Podcasts about subodh

In this JCO Article Insights episode, Subodh Selukar interviews author Dr. Robert Maki on "Combining Response and Toxicity Data to Implement Project Optimus" by Maki, et al published in the Journal of Clinical Oncology September 11, 2024. TRANSCRIPT Subodh Selukar: Welcome to this episode of JCO Article Insights. This is Subodh Selukar, JCO's editorial fellow. Today, I am interviewing Dr. Robert Maki on his recent editorial, “Combining Response and Toxicity Data to Implement Project Optimus.” At the time of this recording, our guest has disclosures that are available in the manuscript and will be linked in the transcript. Dr. Maki, welcome to our podcast. Dr. Robert Maki: Hi, Subodh. It's a pleasure to be able to take part. Subodh Selukar: Yeah, thank you. So, to start us off, would you give an overview of your article? Dr. Robert Maki: Yes. Well, it's not my article, but it's just an editorial which is a commentary on an article by authors Cheng and Associates. It's called, “Exposure-Response-Based Multiattribute Clinical Utility Score Framework to Facilitate Optimal Dose Selection for Oncology Drugs.” That's a very technical title and so forth, and yet it's a JCO article because we think that it makes an important point that in oncological trials, we talk a lot about primary endpoints, oftentimes of overall survival or progression free survival, sometimes even just response rates, but most of the time, we don't take into account the toxicity of an agent. So, you can imagine that if a drug is relatively nontoxic, then what you see is what you get. Progression free survival could be associated with what is called some sort of so-called clinical benefit. However, if a drug is really toxic and you're just laid up on the couch all day or bed bound, or need transfusions three days a week, where is that really beneficial for the patient? But, by the same token, there's no quality of life without life itself. You have to have some sort of evidence that someone is going to be around for a longer period of time as an indication of benefit. So, these are ideas that have been played out to some degree for the better part of a quarter of a century. There's a biostatistician at MD Anderson named Peter Thall, who's one of the first people to think about this idea of combining toxicity data and response data as some sort of a combination primary endpoint for a trial. And where this comes into play for Project Optimus, this FDA initiative to come up with not just necessarily one dose or one dose and schedule, but rather a range or multiple doses and schedules for a drug based on the toxicity that's seen, is that this new paper by Dr. Cheng and colleagues provides one mechanism for doing this, for combining not just traditional clinical outcomes data, but also toxicity data. Subodh Selukar: So, you mentioned Project Optimus is an important component of all of this. So, can you tell a little bit about what Project Optimus is and maybe a little bit potentially about how Project Optimus has affected you so far? Dr. Robert Maki: I'd say it's having an effect mostly in the earlier phases of drug development. I'm not certain, but I think it was an outgrowth of some of the toxicity that was seen in some of the studies that were done over the course of the last 10 to 15 years with kinase-targeted drugs. The overall goal from the FDA Project Optimus was to work with companies, with academia, groups like ASCO and regulatory authorities, as well as patients to try and come up with dosing for everyone basically based on patient characteristics that they're focusing not just on those outcomes, such as progression, pre survival, overall survival, but also looking for quality of life and adding that into the mix in terms of how you choose a dose. So that's an effort that's been going on for the last several years now. There's been some nice articles on that from FDA on that and perhaps we could provide some links to those as well for people who are interested in some of the more introductory core information about Project Optimus. Subodh Selukar: Yeah, for sure. And so, I mean you're on the editorial board at JCO and you've written this editorial, but has Project Optimus affected your clinical research yet? Dr. Robert Maki: It's just beginning to. So, in phase 1 and 2 clinical trials, especially in phase 1, the goal is not necessarily to look for activity, but just to come up with a recommended phase 2 dose and schedule of a drug. Well, Project Optimus says, “Okay. Well, maybe there's more than one dose and schedule that should arise.” And as I was alluding to earlier, this may have arisen out of what was seen previously where a number of the multi targeted tyrosine kinase inhibitors were developed. But when you got to the phase 3 trial, it was necessary to have dose reductions in 30%, 40%, 50%, 60%, even 70% of patients in some situations. So that to me represents a drug or a development pathway for that drug that was in essence incorrect. Yes, we talk about in traditional chemotherapy of trying to get the maximum dose we can, but is that always the best thing for the patient? And we recognize that there really is a plateau usually for systemic therapies we give, that there is a limit to dose escalation even within an individual patient to try and achieve that same benefit. At some point you're just going to add toxicity. The idea is to bring some element of toxicity into the decision making for a recommended phase 2 dose and schedule or schedules in that case. Subodh Selukar: And so, building on that, so I think one advantage of these different approaches is that they might identify a single optimal dose, or maybe they'll recommend this range of doses that maximize some maybe clinical utility score combining these different aspects. In the current paradigm, it seems like probably response and toxicity are just these separate concepts that aren't typically linked together. But we typically do have a single recommended dose. But like you said, they might in subsequent trials have a lot of dose reductions and stuff like that. So how do you think about the process now where this is a single recommended dose of, but there are deviations from that recommended dose in the research process. Like you said, in subsequent trials or within a trial, maybe patients are needing their own dose reductions as well. And then separately once a product is approved, what do you think about deviating from the recommended dose for your standard clinical practice? Dr. Robert Maki: Oftentimes a work in progress. So even after phase 1, maybe having only treated 30 to 50 patients, they may be relatively homogeneous and that they have to be healthier to qualify for phase 1 trial. Once the drug is released to the whole wide world, then it becomes a different scenario, and you may have patients with poor performance status to start with. Can they still get the same benefit as the patients who got the medication in the context of a clinical trial? And it may not be the case. And I think this is where Project Optimus and the idea of giving more than one dose or schedule may be useful and say, “Okay. Well, you can give 20% less,” and what's the trade off? Maybe the drug doesn't work as well, but it is less toxic. On average, do you really lose a whole lot as a matter of a few weeks of median progression free survival? Or does the response rate really drop off as you decrease the dose intensity of your drug? One concern about having more than one dose and schedule is could you potentially be underdosing patients by the same token? Since we usually have some amount of time, at least a few weeks, to work out what's tolerable for our patient, at least the parameters of having more than one dose and schedule to choose from can be useful. Subodh Selukar: So then thinking about potentially maybe we would have a range of doses to recommend, what do you think are going to be challenges once that starts to be incorporated into clinical practice? What kind of complications do you think might happen explaining this to a patient? Dr. Robert Maki: That's a really, really good question and something that we- I think, just have a difficult time with just the regular consent form. It used to be that maybe you had a couple of information sheets on a standard drug, or if it's a clinical trial, then you'll have a relatively modest consent form that's supposed to be at, whatever, 7th, 8th, 9th grade reading level. But now you start adding this form with complex text to a consent form for a clinical trial. What are people really signing up for? They get a 40-page document, and I don't think they really understand that. So, the idea that you're trying to relate to them, pushing as hard as you can, but by the same token watching out for that toxicity, I think really does speak to those endpoints of the program, that it really can be a patient-friendly idea. Are we going to necessarily get it right every time? No. As I was mentioning previously there, if you're only treating 30 to 50 patients, you may only have partial information and you come up with some sense of dose and schedule to give. And then you move that into phase 2 and phase 3, and you may have to, you see that maybe one dose and schedule is a lot more effective as you get into a randomized portion of a phase 2 trial before you move to phase 3, for example, or you see that the toxicity is much greater with no better evidence of progression free survival. So those two scenarios could certainly rise. You can't predict them in the early phases of development of a drug, but you have to be able to react or be able to react with a solid clinical trial design that allows you to have that flexibility to make those decisions later. This is where discussion with the regulators, obviously is very important to make sure that what you're doing really still fits these guardrails, as it were, of traditional clinical trial design, or these ideas of adding in the toxicity-based information from Project Optimus. Subodh Selukar: One of the challenges in early phase trials is, like you said, we might have 30 to 50 patients at the end of the study. I think in the editorial, you mentioned that some of these newer metrics might require more and more patients. Maybe we need 30 to 50 patients on a single dose in order to have reliable understanding of these clinical utility scores. Whereas right now a sample size at a single dose might be six patients, it might even be fewer. What are your thoughts on that aspect of it? Dr. Robert Maki: That's an important point, too. When you're doing, let's say, a quick and dirty, as you might say, 3+3 design, which has very large error bars in terms of the confidence intervals around a dose and schedule compared to some of the newer Bayesian-based designs, yes, you can get a phase 1 trial quote done, especially if it's a ‘me too' sort of drug, so say, another checkpoint inhibitor, you kind of know the characteristics of those over another inhibitor of a specific kinase, you know the toxicities to expect when you block, let's say, EGF receptor. So, if you have some idea, and therefore you're able to more rapidly get to that recommended phase 2 dose from a phase 1 trial, if it ends up being a new drug, then maybe 30 to 50 patients isn't enough. And you really do need to continue that assessment of both response and toxicity as the trials move forward into phase 2 and phase 3. So, it's kind of one of those ideas of continuous process improvement that if we are going to do this, we really do need to include it, not just in early phase trials, but especially for agents that are acting through a new mechanism of action, that we look at that holistically across the drug development spectrum. And now that trials are kind of being smashed together, phase 1 and 2, now phase 2 and 3, that really increases our need to also add in the assessment of toxicity, and maybe not just on the basis of our own evaluations or lab evaluations of toxicity, but patient reported outcomes, which is something that wasn't addressed in the Cheng article and really hasn't been well addressed in clinical trials in general, I would offer. There are precious few trials that incorporate patient reported outcome data as a means to determine what's too toxic for a patient, for example. So how do we do that? As you know, we do have patient reported CTCAE clinical toxicity criteria that are based on patient reported outcomes. And wouldn't it be interesting, at the very least, as an academic project, but even more importantly, later on, to use those as the key means to determine whether a dose is too toxic or not in the development of the drug. That, to me, would be really, really interesting and kind of turns the idea of some of the data that we collect on its head. I guess, yes, we do need to collect things like liver function tests and so forth. It is one metric of toxicity of a drug. But patients have a lot of fatigue, we really do a poor job of documenting that as clinicians, and not to mention the elements that go into what that fatigue is. To be able to capture that through PROs would be another noble effort that I think has been underutilized and underappreciated in oncology clinical trials overall. Subodh Selukar: And so, what do you think are barriers to doing it now? Dr. Robert Maki: We tend to, for lack of a better term, cut and paste from what we've done before, to develop new, let's say, by patient reported outcome score or metric or worksheet for a given diagnosis. That can be hard, that takes a lot in and of itself, and perhaps has been one of the barriers that we don't have enough disease specific PROs, at least for some diagnoses. For others we do. And the fact that we do have PRO-scored CTCAE sorts of score tables, now, certainly makes it easier to validate and use these tools in clinical trials. So, I would love to see more of that, even if it ends up being secondary tertiary endpoints on phase 1, 2, and 3 trials. It's a pretty easy thing to add, even if you're doing that for the first time. Get some experience with it, and it can only help patients get through a trial or even just assessing it as part of a standard of care that will help our patients in the longer run. Subodh Selukar: Yeah. And so, thinking about other metrics of success, you mentioned a couple in your article. These aren't necessarily patient reported outcome ones, but like RECIST and RANO. I was curious. I think the Cheng article, maybe I would think about it as a general framework for combining response and toxicity together, whereas some of these other metrics are a lot more disease specific, potentially, or agent and disease specific, maybe even. Do you think that clinical research will end up settling on these metrics that are kind of increasingly specific, or do you think that there's a possibility for general frameworks? Dr. Robert Maki: Yeah, that's a tough question. I'm just trying to think of some of those patients reported outcomes. They've got kind of the general assessment ones, and then you do have ones that are more disease specific, just like we do have response criteria that are different for, let's say, lymphoma versus brain tumors versus colorectal cancer. We do have different ways of measuring those outcomes, and we all complain that those are imperfect measures. You can always find circumstances where that patient was responding, but it was called progression or vice versa. So even from these more objective tools like RECIST and the like, it's a challenging field, that's for sure. We keep going around and trying to find ways of improving those sorts of systems. But let's say, for example, you used - this is part of the reason we moved from two dimensional measurements in WHO criteria versus one dimensional RECIST - if you have two dimensions, well, you have that much more variability in the measurements of the lesion. So, it turned out that we just didn't gain anything by having those bidimensional measurements. Now, since we have the ability to measure tumors better in three dimensions, should we be using volumetric assessments? Part of it depends on the size of the tumor. If you're dealing with a tumor that's 1 cm versus 8 cm, well, then the volumetric changes, you have a lot more variability, the small ones, than the big ones. Not to mention the fact that you have shapes that are not just an ovoid mass in a lot of cancers. There's just so many pitfalls in these sorts of data. What really matters at the end of the day, one thing that's underappreciated, and again is underscored by Project Optimus, is getting back to the patient. Subodh Selukar: Your editorial made me have this one thought, and so bear with me, it's like a multi-part question. One of the reasons that we're becoming more