energetic and angular properties. Although obtaining polarization data is difficult due to the inherent complexities regarding GRB observations, advances are being made, and theoretical modeling of synchrotron polarization is now more relevant than ever. In this manuscript, we present the polarization for a fiduciary model where the synchrotron forward-shock emission evolving in the radiative-adiabatic regime is described by a radially stratified off-axis outflow. This is parameterized with a power-law velocity distribution and decelerated in a constant-density and wind-like external environment. We apply this theoretical polarization model for selected bursts presenting evidence of off-axis afterglow emission, including the nearest orphan GRB candidates observed by the Neil Gehrels Swift Observatory and a few Gravitational Wave (GWs) events that could generate electromagnetic emission. In the case of GRB 170817A, we require the available polarimetric upper limits in radio wavelengths to constrain its magnetic field geometry. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2211.12477v1

Local gravitational instability of stratified rotating fluids: 3D criteria for gaseous discs by Carlo Nipoti. on Monday 21 November Fragmentation of rotating gaseous systems via gravitational instability is believed to be a crucial mechanism in several astrophysical processes, such as formation of planets in protostellar discs, of molecular clouds in galactic discs, and of stars in molecular clouds. Gravitational instability is fairly well understood for infinitesimally thin discs. However, the thin-disc approximation is not justified in many cases, and it is of general interest to study the gravitational instability of rotating fluids with different degrees of rotation support and stratification. We derive dispersion relations for axisymmetric perturbations, which can be used to study the local gravitational stability at any point of a rotating axisymmetric gaseous system with either barotropic or baroclinic distribution. 3D stability criteria are obtained, which generalize previous results and can be used to determine whether and where a rotating system of given 3D structure is prone to clump formation. For a vertically stratified gaseous disc of thickness $h_z$ (defined as containing $approx$70% of the mass per unit surface), a sufficient condition for local gravitational instability is $Q_{rm 3D}equivleft(sqrt{kappa^2+nu^2}+c_s h_z^{-1}right)/{sqrt{4pi Grho}}

MEANWHILE SOCIALS https://soundcloud.com/meanwhilerec https://www.facebook.com/meanwhilerecordings https://www.instagram.com/meanwhile_recordings ARTIST SOCIALS https://soundcloud.com/navarstory https://www.facebook.com/Navarstory https://www.instagram.com/navarstory/ Hitting the heights once more on their Meanwhile imprint, GMJ & Matter turn to the iconic figure of Navar for the label's 38th release as he delivers his 3-track “Return of the Sun”. A dazzling career that spans over a decade and a double century of releases, Navar has seen his music featured on the likes of Guy J's Lost & Found, Cid Inc's Replug and Eelke Kleijn's Outside The Box Music. Now returning to Meanwhile after his remix of Alex O'Rion's “The Chase” in February 2022, the “Return of the Sun” title track is a compelling blend of rhythmic dynamism and trademark melodic prowess. Building over the course of its coruscating 9-minute voyage, elegant and flowing melodies drift atop a deep kick and shimmering hi-hats. Redolent in cascading delays, blissful warmth radiates through the sonic layers that pause briefly for breath at the two-thirds point, before picking up the pace in the latter stages in a work where new motifs enter the aural collage. Opening with atmospheric pads and rippling effects, “Trips” slowly hits is stride with heavy beat and clicking percussive groove. A subtle and intelligent offering, delicate melodies play across the mid-range in syncopated delays while a seismic legato bassline pitches its way in lockstep with the rhythmic foundation. The result is a shimmering beauty that unexpectedly draws to a dramatic and vibrant conclusion with a new 16th note bassline groove in the final movement. The aptly titled “Luminescence” concludes the triptych with a huge bassline groove and velvety synth line that scuds across the sonic landscape in stereo-panned glory. Stratified layers of sound make their play as twinkling keys and counterpoint motifs rise and fall in a beautifully woven tapestry. The result is the perfect juxtaposition of low-end vibrancy and majestic melodic touch that is a hallmark of the Navar production sound. A renowned artist who has always shone brightly in the electronic music firmament, Navar glows incandescent with “Return of the Sun”.

Coronavirus Update #70 GOOD NEWS: This information is so important to help us all understand risk. Stratified risk is the only true way to measure personal risk. Let us look at some CDC data from the spring Omicron BA.1 and .2 spikes versus the fall 2021 delta wave. Median age of hospitalization has increased from 60 years old with Delta to 64 with BA.1 and 71 with BA.2. Any underlying medical condition associated with hospitalization increased from 89% with Delta to 92% with BA.1 to 95% with BA.2 respectively. Length of hospital stay decreased from 4.8 to 3.9 to 3.3 days. ICU admission was down from 24% to 18% to 13% of admitted patients. Mechanical ventilation decreased from 14% to 8% to 6% of admitted patients. And Finally, death from 12% to 8% to 5% overall. What we can glean from this data set is very clear. With successive SARS2 mutations coupled to increased population based exposure to virus via infection or vaccine, we are now seriously in a reduced risk state unless you are older than 65 years with a comorbid disease or younger than 65 with a serious disease. 95% of hospitalizations were related to a comorbid disease regardless of age. The other big takeaway was this: if you are in this high risk group, getting every available booster is vital to your survival based on the risk reduction data. For everybody else, the data is clear, you are ok - to boost or not to boost is up to you. But, absolutely work on your general health. To your health, Dr. M