and more interested in these alternative approaches, these clinical utility scores and everything, is that these new agents are being proposed, where there's a hypothesis that there's more complicated relationships between dose, response and toxicity. And so, 50 years ago, researchers probably didn't hypothesize that these complicated relationships were happening. They probably thought that they were more straightforward. What do you think would have happened if we had had these conversations that we're having today if we'd had them 50 years ago, what do you think would be different? Do you think that maybe we would have different therapies that kind of ended up becoming standard today? Maybe would we interpret or run studies differently today? Dr. Robert Maki: I like that question as well. Now, if we go back to the Charles Moertel studies back from the 1970s, the whole reason that we have tumor measurements as a criterion are really based on his work, where he got a series of clinicians together and he put these masses underneath a piece of rubber sheeting, and they tried to determine how well they could determine the difference between a mass that they could palpate. And this is when we came up with the idea that a partial response was a 50% decrease in the cross-sectional area of a mass. That came from that very crude but important work from about 50 years ago. And of course, that was also a time when there really wasn't any imaging. Maybe the best you would have would be x-ray tomography to look at a lung nodule or something like that. It was a little bit of a different era. We didn't know how our drugs worked very well. We had at least some biochemical reason to use chemotherapy, and we tried to leverage that. But it was always the idea of more is better, finally disproved later on, in let's say the era of breast cancer, looking at the AC combination or doxorubicin as part of a treatment for breast cancer, that there was a ceiling to the benefit of doxorubicin in the adjuvant setting. Even then, it was clear that we needed to think about dose and schedule. We also didn't have the variety of drugs that we have now, or the different metrics that we have, circulating tumor DNA or something along those lines. Those sorts of things just never existed then either. So, we need metrics that are appropriate for their time, and we have more tools to work with. I suspect that we'll have more specialization in oncology along disease lines, or even molecularly characterized subsets of diagnoses as well. All the detailed classification that we now need for a lymphoma, for example, or different flavors of triple negative breast cancer, all of those things are impacting how we even put a person on a trial. Similarly, since these patients are also going to get different classes of drugs that are relatively unique to them, there are a lot of drugs now that are available that really are only approved for one diagnosis. Then you really have to drill down pretty deeply in order to be able to focus on that clinical scenario. But I think we have the means to do so. Nonetheless, the general idea of these frameworks, again, the idea of combining response and toxicity data that can apply across essentially any cancer or neoplasm that we want to study. Subodh Selukar: Okay. So, I want to move a little bit to aspirational, like where we want to move forward now. And so I think you've talked a little bit about this so far already, but would you tell me a little bit about when you're seeing a patient, interpreting results that have been given in clinical trials, are there results, metrics, summaries of trials that you wish you could communicate to them, metrics that actually already exist but don't really get implemented? You already mentioned quality of life is something that doesn't seem to be there but are there other things that maybe quality of life might not just be collected enough yet. But are there metrics on data that we have and we just don't really report them at all? Dr. Robert Maki: That may be the case, or maybe the data end up in a secondary and tertiary publication, so they don't really become part of the lingua franca of the oncologist. I think it really speaks to just having the experience as an oncologist that you try the FDA-approved dose for medication for somebody and you run into trouble if they're, let's say, in their 80s, whereas the study population was in their 40s and their 50s with better bone marrows or better renal function on average, and things like that. So, another untested waters are geriatric oncology. What are the maximum tolerated doses when they're 80 versus when they're 40 or 50? It's a real challenge. Probably they had the most experience of that with things like prostate cancer, where we do treat largely an older population of men compared to other diagnoses, potentially. I suspect we're going to see just more specialization, just like we do with the medications. We do need more specialized assessments for those adverse events and or quality of life that will be diagnosis specific. If you have GI cancer, abdominal pain is going to be a bigger issue or obstruction sorts of questions. And the symptoms that you may have from having a tumor within the abdomen versus, let's say, another diagnosis, which may tend to give you more, let's say, lung metastases. So those little subtleties can't come out. And the toxicities of the drugs that we use in those diagnoses are also going to differ as well. So those should be kept in mind as we come up with, let's say, disease specific toxicity metrics that we want to combine with those outcome data. So, I think we're going to see more and more specialization of that over time. You have to create the tool and you've got to validate it. So, all these things will take some time. But again, people have been interested in this for a long, long time. There are any number of careers that are built around quality of life and cancer, or for example, long term survivorship in pediatric cancer patients. And all of these things can be very useful and just require our attention, both as clinical investigators as well as clinicians, when we face our patient's day to day. Subodh Selukar: And so just one last question before we close. Is there anything that we haven't had a chance to talk about that you like to share with our listeners? Dr. Robert Maki: If it's anything it's that I'm really heartened as I get older with this very large influx of new clinicians and new investigators. Oncology continues to get more interesting and more sophisticated. We need more people- we still don't have enough oncologists, even for our population here in the United States. We'll have plenty to do for a very, very long time. So, I'm excited to see a new generation of young oncologists such as yourself and the trainees that I see here, the new fellows, junior faculty who are all beginning to answer these questions, thinking about them. And as me and some of my more senior friends can help promote this kind of idea and help together to answer some of these questions. We're still trying to figure it out and there are just so many variables and clinical scenarios that we need to chase down in terms of clinical research. It is going to be an ongoing discussion and hopefully this article is just one example towards the goal again of finding the right dose for our given patient. Subodh Selukar: Thank you so much for sharing and yeah, I'm very excited to be a part of this as well. This has been Subodh Selukar interviewing Dr. Robert Maki on his recent editorial, “Combining Response and Toxicity Data to Implement Project Optimus.” Thank you for listening and stay tuned for the next episode of JCO Article Insights.   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.    Dr. Robert Maki Disclosures: Consulting or Advisory Role: Deciphera, PEEL Therapeutics, Eisai, GlaxoSmithKline, Medtronic, Boehringer Ingelheim Speakers' Bureau: MJH Life Sciences  Research Funding: Amgen, Astex Pharmaceuticals, Boehringer Ingelheim, BioAtla, C4 Therapeutics, InhibRx, Regeneron, SARC: Sarcoma Alliance for Research though Collaboration, TRACON Pharma Patents, Royalties, Other Intellectual Property, Uptodate Travel, Accommodations, Expenses Company name: Stand up to Cancer, Fondazione Enrico Pallazzo  

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On today's episode we are joined by Subodh Garg from the hit Netflix series "Love on The Spectrum". We get into some of his favorite foods to eat, his favorite sports teams and his current celebrity status + dating life.You can find every episode of this show on Apple Podcasts, Spotify or YouTube. Prime Members can listen ad-free on Amazon Music. For more, visit barstool.link/thedogwalk

This week James and Luke are meeting Sujay Sohani and Subodh Joshi, co-founders of Sri Krishna Vada Pau – or SKVP, the acronym given to the chain by the restaurant's followers on social media. Tapping into the current trend for vegetarian and vegan food, as well as for affordability, the Vada Pau – or the Mumbai burger, as it's sometimes referred to – celebrates the street food of the pair's native Mumbai. **Introduction**(0:00 – 5:06) (Starter) James and Luke introduce Sujay Sahani and Subodh Joshi, the founders of Shree Krishna Vada Pav. **Interview** (5:07 - 24:05) (Main) Sujay and Subodh discuss the importance of originality and authenticity in their recipes. **Post interview discussion** (24:06 – 29:50) ?James and Luke discuss how SKVP is simultaneously attractive to South Asian as well as British audiences. (Dessert) **Closing Remarks and acknowledgments** (29:51- 30:20) The Migration Menu has been brought to you by James Staples and Luke Heslop, with help from Tina Boulton, Esther Opoku Debra and Vimal Dalal. If you have any questions or comments for us, send them in and we will address them in a future show, you can get in touch at info@themigrationmenu.com. Or on ‘X' - formerly Twitter: @migration_menu. Restaurant location: 23 High St Uxbridge UB8 1JN Menu dishes eaten: Vada Pau Chow Patty Chaat Onion and Potato Bhaji Sweet Chai Menu: https://skvp.co.uk/#_menu To see images for this episode, click here.Literature mentioned: Ray, K. 2016. Dreams of Pakistani Grill and Vada Pao in Manhattan: Immigrant Restaurateurs in a Global City, The Ethnic Restauranteur, Bloomsbury For a list of academic literature on these topics and more, please see the list of extended bibliography on the references page or click here. Guest speakers: Sujay Sahani Subodh Joshi For more information, please visit our website: https://themigrationmenu.com/ Hosted on Acast. See acast.com/privacy for more information.

Navigating Independence and Relationships: Subodh and Aarti's Journey on EYK | Season 3, Episode 2Welcome to a special episode of Everything You Know, presented by Easterseals. Today, we've got a truly enlightening conversation lined up with our guests, Subodh Garg and his sister, Aarti Garg. Subodh, a charismatic individual diagnosed with autism at the age of 3, shares his journey towards independence, his exceptional memory, and his experiences with dating and social interactions. Aarti, who plays a crucial role in managing Subodh's social engagements and safety online, provides insight into their sibling dynamics and the support systems that help Subodh navigate his challenges and aspirations.In this episode, we delve into the importance of the diverse representation of autism in media, the critical role of technology in improving communication skills, and the universal struggles with dating and social skills. Subodh also discusses his participation in the show Love on the Spectrum, his employment goals in accounting, and his passion for travel. Join hosts Erin Hawley and Lily Newton as they explore these topics and more, offering a broader perspective on neurodiversity and the common human desires for love and connection. Stay tuned as we challenge the misconceptions about autism and celebrate the diverse capabilities and aspirations of individuals on the spectrum.Timestamps0:00 - Introduction to today's episode with hosts Erin Hawley and Lily Newton, featuring guests Subodh and Aarti Garg.2:45 - Subodh Garg discusses his journey towards independence and his aspirations in accounting.5:20 - Exploring the sibling dynamics between Subodh and Aarti Garg, including the misconceptions about their relationship.7:40 - Aarti Garg talks about her role as a manager rather than a caretaker in Subodh's life.10:15 - Challenges of making and maintaining friendships as adults, emphasized by Subodh's experiences.13:30 - Subodh's take on his participation in Love on the Spectrum and developing his dating skills.18:29 - The impact of "Love on the Spectrum" on Subodh's life, as discussed by Aarti.21:10 - Conversation about the universal struggle with dating and social skills.24:05 - Subodh and community building: From online dating to maintaining connections with the show's cast.27:50 - The transportation hurdles and Subodh's use of Access, a paratransit service.30:16 - Subodh's employment ventures at Teledelis and Insight, and his educational goals.33:45 - Lily Newton and Aarti Garg critique the representation of disability in mainstream media and specific TV shows.37:12 - The role of digital content in Subodh's life, including his Instagram engagement and travel posts.40:40 - Detailing the disability readathon initiative and its significance, shared by Erin Hawley.43:28 - Reflections on maintaining friendships amidst life changes and busy schedules.45:35 - Subodh's exceptional memory skills and affinity for recalling specific dates and personal milestones.49:20 - Deep dive into Subodh's past therapies, ongoing supportive services, and aspirations for travel.52:15 - Discussion on the broader spectrum of autism and the personal ambitions of individuals with autism.55:00 - Closing thoughts, upcoming initiatives, and a thank you to Subodh and Aarti Garg for their participation.57:10 - Call to action for disability advocacy and an invitation to listen in to future episodes presented by Easterseals.Connect with Subodh GargInstagram: https://www.instagram.com/traveling_subodh/?hl=enConnect with Aarti GargInstagram: https://www.instagram.com/aartipaarty/?hl=en

Subodh Kulkarni is CEO and President at Rigetti Computing, and our topic in this episode is quantum computing and its implications for our changing planet. Rigetti Computing, a publicly listed company, builds quantum computers and superconducting quantum processors. It also provides cloud-based access to quantum computing for both commercial and research purposes. Quantum computing, a field rooted in theoretical physics, is complex and involves the use of quantum bits or qubits, which differ from binary computing's zeros and ones. As the world's computing demand continues to soar with AI and data centers consuming vast amounts of energy, AI also has the potential to unlock climate change solutions through innovations in biotech, advanced energy, planetary modeling, and more. We wanted to learn from Subodh about how quantum computing might change the game in all of these areas as it matures. Is it possible that quantum computing is an enormous future climate solution? Let's find out.  In this episode, we cover: [02:39]: Subodh's background and joining Rigetti as CEO[05:26]: Basics of quantum computing versus classical computing[09:19]: Introduction to the subatomic world[11:46]: Physicality of a quantum computer [15:01]: Rigetti's business model: cloud access and on-premise quantum computers[17:06]: Qubit development and the potential to follow Moore's law[18:02]: The power requirements of maintaining a hyper-cold environment for quantum computing[20:02]: Quantum computing's potential to reduce data center energy consumption[24:25]: Quantum's strength in probabilistic versus deterministic computation[29:26]: Rigetti's involvement in DOE's fusion project[30:59]: Predictions for quantum computing advancements in the next 10 years[33:45]: How quantum computing can bolster artificial intelligence[36:18]: Current state of quantum computing and near-term inflection points[37:16]: Initial use cases for quantum computing, Rigetti's commercialization strategies, and government funding[41:08]: Collaborative projects with major financial and pharmaceutical companies[42:12]: Potential applications in weather modeling and synthetic biologyEpisode recorded on Jan 23, 2024 (Published on Mar 4, 2024) Get connected with MCJ: Jason Jacobs X / LinkedInCody Simms X / LinkedInMCJ Podcast / Collective / YouTube*If you liked this episode, please consider giving us a review! You can also reach us via email at content@mcjcollective.com, where we encourage you to share your feedback on episodes and suggestions for future topics or guests.

This episode of on-farm trials features Frank Wolf of Lester Wolf farms outside of Uniontown,Washington, and his collaboration as a PI on the PNW cover crops project alongside SubodhAdhikari of the University of Idaho. A conversation with them highlights years of workingtogether that has resulted in these collaborative on-farm cover crop trials, how they are workingtogether to look at various mixes, get them seeded, and what and how data is being collected tomeasure impact on subsequent crops, soil, weeds, and insects to create a regionaldecision-making tool based on their findings.

Step into the vibrant world of Dr. Subodh Kerkar, a distinguished artist and the visionary force behind the Museum of Goa. In this episode, we delve into the inspiring journey of a medical professional turned artist who transcended conventional boundaries to carve a niche in the dynamic realm of contemporary art. Uncover the tales of Goa's rich history, the democratisation of art, and the intriguing fusion of tradition and modernity in the artistic landscapes curated by Dr. Kerkar. Join us as we explore the profound impact of his museums and his relentless pursuit to make art an inclusive experience for all. [00:38] - About Dr. Subodh Kerkar Dr. Subodh is an Artist Founder and Director of the Museum of Goa. He is a qualified medical professional who gave up medicine to pursue the arts. Dr. Subodh has been recognised, felicitated and awarded several times. --- Support this podcast: https://podcasters.spotify.com/pod/show/tbcy/support

Steve impresses during a waterside date. Dani pursues a speed dating match who loves animation while Subodh prepares for a big day with Rachel. XOXO Tess & Mel

Steve sets up an online profile, and Subodh has a practice date ahead of his first real date. After a dreamy outing with Solomon, Dani makes a decision. We love you all! XOXO Tess & Mel

Welcome to episode 33. In this episode I am pleased and honoured to have this gentleman join me from the Indian subcontinent. His company's philosophy is to be ‘a class above' and their premium range and innovative shaving and skincare products should be on every wet shaver's radar.  Co-founder of Pink Woolf Subodh Sharma joins me! You can now get your very own Retro Wet Shaving Podcast merch! From t-shirts, mugs, stickers, phone and iPad covers. BUY here - https://www.redbubble.com/people/The-Retro-WSP/shop?asc=u  Help support the podcast, enter the code RETRO at The Wet Shaving Store checkout https://wetshaving.store/ . If you've enjoyed this episode and would like to show your appreciation and make a small donation and buy me a coffee, please visit ⁠⁠⁠⁠⁠https://www.buymeacoffee.com/dyspraxicshaver⁠⁠⁠⁠⁠. Intro Music ► Music Credit: Dj Quads Track Name: "www is a thing" Music By: Dj Quads @ https://soundcloud.com/aka-dj-quadsOriginal upload HERE - https://www.youtube.com/watch?v=9cqqU...• DJ QUads YouTube channel HERE: https://www.youtube.com/channel/UCusF...• Dj Quads on SoundCloud HERE: https://soundcloud.com/aka-dj-quads• Dj Quads on Twitter HERE: https://twitter.com/DjQuads• Dj Quads on Spotify HERE: https://open.spotify.com/artist/2VZrd...• Dj Quads on Instagram HERE: https://www.instagram.com/djquads/

Sticker Genie is a print partner for many of my illustrator friends who are into merchandising. Subodh, the brains behind Sticker Genie shares his story of how he got into the print industry and then eventually struck gold with the sticker printing business. His clients are artists and illustrators from around the country.  He shares a lot of good info on how to set up your artwork for the best print quality!  ---------------------------------------------------------------------- His page: @stickergenie.in www.stickergenie.in  My work: @swarnavod More about this podcast: Paper Pencil Podcast on Insta: @paperpencilpodcast https://www.swarnavod.com/podcast --- Send in a voice message: https://podcasters.spotify.com/pod/show/swarnavod/message

Subodh Gupta is one of India's leading contemporary artists. His works have been exhibited in the most prestigious art fairs and museums across the globe - including Centre Pompidou and the Victoria & Albert Museum. He is best known for his incredible sculptural works made of household metal objects such as kitchen utensils, lunch boxes, and cookware, and his work highlights the socio-economic landscape of India and cultural transitions. Currently, Subodh is showcasing his new Installations at the iconic Le Bon Marche in Paris which is the first ever department store in the world. Titled Sangam, the exhibition will be on display until February 19, 2023. Here are a few things we discuss with him - You went to art school in Patna in the 1980s. What was your education like at the time? This is your first time exhibiting at a department store. How did you navigate this, and what inspired the name Sangam? Utensils are a key motif in your art. How do you and your team go about sourcing so many utensils? The Design Pataki Podcast is brought to you by Design Pataki, one of India's foremost digital magazines on luxury design. For our top editorial stories on art, architecture and interiors, head to www.designpataki.com. To contact Design Pataki, please email info@designpataki.com. The Design Pataki Podcast is produced in collaboration with Studio41.

Hey Wicked Hunters,  I'm so excited to share this week's podcast with someone who's a master in storytelling.  Subodh is a photographer who left his job to pursue his passion for photography. In this podcast, he shares how he came across many challenges to staying afloat during the pandemic. He thought he had to let go of working on his passion for photography.  But during the toughest time, Subodh finds the courage to push on and pivot to stay true to his purpose. Subodh is a master of storytelling both through words and photography. A true inspiration.  You can find more of Subodh work on: https://twitter.com/SubodhShettyyy https://linktr.ee/SubodhShettyy  Other ways to listen and subscribe to the podcast: Spotify - http://bit.ly/twhspotify  Apple Podcast - https://bit.ly/Theartofphotography  Google Podcast: https://bit.ly/TheArtOfPhotographyWithStanleyAr  Website: podcast.thewickedhunt.com   Tune In (Alexa) - https://bit.ly/TuneInTheArtOfPhotographyPodcastWithStanleyAr    For those of you who want to see connect with Stanley Aryanto, you can go to the following: Instagram: https://www.instagram.com/thewickedhunt/    Facebook: https://www.facebook.com/thewickedhunt/ Twitter: https://www.twitter.com/thewickedhunt/  https://www.TheWickedHunt.com/    Don't forget to let us know your favourite part of the Podcast in the comment below and subscribe --------- Transcription: 0:00   Need, something else shows up? You know, that's how light works, you know, if you're true to what you do, and especially after COVID, I realised, you know, I said, the COVID story is a long story. And I literally thought that's the end of my whole journey, you know, the photography, end of it, let's go back to work, because I'm done. But that's when something happens. You know, a number of things have happened in COVID Unexpected jobs, some unexpected awards, I don't even participate in photography competitions. But during that time, there was no option I had to participate so that I can earn some money out of it and sustain myself till the COVID goes away. So I won awards, I got unexpected jobs from really big, big corporate companies, which kept me afloat, and then came NFT. And it completely changed the game. So whenever you feel that's it, that's the end of it. Just know that it's just a passing phase, and it will be okay. So yeah, follow your passion, everything's gonna be okay. 1:03   Here we go. Hunters, welcome back to The Art of Photography podcast, where we share artists journey, and how they find hope, purpose and happiness, true photography. And today, we have somebody who's very, you know, very iconic in the NFT world, and he is someone who have such an incredible work, both in all kinds of genre, and I am so honoured to have him here, because, you know, he runs a lot of Twitter spaces. And for those of you who are not in Twitter, it's basically a place for us to voice hang out around each other. And he got one of the craziest story. So this is one of the reasons why I want him here to share some of the story in, you know, not only to intrigue you, but also in hope that you can draw inspiration from where he had gone through. So let's welcome to both Shetty both how're you doing Welcome to the Art of Photography 2:03   podcast. I certainly. And hi to everyone listening. So nice to be here. It's always interesting to get a chance to share your story because that's what we do. You know, we are storytellers, and they can never be enough that we can speak about our journey as well as our art. So it's good to be here. 2:23   Ya know, like, absolutely. And I think you're really good with storytelling is something that, you know, every time I hear you talk, I always try to learn and pick up the way you tell a story. It's just so, so intriguing, and really keep you on the edge. So I really enjoy that. So hey, no doubt 2:45   that he said that because I was keep wondering if I make people bored in my spaces with my stories, you know, because sometimes I go all over the place because I am a guy who's very curious. And I'm not a guy who just sticks to photography. I go everywhere, you know, I am into cosmic stuff, you know, Neil deGrasse Tyson, Carl Sagan and all that. I'm towards the other side. I watch a lot of podcasts, including all this Joe Rogan stuff. So yeah, I go everywhere. So I bring everything to the table. Wherever I can connect the dots. I'm like, oh, yeah, that makes sense. This makes sense. So sometimes I wonder if my storytelling is all random. But I'm glad that makes sense. 3:22   Well, it's, it's interesting, right? Because a lot of people have different kind of take to it. But I'm, I'm very similar to you. I love hearing like, I get curious very easily. And I love to explore. So when you should, you know, tell a different thing about a totally different thing about the initial story that we were talking about, I actually get really intrigued about it. So I don't know if it's just me, but I'm sure you know, a lot of people are on your space. I'm sure they are really enjoy it. But um, you know, you you made a lot of success in the NFT world. And I can say that you're one of the person who helped shape the NFT world right. Now, before we kind of get into that. And, you know, like your amazing photography, not only in wildlife and other genre, just tell us a little bit about who is both, you know, and how did you get started with photography? 4:20   Third, no, I'm, I come from a corner in India, which is South India, there's a small little town called Manipal. So that's where it comes from. Manipal is known for its educational universities and everything. It's spread across the world, including the place I'm right now in Dubai. So even in Dubai, we got a Manipal University, which comes from my back door. So yeah, it's very famous place for education. That's where I come from. And as far as you know, my photography goes, I came to Dubai in 2009 in search of a job at that point, I had no photography in my life. So I came to look for a job because just to go uh you know, find something which is worthwhile came to the why and I had a pharmaceutical degree. So I got into this pharma field and I used to be the pharma business and yeah, eventually device is a beautiful country city with a lot of wonderful cityscapes and Burj Khalifa and whatnot, it's very well organised and very much ready for photographers to explore. So in between all that, you know, there was Facebook, which is quite new at that time, and in Facebook, I would see that photographers from Dubai are posting pictures of Dubai in a very beautiful way. And yeah, we all know, you know, photography versus our eye, there's a difference. Because in photography, there's editing this blue hour, this golden hour, which is not that vibrant in our normal life, you know, we just see it in real way. So that photos really got me I'm like, Wow, man, these people are creating some standards. And I think I shouldn't be creating the same because they're all next to me, you know, this all wonderful structures. And that's how I began photography, I got a camera, and it was just a Nikon three, one double zero, which is the most basic camera can buy. Because it's not so sure, because there have been phases in my life, where I've got a guitar, for instance, before photography, I got a guitar, I'm like, Okay, I'm gonna learn music and I failed miserably. And I realised, I should be more careful because that guitar was very expensive one, and then it's of no use, because I can't play the guitar. So I'm like, I'm not gonna do the same mistake with my photography. So I got a very, very cheap camera with a kit lens and explored the streets of Dubai, shooting all the cityscapes and everything. And then I realised, okay, there's something in this photography, which clicks for me, you know, I have some kind of an eye for it. Because I would always, even in my real life, you know, whatever I do, even right now, as I speak to you, there is keyboard in front of me, there is mouse in front of me, there's the airport in front of me, even when they're on the table, I like to keep it organised, I don't want it to be scattered all over the place, that compositional thing is always in me, keeping things in order. So that's exactly what I did with photography, I was trying to create a order in those chaos. And I realised there is something called composition, which comes to me naturally, and I took it took advantage of it. And we may hit Facebook today. But Facebook is where I got all the encouragement. During my beginning days, there used to be a lot of photography groups, and I would take my, you know, beginner style images and post on the group. And they would give me feedbacks. And I learned a lot through that process. And I realised that, you know, it's a bunch of people who are creating all these things for nothing but happiness, you know, just for the sake of feeling good. And I realised this is a nice place to be. And that's how it all began. Eventually, he wants you in every picture I took during those days in the beginning, this would be 301, double zero, then I got a wide angle lens, I would pop up a ND filter on it, and 1000 which is like crazy, high amount of nd I wanted everything to be a five minute exposure, nothing less would do. So that was my initial phase. And then I eventually started getting bored of it. I'm like, Is that the end of my photography? I'm not connecting to it anymore. So then one of my friends told me into street photography, I said, No, I'm not interested. I don't want to do streets. Because Dubai has two sides. One is the Burj Khalifa and the buildings. Other side is the old Dubai with real people doing real things on the streets. People mean, he said, Come over, just try streets once, maybe you will like it. And I tried it. And that was the life changing moment, I would say in photography, because I completely quit the cityscapes and got into street photography, meeting people talking to them, having some tea with them taking their portraits, you know, everything is a chaos and in between that you're finding some gems that really clicked for me. And that's how my photography began. And then eventually you start meeting the right people connecting with a small bunch of you create