An interview with Dr. Surendra Shastri from the University of Texas MD Anderson Cancer Center in Houston, TX, and Dr. Jose Jeronimo from the National Cancer Institute in Bethesda, MD, co-chairs on "Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Guideline Update." Dr. Shastri and Dr. Jeronimo review the updated recommendations in the guideline, covering screening, triage, management, follow-up, and considerations for special populations. Read the full guideline at www.asco.org/resource-stratified-guidelines.   TRANSCRIPT Brittany Harvey: Hello, and welcome to the ASCO Guidelines podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content, and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at: asco.org/podcasts.  My name is Brittany Harvey, and today I'm interviewing Dr. Surendra Shastri from the University of Texas MD Anderson Cancer Center in Houston, Texas, and Dr. José Jerónimo from the National Cancer Institute in Bethesda, Maryland; co-chairs on ‘Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Guideline Update'.   Thank you for being here, Dr. Shastri and Dr. Jerónimo.  Dr. José Jerónimo: My pleasure.  Dr. Surendra Shastri: Thank you very much.  Brittany Harvey: First, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The full Conflict of Interest information for this guideline panel is available online with a publication of the guideline in the JCO Global Oncology.   Dr. Shastri, do you have any relevant disclosures that are directly related to this guideline topic?  Dr. Surendra Shastri: No, I don't have any disclosures.  Brittany Harvey: Thank you. And Dr. Jerónimo, do you have any relevant disclosures that are directly related to this guideline topic?  Dr. José Jerónimo: No, I don't have any.  Brittany Harvey: Thank you both. So, to start us off, Dr. Jerónimo, what prompted this update to ASCO's guideline on secondary prevention of cervical cancer, last published in 2016? And what is the scope of this guideline update?  Dr. José Jerónimo: That's a great question. Yes, it's natural for people to start wondering why the guidelines change or are updated so frequently. And I think there are several factors. The main one is that science on cervical cancer and other diseases is evolving very rapidly; there are new publications, there are new technologies, there is new information about different aspects of cervical cancer prevention specifically. The updates of those technologies is so fast that we need to periodically update the guidelines to accommodate these new options.  Now, I have to highlight that the ASCO guidelines in 2016 -- those guidelines were already very ahead of everyone else. What I mean is, in 2016, we were already recommending HPV testing for everyone all over the planet as a preferred option. It's something that other guidelines, other organizations were still wondering about, but we were really very upfront on that recommendation, considering that that's the best technology we have. I think the updates of the guidelines is important because we need to keep with science, and we need to keep the doctors using the guidelines also updated on what exactly is out there, and what options could be usable for the different settings.  Brittany Harvey: Great, thank you for that background on the guideline update and for describing why the guideline needs to be updated over time. So then, Dr. Shastri, as this is a resource-stratified guideline, can you describe the four-tiered framework of the guideline? Specifically, what are the Basic, Limited, Enhanced and Maximal resource levels?  Dr. Surendra Shastri: Saying one size doesn't fit all would be a cruel example in health situations where it's really unfortunate that there are large disparities across the world, between countries, within countries, and that's the reason why we need resource-stratified guidelines. We can't just sit in ivory towers and preach to people who don't have anything. So that's the reason why we have the resource-stratified guidelines, and we have followed the same resource structure that the Breast Health Global Initiative is following.  So, we basically have four different resource levels. The most Basic one, or the core resources, is where you have just very basic public health services available. It's not services which are looking for outcomes and are just part of the social welfare that the country has to provide. Many times, those are also situations where the health priorities are very different.  For example, health priorities for some countries might still be infectious diseases, as it was amply displayed in the current pandemic. So, considering those situations, the expenditure that the country does or expenditure a local governing body does on a particular disease could be very different. So, at Basic, just available screening services at the lowest level.  Then you have the Limited; the Limited is slightly better than the Basics. They have maybe some of the newer technologies like Dr. Jerónimo just explained, not all of it. Some of those may not be able to provide in the same frequency or to everybody out there. But they are at this point of time looking at outcomes, looking at cost-effectiveness and those kinds of things.   Step up a little bit, and you have Enhanced level. That's the third tier of the resource level that we are talking about. In the Enhanced level, we have much better services available, we have organized services available. And those services have probably a system of tracking and recording clients or people who undergo screening and early detection.  And the final is the Maximal level. In the Maximal level, it is what we see across North America, or what we see in Europe, where you have the latest technologies, you have established systems, and you have systems to track and follow people. Again, I will caution here, even if I say North America or Europe, it's not across North America and across Europe. There are several places in North America, there are several places in Europe, which do not have the same resources. And that's why in this guideline, we're not talking about country guidelines, we're talking about resource-limited guidelines.  Brittany Harvey: Understood. I appreciate that description of the stepwise approach and how it isn't necessarily applicable just to one country, but there are differences in resource levels across countries and within countries.   So then, the guideline panel made recommendations across these four resource levels. Next, I'd like to review the key recommendations of this guideline update across those resource levels. So, Dr. Jerónimo, what are the recommended methods for cervical cancer screening?  Dr. José Jerónimo: That's a challenging situation on what to use in the different settings. Dr. Shastri already described very clearly the different scenarios we are facing; places with extremely limited resources where basically you have only maybe an evaluation table there, and places in the other extreme with all the resources and all the technologies available.  But even though we have very different areas with very different resources, the most recommended test for a screening for cervical cancer in all of them is HPV testing; the testing for the Human papillomavirus that is directly related to cervical cancer. The question could be, "Okay, why are you recommending that test for places where maybe now they are not going to be able to do it?" I think it's important to put that technology as a target, even though the sites are not prepared right now to do it, but they have to go towards that goal of implementing HPV testing.  Meanwhile, the guidelines also highlight that there are other options that could be used in the meantime to do some screening, one is visual inspection with acetic acid that is being already implemented in many places. And the reason why we are recommending HPV testing even in those places with extremely limited resources is because there are some advantages. First, with HPV testing, it's very highly sensitive, extremely highly sensitive. That means that you have a sensitivity over 90% with good validated tests. Second, because it's highly sensitive, you have the option to have a smaller number of screenings in the lifetime. Instead of -- some people remember, some years ago, the screening for cervical cancer with Pap smear was done every year.  But now we know that it's changing. With HPV testing, we are now recommending every five years or in these guidelines, depending on the resources, could be every 10 years, or could be once or two times in the lifetime of the woman. And with that, we are going to have a huge impact.  The other great advantage of HPV testing is that it can be self-collected by women. That means that basically, a woman takes the small brush, goes to a private place and introduce that in their vagina and collect the sample herself, without the need of specula, without the need of trained personnel, without the need of having all the infrastructure that is required for a pelvic evaluation.  And that's big because in that way, we can reach populations that are hard to reach. And also, we are dealing with some issues like cultural resistance to have a pelvic evaluation. I mean, that's the biggest advantage for HPV testing. And we have now examples showing that this is very well accepted in many, many studies around the world with different populations around the world showing that self-collection is very accepted. That means that the preferred test for cervical cancer prevention is HPV testing right now. There are options displayed in the guidelines for cities where it's not possible to do it now, but that's the role.  Brittany Harvey: Understood. Thank you for explaining what testing is recommended; HPV testing, and then also the timing and collection strategies across settings. So, then following that, Dr. Shastri, what is recommended regarding triage for patients who have positive results or other abnormal results?  Dr. Surendra Shastri: So, let me briefly explain what triage is; right up following the primary screening when the woman has a positive result, a second technique or technology is used to determine whether this person needs to be treated, or this person needs to be tracked and followed up in a particular way. So, our recommendations for triage in the updated guidelines is that for the Basic settings, just like Dr. Jerónimo mentioned, if we have used HPV screening in the basic settings; that's the molecular test, and if that is positive, then we use another strategy which is known as, visual assessment for treatment. And this strategy is used to determine whether a woman should be treated with thermal ablation, or with LEEP, or she just needs to be followed. Whereas all the other three settings, HPV genotyping along with cytology, or cytology alone should be used for triage.  Brittany Harvey: Great. Thank you for explaining those triage recommendations. So then following triage, Dr. Jerónimo, what is recommended regarding management and follow-up strategies for patients with precursors of cervical cancer?  Dr. José Jerónimo: I think treatment also has evolved significantly in the last 20 or more years. And specifically, in the last five years or 10 years, there are new options that are becoming more popular because there is more evidence supporting the effectiveness of this technology, and ablation of that tissue is really one of the best options in most of the places.  I always try to compare the pre-cancer lesion like the paint on your wall, in your house. If one of the kids come with something and you start to scratch something in there, you don't need to turn the wall down in order to fix that problem. Basically, you just have to remove that area and put some new paint, and that's going to be corrected. In the same way, when you have a pre-cancer of the cervix, it's very, very superficial. It's not cancer, it's pre-cancer. You don't need to remove the whole cervix or the whole uterus to treat that. With ablation, basically what we are doing is destroying that tissue that is in the very surface, and new cells, healthy cells are going to come and are going to cover that area. That's the idea. The technologies that are more usable for areas with limited resources could be the thermal ablation or could be cryotherapy.  The other advantage of those technologies is basically there is no major complication; no bleeding, no major problems. Of course, as Dr. Shastri explained, there are more resources in other places. In other places, you have more resources, you can do a LEEP; that is, basically using an electrical device, removing part of the cervix and sending that to the pathologist. That's also one option that is acceptable and recommended in the guidelines. I think the main idea is, we need to remove that area with disease, with pre-cancer. We can remove it using ablation; just destroying the cells, or we can remove it using some excisional procedure. That all depends on the resources you have.  But how effective those technologies are, I could say there is very high cure rates using thermal ablation, for example, or LEEP. Very important to consider, doing the procedure, you can do it anywhere. Doing a LEEP, in theory, you can do it anywhere where you have electricity and you have the equipment. But remember, you have to be prepared not only for the treatment, you have to be prepared for the complication. If you have a LEEP, a very portable device and you have electricity, but if you are far from the next health facility, if you have a complication like you are bleeding in that setting, it's going to take hours, hours and hours just to evacuate that patient to the health facility. That's why you need to be very careful not only on the treatment, but also managing the complication.  Brittany Harvey: Understood. I appreciate you reviewing those technologies. So then, following those notes that Dr. Jerónimo just made, Dr. Shastri, are there any changes to the recommendations for special populations or highlights that you'd like to note that are identified in the guideline?  Dr. Surendra Shastri: This is a speciality of the ASCO guidelines really also to take a look and make recommendations for special populations. And by special populations here I mean the ones that we have looked at and recommended cervical cancer screening for are; women who are HIV positive or immunocompromised, immunosuppressed due to any other disease, or any other reasons, maybe because of medication, or cancer or other disease conditions which requires immunosuppressives.  For such women, we would say you start screening for cervical cancer as soon as the first diagnosis; the diagnosis of the disease which is causing immunosuppression is done. That's the first time. And then, through their lifetime, you screen them twice as frequently as you would do for other women who do not have an immunocompromised situation. So, you do it more frequently. As far as the management post-screening with positive results is concerned, for women with HIV as with all immunosuppressed women, it is the same. The triage is the same and the management will be the same as for all other women.  Then also pregnant women. For pregnant women, we recommend in the very Basic settings, pregnant women should be screened six weeks postpartum. And in all other settings, all other levels, we recommend that they should be screened six months postpartum. The very reason is, in many basic settings, you may not even get those women back for screening. That's the reason why we try to screen as early as possible. But on the safer side, the earliest possible is six weeks postpartum; that is, she is still probably following up for postpartum reasons of the pregnancy or immunization for the kid. That's the time we should go ahead and do it.  And finally, women who have undergone a hysterectomy but still have an intact cervix, need to get screened in the same way as other women. However, they could stop screening over a period of time, if they have more than three negative results.  A very interesting subject that we discussed in our committee, and we have put it up there as a statement to bring it up is that, we now come across several people who are transgender, who have an intact cervix. So, getting such people into screening, and screening them like all others, will be an important priority. We have put out a statement saying that, although we mentioned that this is for women, it is for all persons who have an intact cervix. So these screening guidelines apply to everyone.  Brittany Harvey: Yes, it's important that all persons with a cervix get screened for cervical cancer as it is something that can affect anyone with a cervix. And those are important considerations for clinicians that you noted across several different populations.   So then, in your view, Dr. Jerónimo, what is the importance of this guideline overall, and how does it impact clinicians?  Dr. José Jerónimo: That's, I think the core of the guidelines is how this is going to affect the practice of clinicians. I think the main message here with the guidelines is: first, clearly acknowledging that the resources are different in different settings, and we need to accommodate to those settings to provide the best service. I think for clinicians, it is presenting options that could be suitable for their setting. As Dr. Shastri mentioned at the beginning, we are not talking specifically about countries. Because in one given country, you can have areas with Maximal resources, you can have areas with Limited resources, and you can have areas with Basic resources. If you try to apply that new, most modern, expensive technologies everywhere, you're going to be just doing the screening in very few places in the country because it's not possible.  With the guidelines, we are giving the option saying, "Okay, if you don't have access to those technologies, you can get started using this. For example, visual inspection. If the technology becomes available, for example, HPV testing, you can start to use HPV testing, because that's the goal. That's what you really need to look for. If you don't have the resources or the conditions to do excision procedure like a LEEP, you can do ablation, and that's okay. And basically presenting, you have different options to accommodate to your place. But the most important part is, do it well. Do it well, reach as many women as possible with your screening, and treat as many positive women as possible." I think that's the best message here. And I think that's the way these guidelines are going to help and impact the world of clinicians.  Brittany Harvey: Yeah, that's the core message of the resource-stratified guidelines; is using the resources you need to help and treat and screen the most people possible. So then finally, Dr. Shastri, how do these guideline recommendations affect patients?  Dr. Surendra Shastri: I will just add one line to the response that Dr. Jerónimo just gave you. We already have an existing country guideline, these are meant to complement those guidelines, and meant for the policymakers in those countries to open their eyes and realize that there are people at different resource levels, who may or may not have an insurance program, who may or may not have a socialized system which provides the same level of health care for everyone. So, use what we recommend because that's the current evidence for use.  Coming to how people are going to benefit, which was your question, these guidelines are going to make cervical cancer screening available and accessible to all women across the globe. We are talking about different options. We are not saying that, "if you don't have X, don't screen." We are saying, "if you don't have X, try Y. If you don't have Y, try Z." So, this opens up doors for all women across the globe to get screening. That is the ultimate goal, because if you want to reach the WHO goal of eradication of cervical cancer, then that's possible only through two means; one, is giving cervical cancer screening, preferably HPV, through whatever means or resources that the country has, and the vaccination, which is of course, being dealt by another committee over here.  So of course, all women across the globe will get benefit of newer technologies, simpler, cost-effective technologies, technologies that don't require them to -- for example, a self-collection, the woman doesn't really have to go anywhere. She doesn't have to go and wait in a clinic for hours to get a screen. She doesn't have to make repeat visits to get a screen. She doesn't have to lose her wages. These are things which are real. She doesn't have to lose her wages for the day, she doesn't have to arrange for child support to look after her children just to go and get herself screened. Those are some of the social determinants of health, which prevent women from going and getting themselves screened. So, by a simple technique like self-collection, we removed that entirely.  Going forward, we are going to see Artificial Intelligence, we are going to have deep machine learning, we are going to change the technology and the strategies, and we will come back with another update to this, maybe very soon, sooner than what we did this time.  Brittany Harvey: Absolutely. Those are excellent points. And we'll look forward to future updates as technologies continue to advance. So, I want to thank you both so much for your work on updating these resource-stratified guidelines for the secondary prevention of cervical cancer. And thank you for your time today, Dr. Shastri and Dr. Jerónimo.  Dr. José Jerónimo: My pleasure.  Dr. Surendra Shastri: Thank you for inviting us.  Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO guidelines podcast series. To read the full guideline go to: www.asco.org/resource-stratified-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available on iTunes or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.    The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.   