your own small little group and then you start going out more and more, it becomes something that you look forward to, you know, you pretend to work for five days during the week, just looking forward to that two days of weekend when you can go out and shoot again. That gives the boost which is incredible, I'm sure in every photographer understand. Yeah, no, 9:07   I totally it's like a getaway for us. Right? It's a way to be free and be ourselves and be able to express ourselves. Now that's that's really interesting. I don't think I've heard that side of you know, of the long exposure part so you're really intrigued with the really extra long exposure creating that really smooth scene and then you turn into street photography and that kind of sparked your your idea. I mean, your your love for photography. Now. What are you know, like, I guess when you say you tried guitar before, and I'm sure as someone who loves to explore everything, right? I'm sure there's a lot of things that you like to try in the past. So what make you stay in photography, like what what is different compared to guitar and other thing that you have? pursued and try and, you know, want to be good at? 10:04   Yeah, I mean, one, there are a couple of things, you know, if I have to again, go back to those days, when I got into streets, what made me connect to the streets is the stories that comes along, you know, because you don't just meet a person, you meet a building you I mean, not made, you see a build, take a picture that's about it, there's no conversation, it looks great, it gets a lot of whatever, Marie shares and everything, but still, you're not communicating anything really interesting there. But in case of people, every time I point a camera, you know, even before you point a camera to a person, there will be a small conversation, can I take a picture of you, this and that, and then there'll be some jokes, and people usually get nervous. And all those little things which you navigate as you get to the point where you take a picture, that's very, very interesting for me, because I get to learn a lot. And I come from India, and in Dubai, it's a mix of India and Pakistan, and all kinds of nationalities, Egyptians and whatnot. You know, everyone, there are 170 nationalities in UAE. So you have a chance to communicate with so many people, and sometimes you you you can make a picture, without even knowing the language, you know, if it's India or Pakistan, I can talk in my language, Hindi, and they will get to know what I'm trying to say. But there are certain times when you meet a Chinese, they don't talk a word of English, how do you communicate, I still want this picture. That navigation, you know, makes it a lot of fun, you know, do you just realise that humans are humans, you know, it's, it's so much fun. No, you explore the psychology and how it all works. And at the end of it, you know, you bring a smile on their face, you have a smile on your face by the end of it. And even eventually, as that thing progressed, and I realised that I love people, I love to shoot people, but they're still in my mind, maybe just another face, you know, I liked long exposure of city that accepted to STS, maybe there's something else I need to do, maybe I still not found that real side of my photography. And that's how I realised that I should travel and travel to the Himalayas, my very first trip was to the Himalayas, and in India, and when I went to the Himalayas, it's my first time seeing all the snow peaks and everything. I took all my wide angles, and ND filters and everything, because I thought maybe this is the real face of my photography, where I'll put a nd take a picture of this Himalayan peaks, and I'll be so connected. But then I realised you went to Himalaya, I was interacting with people more, I was enjoying meeting those locals more than the mountains. I enjoy seeing the mountains, I love that lack of oxygen, it makes me feel more alive, weirdly. But what really connected to me was the locals, you know, the people on the land. So again, I realised people are my strength, you know, I need to do this more and more and more, and it gives me wings, you know, because throughout my life, I don't know how it works in your country. But in India, we are always busy with study, study, study till one point and you get your degree and then you go out and start working. There's no real exploration happening there, you know, nowadays is changing. But before during our times, I feel I'm not that old to say during our times, that is the 1990s There are still no such concept as to ask you get your education, you're also travelling and exploring none of those things. You just study, study, study, and you get a degree, you're into job, and then you just live that normal life. But here, it gives me a chance to explore the world for the first time and all because of just one little thing in my hand, which is camera, which gave me all the excuse. And I began travelling like a lot, it is literally a viral infection. Now once I took the flight and went to Himalayas, I'm like where next? You know, and I still had a job, full time job. And I would still make sure that I find excuses, take some leaves of the job and get out and make this travels happen. I went to many, many places in India, Sri Lanka, and Nepal, one after the other, I started taking off places from my from my bucket list. So yeah, this connects connecting with people and excuse to travel to a new place, meet new people, and understand the culture, you know, it completely changes your perspective towards the world. I think that's what keeps me going. It kept me going to the extent where in 2017, you know, 2010 is when I took photography 2017, seven years of managing photography, and my corporate job came to a standstill in English like either choose this or choose that you can't do both. Now we know it because it won't justify either often. So that's when I gave up on my full time job. And I in 2017, I became a full time photographer, I put up my own company in Dubai, which is quite expensive to do and quite a risk to take. And since then, I've been doing photography workshops, which again is an important factor which keeps my photography going because I know that whatever I create, it's one thing to just put it on social media this and that getting the likes and followers and whatever. But also at the same time you're creating a bigger impact which is inspiring others to take up the same passion because a lot of people have cameras. It's not a big deal. Everyone has a camera now, but making them step out of their comfort zone, making them travel with me so that I can show them what I see how I feel, why it's so important to capture these people that is a catalyst, which keeps me going. And that's why I do photography workshops full time, that's my full time job now. So as such kind of motivation, there's nothing that can stop it. Yeah, wow, that's, that's 15:20   inspiring. And, you know, like, I totally can resonate with that, you know, having to being told that the only way to succeed in life is to go to school, get a good grade, and then you go to a good university and get good grades, get good job, get married, buy a house, and you die, right. And, honestly, like, I didn't know any other way of life until like, when I was 30. And that's when I left my career as a mechanical engineer. And, you know, I didn't even know what I was doing. But I, I know that it's not what I wanted to do. And I know that I love photography. So I totally can resonate with what you meant, you know, especially. And like, when you look at the Western culture, it's a little bit different, right. And they're encouraged to explore and take a gap year before before the, the before they full time work and stuff like that. So they can actually figure out what they want to do in life, whether they like that lifestyle, or whether they like the nine to five, which nothing too, nothing wrong with it at all. But I think the worst thing is when you do something that is not you, right, and just have that, that conflict within yourself, but really love what you shared there. And one thing that I really admire with you is the storytelling, right? I said this earlier, now you normally you do storytelling through words, but also through your photography. Now, I want to get into a little bit more of that. So when you go out there, right, whether it's on the street, whether it's the building, whether it's the wildlife, or the landscape and travels. How do you translate what you see? And how do you translate that into a frame that tell us story? 17:09   Yeah, that's a very interesting question. Because storytelling is always debated. In photography, even now, in Twitter spaces. There's always every second day that someone comes up and says, Your photo should do the talking. Artists should not add descriptions. I'm like, No, you have to add your descriptions. Because, you know, because we are storytellers, what's what's this? You know, what's the point, you know, without any story, just a beautiful image is common, you know, it's everywhere. What makes the picture special is the story which comes behind it, because it's the artistic emotion that comes along with it. So when I think one of the common mistakes that people do, even I did before, and I learned from that, through experience, is when you're telling, trying to tell a story, don't just tell the story of what's in front of you, you know, if I'm taking a picture of, for instance, in order to do a quick example, one of my NFT was a wildlife image of a lioness with her cups, you know, it's a single frame with one lioness and three cups next to her. My story could have been here is a lioness in Maasai Mara, in Kenya, sitting on a termite hill and watching the sunrise or whatever, that would be straightforward, because anyone who sees the picture, that story is there, you know, they will, they can read it, it's common knowledge. So you don't have to tell something which is already there. Tell something beyond that, you know, tell what you feel about it. Take it around, you know, in a different manner. For instance, in that picture, my story was about Lion King. You know, I connected the Movie Lion King, which we all know the Disney movie, in that movie, lion is the king and lioness is completely ignored. Because it's a lioness. It's all about the king what he does, and blah, blah, blah, fighting with his brother. I don't know the story exactly. But it's all about the lion as the hero. But in real life, when you see wildlife photography, when you see these lions and real, it's never about the Lion King. You know, it's always about the Queen, because she's the one who hunts, who brings food for the whole family. She's the one who protects the kids. She's also the one who manages to keep lion in check. The King is kept in check by the lioness because they can misbehave sometimes. So it's all run by the Queen, and no one talks about it. So here I had a chance to tell that story that Disney had some in no like knowledge of how the animal world works, they would make this lion is the real king of that movie and not the lion acid as a whole. So that's the kind of narrative doesn't have to be always straightforward. Here is this thing and that's about it. Take it in other direction, tell what you feel about it. You know, as I'm shooting. I'm always thinking, you know, my mind is such I told you I'm a very, very curious guy and always thinking in different different ways. Even when I look at a lion or a cheetah or a leopard when I'm shooting them. I'm thinking of their mind, you know, like what they should be thinking right now. I'm never looking at a straightforward picture. I'm always looking in different different ways. For instance, a fly comes and sits on the face of a leopard I keep in mind The thing I keep looking at its eyes, what's its reaction to the flight as it walks around its face? What is it thinking right now, you know, that's the kind of thing I'm building in my head. And if I put that picture out tomorrow, I'll maybe talk about the flight and the leopard together, rather than tell it that we're sitting in a bush. Now, that's very boring. So I always take it in different different directions, a whole image description of a leopard, where I didn't talk of the leopard, I just wrote about its tail. Because the tail of a leopard is always it has its own language, it's always moving with its thoughts. And you can always see, when it's more curious, it moves in one way, when it's very bold, it moves in another way. So I wrote a story just about the tale of the leopard. I didn't even talk about the leopard itself. So those are the things you know, storytelling is very important. It's your narrative. And your job as a photographer is to tell the story, otherwise, how will you be remembered? Not by your 10,000 likes, not by your 1 million followers, you will be remembered by your stories. 20:57   Yeah, wow. That's, that's very profound. And it's really good to share that. And I think it's, it's a new perspective as well to kind of think about it from a different perspective. And I mean, I myself learn from that a lot, being able to look at a scenery, something that could happen, but tell it from a perspective of a different, different, different way, not only what you see, and that's really cool, I really enjoy that. Thanks for sharing that even for 21:26   instance, when I went to Everest base camp, I had a bunch of pictures which I created, I posted them on Instagram, and this and that. And during that time, again, the same thing came to my mind, okay, I went to Everest base camp, what do I say I brag about being in Everest base camp? What do I do with the storyline, and I was thinking about it. And as well, as I was walking to Everest base camp for those 10 days, I have to look at the people around me, like I said, you know, I look at a flight sitting on a leopard. So here, I have like 100 people in front of me. So I observe each one of them what's going through their mind, there's a small kid walking the Everest base camp. This is a two year old male who's walking the rest to Everest base camp. There are a lot of investors wanting to rush Basecamp. I'm thinking of all their stories, why they are here know what they're trying to do what they're trying to achieve. So I wrote a story about that, you know how it's not about me making it to Everest base camp. It's about why any one of us take that journey, whether it's Basecamp, or whatever it could be whatever the face of your life, why do we take that journey? You know, I wrote a story about the why of why we travel, and what it means to each one of those individuals. So the stories can be taken in many, many ways. Rather than say, I went to a rich base camp, and I made this image, I can take it in my own direction, my own emotions. So yeah, we have the subconscious of thoughts. In always, we're thinking, there's a second voice in our head, each one of us have that voice. Just note the note down those voices. Because every time you start giving some thought to that voice, you're hearing the story line, which you're building, as you're noting them down, you know, most of us unconsciously forget what our second mind was saying, you know, when you're pointing your camera at whatever it could be pointing it your mind. Second mind is always doing the other narrative in your head, if you just give it some thoughts, and put a mental note to that you have a story right there. That's the other side of the story, then what you're looking at? 23:15   Wow, that is so much value, right? There's so much wisdom, and I really love that. And, you know, just going to that storytelling, and you know what you say about the second mind. We talked you talked about how they are the obvious and they are the thing that that come into the story, right, the secondary and tertiary and the things that not necessarily been the main focus, not the the main, grand, grandest, most obvious thing. Now. We know that, you know, in this world, in this era, right now, there is so many different types of distraction, right, our phone is keep buzzing, and then somebody's calling and, you know, we got our, our iPod, our iPhone, and you know, some people you have even like multiple phones and all this stuff. So how do you kind of separate that separate? The, you know, like, kind of isolate yourself in in this moment, so that you could hear and listen and explore what's in front of you? 24:24   Yeah, I mean, I do deep space photography. And in deep space photography, we have a term called signal to noise, which is how much of signal and how much of noise are you capturing? So I think that's the same thing here. You know, cut the noise, you know, there will be a lot of distractions, whether it's NFT side of the world, you see how many dramas run there every single day. I don't indulge in those dramas. I read them. I move on this AI conversation going on right now. What is AI whether AI is art, or is not art. I have my opinion. If I have a space, maybe I'll talk about it. And that's about it. Beyond that. I don't go are, you know, going into every tweet and commenting on everyone and trying to prove that they are wrong? I am right. The moment you start doing into getting into that business, you're wasting your time, you know, your time is valuable, and your energy is important. So yeah, just trying to avoid all those nonsense we know even Instagram, there is a real nowadays, people are doing all kinds of shit on that Instagram nowadays, know, wonderful artists are lost their track, you know, they're doing whatever it takes to get that little followers and views and million, whatever. So I don't even give a damn I do my reels, but in my own way now very classy way in a very cinematic way. I said, I will never get into that business of me walking with the camera, and then the transition happens. I am like, I don't need all that, you know, that's not the kind of artists that I am. So you have to just choose your poison, you know, and choose your path. A lot of my friends say you're missing out on Instagram by not doing really, if you keep posting your wonderful cinematic videos, no one cares about them. If you put all your images, no one cares about it. I'm like, doesn't matter. I don't care. If it's 100 people liking my image or 1000 people liking my image doesn't matter. Whoever connects connects, or doesn't doesn't, I'll just let it be. You know, that's one of the things I do in my life, or just as being stoic. If you can't control something, just let it go. Don't break your head over it, you know. So I think that itself solves half of the issues. Otherwise, yeah, there is a lot of things. there's Twitter, there's Instagram, there's a little bit of Facebook, there's vero now new software, social media. And there is what WhatsApp and telegram and how many things are gonna manage. If you put if you intelligence into all these things. Even I have my friends, you know, I'm sure I hope he doesn't listen to this. But if he doesn't, that's fine. But we, me and him, we were both photographers. And before, you know, before I came into nfts, and everything we used to, during especially COVID days, we used to have a lot of wonderful friends. But we disagree on many things. And we used to have a lot of arguments on WhatsApp, very passionate, not like we are punching each other on face. It's just opinions. And it could be about COVID. Or it could be about vaccine and whatever. And we would argue a lot to and fro to and fro to and fro could go on and on and on forever. And now I realised that while I was doing that, it's a waste of time. Now, whenever he sends me something like that, I just have a common response. You are right, even though I don't believe in it. I just say you're right. And that's it, then what what else is left to say? He's right, nothing to argue about. So I just let it be, you know, now I learned that style of just letting it go. If you want to think you're right, you're right. Enjoy the madness. And let's move on, you know, so Yeah, time is very, very valuable. And I'm trying to now figure out ways to not waste my time on noise. Stick to the signal, signal to noise is very, very important. That is incredible. 27:51   And yeah, like, you know, there is there is a saying that, you know, in order to win the war, sometimes you have to lose a fight, right. And then sometimes you just have to let go and, and sometimes letting go is the best way to win. So that's very wise of you to kind of share that. And I really 28:11   love something. We all have opinions. And we're all passionate about our opinions. But it doesn't mean you could just go and bounce everywhere your opinions, you know, just give it when it has to be given. If you just go around 100,000 times running around with your opinion, then you're just being a joke, you know, so just keep it to yourself. It's okay to not always have everyone agree to you, you know, it's okay, we are humans. And there's always agree to disagree which happens. And most often. The moment you stay away from this madness, you have more time to do something else. People ask how do you I have so much of time to run spaces? How do you have so much time to go out and shoot and to make all this photography trips? That's exactly because of this reason? And I don't I use my time for space because I save that time by not arguing with someone else outside. So why don't you start saving time somewhere? You can invest it in the right place. 29:04   Yeah, that's absolutely important, right, focusing on the right things in life that give you the energy and give you the positivity. And that's great. And I think one thing that I want to get into a little bit deeper is what you said earlier about the social media, right? How the social media kind of drive that attention and drive, how people are putting out content and are and how people are consuming it. Now, I know that the social media is, you know, with everything that happened is one of the biggest source that creates impostor syndrome, one of the biggest source that create this lack, right because what people see on social media is it's never it's almost never like what it's in real life. It's the highlight of everyone's real right. I mean, even peep when people share The struggles like I do share a lot of my struggles on social media. But even that, like you don't know what I had to actually go through behind the curtain, you know, just to share that one thing, right? So what what do you what do you have to say for people who are kind of hitting this wall of imposter syndrome and, you know, searching for followers and looking for ways to, to get more exposure, because I think there are two different view of this, which is, you know, it's important to get the exposure and get your, you know, social media kind of have the engagement and so forth. Because a lot of times, that's when you get your sales, or that's when you get your next opportunity. You know, there aren't a lot of opportunity associated with the exposure you get on social media. But at the same time, there is also the negativity behind that, where it actually bring down, you know, the way you feel even the way you react to the world and behave as a person. So how do you have anything to say about how to find a balance and how to treat social media from that sense? 31:18   Yeah, I think I would be the last person to talk about social media, because I never followed I like I said, I never followed any of those norms of social media, and Instagram, there was a time when, as tax, you know, I have my own friends who used to use certain apps, which would create hashtags for them every single day, depending on what's the most happening hashtags. They would say, use this app, use this hashtag. I'm like, I'll not use a single hashtag, I don't care. No, that's my way. I don't care if they like me, or if they don't follow me. I just don't care. And that's the reason my Instagram is still below 20,000. You know, like, it's taken eight years, nine years to reach that 20,000 Because I'm not never pushing it. Well, my friends, maybe they have 100,000 followers, who cares? You know, I don't give a damn, you know, that 19,000 is also we know how Instagram works, you know, 556 1000 of them would be fake profiles. Maybe I have, let's say 10,000 actual followers, that's enough for me, you know, that's my little crowd. I'm happy with that. And, you know, I really don't care much. I don't use any of those hashtags. Like I told I don't do any of those trending reels, I do it my own way. And I never get into, you know, you had to post it this time of the day, you have to put post at this time of the night to get the maximum reach. I'm like, I don't give a fuck, I will post whenever I want. You know, I don't care. So that's been always me. And that continues to be me. Even in Twitter. There's a lot of algorithm things people talk about don't retweet too much. I'm like, I'll read it. 100 people every day, I don't care. Don't go to it too much. I'll record record with everyone. I don't care. So yeah, I mean, I just don't care. That's been my way. Even Twitter. I'm surprised. You know, it grew very fast. I came in January. And today, it's what December, almost 910 months awkward. So I never expected all these things to happen in Twitter, I just came in thinking, okay, and other social media, and I'm just gonna be me, you know, again, I'll never put any hashtags. And never do anything time based or anything that helps the algorithm, I'll do everything it takes not to feed algorithm, I'll do whatever I want. That's all you know, I don't care about algorithm and everything. We have spaces on this topic where people discuss, and I'm the bad guy there because I say do whatever the hell you want. Don't care about the algorithm. If the shadow venue, they'll bring you back not a problem. So yeah, that's been my way. I'm the last person to talk about social media and never let it really influence me too much. And, yeah, you had to just create your own piece with social media, if you just chase, if you look at others getting 1 million views or 10 million views on tick tock. And if you want the exact same thing to happen to you, you're wasting your energy, you know, just do good work, keep posting them up, and enjoy the process, rather than worrying about things you can't control. So yeah, I don't really I'm not the person to talk about social media at all. Yeah, well, I 34:08   think you have talked a lot about social media and I think that's very important to have. You know, I personally still believe that it's important to have the exposure but I think it's important to have that mindset as well of sticking to your own thing and not diluting your value right I think that is I see that a lot of people like you say a lot of good creators are no longer an artist in social media because the reels is you know, more and more people get attracted to 34:38   reels. The world is growing. 34:41   There you go. And, you know, and and it's I think it's okay to have that in social media. But, you know, when when you are an artist and you do too much of that then are what what are you doing right, you weren't that's not the reason you're here. It's different, you know, 34:57   disclose that in the difference. There are two kinds of creators, one who just lowers and likes and reads. And maybe that's their, that's what you need, do whatever it takes, then there's other kinds, who doesn't give a damn, just does whatever he likes. And when I see Instagram or any place I go, whether it's vero or Instagram, or even Twitter, you know, I know that I create a portfolio everywhere I go, I don't like to post random things, my selfies my whatever, you know, my cat, my car, I don't need all those things. I'm a photographer, and I'm going to stick only to that my voice and my language, then I'm a guy with a tattoo on my hand, which says religion, photography. So I need to take that thing seriously. So I treat it that way I can like my religion. So wherever I go, I make sure it's my portfolio and whatever people, if they visit Instagram, they'll see a clear portfolio of mine, what I do is exactly what I show. And beyond that, knows, even now I'm talking not talking to you with the camera on because that's me, I don't like to put my selfies. I don't like to do any of those self indulgent things, you know, because I'm not that guy. For me, it doesn't matter. You like my work? That's my signature. And that's about it. You know, beyond that, I can't help it. You know, and same thing with Twitter, I keep a portfolio. Same thing with vero, I keep a portfolio. So I like to keep it organised. So that another kind of photography photographer who's on social media, so if you're the first kind, if you want all the followers and likes and reach and algorithm and everything you care about, then of course, you need to play the game, which people are doing on social medias. But yeah, it's it's it's your path, you take your path, my path is this, I don't care about all that. 36:34   Yeah, that's incredible. And I think that's one of the most important thing for us to stick to is, you know, whatever feels right to us, and whatever was, you know, our own path now, you know, just kind of take it back a little bit, you know, you talk about this photography, talk about the storytelling, and how you can impact people and all this stuff. Now, if I were to ask you a one liner question, right? What is your mission in photography, like what you're hoping to bring to the world through what you've captured in the form of photographs? 