Transition from multipolar to dipolar dynamos in stratified systems by B. Zaire et al. on Monday 26 September Observations of surface magnetic fields of cool stars reveal a large diversity of configurations. Although there is now a consensus that these fields are generated through dynamo processes occurring within the convective zone, the physical mechanism driving such a variety of field topologies is still debated. This paper discusses the possible origins of dipole and multipole-dominated morphologies using three-dimensional numerical simulations of stratified systems where the magnetic feedback on the fluid motion is significant. Our main result is that dipolar solutions are found at Rossby numbers up to 0.4 in strongly stratified simulations, where previous works suggested that only multipolar fields should exist. We argue that these simulations are reminiscent of the outlier stars observed at Rossby numbers larger than 0.1, whose large-scale magnetic field is dominated by their axisymmetric poloidal component. As suggested in previous Boussinesq calculations, the relative importance of inertial over Lorentz forces is again controlling the dipolar to multipolar transition. Alternatively, we find that the ratio of kinetic to magnetic energies can equally well capture the transition in the field morphology. We test the ability of this new proxy to predict the magnetic morphology of a few M-dwarf stars whose internal structure matches that of our simulations and for which homogeneous magnetic field characterization is available. Finally, the magnitude of the differential rotation obtained in our simulations is compared to actual measurements reported in the literature for M-dwarfs. In our simulations, we find a clear relationship between anti-solar differential rotation and the emergence of dipolar fields. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2209.11652v1

Transition from multipolar to dipolar dynamos in stratified systems by B. Zaire et al. on Monday 26 September Observations of surface magnetic fields of cool stars reveal a large diversity of configurations. Although there is now a consensus that these fields are generated through dynamo processes occurring within the convective zone, the physical mechanism driving such a variety of field topologies is still debated. This paper discusses the possible origins of dipole and multipole-dominated morphologies using three-dimensional numerical simulations of stratified systems where the magnetic feedback on the fluid motion is significant. Our main result is that dipolar solutions are found at Rossby numbers up to 0.4 in strongly stratified simulations, where previous works suggested that only multipolar fields should exist. We argue that these simulations are reminiscent of the outlier stars observed at Rossby numbers larger than 0.1, whose large-scale magnetic field is dominated by their axisymmetric poloidal component. As suggested in previous Boussinesq calculations, the relative importance of inertial over Lorentz forces is again controlling the dipolar to multipolar transition. Alternatively, we find that the ratio of kinetic to magnetic energies can equally well capture the transition in the field morphology. We test the ability of this new proxy to predict the magnetic morphology of a few M-dwarf stars whose internal structure matches that of our simulations and for which homogeneous magnetic field characterization is available. Finally, the magnitude of the differential rotation obtained in our simulations is compared to actual measurements reported in the literature for M-dwarfs. In our simulations, we find a clear relationship between anti-solar differential rotation and the emergence of dipolar fields. arXiv: http://arxiv.org/abs/http://arxiv.org/abs/2209.11652v1

Article discussed in this episode:Effect of Weight Loss and CPAP on OSA and Metabolic Profile Stratified by Craniofacial Phenotype: A Randomized Clinical Trial

An interview with Dr. Linus Chuang from Danbury Hospital and Norwalk Hospital, Nuvance Health in Connecticut and New York, co-chair on “Management and Care of Patients with Invasive Cervical Cancer: ASCO Resource-Stratified Guideline Rapid Recommendation Update.” Dr. Chuang discusses the updated recommendation on the use of pembrolizumab in patients with persistent, recurrent, or metastatic cervical carcinoma, based on the results from the KEYNOTE-826 study. For more information, visit, www.asco.org/resource-stratified-guidelines. Transcript BRITTANY HARVEY: Hello, and welcome to the ASCO Guidelines podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Linus Chuang from Danbury Hospital in Norwalk Hospital, Nuvance Health, in Connecticut and New York, Co-Chair on "Management and Care of Patients with Invasive Cervical Cancer-- ASCO Resource-Stratified Guideline Rapid Recommendation Update." Thank you for being here, Dr. Chuang. LINUS CHUANG: Thank you for having me. BRITTANY HARVEY: First, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The full conflict of interest information for this guideline is available online with a publication in the Journal of Clinical Oncology Global Oncology. Dr. Chuang, do you have any relevant disclosures that are directly related to this guideline topic? LINUS CHUANG: No, Brittany. BRITTANY HARVEY: Thank you. Then talking about the content of this publication, so what prompted this rapid update to the "Management and Care of Patients with Invasive Cervical Cancer-- ASCO Resource-Stratified Clinical Practice Guideline," last published in 2016? LINUS CHUANG: ASCO Rapid Recommendations Updates highlight revisions to ASCO guideline recommendations on "Management and Care of Women with Invasive Cervical Cancer, the ASCO Resource-Stratified Clinical Practice Guideline" that was published in September of 2016. We revised the guidelines to reflect new and practice-changing data on the use of pembrolizumab combination therapy in patients with metastatic, recurrent, or persistent cervical cancer in enhanced and maximal settings. BRITTANY HARVEY: Great. Then based off this new data for the pembrolizumab combination therapy, what are the updated recommendations from the guideline panel? LINUS CHUANG: Based on this recently published report about the KEYNOTE-826 study, the checkpoint inhibitor pembrolizumab alongside standard chemotherapy with or without bevacizumab as first-line therapy significantly improved the overall and progression-free survival in patients with persistent, recurrent, or metastatic PD-L1 expressing cervical cancer. BRITTANY HARVEY: Great. Thank you for providing that recommendation. So what should clinicians know as they implement these recommendations, and for which settings do these recommendations apply? LINUS CHUANG: This trial included 617 patients, pembrolizumab 200 milligrams delivered intravenously every three weeks in combination with standard chemotherapy and with or without bevacizumab for up to 35 cycles. It's worth emphasizing based on the following study results the median progression-free survival was 2.2 months longer in the pembrolizumab group that have a PD-L1 combined positive score of 1 or more. And the progression-free survival at 12 months was also longer by 20% in the pembrolizumab group when compared to the placebo group. The overall survival rate at 12 and 24 months were higher in the pembrolizumab group-- 75% and 53% respectively-- compared with the placebo cohort-- 63% and 41% respectively. According to the study, the most common adverse reactions, which occur in more than one in five patients in the pembrolizumab group, are anemia, neutropenia, alopecia, and peripheral neuropathy. Based on this data our rapid communication recommended this regimen be used in the enhanced and maximal settings where the pembrolizumab is available. BRITTANY HARVEY: Great. Thank you for reviewing that data in the context of this recommendation. So how will these guideline recommendations impact patients? LINUS CHUANG: So pembrolizumab with the standard chemotherapy with or without bevacizumab demonstrated improvement in the progression-free and overall survival much longer than those without the pembrolizumab group. And this has emerged as a front-line therapy for the group of patients that have persistent, recurrent, or metastatic cervical cancer with PD-L1 expression cervical cancer. BRITTANY HARVEY: OK, thank you. And then finally, what emerging evidence is the panel anticipating regarding treatment of invasive cervical cancer? LINUS CHUANG: This is an exciting time. Exploration of other PD-1 and PD-L1 inhibitors, monotherapy, or as part of combination therapy for cervical cancer will expand the management of patients with recurrent or metastatic cervical cancer that progressed after platinum-based chemotherapy. It is also important to explore the ability of pembrolizumab with chemoradiation with or without concurrent and maintenance pembrolizumab to improve outcomes for patients with high-risk locally advanced cervical cancer. BRITTANY HARVEY: Great. That's very exciting to see that evidence coming to fruition. So I want to thank you so much for your work to rapidly update this guideline and for your time tonight, Dr. Chuang. LINUS CHUANG: Thank you for having me today. BRITTANY HARVEY: And thank you to all of our listeners for tuning into the ASCO Guidelines podcast series. To read the full guideline, go to www.asco.org/resource stratified guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in iTunes or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode. SPEAKER 3: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Episode: 00092 Release Date: January 31, 2022 Description:  In this week's episode, Dr. Rachel Santos looks back at her time as a crime analyst and manager at the Police Foundation.  She talks about the importance of crime analysis being part of the police department's policy using the Stratified Model that she and her husband Roberto Santos developed. Rachel goes into how crime analysis implementation at police departments has changed from just a CALEA check box to actually be properly utilized for crime prevention. She gives some insight into her new book:  the 5th Edition of Crime Analysis with Crime Mapping due out in February of 2022.  Rachel is currently a professor and the co-director at the Center for Police Practice, Policy, and Research at Radford University in Virginia.   Do you like our new intro and outro?  Comment below or email us at leapodcasts@gmail.com.  Name Drops: Sam Gwinn (00:01:28), Noah Fritz/Sean Bair/Paul Bentley/Dan Helms/Mary Velasco/Eric Nelson/Tammy Garret (00:02:55), Larry Sherman/David Weisburg/Herman Goldstein/John Eck/Gloria Laycock/Mike Scott/Ron Clark (00:11:44), Amanda Bruner (00:53:36), Sean Bair (01:05:02) Public Service Announcements:  Sean Bair (https://www.leapodcasts.com/e/sean-bair-–-the-entrepreneur/) Barry Fosberg (https://www.leapodcasts.com/e/atwje-barry-fosberg-the-data-czar/) Related Links: https://in.sagepub.com/en-in/sas/crime-analysis-with-crime-mapping/book270193, https://www.radford.edu/content/chbs/home/police-practice/resources.html, https://www.policechiefmagazine.org/the-stratified-policing-model-delaware-state-police/, https://www.leapodcasts.com/p/hiring-guide/  Association(s) Mentioned: IACA Vendor(s) Mentioned:  Contact: rsantos5@radford.edu, https://www.linkedin.com/in/rachel-santos-8a383758/  Podcast Writer: Mindy Duong Podcast Researcher:  Theme Song: Written and Recorded by The Rough & Tumble. Find more of their music at www.theroughandtumble.com. Logo: Designed by Kyle McMullen. Please visit www.moderntype.com for any printable business forms and planners.  Podcast Email: leapodcasts@gmail.com   Podcast Webpage: www.leapodcasts.com   Podcast Twitter: @leapodcasts YouTube Version: https://youtu.be/8x2jwaeJNpc    00:00:17 – Introducing Rachel 00:02:55 – Working with All-Stars 00:10:40 – Police Foundation 00:18:16 – Becoming a Professor 00:33:25 – Break:  Sean Bair & Barry Fosberg 00:34:18 – Stratified Policing  00:54:28 – 5th Edition of Crime Analysis with Crime Mapping 01:00:49 – Universities and Analysis 01:06:23 – Words to the World

Eric Weinstein joins me for a multi-episode conversation covering mathematics, physics, history, politics, economics, and money.Be sure to check out NYDIG, one of the most important companies in Bitcoin: https://nydig.com/GUESTEric's twitter: https://twitter.com/EricRWeinsteinEric's YouTube: https://www.youtube.com/ericweinsteinphdEric's Podcast: https://ericweinstein.org/PODCASTPodcast Website: https://whatismoneypodcast.com/Apple Podcast: https://podcasts.apple.com/us/podcast/the-what-is-money-show/id1541404400Spotify: https://open.spotify.com/show/25LPvm8EewBGyfQQ1abIsE?si=wgVuY16XR0io4NLNo0A11A&nd=1RSS Feed: https://feeds.simplecast.com/MLdpYXYITranscript:OUTLINE00:00:00 “What is Money?” Intro00:00:08 Kayfabe and Kayfabrication: A System of Stratified Lies00:05:00 Inauthenticity Cannot Be Separated from Authenticity00:08:08 “The Idealism of Every Age is the Cover Story for Its Thefts”00:09:30 The Inauthenticity of Money Causing the Inauthenticity of Politics?00:13:10 The Prevalence of Politics as Premised on the Violability of Property00:16:47 Is There Any Justification for Government Coercion?00:19:01 The Kayfabrication of Central Banking00:22:55 NYDIG00:24:03 Markets as the Extension of Evolution by Other Means00:25:09 Markets as Engines of Mimesis00:28:41 Culture as a Bulwark Against Central Banking00:32:07 Culture as Downstream of Terrestrial and Technological Realities?00:33:33 “Money is Fungible Freedom”00:34:15 Central Banking and Embedded Growth Obligations (EGOs)00:39:11 Bitcoiners as the New Gold Bugs?00:41:50 Economic Consequences of Non-State, Hard Money00:43:57 The Possibility of Algorithmic Central Banking?00:50:25 “Bitcoiners Have to Start Thinking Like the Big Dogs”00:54:11 The Stability of Rules as the Bedrock of Peace00:55:45 “Satoshi is the George Washington of Money”01:00:47 Bitcoin Reveals Incompetence of Lack of Ethics Among LeadersSOCIALBreedlove Twitter: https://twitter.com/Breedlove22WiM? Twitter: https://twitter.com/WhatisMoneyShowLinkedIn: https://www.linkedin.com/in/breedlove22/Instagram: https://www.instagram.com/breedlove_22/TikTok: https://www.tiktok.com/@breedlove22?lang=enAll My Current Work: https://linktr.ee/breedlove22​WRITTEN WORKMedium: https://breedlove22.medium.com/Substack: https://breedlove22.substack.com/WAYS TO CONTRIBUTEBitcoin: 3D1gfxKZKMtfWaD1bkwiR6JsDzu6e9bZQ7Sats via Strike: https://strike.me/breedlove22Sats via Tippin.me: https://tippin.me/@Breedlove22Dollars via Paypal: https://www.paypal.com/paypalme/RBreedloveDollars via Venmo: https://venmo.com/code?user_id=1784359925317632528The "What is Money?" Show Patreon Page: https://www.patreon.com/user?u=32843101&fan_landing=trueRECOMMENDED BUSINESSESWorldclass Bitcoin Financial Services: https://nydig.com/Join Me At Bitcoin 2022 (10% off if paying with fiat, or discount code BREEDLOVE for Bitcoin): https://www.tixr.com/groups/bitcoinconference/events/bitcoin-2022-26217Automatic Recurring Bitcoin Buying: https://www.swanbitcoin.com/breedlove/Buy Bitcoin in a Tax-Advantaged Account: https://www.daim.io/robert-breedlove/Home Delivered Organic Grass-Fed Beef (Spend $159+ for 4 lbs. free): https://truorganicbeef.com/discount/BREEDLOVE22