37:13   Yeah, I do all kinds of photography, as you know. And wherever I do, there's always a story that I stick to, you know, whether it's wildlife, with wildlife, I'm trying to, from my own style, you know, I'm trying to create an awareness and make people appreciate this wonderful creatures, every time I speak about them, I speak with a lot of passion, I always mentioned, what's the problem happening in this field of wildlife, you know, when it comes to these animals, and I can kind of stress on how valuable they are, how little they are in this world, and how we can maybe do a small little thing and create a difference, et cetera, et cetera. So there's that, you know, I'm always I love wildlife. And from my childhood, I have been loving them. And I bring all that passion to that field. And with my portraits, I always like to tell the story of people there, you know, mostly, it's about what I learned is what I try to preach, which is when I have to travel to these corners of the world, and meet these people staying in the most humble way, and at the same time, most happiest people I ever come across. Because what I see in Dubai is miserable, you know, the people have so much of money, they're driving a Mercedes and whatever in a Lamborghini. And still, they're not happy to concede in the face. But when I go to this corner of the world, and people have literally nothing, and they're still the happiest people. So I try to communicate that, you know, there's some learning, that's my learning from these places. So wherever I go, I find those books, you know, as to what makes me go there again, and again, because I'm not a person who's ticking off all the countries in the world. And that's not my mission. I've seen some photographers do that. It's cool. If you want to visit every country in the world, that's incredible. But for me, it's always about going back to the same place. You know, once I go to a place, it's not like, I'm done, I've visited this place, it's over, I'm done with this place, I go again, and again and again, because I like to go into the depth of that place and understand the real, more and more depth of the stories behind those people and how they live and what they do. So yeah, these are the narratives that I've played with. And I think overall, you think of a broader perspective, after 50 years, what what is that I'm trying to create is just a beautiful narrative of how beautiful the spaces are. And those spaces may be very limited. Maybe I'll have 15 places explored in complete depth, rather than how 120 countries explored in 50 years. I don't want that attack, I just want those few places explored very, very well, in every sense possible, you know, so, yeah, for instance, I go to the Similan village, that's a bunch of villages around and so whenever I go, I was trying to create pictures of people and tell their stories. Then I started exploring more towards the Buddhist side of it, you know, because they're all Buddhist. And there are monasteries, first trying to understand from the monks side of life, you know, what they do, how they stay. What is their prayer rhythm, this and that, that I was trying to explore for some years now. I want to go back and explore the wild side side of it, you know, because they have snow leopards in that. So you need to go in certain times to find those snow leopards that adds another layer to that place. Every single time, you know, I try to keep on building on the same thing. So I want to be that guy who has taught maybe 15 places in absolute depth and created a nice long story through many, many years of visiting, rather than be the guy who visited 120 countries. 40:27   Yeah, that's, that's a really good thing. You know, I, I was in the same place. You know, before when I first started photography, I've been to I think, 27 countries. And after no 28. And after I started photography, for real, I've only been to an extra one country because I noticed the same way it's more interesting to go into that then all of these places, just going to the popular place, right? It's just, it's, it's incredible. When you see people just go to the main attraction, take one shot, a selfie, and then they go home, they like, don't look at the other place. You know, they didn't even go around the corner. And it's incredible. And yeah, I can totally resonate with that. Now, you know, when I want to talk a little bit about Nepal in the Himalaya, and I know how passionate you are about it. But one thing that I never heard is that what what really what really pull you about the Nepal in the Himalaya region that makes you really love that area compared to any other world? Because, you know, there are a lot of beautiful places around the world. Right. There are a lot of interesting culture everywhere. beautiful mountain tops as well as the landscape. But why Nipah? Why what keep pulling you into Nepal in the Himalaya region? 41:55   Yeah, that's a terrible question. Because I really don't know. I just don't know sometimes there are things which you can't explain. I think Himalaya is one of them. You have been to Pune. Basecamp. So you know it. So you know, my I can, that's my curious mind. I told you I look into Cosmos a lot. I look into a large number of things. And there are many sections of things that I will look into in much depth. And one of them is Himalayas. You know, if I look at my book cabinet right now, I think almost 50% is photography books. Other 50% is Himalayan books, you know, people who have climbed this wonderful mountains, I have, I've read almost every book possible in our field. And I don't even have a place to store those books anymore. Because that's how much I get intrigued by these mountains. Because the first time I saw it in my life, as I said, my travel photography began with Himalayas. The first time I put my eyes on it, I knew that okay, this is gonna be something very, very interesting for my future because I knew right then that I'm going to be coming back to this place over and over and over again. Because I don't know what's about it, you know, even when you go to Everest base camp, or you go to Annapurna base camp or any of these base camps, which is hard track, you don't really know if you think it's like you see in movies, people running around with full energy. No, you are, you are tired, you know, you are dirty, you are smelly stink like shit. So let's start painting and you know, everything is weird about that place. It makes you feel like what the fuck I'm doing here. But at the same time, I feel alive. You know, being in between all that madness. I feel good about it. So that's what I like about that particular place. It's a suffer fest, but at the same time, it makes you feel alive. I know. You're laughing a lot. I don't know what stinking part was funny, I guess. I don't know. But yeah, that's what makes Himalayas what it is, you know, lack of oxygen makes me feel good. And also, you know, like, one of my idols, you know, when it comes to I like people who live their life to the fullest without giving a damn and technically like, they know that life is so valuable. One of them is Reinhold Messner, if you know, Reinhold Messner, he is the first person to climb all 14 peaks, Himalayan peaks 8000 metres without supplementary oxygen. So I read a lot about him. Maybe I have some 20 books from him right now. Sitting in front of me as I speak. I read all of his books. I've seen every documentary that he has made. You know, these are the people who really make me want to go back to Himalayas because their passion is very contagious. And when you read the books and exactly why they go back, is exactly what you go back. I want to see everything there they have seen. So yeah, just a lot of things. You know, I said, it's very hard to explain. If you've never been to Himalayas, you'll never know. But once you go there, as I said, it is sufferfest but you'll enjoy the suffering of that place, you will come back much smarter and wiser. There's a reason why Indian monks and Nepali Buddhist monks go to the mountains to do their meditation. They can do anywhere but they still go to the extreme Himalayas, because there's something about that place which cannot be explained. 45:00   Yeah, I know it, I can, I can tell I can I can feel the same thing when I was in Annapurna. It's just something about the place that it felt magical. And the reason why I love a lot is that it always reminded me every time I go hiking, it always I always asked that question. I was like, Why? Why? Why am I here? Why do I put you through all this struggle, but as soon as you came down, you have a shower, and you just go, what is next? Right? What's the next mountain to go out to? And when you say that, it's just it cracked me up? Because it reminded me of that moment, every time you go up, and you look at this big wall in front of you, and you can't even see the summit, because they're so high and you go like, what am I doing here at 10pm at night, going into this mountain with all this crap behind me. But yeah, there's something about, you know, the achievement behind that there's something about the peacefulness behind it. And it's, it's, it's, it's, you know, one of the stories that I tell from one of the piece that I just released, it's about the freedom you get when you get out there, and it feels like, you know, everything just doesn't matter. So I can, you know, yeah, really 46:18   also, another reason for that is because, first of all, you're in a complete remote place, especially when it took off base camps and everything, you're cut off completely. There's no internet, there's nothing, you know, you just have you and maybe a guy who doesn't talk much. So you're not talking to him a lot. He just talks once in a while. So you're it's just you and the mountain and maybe a beer or a chai in your hand. And you're sitting there in the middle of nowhere. So these are the moments which we are missing right now, you know, because we're in such a fast life, social media, they send that phone buzzing all the time, in that place. You just realise that your phone, you're holding the phone, but it feels like useless. And because there's no internet, you don't know what to do with that phone in your hand. And then you throw it away and just look at what's in front of you. And just you look at lost in your thoughts, you know, you you get a break that your brain requires. And it starts processing things which have been lagging behind in the RAM. So yeah, it's like a nice reboost to your brain, and it helps you clear a number of things. So yeah, when I always say, you know, doesn't matter what the question is, you know, Himalayas are always the answer because it will give you answers for questions, which you didn't even know you had. So you know, that's what they do. And yeah, like, for instance, when I was in Annapurna base camp, like I told like you also said it's a suffer fest. It is the hardest trick I've done. An Irish base camp was hard, but it was okay. But Annapurna was absolute madness, you know, and I was not in my best form at that time, because I just came back from a trip to the US. I went to New York and all that things, and I came back and immediately, I went to Annapurna base camp without even trying to give myself a break because I just wanted to go to Himalayas, maybe because I saw New York and I really wanted a break from that city. So I went all the way to Himalayas. Annapurna base camp, it was bloody hard. It was raining all the time. It is not really comfortable. You know, I was wet from head to toe, every single day of the walk in six days is completely wet. And it was really, really hard. Same thing again, I asked myself the same question what the fuck I'm doing here. I could have been staying in Dubai and relaxing my warm home. But I was there anyways. So it happened. It is the best camp the first once it is the best camp for the first time when the rain stopped. And everything was visible under Pune in front of you. Extremely gorgeous. And then it was just a small break of 30 minutes and then it started raining again. I'm like shit, okay, now I need to walk back. You know, you know it walking down is harder than walking up to the base camp. So I'm like, I need to go down with all this rain again. My mind was like, please get rid of this place, you know, if you want to. And I was like, Can I call a helicopter get to get off this place because I don't want to walk again. So he sat down recently quarters right now in this weather. I'm like, Okay, let's walk. And I told my guide, how long is the walk to reach Pokhara which is the city we need to go to the city at the end of it. It takes for four nights of walk, you know, like every four nights, your stay in the mountains. And then finally you reach a point where you can go to the city. I'm like, No, I'm not going to stay the walk for four days in this rain. Let's do one thing how much is the kilometres he said almost 38 kilometres of walk to reach to the point where you can take a car to reach the city. I'm like, Okay, let's walk from now. It's seven o'clock in the morning. We will not stop for a single second. No food. No nothing. We are water bottles. We just keep bringing water. Are you up for the challenge? It's like no, no one does that. 38 kilometres in a rain downhill. You can't do that. I'm like, let's do it. And we worked nonstop. You know, I have that phone screenshot in my phone. I burned like 1000s and 1000s of calories. You know, maybe it was crazy. I never burned so much calories in my life. So 38 kilometres. We walked from seven am to 4pm nonstop, not a single break. We just kept walking because I wanted to get out of that place. You know, there are those instances also in MLS. It's not like always romance. So yeah, but that's what makes it interesting. So as soon as I came back, I reached my hotel in Pokhara. I took my shower, I felt good again. And then I came to the reception of the hotel. And the hotel had a number of maps of Nepal, you know, of all the base camps. I just came back from a base camp where it was. I had to walk 38 kilometres to escape. And now I was looking at this posters on the wall, and I'm like, which is this base camp? This amount of sleep? I'm like, Okay, this is my next one. When do I come back? So that's the mattress. 50:43   Yeah, no, I heard that story before. And, you know, it's just crazy. And I know how frustrating it can be when it's raining and all that stuff but doing 38 kilometres on the way down all the way to, you know, from Annapurna base camp. That's 5000 5000 Plus, right, and it's just crazy. Yeah, no doubt you burn all that calorie man, you got all the rain, you got going downhill all the gears, of course you burn all that calorie. But that's Yeah, that's really cool story, you know, and it's true, right. And I think this goes back to what we say earlier, a lot of times people don't see this struggle, about, about the journey. But I think what I noticed from, from the way you approach life, the way you approach your journey, is that you have a way to still enjoy the journey. Even if, you know, there are challenges now, you know, I know that is something that's very difficult to do nowadays, especially looking at everyone else's successes all the time, right? So for the listeners who kind of in that situation where they're like, Okay, I want I'm in a and I want to get to where I want to go next, right, which is my dream, whatever that may be. But this every time I hit a journey of challenges, I feel discouraged. So, you know, how can people enjoy the journey to get to where they want to be? 52:12   One day? I think I'm not an expert again, of this, because it's very, very much, it's up to each individual to choose their happiness. So my way, you know, is my way always your way, it doesn't mean it has to be the same way for both of us might, what I say may not resonate with someone else. So it's up to each person, each one has their own, you know, priorities and life and family and loved ones and etc. So yeah, it's totally different, you know, I can't preach because, you know, for even for a single example, is I'm not married. So if I say something, people will say, yeah, that's easy for you, because you're not married, I'm married, I have two kids, I can't do the same thing. So it can be different to different people. But yeah, you need to find your own peace, with how you can create that balance and feel good about the life that you have. You know, for instance, I was in Tajikistan, and it was one of those craziest, the craziest roads, you know, there, the place is beautiful, but the roads are horrible. It's next to Afghanistan. You can you're always next to Afghanistan, there's just a small river, which divides you and Afghanistan. It's it was at the peak of Taliban when I went there. So people are a bit scared to come, but they still came. So we are going through that journey. And you know, at one point, the road is so bad, so horrible, that you just your bones feel like they're all broken, you know, and one of my friend who was there, he's a corporate guy, and he has a job in Dubai in a luxurious place. And all that is taste. So he came on that trip. And he is not used to this things much. He likes adventures, but not this kind of adventure, it was a little bit too much for him. Because at the end of the night, you stay in a small little house. And it's not like a five star hotel. So everyday are struggling through the journey. I enjoy that. But he had some problems and happens in between the journey. We just stopped for a smoke and we both were smoking in a corner. And he's like, I don't know, I think I shouldn't have come on the strip because it's too hard for me. I told, first of all, just look at your surroundings. And you're standing right here having a smoke. Look at look in front of you. There's Afghanistan. And look at the right side. There's Himalayan mountains upon mountains. And you're here, you know, what are your colleagues doing right now? They're smoking in Dubai, of course, in their office, but what are they looking at the same blocks of city and the same stupid office they have to go back to what's next nine days, you're free, you know, you're in middle of nowhere. How many people should I visited this place which are visited right now? Maybe 5% of the world's population, you are the lucky one. You know, enjoy that moment. Because you are lucky enough to be here, you know? So that's how I put things into perspective. Whatever happens, always see it as one of those. You know, we have a chance to travel if you have that chance alone. You're already lucky enough compared to 80% of the world because others would love to do that, but they don't have the means or freedom to do that. So I think we're already lucky enough that we have this passion, we travel the world. And that's enough blessings, just count those blessings, and you will feel good about it. That is such 55:13   a good advice. And, you know, I think, going back to what you said earlier, it's about, you know, where do you put your focus on? And just hearing what is the story that you tell me, it seems like, you know, your your friend at that time was in a really good place, but his focus was on the negative part of it, and not the positive part of it. And that really changed a lot of perspective for a lot of people just shifting that tiny bit of perspective. Right. So, yeah, that's, that's a really good, you know, a really good advice. Now, you know, one of the thing that I'm interested in is, you know, you're I came across you in the NFT world, and you are, you know, one of the voice in NFT. World, a lot of people hear your wisdom and follow your wisdom now, what, what draw you into the NFT in the first place, and what made you stay in the space? 56:07   Yeah, that's super important for me, because NFT has not been one of those things, which has completely transformed my life, at least, in terms of my passion. Because I came, you know, as I said, I do workshops for a living, and my workshops are travel workshops, and need to travel to a place to do whatever I do. And that's my revenue, you know, that's my income. And that's all that's my sole income. That's the main thing, I don't do anything else. Even if I get commercial jobs in Dubai, I would just push it across, you know, to my friends, I would say you do it, I don't want to do this job, architectural, or whatever, you know, event photography, and never like all those things. Because I've quit my job with a very, very particular team, which is I want to travel and I want to take people along with me, and that's about it. So I do that full time. It was great. Till COVID came in, you know, when COVID came, we all know, world shutdown. And then travel stopped and my sole source of income came to an end. That was the biggest hit. And when you think of it, I stay in Dubai is such an expensive place. And travel has stopped. Everything that you have earned is now disappearing, like super fast pace, you know, like Dubai, it doesn't take much time for money to operate. So it's going through that really, really rough phase in my life where things are going really south. And I'm like, What the hell do I do now? 2020 is gone. 2021 is still the same. There are so many rules to travel, no one wants to travel because there's so many paper works and this and that. So they're just not really working. And I'm like, That's it. I'm done. What do I do now go back to Job, put the tie and suit and get back to work. That was almost a situation though. I didn't want to do that. So that's when NF T came into my life. You know, it came a little bit late. I wish I entered you one more earlier. But one of my friends who's into NFT He kept telling me because he knows exactly what I go through every single day. I mean, every single weekend we go together to shoot and that guy always says come to an empty come to an after you are going through this tough time. I think NFT is your answer. You know you can earn some money and pay your rents and at least take some break from your your hair start turning white what's going on with you. I'm like no NF T's this NF T's that it's a bubble. The typical bullshit that people say I used to believe all those things. So at the end of it, he finally convinced me one fine day he just said, please open a meta mask and come to an update. That's it. Today's the day. And we finally opened the meta mask and he convinced me to come I came in to Twitter, nothing I know nothing about Twitter. I know nothing about nfts I just entered with one follower being my friend who pulled me in. And then eventually I started interacting with people and I realised that the whole community thing which people talked about is actually true. You know, the people are different in NFT. At least during those days in the bull market, people are very, very active and very, very friendly. And everyone is trying to pull each other up rather than push each other down from like, Okay, this sounds interesting, this better than Instagram and all that. And finally, I came up with a collection and first Genesis collection, which was all my email and portraits, some of my best works, I put it out at a very affordable price. And within the first minute of launching that collection, one of my collectors just happened to collect it within the first minute of dropping it. He bought a pitcher at 0.5 at the end. During those days, it was like almost $2,000 I was like $2,000 for my pitcher. In the minute of dropping, I was like I had tears in my eyes because there's something which I never experienced before someone was valuing my work, whatever money money is secondary in that place. Someone valued it, you know, within a second within a minute of dropping. So I realised you know eventually as things moved on, I realised that this place is absolutely brilliant, you know, everything that I thought the illusions that I had was all wrong and yeah, since then I gave myself 100% to it. And it's been wonderful you know, after that have launched many many collections sold out many many collections, and no doubts That that is paying my rent, it's been my all kinds of things in all the bills that I have, it has helped me float through it. So it's been wonderful. Yeah, I think it's a blessing, which came at the right time. Otherwise, by now I would be back to work, maybe giving up all my dreams. 1:00:17   Wow, that's what a journey isn't it and, you know, you come in there and you know, you know, coming from somebody who think it's all, you know, all the objection that everyone can come in, don't want to come in from and then you finally convince come in and know you're here with, you know, one of the biggest boys in the NFT world, you know, sharing your wisdom and your stories in there. And I think it's just incredible. Now, for, you know, for for, for the people who cannot like jump in here and think like, okay, you know, NFT is just a money making scheme and all this stuff. Is there, is there, what's the future of NFT? For you? Lik

Please join author Subodh Verma and Guest Editor Christopher Granger as they discuss the article "Empagliflozin and Left Ventricular Remodeling in People Without Diabetes: Primary Results of the EMPA-HEART 2 CardioLink-7 Randomized Clinical Trial." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your co-host. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Peder Myhre: And I'm Dr. Peder Myhre, social media editor and doctor at Akershus University Hospital at University of Oslo in Norway. Dr. Carolyn Lam: Peder, I am so excited to be discussing this issue. So many great articles and a feature discussion coming up on the SGLT2 inhibitor, empagliflozin. And do you think it's got effects on left ventricular remodeling in people without diabetes? Very interesting question. Dr. Peder Myhre: That is so interesting, Carolyn. I can't wait to hear this discussion. Dr. Carolyn Lam: Yep, I agree, but we got to wait till we discuss the other papers in today's issue. I want to go first. So we know that non-vitamin K oral anticoagulants, or NOACs, they've become the standard therapy for preventing stroke and ischemic thromboembolism in most patients with atrial fibrillation. But, what is the effectiveness and safety of NOACs in patients on dialysis? That is hemodialysis. The AXADIA-AFNET 8 study sought to test the hypothesis that apixaban would be non-inferior to vitamin K antagonists in these very patients undergoing hemodialysis. Dr. Peder Myhre: Oh wow. This is really a gap of knowledge that we've been waiting to hear more about. NOACs in patients with hemodialysis. Tell us about this trial, Carolyn. Dr. Carolyn Lam: Sure. So this is from corresponding author, Dr. Reinecke, and colleagues, from University of Munster in Germany. And it's an investigator initiated prospective randomized open-blinded outcome assessment of 97 patients with atrial fibrillation on chronic hemodialysis randomized to either apixaban 2.5 mg BID, or a vitamin K antagonist, aiming for an INR between 2 and 3. Over a median follow-up time of 429 days for apixaban, and 506 days for the vitamin K antagonist, the composite primary safety outcome of first, major bleeding, clinically relevant, non-major bleeding, or all cause death, occurred in 46% of patients on apixaban, and 51% of patients on the vitamin K antagonist. That would be a hazard ratio of 0.91, with a p for non-inferiority being 0.157. How about the primary efficacy outcome? While this was a composite of ischemic stroke, all cause death, myocardial infarction, or deep vein thrombosis, and/or pulmonary embolism, and that occurred in 21% of patients on apixaban and 31% of patients on the vitamin K antagonists. Again, no difference when there was testing. So, in summary, Peder, there were no differences in the safety or efficacy observed between apixaban and vitamin K antagonists in patients with atrial fibrillation on chronic hemodialysis. Of note, however, even receiving oral anticoagulations, these patients remain at very high risk of cardiovascular events. So these data really support the consideration of apixaban for prevention of cardiovascular complications in patients with atrial fibrillation on chronic hemodialysis, but larger studies are definitely needed. Dr. Peder Myhre: Oh wow, Carolyn, that is so clinically relevant. And the next paper is also a clinically relevant paper. And it comes to us from the SPRINT authors. And to remind you, the SPRINT study was a study of intensive systolic blood pressure lowering compared to standard blood pressure lowering. And the results demonstrated that there was a robust reduction in both heart failure endpoints and all cause mortality. And in this sub-study that comes to us from corresponding author Jarett Berry from University of Texas Tyler School of Medicine, these authors look at the mechanisms through which intensive blood pressure lowering reduces the risk of these endpoints. And given the important role of cardiac injury and neurohormonal activation in the pathways leading from hypertension to heart failure, and strong association that has been observed between hypertension and levels of cardiac troponin and NT-proBNP, the authors hypothesized that intensive systolic blood pressure lowering would decrease levels of high sensitivity cardiac troponin T and NT-proBNP. Dr. Carolyn Lam: Cool. That's interesting. So how did they do this, and what did they find? Dr. Peder Myhre: So, as expected, Carolyn, the authors found that increases in troponin and NT-proBNP from baseline to 1 year were associated with a higher risk of heart failure and death. And there were really no significant interaction by treatment assignment. But let's look at the changes in troponin. And these results showed that randomization to intensive blood pressure lowering versus standard blood pressure lowering resulted in a significant 3% increase in cardiac troponin T level over 1 year follow up, and a higher proportion of participants with more than 50% increase, and that's with an odds ratio of 1.47. And Carolyn, in contrast, NT-proBNP decreased by 10% in intensive blood pressure arm. And these patients had substantially lower probability of increasing more than 50% in NT-proBNP, with an odds ratio of 0.57 compared to the standard arm. And now, to the most interesting part of this analysis, Carolyn, the association of randomized treatment assignment on changes in troponin was completely attenuated after accounting for changes in eGFR during the follow up, whereas the association of treatment with NT-proBNP changes were completely attenuated after adjusting for changes in systolic blood pressure. So Carolyn, the authors highlight in their discussion the importance of non-cardiac factors influencing variation in cardiac biomarkers, and raise questions about the potential role of cardiac troponin T as a surrogate marker for heart failure or death in blood pressure lowering studies. Dr. Carolyn Lam: Wow, very interesting. Thanks, Peder. Can I tell you now about a preclinical study? Very interesting, because it shows that cardiac inflammation and hypertrophy are regulated by a heart-brain interaction. Dr. Peder Myhre: Wow, Carolyn, a heart-brain interaction. I'm excited to hear more about this. Please explain. Dr. Carolyn Lam: I'd love to, but first some background. Interleukin-1 beta, now that is a pro-inflammatory cytokine that causes cardiac hypertrophy and heart failure. I need to familiarize you with this, the nucleotide-binding domain leucine-rich containing family, pyrin domain-containing-3, NLRP3 for short, which is an inflammasome, which is a cytosolic multiprotein complex that mediates active interleukin-1 beta production. Okay? So you know these terms, and now I want to tell you about the study. This is an elegant series of experiments performed by co-corresponding authors, Dr. Higashikuni, from University of Tokyo, and Dr. Sata, from Tokushima University Graduate School of Medicine, and their colleagues. They first showed that genetic disruption of the NLRP3 inflammasome resulted in significant loss of interleukin-1 beta production, cardiac hypertrophy, and contractile function during pressure overload. Next, a bone marrow transplantation experiment revealed an essential role of NLRP3 inflammasome in cardiac non-immune cells in myocardial interleukin-1 beta production and the cardiac phenotype. It was extracellular ATP released from sympathetic nerve terminals that induced the