Interview with Jaime Delgadillo, author of Stratified Care vs Stepped Care for Depression: A Cluster Randomized Clinical Trial Hosted by John B. Torous, MD, MBI.

Interview with Jaime Delgadillo, author of Stratified Care vs Stepped Care for Depression: A Cluster Randomized Clinical Trial Hosted by John B. Torous, MD, MBI.

Commentary by Dr. Valentin Fuster

Turkey 5, as it's called, gets all the attention.

Commentary by Dr. Valentin Fuster

Dr Manish Vira MD discusses Risk stratified management of non muscle invasive bladder cancer 4/21/2020

Welcome to PT Elevated! Our first guest is the esteemed Anthony (Tony) Delitto, PhD, PT PhD, the Dean of School of Health and Rehabilitation Science and Professor of Physical Therapy at University of Pittsburgh. Our hosts Kory Zimney, PT, DPT, PhD and Paul Mintken, PT, DPT, OCS, FAAOMPT talk with Tony about all things low back pain. He talks his foundational research for Treatment-Based Classification, the Low Back Pain Clinical Practice Guideline and his new research on implementation. Tony Delitto has been practicing and researching for over 40 years, and his expertise and wisdom combine for an episode packed with tips and takeaways for your clinic. Here are some highlights from the episode: What are Delitto's key takeaways from LBP research? There is A LOT of it that you can work from. Active approaches are the way to go. Pay attention to the behavioral component and use psychologically-informed care in your practice. Avoid passive approaches. Here's his original CPG: Low Back Pain Clinical Practice Guideline Delitto's research on Treatment-Based Classification came from organically joining up with other physical therapists. Listen in to see how the basis for Treatment-Based Classification came about with his colleagues Richard (Dick) Erhard and Richard (Rick) Bowling as well as Steve Rose.  Find the Treatment-Based Classification paper here: A Treatment-Based Classification Approach to Low Back Syndrome: Identifying and Staging Patients for Conservative Treatment Delitto's research focus is now on implementing the research that has been done over the last 40 years, and he believes that will be the great challenge of the next generation. Hear him discuss two of his most recent papers that work to close the gap between research and creating processes to access low back pain patients. Here are the two papers on implementation: Implementing stratified care for acute low back pain in primary care using the STarT Back instrument: a process evaluation within the context of a large pragmatic cluster randomized trial Stratified care to prevent chronic low back pain in high-risk patients: The TARGET trial. A multi-site pragmatic cluster randomized trial Lastly, Tony Delitto's clinical pearl for all new clinicians: "The time you spend talking with your patients is more valuable than the time with your instruments." Connect on Socials: @TonyDelitto @ZimneyKJ @PMintkenDPT @EIMteam

An interview with Dr. Zeba Aziz from Hameed Latif Hospital in Lahore, Pakistan, Dr. William Burke from Stony Brook University Hospital in Stony Brook, NY, and Dr. Keiichi Fujiwara from Saitama Medical University International Medical Center in Saitama, Japan, authors on "Assessment of Adult Women with Ovarian Masses and Treatment of Epithelial Ovarian Cancer: ASCO Resource Stratified Guideline." This guideline provides recommendations in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer. Read the full guideline at www.asco.org/resource-stratified-guideline.   TRANSCRIPT ASCO: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care, and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. BRITTANY HARVEY: Hello, and welcome to the ASCO Guidelines podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content, and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at podcast.asco.org. My name is Brittany Harvey, and today, I'm interviewing Dr. Zeba Aziz from Hameed Latif Hospital in Lahore, Pakistan, Dr. William Burke from Stony Brook University Hospital in Stony Brook, New York, and Dr. Keiichi Fujiwara from Saitama Medical University International Medical Center in Saitama, Japan, authors on Assessment of Adult Women with Ovarian Masses in Treatment of Epithelial Ovarian Cancer: ASCO Resource Stratified Guideline. Thank you for being here, Doctors Aziz, Burke, and Fujiwara. First, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The full conflict of interest information for this guideline panel is available online with the publication of the guideline and the Journal of Clinical Oncology, Global Oncology. Dr. Burke, do you have any relevant disclosures that are directly related to this guideline topic? DR. WILLIAM BURKE: I do not. BRITTANY HARVEY: And Dr. Fujiwara, do you have any relevant disclosures that are related to this guideline topic? DR. KEIICHI FUJIWARA: Yes. I have the consultancy for the PARP inhibitors development. BRITTANY HARVEY: Thank you. And then Dr. Aziz, do you have any relevant disclosures that are related to this guideline? DR. ZEBA AZIZ: No, I don't. BRITTANY HARVEY: Thank you. OK, so first, Dr. Burke, can you give us a general overview of what this guideline covers? DR. WILLIAM BURKE: Sure, Brittany. The purpose of this guideline is to provide expert guidance in treatment of adult women 18 years and older with epithelial ovarian cancer, including fallopian tube and primary peritoneal cancer, to clinicians, public health leaders, patients, and policymakers in a resource-constrained setting. To do this, ASCO has established a process for development of resource stratified guidelines, which includes a mixed methods of evidence-based guideline development, adaptation of the clinical practice guidelines to other organizations, and formal expert consensus. This guideline summarizes the results of this process and presents resource-stratified recommendations. The recommendation of this guideline centers around the four key clinical questions pertaining to the care of women with ovarian cancer. BRITTANY HARVEY: Great. And then, as you just mentioned, this is a resource-stratified guideline. So Dr. Fujiwara, can you tell our listeners about the four-tier resource stratification used for the development of this guideline? DR. KEIICHI FUJIWARA: Oh, yes. So we have the four tiers resource stratification, which were basic, limited, enhanced, and maximum. So for the basic, it's the core resources or fundamental services that are absolutely necessary for any public health or primary health care systems to function. So the basic levels of this typically are applied in our single clinical interactions. For the limited, so this is the second tier resources or services that are intended to produce major improvements in outcomes such as, for instance, cost-effectiveness, and are attainable with a limited financial means and modest infrastructures. So the limited level of service may involve single or multiple interactions. And the third  tier is enhanced. The third tier resources or services that are optional, that are important, enhance the level of resources should produce further improvements in the outcome and to increase the number of the quality of options in the individual choices. Lastly, the fourth tier is a maximal, so high-level or state of the art resources, or services that may be used or are available in some high-resource countries, and/or may be recommended for the high resource setting guidelines that do not adapt to resource constraints, but that nonetheless should be considered for a lower priority than those resources or services listed in the other categories on the basis of extreme cost and/or impracticality for the broad use of the resource-limited environment. BRITTANY HARVEY: Great. Thank you for going over those. So next, I'd like to review the key recommendations of this guideline. This guideline addresses four overarching clinical questions. So first, Dr. Aziz, what are the key diagnostic and staging recommendations for patients with symptoms of epithelial ovarian cancer? DR. ZEBA AZIZ: Thanks, Brittany. Basically, as pointed out, we have three levels. The basic level usually involves one or two encounters, and at the basic level, the doctor makes a clinical assessment of a suspected ovarian mass, takes a good history and physical, and the family history is also important at the same time. At the basic level, one can do a chest X-ray and an ultrasound to confirm the suspicion, and then the doctor should ideally send the patient to a limited or an enhanced level-- wherever the patient can go. At the limited and enhanced level, again, you have to do diagnostics, which include a CT scan and an MRI if it's available and feasible. You can do the biomarker studies for CA125 and CEA level, and to make a diagnosis, you can do a CT-guided biopsy. You can also do a cell cytology and if a cell block preparation can be made through cell block. Very rarely, if need be, and if you think that you need to make a diagnosis and you can't do anything else, laparoscopy can be done. Once the diagnosis is made, you then go for staging. And the staging is usually done when you're doing a CT scan and you do an abdominal and pelvic CT scan. You do a CT scan of the chest if you think it's needed. Otherwise, a chest ray will suffice. And then you go forward and get a diagnostic workup done and send it to the surgeon for either and decide on a multidisciplinary with a neoadjuvant or surgical assessment testing. BRITTANY HARVEY: Great. Then so next, Dr. Fujiwara, what are the overarching recommendations for surgery with women with stage one to four epithelial ovarian cancer? DR. KEIICHI FUJIWARA: Yes. So the purpose of the surgery is to diagnose, stage, and/or for treatment. So we strongly recommended the ovarian cancer surgery should be performed by trained gynecological oncologists or surgeons with oncologists' surgical expertise. If it is not suitable, we strongly recommend to refer those patients to the highest-resourced level center with an oncology surgical care capacity. For the staging purpose, where the feasible patients with a presumed early stage ovarian cancer should undergo surgical staging by train surgeons. In basic setting, surgical staging is not feasible. Thus, it is not recommended. For the treatment purpose of the women with advanced ovarian cancer, which is a stage three or four, should receive optimal surgical debulking to remove all visible disease to improve overall survival by trained surgeons. BRITTANY HARVEY: Great. And then Dr. Burke, what are the key recommendations for optimal adjuvant and systemic therapy for patients with stage one to four epithelial ovarian cancer? DR. WILLIAM BURKE: Sure. Well, one of the most important things is that access to appropriate evidence-based chemotherapy agents, contraindications to chemotherapy, and potential side effects of chemotherapy should be evaluated and managed in every patient. Basic resource settings that most likely lack the capacity to provide safe administration of chemotherapy should refer patients to a higher level center for evaluation. Limited settings without skilled capacity should refer patients to settings with access to specialized care. Some other notes include that clinicians should be able to document pathology and stage to determine eligibility for adjuvant chemotherapy. If pathology confirmation is not possible due to patient or resource limitation, alternatives can be discussed. Clinicians should not administer systemic treatment, adjuvant chemotherapy, to patients with ovarian low malignant potential tumors or early stage, microinvasive borderline tumors, independent of stage. Combination chemotherapy with paclitaxel and carboplatin is the standard of care for adjuvant therapy in ovarian cancer. However, single agent carboplatin may be utilized due to resource limitation or patient characteristics. Only in enhanced settings, highly selected cases can be assessed for appropriate evidence based intraperitoneal chemotherapy following optimal debulking, where there are resources and expertise to manage the toxicities. BRITTANY HARVEY: Great. And then the last overarching clinical question-- Dr. Aziz, what is recommended for patients with recurrent epithelial ovarian cancer? DR. ZEBA AZIZ: You know, with recurrent ovarian epithelial cancer is a tough option, especially in patients residing in the low-middle income countries. Supportive care treatment should be started together with whatever we have to do. So there are three options. There's one patient who presents with a rising CA125 with no evidence of disease and asymptomatic. We can elect to follow these patients, and it's easier to follow them until they become symptomatic or they have evidence of disease. If you have small volume disease which is resectable, you send them to an enhanced level setting, ideally where surgery can be done. Then you also look at patients and divide them into platinum resistant or platinum sensitive. If they're platinum sensitive, you can give a platinum-containing regimen, but if they're platinum resistant, you can put them on a non-platinum chemotherapy-- a single agent or whatever-- but these patients are tough to manage in that part of the world. BRITTANY HARVEY: Definitely. Well, thank you all for reviewing each of those key recommendations. The full recommendations are available in the guideline, but those are some important highlights. Thank you very much. So Dr. Burke, in your view, what is the importance of this guideline, and how will it change practice? DR. WILLIAM BURKE: Sure. Well, I think the importance of this guideline is that it globally targets health care providers, including gynecologic oncologists, surgeons, nurses, and palliative care clinicians, as well as non-medical community members, including patients, caregivers, and members of advocacy groups, providing them with resource-stratified clinical guidelines, recommendations that can be implemented across many health settings. The guideline will hopefully raise awareness among frontline practitioners, and provide guidance to provide adequate services in the face of varied and sometimes limited resources we see throughout the world. BRITTANY HARVEY: Great. And Dr. Aziz, how do you envision that these guidelines can be applied in low and middle income regions? DR. ZEBA AZIZ: These are extremely important guidelines for our part of the world. Remember that there are about 70 low-middle income countries, and all these countries-- and within each country-- there's marked variability in training of physicians who encounter cancer patients. There's also difficulty by the patients in accessing a few tertiary care centers, cancer care centers which are present, and most of all, financial implications, because you have to go there, you have to stay there, you have to get your chemotherapy, and this is true for the marginalized population. You also have to remember that more than 50% of our patients are treated in a limited resource setting, and the availability of enhanced resources are very difficult for them. And these limited settings are in public sector hospitals, where the doctors-- some of the doctors are very good, but the physicians or surgeons are overworked. They have resources ranging from minimal to moderate, depending on the funds available. And because they're overworked and there are few working hours, detailed counseling of the patient is infrequent because there are a large number of patients there. And the majority of surgeries, which is the cornerstone of ovarian cancer, is done by the postgraduate fellows who are there. Sometimes the senior consultants do surgeries, but most of the time, it is done by them. First time chemotherapy is easier to deliver because it does not have any expensive medicines. There are a lot of generics for carboplatin and taxanes regimen available, so it's not a major problem. But treating the side effects, again, becomes very expensive, and the patients have to come back and forth. The relapsed disease is very difficult to treat because we don't have too many options there and it is expensive. We've also seen that patients who are treated at an enhanced level do much better. Their survival outcomes are better, the supportive care treatment is better, and the progression-free survival is also better. BRITTANY HARVEY: Great. Thank you for reviewing that information. And then finally, Dr. Fujiwara, Dr. Aziz touched on this a bit on how it impacts patients, but how else do you view that these guideline recommendations will affect patients? DR. KEIICHI FUJIWARA: Yes. As Dr. Aziz said and Dr. Burke said, this guideline is written for the patients around the world in a different medical environment. So I think that it is very useful resource of information for patients to receive the best ovarian cancer treatment that suits the actual situation of each country or regions. BRITTANY HARVEY: Great. Well, thank you all for your work on these important guidelines. It sounds like they're going to have a real impact globally, and so I really appreciate both all of your work on these guidelines, and also for taking the time to speak with me today, Dr. Aziz, Dr. Burke, and Dr. Fujiwara. DR. ZEBA AZIZ: Thank you, Brittany. BRITTANY HARVEY: And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast Series. To read the full guideline, go to www.asco.org/resource-stratified-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO guidelines available on iTunes or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode.

In this episode, I explore the notion of fit and how it is missing from the Stratified Design paper.

Professor of clinical oncology at the University of Oxford and Clinical Director of the Oxford Institute for Radiation Oncology - Stratified medicine studies: what we have learnt from the set-up and delivery of the adaptive FOCUS 4 trial. Transcript: https://docs.google.com/document/d/1kkNeISk15owBsojhUk68ypHnUueDDcGnD6kv3by_L4w/edit

Coffee Sessions #32 with D. Sculley of Google, The Godfather Of MLOps. //Bio D is currently a director in Google Brain, leading research teams working on robust, responsible, reliable and efficient ML and AI. In his time at Google, D worked on nearly every aspect of machine learning, and have led both product and research teams including those on some of the most challenging business problems. // Links to D. Sculley's Papers ML Test Score: https://research.google/pubs/pub46555/ Machine Learning: The high-interest credit card of technical debt https://research.google/pubs/pub43146/ Google Scholar: https://scholar.google.com/citations?user=l_O64B8AAAAJ&hl=en --------------- ✌️Connect With Us ✌️ ------------- Join our slack community: https://go.mlops.community/slack Follow us on Twitter: @mlopscommunity Sign up for the next meetup: https://go.mlops.community/register Connect with Demetrios on LinkedIn: https://www.linkedin.com/in/dpbrinkm/ Connect with David on LinkedIn: https://www.linkedin.com/in/aponteanalytics/ Connect with Vishnu on LinkedIn: https://www.linkedin.com/in/vrachakonda/ Connect with D. Sculley on LinkedIn: https://www.linkedin.com/in/d-sculley-90467310/ Timestamps: [00:00] Introduction to D. Sculley [00:40] Biggest Papers were written by D for Machine Learning [02:08] What's changed since you wrote those papers? [02:56] "No 1, there is an MLOps community." [04:38] Old best practices [05:12] "The fact that there are jobs titled MLOps, this is different than it was 5 or 6 years ago." [06:30] Machine Learning Systems then and now [07:08] "There wasn't the level of general infrastructure that was looking to offer the large scale integrated solutions." [07:57] ML Test Score [11:09] "The Test Score was really written for situations where you don't care about one prediction. You care about millions or billions of predictions per day." [12:27] "In the end, it's not about the score. It's about the process of asking the questions making sure that each of the important questions that you're asking yourself, you have a good answer to." [13:04] What else is needed in the Test Score? [14:36] Stratified testing [17:05] Counterfactual testing [18:34] Boundaries [19:15] Dark ages [20:27] How do you try in Triage? [21:10] "Reliability is important. There are no small mistakes. If there are errors, they're going to get spotted and publicised. They're going to impact user's lives. The bar is really high and it's worth the effort to ensure strong reliability." [23:11] How do you build that interest stress test? [24:39] "I believe that stress test is going to look like a useful way to encode expert knowledge about domain areas." [25:37] How do I bring robustness? [26:47] "Because we don't know how to specify the behaviour in advance, testing the behaviour that we wanted to have is a fundamentally hard problem." [27:22] Underspecification Paper [30:58] "It's important to be evaluating models on this auto domain stress test and make sure that we understand the implications of what we're thinking about while we are in deployment land." [32:27] Principal challenges in productionizing Machine Learning [34:57] "As we expose our models to more specifics, this means there are more potential places our models might be exhibiting unexpected or undesirable behaviour." [42:37] Splintering of ML Engineering [46:00] Communities shaping the MLOps sphere [46:42] "It's much better to have one large community than three smaller communities because of those edufacts." [47:47] Concept of technical debt in machine learning. [49:28] "The good idea is to tend to make their way into the community if they are in a form that people can digest and share."

White button mushrooms could slow progression of prostate cancer Beckman Research Institute, March 19, 2021 The chemicals present in white button mushrooms may slow the progression of prostate cancer, according to a mouse study presented virtually at ENDO 2021, the Endocrine Society's annual meeting. "Androgens, a type of male sex hormone, promote the growth of prostate cancer cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells," said lead researcher Xiaoqiang Wang, M.D., Ph.D., M.B. (A.S.C.P.), of the Beckman Research Institute of City of Hope, a comprehensive cancer center in Duarte, Calif. "White button mushrooms appear to suppress the activity of the androgen receptor." City of Hope's Shiuan Chen, Ph.D., the principal investigator of this project, previously conducted a phase one clinical trial of white button mushroom powder in patients with recurrent prostate cancer, which indicated that the mushrooms reduced levels of prostate-specific antigen (PSA) in the blood, with minimal side effects. Heightened blood levels of PSA in men may indicate the existence of prostate tumors. The new study aimed to understand the mechanism behind this finding. The researchers studied the mushroom extract's effect on prostate cancer cells that were sensitive to androgen. They also studied the extract's effect on mice implanted with human prostate tumors, which creates an animal model whose results would be more reliable as the research is translated to human clinical trials. The researchers found that in prostate cancer cells, white button mushroom extract suppressed androgen receptor activity. They also found that in mice treated with white button mushroom extract for six days, prostate tumor growth was significantly suppressed, and levels of PSA decreased. "We found that white button mushrooms contain chemicals that can block the activity of the androgen receptor in mouse models, indicating this fungus can reduce PSA levels," Wang said. "While more research is needed, it's possible that white button mushrooms could one day contribute to the prevention and treatment of prostate cancer."     Study shows stronger brain activity after writing on paper than on tablet or smartphone University of Tokyo, March 18, 2021 A study of Japanese university students and recent graduates has revealed that writing on physical paper can lead to more brain activity when remembering the information an hour later. Researchers say that the complex, spatial and tactile information associated with writing by hand on physical paper is likely what leads to improved memory. "Actually, paper is more advanced and useful compared to electronic documents because paper contains more one-of-a-kind information for stronger memory recall," said Professor Kuniyoshi L. Sakai, a neuroscientist at the University of Tokyo and corresponding author of the research recently published in Frontiers in Behavioral Neuroscience. The research was completed with collaborators from the NTT Data Institute of Management Consulting. Contrary to the popular belief that digital tools increase efficiency, volunteers who used paper completed the note-taking task about 25% faster than those who used digital tablets or smartphones. Although volunteers wrote by hand both with pen and paper or stylus and digital tablet, researchers say paper notebooks contain more complex spatial informationthan digital paper. Physical paper allows for tangible permanence, irregular strokes, and uneven shape, like folded corners. In contrast, digital paper is uniform, has no fixed position when scrolling, and disappears when you close the app. "Our take-home message is to use paper notebooks for information we need to learn or memorize," said Sakai. In the study, a total of 48 volunteers read a fictional conversation between characters discussing their plans for two months in the near future, including 14 different class times, assignment due dates and personal appointments. Researchers performed pre-test analyses to ensure that the volunteers, all 18-29 years old and recruited from university campuses or NTT offices, were equally sorted into three groups based on memory skills, personal preference for digital or analog methods, gender, age and other aspects. Volunteers then recorded the fictional schedule using a paper datebook and pen, a calendar app on a digital tablet and a stylus, or a calendar app on a large smartphone and a touch-screen keyboard. There was no time limit and volunteers were asked to record the fictional events in the same way as they would for their real-life schedules, without spending extra time to memorize the schedule. After one hour, including a break and an interference task to distract them from thinking about the calendar, volunteers answered a range of simple (When is the assignment due?) and complex (Which is the earlier due date for the assignments?) multiple choice questions to test their memory of the schedule. While they completed the test, volunteers were inside a magnetic resonance imaging (MRI) scanner, which measures blood flow around the brain. This is a technique called functional MRI (fMRI), and increased blood flow observed in a specific region of the brain is a sign of increased neuronal activity in that area. Participants who used a paper datebook filled in the calendar within about 11 minutes. Tablet users took 14 minutes and smartphone users took about 16 minutes. Volunteers who used analog methods in their personal life were just as slow at using the devices as volunteers who regularly use digital tools, so researchers are confident that the difference in speed was related to memorization or associated encoding in the brain, not just differences in the habitual use of the tools. Volunteers who used analog methods scored better than other volunteers only on simple test questions. However, researchers say that the brain activation data revealed significant differences. Volunteers who used paper had more brain activity in areas associated with language, imaginary visualization, and in the hippocampus—an area known to be important for memory and navigation. Researchers say that the activation of the hippocampus indicates that analog methods contain richer spatial details that can be recalled and navigated in the mind's eye. "Digital tools have uniform scrolling up and down and standardized arrangement of text and picture size, like on a webpage. But if you remember a physical textbook printed on paper, you can close your eyes and visualize the photo one-third of the way down on the left-side page, as well as the notes you added in the bottom margin," Sakai explained. Researchers say that personalizing digital documents by highlighting, underlining, circling, drawing arrows, handwriting color-coded notes in the margins, adding virtual sticky notes, or other types of unique mark-ups can mimic analog-style spatial enrichment that may enhance memory. Although they have no data from younger volunteers, researchers suspect that the difference in brain activation between analog and digital methods is likely to be stronger in younger people. "High school students' brains are still developing and are so much more sensitive than adult brains," said Sakai. Although the current research focused on learning and memorization, the researchers encourage using paper for creative pursuits as well. "It is reasonable that one's creativity will likely become more fruitful if prior knowledge is stored with stronger learning and more precisely retrieved from memory. For art, composing music, or other creative works, I would emphasize the use of paper instead of digital methods," said Sakai.   Eating processed meat could increase dementia risk? University of Leeds (UK), March 22, 2021 Scientists from the University of Leeds's Nutritional Epidemiology Group used data from 500,000 people, discovering that consuming a 25g serving of processed meat a day, the equivalent to one rasher of bacon, is associated with a 44% increased risk of developing the disease.  But their findings also show eating some unprocessed red meat, such as beef, pork or veal, could be protective, as people who consumed 50g a day were 19% less likely to develop dementia.?  The researchers were exploring a potential link between consumption of meat and the development of dementia, a health condition that affects 5%-8% of over 60s worldwide.  Their results, titled Meat consumption and risk of incident dementia: cohort study of 493888 UK Biobank participants, are published today in the American Journal of Clinical Nutrition.  Lead researcher Huifeng Zhang, a PhD student from the University of?Leeds'?School of Food Science and Nutrition, said: "Worldwide, the prevalence of dementia is increasing and diet as a modifiable factor could play a role. Our research adds to the growing body of evidence linking processed meat consumption, to increased risk of a range of non-transmissible diseases."?  The research was supervised by Professor Janet Cade and Professor Laura Hardie, both at Leeds.  The team studied?data provided by UK Biobank, a database containing in-depth genetic and health information from half a million UK participants?aged 40 to 69, to investigate associations between consuming different types of meat and risk of developing dementia.??  The data included?how often?participants?consumed different kinds of meat, with six options from never to once or more daily, collected in 2006-2010 by the UK Biobank.?The study did not specifically assess the impact of a vegetarian or vegan diet on dementia risk, but it included data from people who said they did not eat red meat.?  Among the participants, 2,896 cases of dementia emerged over an average of eight years of follow up.?These people were?generally older, more?economically deprived, less educated, more likely to smoke, less physically active, more likely to have stroke history and family dementia history, and more likely to be carriers of a gene which is highly associated with dementia. More men than women were diagnosed with dementia in the study population.??  Some people were three to six times more likely to develop dementia due to well established genetic factors, but the findings suggest the risks from eating processed meat were the same?whether or not?a person was genetically predisposed to developing the disease.?  Those who consumed higher amounts of processed meat were?more likely to be male, less educated, smokers, overweight or obese, had lower intakes of vegetables and fruits, and had higher intakes of energy, protein, and fat (including saturated fat).?  Meat consumption has previously been associated with dementia risk, but this is believed to be the first large-scale study of participants over time to examine a link between specific meat types and amounts, and the risk of developing the disease.?  There are around 50 million dementia cases globally, with around 10 million new cases diagnosed every year. Alzheimer's Disease makes up 50% to 70% of cases, and vascular dementia around 25%. Its development and progression are associated with both genetic and environmental factors, including diet and lifestyle.??  Ms?Zhang said: "Further confirmation is needed, but the direction of effect is linked to current healthy eating guidelines suggesting lower intakes of unprocessed red meat could be beneficial for health."  Professor Cade said: 'Anything we can do to explore potential risk factors for dementia may help us to reduce rates of this debilitating condition. This analysis is a first step towards understanding whether what we eat could influence that risk."   Tea drinking slashes the risk of cognitive decline and Alzheimer's disease: Singapore population-based analysis   National University of Singapore, March 20, 2021   Tea consumption halves the risk of cognitive impairment for people 55 years old and above, and also dramatically reduces the risk of developing Alzheimer's disease among those at greater genetic risk.   These were the key findings of a longitudinal study involving 957 seniors led by assistant professor Feng Lei from the Department of Psychological Medicine at National University of Singapore’s (NUS) Yong Loo Lin School of Medicine. It found that regular consumption of tea lowers the risk of cognitive decline in the elderly by 50%, while APOE e4 gene carriers who are genetically at risk of developing Alzheimer’s disease may experience a reduction in cognitive impairment risk by as much as 86%.   The research team also discovered that the neuroprotective role of tea consumption on cognitive function is not limited to a particular type of tea – so long as the tea is brewed from tea leaves, such as green, black or oolong tea.   “While the study was conducted on Chinese elderly, the results could apply to other races as well. Our findings have important implications for dementia prevention. Despite high quality drug trials, effective pharmacological therapy for neurocognitive disorders such as dementia remains elusive and current prevention strategies are far from satisfactory. Tea is one of the most widely consumed beverages in the world. The data from our study suggests that a simple and inexpensive lifestyle measure such as daily tea drinking can reduce a person’s risk of developing neurocognitive disorders in late life,” said assistant professor Feng.   However, he said much more work is needed to fully understand the biological mechanisms responsible for these benefits.   Assistant professor Feng added: "Based on current knowledge, this long term benefit of tea consumption is due to the bioactive compounds in tea leaves, such as catechins, theaflavins, thearubigins and L-theanine. These compounds exhibit anti-inflammatory and antioxidant potential and other bioactive properties that may protect the brain from vascular damage and neurodegeneration. Our understanding of the detailed biological mechanisms is still very limited so we do need more research to find out definitive answers."   In this study, tea consumption information was collected from the participants, who were community-living elderly, from 2003 to 2005. At regular intervals of two years, these seniors were assessed on their cognitive function using standardised tools until 2010. Information on lifestyles, medical conditions, physical and social activities were also collected. Those potential confounding factors were controlled in statistical models to ensure the robustness of the findings.   The paper, published in The Journal of Nutrition, Health & Aging, stated: "A total of 72 incidents of neurocognitive disorders (NCD) were identified from the cohort. Tea intake was associated with lower risk of incident NCD, independent of other risk factors. Reduced NCD risk was observed for both green tea (OR=0.43) and black/oolong tea (OR=0.53) and appeared to be influenced by the changing of tea consumption habit at follow-up. Using consistent non-tea consumers as the reference, only consistent tea consumers had reduced risk of NCD (OR=0.39). Stratified analyses indicated that tea consumption was associated with reduced risk of NCD among females (OR=0.32) and APOE e4 carriers (OR=0.14) but not males and non APOE e4 carriers."   It concluded that regular tea consumption was associated with lower risk of neurocognitive disorders among Chinese elderly. Gender and genetic factors could possibly modulate this association, it added.     Exposure to common chemical during pregnancy may reduce protection against breast cancer Research suggests propylparaben is an endocrine disruptor University of Massachusetts, March 16, 2021 Low doses of propylparaben - a chemical preservative found in food, drugs and cosmetics - can alter pregnancy-related changes in the breast in ways that may lessen the protection against breast cancer that pregnancy hormones normally convey, according to University of Massachusetts Amherst research. The findings, published March 16 in the journal Endocrinology, suggest that propylparaben is an endocrine-disrupting chemical that interferes with the actions of hormones, says environmental health scientist Laura Vandenberg, the study's senior author. Endocrine disruptors can affect organs sensitive to hormones, including the mammary gland in the breast that produces milk. "We found that propylparaben disrupts the mammary gland of mice at exposure levels that have previously been considered safe based on results from industry-sponsored studies. We also saw effects of propylparaben after doses many times lower, which are more reflective of human intake," Vandenberg says. "Although our study did not evaluate breast cancer risk, these changes in the mammary tissue are involved in mitigating cancer risk in women." Hormones produced during pregnancy not only allow breast tissue to produce milk for the infant, but also are partly responsible for a reduced risk of breast cancer in women who give birth at a younger age. The researchers, including co-lead author Joshua Mogus, a Ph.D. student in Vandenberg's lab, tested whether propylparaben exposure during the vulnerable period of pregnancy and breastfeeding adversely alters the reorganization of the mammary gland. They examined the mothers' mammary glands five weeks after they exposed the female mice to environmentally doses of propylparaben during pregnancy and breastfeeding. Compared with pregnant mice that had not received propylparaben, the exposed mice had mammary gland changes not typical of pregnancy, the researchers report. These mice had increased rates of cell proliferation, which Vandenberg says is a possible risk factor for breast cancer. They also had less-dense epithelial structures, fewer immune cell types and thinner periductal collagen, the connective tissue in the mammary gland. "Some of these changes may be consistent with a loss of the protective effects that are typically associated with pregnancy," says Mogus, who was chosen to present the research, deemed "particularly newsworthy" by the Endocrine Society, at the international group's virtual annual meeting, ENDO 2021, beginning March 20.  Mogus says future studies should address whether pregnant females exposed to propylparaben are actually more susceptible to breast cancer. "Because pregnant women are exposed to propylparaben in many personal care products and foods, it is possible that they are at risk," Mogus says, adding that pregnant and breastfeeding women should try to avoid using products containing propylparaben and other parabens. "This chemical is so widely used, it may be impossible to avoid entirely," Mogus adds. "It is critical that relevant public health agencies address endocrine-disrupting chemicals as a matter of policy."     Low magnesium levels associated with depressive symptoms and metabolic disorders in men Pomeranian Medical University (Poland), March 19, 2021   According to news reporting from Szczecin, Poland, research stated, “Background: changes in the concentration of magnesium influence numerous processes in the body, such as hormone and lipid metabolism, nerve conduction, a number of biochemical pathways in the brain, and metabolic cycles. As a result, changes in magnesium concentration may contribute to the emergence of such pathologies as depressive and metabolic disorders, including hypertension, diabetes, and dyslipidemia.” Our news journalists obtained a quote from the research from Pomeranian Medical University: “Methods: blood samples were taken from 342 men whose mean age was 61.66 ± 6.38 years. The concentrations of magnesium, lipid parameters, and glucose were determined using the spectrophotometric method. Anthropometric measurements were performed to determine each participant’s body mass index (BMI). Additionally, all participants completed two questionnaires: the Beck Depression Inventory and the author’s questionnaire. Results: abnormal levels of magnesium were found in 78 people. The analysis showed that these subjects more often suffered from metabolic disorders such as diabetes mellitus (* * p* * < 0.001), hypertension (* * p* * < 0.001), and depressive symptoms (* * p* * = 0.002) than participants with normal magnesium levels.” According to the news reporters, the research concluded: “Conclusion: our research showed that there is a relationship between abnormal levels of magnesium and the presence of self-reported conditions, such as diabetes, hypertension, and depressive symptoms among aging men. These findings may contribute to the improvement of the diagnosis and treatment of patients with these conditions.”     Self-compassion can lessen feelings of work-from-home loneliness, finds study Indiana University, March 19, 2021 The ongoing COVID-19 pandemic is keeping millions of Americans from their usual offices, as they find themselves still working at home. Even with the vaccine now being distributed, working from home may still be the future for some, and new research suggests the resulting work loneliness negatively impacts employee well-being. Stephanie Andel, an assistant professor of psychology in the School of Science at IUPUI, along with collaborators at York University and the University of North Carolina at Charlotte, recently published a study finding that feelings of work loneliness during the pandemic were associated higher depression and fewer voluntary work behaviors. The research appears in the Journal of Occupational Health Psychology. "We wanted to understand what factors are driving feelings of work loneliness, and to understand how this work loneliness influenced employees' psychological health and work behaviors," Andel said. "We looked at three different factors that we thought might drive work loneliness: perceptions of job insecurity, telecommuting frequency and insufficient communication from their companies about how they were responding to the pandemic. "We found each of those factors contributed to feelings of work loneliness, and we also found that work loneliness was associated with depression and fewer voluntary helping behaviors at work." Participants in the study came from a wide range of industries including manufacturing; technology, such as computer programming; retail; and education. The results are based on weekly surveys of these individuals from mid-March to mid-May 2020. When people feel lonely, the study found, they experience more depressive symptoms, and they are less likely to go above and beyond in their jobs, such as helping a co-worker—something many organizations may have hoped their employees would do during the pandemic. But there is hope—in the form of self-compassion. Andel and colleagues found self-compassion, or being kind to yourself during times of suffering, can mitigate some of the negative effects of work loneliness. "We found that self-compassion helps protect employees from some of the negative effects of work loneliness," Andel said. "We suspect this is because self-compassion leads individuals to be kinder to themselves, makes them more likely to recognize that they are not alone in their feelings and helps them to be aware of—but not consumed by—their negative feelings." Individuals who reported having higher levels of self-compassion exhibited fewer depressive symptoms following feelings of work loneliness in comparison to those with lower levels of self-compassion. But they also engaged in fewer helping behaviors, which surprised the study's authors. "We originally thought if you were more self-compassionate, you might have the energy and mental resources to engage in more helping behaviors at work," Andel said. "However, it turns out that the pattern is opposite of what we expected. Instead, those who were higher in self-compassion were more likely to give themselves a necessary break. We suspect that this may ultimately help them to feel better and help more in the future." Although self-compassion has been studied quite a bit in the field of clinical psychology, it has rarely been examined in the workplace context. Andel is optimistic about its potential to enhance the health and well-being of employees. "It will be very interesting for future research to continue investigating the power of self-compassion in the workplace," she said. "For instance, it would be great to see if managers who promote self-compassion at work foster a better working experience for their employees. Ultimately, my collaborators and I hope to develop self-compassion interventions that can be utilized by companies to help their employees feel and perform better at work." For companies that want to help their employees struggling right now with work loneliness, Andel provides the following suggestions: Provide consistent and clear communication regularly to employees regarding the company's response to the pandemic and be transparent about structural or financial changes that may affect employees' job security or income. Host virtual social gatherings for employees. These should not be mandatory, but rather voluntary social activities aimed at enhancing employee morale and promoting a sense of belonging among employees. Create an organizational climate that promotes and encourages employee self-compassion. For individuals who want to take the initiative themselves to enhance their own self-compassion, Andel suggests that in times of perceived failure or suffering, one should try to avoid negative self-talk and instead, give the same kindness and compassion to oneself that you would give to a good friend. "This is an exciting and important step in bringing self-compassion to the organizational literature, and my collaborators and I look forward to building on this research," Andel said. 

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Recorded February 12, 2021Current Episodes at https://walkinverse.buzzsprout.com/I am moving all podcast here slowly. I will keep buzzsprout for all public reports and here for member only content.Report #37, "Gates, Fauci, and Operation Warp Speed: It's All About Connections." In the last report, we reviewed the mRNA experimental injectable technology. Now we will show a few connections behind it. Grab a pen and notebook and enjoy the report.In the last report, we reviewed the mRNA experimental injectable technology. Now we will show a few connections behind it.To date, health officials claim the novel COVID-19 soars past 16.2 million cases for a virus with a 99.9% survival rate. To justify case count, they continue to use a test proven to produce false positives. This immoral act allows for compliance through fear as these elites can accelerate their agenda without resistance.But before we dig further, please hear these words and wipe the dread from your mind. We will prevail once we remove our eyes from man and place them on the Almighty.And as stated in Isaiah 35:3-5, we have nothing to fear.“Strengthen the weak hands, And make firm the feeble knees. 4 Say to those who are fearful-hearted, “Be strong, do not fear! Behold, your God will come with vengeance, With the recompense of God; He will come and save you.” 5 Then the eyes of the blind shall be opened, And the ears of the deaf shall be unstopped.”Isa 35:3-5With those words in mind, let's view the network which drives the mRNA agenda.Many question why government officials and healthcare providers push an experimental genome therapy labeled a vaccine. They realize it causes illness and death. They have no discernment of long or short-term side effects. And yet, the answer lies before us. Massive financial gain and control for continuous revenue streams at our expense.In an interview, Bill Gates boasted how the vaccine industry returned a 20-1 investment. This statement shows how these elites play for keeps. They do not have our well-being in mind (1).And soon, a Gates-backed (2) firm will release 200 million vaccine kits and millions of experimental injections for vaccination against a coronavirus, aka a common cold.Back in May, Korea's S.K. Bioscience pharmaceutical company received $3.6 million in research funds from the Gates Foundation to support the development of a COVID-19 vax. This same company works as a contract manufacturer for AstraZeneca, which received $750 million from CEPI and GAVI (3) back in June 2020 to support the manufacturing, procurement, and distribution of mRNA injectable technology. In addition, AstraZeneca agreed to supply 1-Billion doses to low and mid-income nations. On top of these quantities, they announced a supply of 400 million doses ready for the E.U. And all the while, under the cover of night, the Imperial College steps into the vaccine game. They plan on another variation by the first half of 2021. Will it work? They have no clue. Professor Robin Shattock (4), the head of the vaccine development team at the University of Imperial College, stated, “We anticipate if everything goes really well, that we'll get an answer as to whether it works by early next year.”Professor Shattock is from the same Imperial College where Neil Ferguson used his fraudulent models to lock the world down (5) through data manipulation. He used invalid inputs based on early estimates. He selected outdated demographics, populations, and hospital bed counts to inflate numbers artificially. Instead of data from specific states to gather credible metrics, his models used the entire U.S. to drive COVID-19 spread. This skyrocketed infection rates and fears, as the model assumed everyone spreads the disease at the same rate—for virus spread detection, it's an outright scam and a crime against humanity. Yet, he still roams free without consequence. Why?The answer lies in the secure funds received from the European Commission, Bill and Melinda Gates Foundation, Wellcome Trust, MRC, and the NIH (Anthony Fauci), which indicates the degree of corruption imposed upon humanity for long term profits.And when we look to NIH and Fauci, we witness extended deception with their ties to Moderna (6). With the mRNA-1273 experiment, the U.S. government appears to have joint ownership through filed patents. With $472 million secured, Moderna plans to reach its target of 500 million doses per year, with a ramp-up to one billion in 2021. Also, (7) DARPA joins Moderna to develop an implantable biochip for the deployment of experimental therapies, which can affect human DNA.But at (8) $19.50 per dose, subsidized by taxpayers, does it matter? It's all about people over profits, which circles us back to GAVI, the WHO, CEPI, and Trump's Operation Warp Speed.Trump pulled finances (9) from the WHO, which everyone cheered as he handed it over to GAVI, the Vaccine Alliance. What most may not realize, Gates and his foundation founded GAVI in 2000 (10). So when Trump pledged $1.16 billion at the virtual Global Vaccine summit, this became part of the Fiscal budget for 2020-2023, which solidified the fact he did not have the American people's best interest in mind. Instead, he increased the hold Bill Gates has on the U.S. population and their health.At the summit, Gates stated, “Since its inception GAVI has helped vaccinate more than three-quarters of a billion children … And now, it's stepping up and saying it's willing to deliver a COVID-19 vaccine as soon as one is available to end the pandemic as soon as possible, … We must also renew our commitment to delivering every life-saving vaccine there is to every child on earth.”In addition, GAVI received a donation of $5 million from the Rockefeller Foundation for “routine immunization programs” and “play a major role in the rollout of a future COVID-19 vaccine.” which aligns with their playbook, Operation Lockstep (11).On top of this, who did Trump put at the helm of Operation Warp Speed? Another Gates connection, a former executive of GlaxoSmithKline, Moncef Slaoui. His role? Work hand in hand with General Gustave Perna for the production and vaccination across the United States.Now we'll look at CEPI, Operation Warp Speed, and Novavax. In 2017 Gates co-founded, “The Coalition for Epidemic Preparedness Innovations (CEPI)” (12) to stop epidemics via vaccines. It's the largest vaccine charity in the world. They made their mark across mainstream when they granted $388 million to an unknown biotech company, Novavax. Another company to fill the world with mRNA injections for COVID-19 (Certificate of Vaccine Identification – Artificial [1] Intelligence [9]). In a move that baffled many, Operation Warp Speed (12) also selected this company and awarded them $1.6 billion in taxpayers' funds. So while the people of the United States have their rights revoked and business destroyed at astronomical rates, the Trump administration gave your future away to Gates for an injection never used or tested on humans.And all the while, the media, Fauci, Gates, social media companies, politicians, and others lied outright to the people about HCQ (13). They knew it worked from day one. But as we see from facts, Big Pharma revenue streams and kickbacks outweighed our health.Instead of protecting people's lives, our officials schemed with these monsters behind closed doors to push an experiment to alter your DNA (14). As learned in Professor Klungland's research, “RNA has a direct effect on DNA stability.” He notes how several research groups collaborate to understand the effects this can have on the DNA molecule. He stated, “We already know that R-loop areas are associated with sequences of DNA containing active genes and that this can lead to chromosomal breakage and the loss of genetic information…” This reveals absolute modification, regardless of what the fake fact-checkers, mainstream, social media channels, or Fauci's pundits claim.To drive this point one step further, we look to the National Cancer Institute for clarification (15). Through research, they learned modification in human mRNA affects gene expression, “NAT10, an enzyme, was found to be responsible for the modification, which itself has been implicated in cancer and aging. This is one of the first examples of a unique chemical modification to mRNA…”To date, these companies refuse doctors and researchers the information required to learn the effects these synthetic drugs have on the human body. But it looks like another revenue stream in cancer therapies with the chemical modification seen in these experiments.And while the PREP Act combined with the unlawful classification of mRNA as a vaccine, these corporations have 100% immunity from all legal action (8) while they engage in an experiment without the people's informed consent (16) — a process which requires compliance or rejection of a medical procedure such as surgeries, anesthesia, radiation, chemotherapy, vaccination, and other scenarios.These experimental war crimes continue under the guise of trials (17), “A new vaccine trial is underway in the U.K. to test whether mixing and matching different COVID-19 vaccines for the first and second doses is effective,” they continue, “The country is currently using the Pfizer-BioNTech vaccine and Oxford-AstraZeneca vaccine, which both require two doses. For the study, run by the National Immunization Schedule Evaluation Consortium, patients will get one dose of each.”Remember, they never approved mRNA technologies for human use. These professionals for profit don't know or care about the long or short term side effects. To further prove these drugs still exist in the experimental stage, Moderna started on July 27, 2020, and will end on October 27, 2020, as noted by the study (18), “A Study to Evaluate Efficacy, Safety, and Immunogenicity of mRNA-1273 Vaccine in Adults Aged 18 Years and Older to Prevent COVID-19.” Pfizer (19) began their test on humanity on April 29, 2020, with a target primary completion on August 3, 2021, and the experiment to end on January 21, 2023, as noted in the “Study to Describe the Safety, Tolerability, Immunogenicity, and Efficacy of RNA Vaccine Candidates Against COVID-19 in Healthy Individuals.”With each injection, they test their poisons on an ill-informed public. And due to PREP, if you or your loved one becomes injured or dies from these jabs, you have zero recourse. Without informed consent, all involved in administration, production, delivery, and procurement—guilty of war crimes against humanity as stated in the Nuremberg Code (20), “The voluntary consent of the human subject is absolutely essential.” No bribes or coercion—all the facts known beforehand. For those front line workers, LEO, Military, Politicians who follow orders, no excuse. During the trials of Nuremberg, ignorance did not afford reprieve from the consequences of their willful actions. They knew and still tested on humans without consent (21).“THE PROOF AS TO WAR CRIMES AND CRIMES AGAINST HUMANITYJudged by any standard of proof the record clearly shows the commission of war crimes and crimes against humanity substantially as alleged in counts two and three of the indictment. Beginning with the outbreak of World War II criminal medical experiments on non-German nationals, both prisoners of war and civilians, including Jews and “asocial” persons, were carried out on a large scale in Germany and the occupied countries. These experiments were not the isolated and casual acts of individual doctors and scientists working solely on their own responsibility, but were the product of coordinated policy-making and planning at high governmental, military, and Nazi Party levels, conducted as an integral part of the total war effort. They were ordered, sanctioned, permitted, or approved by persons in positions of authority who under all principles of law were under the duty to know about these things and to take steps to terminate or prevent them.”Sounds familiar?When Governments (8) and officials receive kickbacks and taxpayers fund Big Pharma experiments with no legal ramifications, it no longer about one health. It's all profits.The time's at hand to end this experiment, or they will end us—no more compliance.There are more of us than them.References* Freedom Lovers TV. 2020. Bill Gates Confesses Vaccines Are His Best Investment w/ ROI of 20 to 1.* Soo Kim. 2020. “Coronavirus Vaccine Update as Bill Gates-Backed Firm Could Make 200 Million Kits a Year.” Newsweek, July 27, 2020, sec. News.* Staff. 2020. “AZD1222 SARS-CoV-2 Vaccine.” Precision Vax. December 6, 2020.* Imperial College. n.d. “Professor Robin Shattock.”* Osburn, Madeline. 2020. “Inaccurate Virus Models Are Panicking Officials Into Ill-Advised Lockdowns.” The Federalist. March 25, 2020.* Patrick Howley. 2020. “BUSTED: NIH Owns Financial Stake In Gates-Funded Coronavirus Vaccine.” National File (blog). June 29, 2020.* Franz Walker. 2020. “DARPA Funded Implantable Biochip Can Potentially Be Used to Deploy Moderna's MRNA Vaccine.” Nanotechnology News. October 12, 2020.* Apuzzo, Matt, and Selam Gebrekidan. 2021. “Governments Sign Secret Vaccine Deals. Here's What They Hide.” The New York Times, January 28, 2021, sec. World.* Broze, Derrick. 2020. “Vaccine Bait & Switch: As Millions Pulled From WHO, Trump Gives Billions To Gates-Founded GAVI.” The Last American Vagabond (blog). July 7, 2020.* The Bill & Melinda Gates Foundation [Internet]. [cited 2021 Feb 9]. Available from: https://www.gavi.org/investing-gavi/funding/donor-profiles/bill-melinda-gates-foundation* N/A. Operation Lockstep: From The Rockefeller Playbook [Internet]. Shadaily. 2020 [cited 2020 Dec 7].* Carmichael, Taylor. 2020. “Why Was Novavax Awarded Almost $2 Billion in Free Money?” The Motley Fool. July 22, 2020.* Patrick Howley. 2020. “EXPOSED: The Truth About Fauci and Birx, Bill Gates And Globalist Elites.” National File. March 26, 2020.* Eyrun Thune. 2020. “Modified RNA Has a Direct Effect on DNA.” PHYS.ORG. January 29, 2020.* NIH. 2018. “A Novel MRNA Modification May Impact the Human Genetic Code.” Center for Cancer Research. November 15, 2018.* Kirsten Nunez. 2019. “Informed Consent in Healthcare: What It Is and Why It's Needed.” Healthline. October 11, 2019.* O'Kane, Caitlin. 2021. “U.K. Study Will Test If Getting Doses of Two Different COVID-19 Vaccines Is Effective.” CBS News. February 4, 2021.* ModernaTX, Inc. 2020. “A Phase 3, Randomized, Stratified, Observer-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety, and Immunogenicity of MRNA-1273 SARS-CoV-2 Vaccine in Adults Aged 18 Years and Older.” Clinical trial registration NCT04470427. clinicaltrials.gov.* BioNTech SE. 2021. “Study to Describe the Safety, Tolerability, Immunogenicity, and Efficacy of RNA Vaccine Candidates Against COVID-19 in Healthy Individuals.” Clinicaltrials.Gov. February 9, 2021.* Government. 2020. “THE NUREMBERG CODE.” February 16, 2020.* Government. 1949. “TRIALS  OF WAR CRIMINALS  BEFORE THE  NUERNBERG MILITARY TRIBUNALS  UNDER  CONTROL  COUNCIL LAW No. 1.” 1949. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit walkinverse.substack.com/subscribe

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.18.304501v1?rss=1 Authors: Fernandez, J., Guttenberg, N., Witkowski, O., Pasquali, A. Abstract: Due to a large number of potential applications, a good deal of effort has been recently made towards creating machine learning models that can recognize evoked emotions from one's physiological recordings. In particular, researchers are investigating the use of EEG as a low-cost, non-invasive method. However, the poor homogeneity of the EEG activity across participants hinders the implementation of any such system by a time-consuming calibration stage. In this study, we introduce a new participant-based feature normalization method, so-called stratified normalization, for training deep neural networks in task of cross-subject emotion classification from EEG signals. The new method is able to subtract inter-participant variability while maintaining the emotion information in the data. We carried out our analysis on the SEED dataset, which contains 62-channel EEG recordings collected from 15 participants while watching film clips. Results demonstrate that networks trained with stratified normalization outperformed standard training with batch normalization significantly. In addition, the highest model performance was achieved when extracting EEG features with the multitaper method, reaching a classification accuracy of 91.6% for two emotion categories (positive and negative) and 79.6% for three (also neutral). This analysis provides us with great insight into the potential benefits that stratified normalization can have when developing any cross-subject model based on EEG. Copy rights belong to original authors. Visit the link for more info

In this episode of the podcast, I have talked about Glaciers and its classification along with distribution and Also talked about my questions that I asked my professor at my university.How Do Glaciers Move?How do glaciers move?How Fast Do Glaciers Move?Additional InformationArêtes are narrow, serrated, knife-edge ridges forming a thin partition between two cirques or adjacent parallel glacial troughs. Horns are pyramidal, steep-walled mountain peaks formed by headward erosion of cirques. To form, a horn must have at least three cirques on its flanks. Glacial Deposits:Both valley and continental glaciers deposit their sediment load as glacial drift, a general term for glacially deposited material. A vast sheet of the glacial drift of the Pleistocene Epoch blankets the northern U.S. and adjacent Canada.Erratics are boulders eroded and transported by glaciers and deposited in areas from which they were obviously not derived. Till is poorly sorted sediment deposited by glacial ice. Stratified drift is layered, sorted sediment deposited by flowing meltwater.MorrainesThe outermost end moraines deposited when the glacier was at it greatest extent are called terminal moraines. If the glacier recedes and eventually stabilizes at a new location, an end moraine has known as a recessional moraine accumulates at the terminus. Ground moraines are deposited as glaciers recede and sediment is liberated form the melting ice. Ground moraines have an irregular, rolling topography.Twitter: https:twitter.com/realyashnegiSuggestions are always welcomed: yashnegi4920@outlook.comSupport the show (https://paypal.me/yashnegi27?locale.x=en_GB)

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.31.231514v1?rss=1 Authors: Shastry, V., Adams, P. E., Lindtke, D., Mandeville, E. G., Parchman, T. L., Gompert, Z., Buerkle, C. A. Abstract: Non-random mating among individuals can lead to spatial clustering of genetically similar individuals and population stratification. This deviation from panmixia is commonly observed in natural populations. Consequently, individuals can have parentage in single populations or involving hybridization between differentiated populations. Accounting for this mixture and structure is important when mapping the genetics of traits and learning about the formative evolutionary processes that shape genetic variation among individuals and populations. Stratified genetic relatedness among individuals is commonly quantified using estimates of ancestry that are derived from a statistical model. Development of these models for polyploid and mixed-ploidy individuals and populations has lagged behind those for diploids. Here, we extend and test a hierarchical Bayesian model, called entropy, which can utilize low-depth sequence data to estimate genotype and ancestry parameters in autopolyploid and mixed-ploidy individuals (including sex chromosomes and autosomes within individuals). Our analysis of simulated data illustrated the trade-off between sequencing depth and genome coverage and found lower error associated with low depth sequencing across a larger fraction of the genome than with high depth sequencing across a smaller fraction of the genome. The model has high accuracy and sensitivity as verified with simulated data and through analysis of admixture among populations of diploid and tetraploid Arabidopsis arenosa. Copy rights belong to original authors. Visit the link for more info

In this episode, Ryan discusses the importance of knowing what the current market is in your city and why it will benefit you. Know the difference between a buyer's market, a seller's market and a stratified market and how it can help you when you are ready to buy or sell. 

Join Ross & I again as we discuss a wide array of arcane and unheard subjects, including but not limited to the Day of YHWH, 1st century Catalcysm, literal restoration of Israel, second exodus-horizontal rapture, affirmation of serpent seed doctrine, raw meat diet, intermittent fasting, and more.