hypertrophic changes of cardiac cells in an NLRP3 and interleukin-1 beta dependent manner in vitro. And finally, depletion of ATP release from sympathetic efferent nerves, or ablation of cardiac afferent nerves, or a lipophilic beta-blocker, all reduced cardiac extracellular ATP, and inhibited the NLRP3 inflammasome activation, the interleukin-1 beta production, and the adaptive cardiac hypertrophy during pressure overload. So all of this suggests that controlling the neuronal brain signals might have therapeutic potential for the treatment of hypertensive heart disease. Neat, huh? Dr. Peder Myhre: Oh, that is so interesting. The heart and brain interaction. And, Carolyn, we're going to stay in the field of preclinical science. And now we're going to talk about another field that is really interesting, and that is regeneration of cardiomyocytes. Because, Carolyn, developmental cardiac tissue holds remarkable capacity to regenerate after injury, and consists of regenerative mononuclear and deployed cardiomyocytes. Whether reprogramming metabolism promotes persistence of these regenerative mononuclear and deployed cardiomyocytes that enhance cardiac function in repair after injury is unknown. Therefore, these researcher, led by corresponding author, Mohsin Khan, from Temple University School of Medicine, investigated whether the RNA binding protein, LIN28a, which is a master regulator of cellular metabolism, plays a role in cardiac repair following injury. Dr. Carolyn Lam: Wow. That is always, always interesting, regeneration and repair following injury. So what did the authors find? Dr. Peder Myhre: Well, Carolyn, through a number of elegant experiments, the authors made the following key findings. For the first time, they documented a role for RNA binding protein LIN28A in regulating cardiomyocyte turnover in the postnatal and adult heart. And LIN28a overexpression promotes cardiomyocyte cell cycle activity during postnatal development and extends cardiac regenerative ability of the mammalian heart to postnatal day 7. And in the adult heart, the authors could demonstrate that LIN28a drives new myocyte formation, augmenting cardiac structure and function after myocardial injury. And Carolyn, I'm sure you're going to ask the clinical implications of this study. Dr. Carolyn Lam: Indeed. Dr. Peder Myhre: And that is that these results may suggest a novel translational role for LIN28a based strategy to replenish cardiomyocytes in the adult heart after injury. Dr. Carolyn Lam: Very nice, Peder. Thank you. Also in the issue is a Research Letter by Dr. Bick on interleukin-6 receptor polymorphism attenuates clonal hematopoiesis mediated coronary artery disease risk among many individuals in the UK Biobank. There's also Cardiology News by Tracy Hampton, where she highlights few really interesting things, like aging cardiomyocytes accumulate new genetic mutations that was published in Nature Aging, cytokines promote tissue repair after a heart attack in mice, and that was published in Science, and scientists identifying molecular alterations in a failing heart at a single cell resolution, which was published in Nature. Dr. Peder Myhre: And there are a couple of other papers also in this issue, Carolyn. And there's first, an exchange of letters by Drs. Halushka, Lu, and Mayr, regarding the article "Circulating MicroRNA-122-5p is Associated with a Lack of Improvement in Left Ventricular Function after TAVR and Regulates Viability of Cardiomyocytes Through Extracellular Vesicles." And finally, we have an "On My Mind" piece by doctors Monda and Limongelli entitled "An Integrated Sudden Cardiac Risk Prediction Model for Patients with Hypertrophic Cardiomyopathy." Dr. Carolyn Lam: Oh, nice. Nice full issue. Thank you, Peder. Let's go to our feature discussion now. Shall we? Dr. Peder Myhre: Let's go. Dr. Greg Hundley: Welcome listeners to this feature discussion on January 24th. And we have with us Dr. Subodh Verma, from St. Michael's University in Toronto, Canada. And a guest editor, Dr. Christopher Granger, from Duke University in Durham, North Carolina. Welcome gentlemen. Well, Subodh, we will start with you. Can you describe for us some of the background information that went into the preparation of your study, and what was the hypothesis that you wanted to address? Dr. Subodh Verma: First, my great pleasure to be here, and thank you very much for the opportunity to discuss this paper with your viewers. As you know, SGLT2 inhibitors have been truly transformative therapies. From a heart failure perspective, we know that they prevent incident heart failure in people with diabetes who have vascular disease or risk factors. They also have been shown to treat prevalent heart failure in people with heart failure and either a reduced, mildly reduced, or preserved ejection fraction independent of glycemic status. And really, these have been the basis of very strong recommendations to use these agents in the prevention of heart failure in people with diabetes, and also in the treatment of prevalent heart failure in people with and without diabetes. Now, the fact that these drugs have such broad effects in people with heart failure has led to a theory that maybe these drugs could be introduced earlier on in the natural history of heart failure in people who neither have diabetes nor have significant heart failure, the so-called sort of stage A or stage B patient. But there really have been no clinical trials evaluating this question. There've been a lot of translational randomized trials that have provided some mechanistic insights about LV remodeling in people with diabetes or in people with prevalent heart failure. And we hypothesized that maybe the first step to evaluate whether SGLT2 inhibitors may have favorable effects on cardiac remodeling in people without diabetes or without heart failure would be to conduct a randomized double-blind control trial looking at indices of left ventricular remodeling in a population that I've just described. Dr. Greg Hundley: Very nice, Subodh. So you've started us into your study design. Maybe describe that a little more fully, and then who was included in your study population? Dr. Subodh Verma: So EMPA-HEART 2 CardioLink was a multi-center double-blind placebo control randomized trial in which we studied the effects of empagliflozin, an SGLT2 inhibitor, at a dose of 10 mg per day versus placebo in people who did not have type 2 diabetes or significant heart failure. We included people who were adults between the age of 40 and 80 who met 1 of 2 entry criteria. Either they had to have one major criteria, which was an increase in left ventricular mass index by specific echo criteria or MRI criteria, or they could have increased LVH as identified by ECG or by intraventricular septal or posterior wall thickness. They could also get in if they had resistant hypertension, hypertension despite being on 3 antihypertensive agents, or the second strata was entry through 2 minor criteria, which included a history of myocardial infarction, a GFR between 30 or 60, or evidence of overweight or obesity. Dr. Greg Hundley: And how many subjects did you randomize? Dr. Subodh Verma: So we randomized, of the 318 that we screened, 169 were randomized to receive empagliflozin 10 mg or a placebo. Patients had a baseline cardiac MRI done, and then the exposure was 6 months. They had a follow-up MRI at the end of 6 months. And the primary outcome measure was a 6-month change in left ventricular mass index from baseline to 6 months between the two groups. Dr. Greg Hundley: Very nice. And so , Subodh, can you describe for us now, what did you find? What were your study results? Dr. Subodh Verma: So, first and foremost, what we found in terms of baseline characteristics was that we enrolled a population of people with a mean age of around 60 with a BMI of around 30 kg/m2, predominantly men, about 80% or so were men. These were patients who did not have significant heart failure. The NT-proBNP at baseline was around 50 pg/mL. The eGFR was around 80 mL/minute, and the vast majority of these patients actually had a history of hypertension. Of course, none of them had diabetes by definition. The hemoglobin A1C was around 5.8%. Now what we found was, despite the fact that we went after patients who we thought would be enriched for a baseline increase in LV mass indices, the baseline LV mass index was mildly elevated, was around 63 g/m2. And over the course of 6 months, we did not find any significant difference in terms of LV mass regression between the placebo and empagliflozin groups. In fact, the adjusted treatment effect was minus 0.30 g/m2, which was not statistically significant. No other differences were found in terms of other indices of a remodeling, including left ventricular and diastolic or end systolic volume indices or in terms of left ventricular ejection fraction. There was a 2% increase in ejection fraction, and the p-value for that was 0.07, but really was not statistically significant. Dr. Greg Hundley: And very nice. And realizing that women may have smaller LV masses, any stratified analysis that evaluated effects on men versus women? And then what about, perhaps in the higher quartile versus lower quartile, of age? Dr. Subodh Verma: Right. So, Greg, we actually did look at various subgroups and covariates, including gender, including age. And age or gender did not really influence the overall result that we obtained. There was really a neutral result in empagliflozin, irrespective of these 2 covariates. We also looked at baseline blood pressure, baseline NT-proBNP, LV mass indices, the presence or absence of heart failure, chronic kidney disease. So for the covariates that we have evaluated over a short term of 6 months in this relatively low risk population, we did not find any heterogeneity the result, per se. Dr. Greg Hundley: Very good. Well, Subodh, thank you so much for that beautiful presentation. And listeners, now we're going to turn to our guest editor, Dr. Chris Granger. And Chris is an expert in the field of heart failure. Also, a lot of familiarity with HFpEF, which sounds a little bit, we're looking at precursors. We don't have HFpEF yet, but maybe trying to inhibit this from happening using empagliflozin. How do you put these results in the context with other studies that have emphasized utilizing SGLT2 inhibitors in patients with sort of a preserved ejection fraction and absence of diabetes? Dr. Christopher Granger: Yeah. Well thanks, Greg. And again, congratulations, Subodh, to your study. And I think you framed some of the context here as these drugs, the SGLT2 inhibitors, as being transformative, which I think is exactly right. And it's such a fascinating story. Right? These drugs, which we thought originally, with their cause of glucose spilling in the urine, and a modest decrease in blood glucose, might have a role for modestly improving glucose control in diabetes. And low and behold, they've turned out to be one of the great stories I think in recent, across all of medicine, in terms of their consistent and substantial improving clinical outcomes for patients with heart failure, with diabetes and cardiovascular disease, and now even kidney protection, and much broader implications. And their well tolerated, and they don't have dose titration. So there's some practical appeal to this class of drugs in terms of their benefits, in terms of clinical outcomes. But we're left with having this amazing evidence-based generated without really understanding why are these drugs so effective? And what are they doing? And you've provided, I think, an important piece to the puzzle. We did have the data from patients with diabetes and heart failure, with diabetes and left ventricular hypertrophy, that there is a modest reduce in LV mass with SGLT2 inhibitors. And what you've shown is that for patients that with mild LVH, with risk for LVH, that we simply don't see a substantial reduction in LV mass with the use of these drugs. So I think that provides this evidence that that's not a major cause of benefit, at least in this earlier phase of development of heart failure. And I think it really underscores the fact that there's a lot of work to do still to understand. We know that the renal effects are obvious place that these drugs have such an important benefit. And then the linkage of renal disease and cardiac performance is one of the areas, I think, that's a very exciting aspect of a probable contribution of the mechanism of these drugs. But I think in the end, we're left with still not really understanding why these drugs are so beneficial. But understanding that, I think, will be important, both for opening new avenues of targeting pathways, as well as being able to tell the clinical community, okay, you have these important benefits, but people do want to also know why are we seeing these benefits. Dr. Greg Hundley: Very nice. Well, listeners, we're going to turn back to Dr. Verma here. Subodh, what do you see is the next study to be performed in this sphere of research? Dr. Subodh Verma: Well, first, my thanks to Professor Granger, Chris, for handling this paper and for his very thoughtful comments. And he's absolutely right. We have such wonderful clinical data, and these results, of course, should not in any way take away from the importance of using empagliflozin or other SGLT2 inhibitors in the prevention of heart failure in people with diabetes, or in the treatment of HFpEF or HFrEF. But we're struggling with trying to understand what is the dominant mechanism of action here. And, in the previous precursor to EMPA-HEART 2, we did EMPA-HEART 1 in people with diabetes, and we saw a modest effect that was statistically significant of reduction in LV mass index. And we did not see this, of course, in a lower risk population without diabetes. And that tells me that remodeling may be occurring to a modest effect, it may require a longer time to actually show its benefits, but that this is unlikely a dominant sort of mechanism through which these drugs are working. And I do share Chris's thoughts that one of the key mechanisms of benefit that needs to be further explored is looking at the renal cardiac axes. We know that these drugs are profoundly renal protective, and that the benefits may actually be secondary to improvements in renal hemodynamics, improvements in renal function. And I think that is a population that needs to be, that's a mechanism that needs to be studied further. So I think the next generation of translational mechanistic studies need to really tease out the renal cardiac axes, maybe tease out populations that are at risk but have more significant left ventricular hypertrophy, maybe evaluate patients for a longer duration of treatment, or select people who truly have significant hypertension at baseline. I think those are groups and questions that need further exploration. And, of course, the translational science needs to be also studied in the context of larger completed clinical trials, where biomarkers are currently available and they can be linked, of course, to the outcomes in those trials. So those are some of my thoughts as to where the field could move towards. Dr. Greg Hundley: Very nice. And Chris, do you have anything to add? Dr. Christopher Granger: Subodh, I think that was a great summary. And I might just make a comment on the other end of the spectrum. That is, we have these drugs and the evidence of their benefit, and yet they're grossly underused in the populations that have proven to have benefit. Now it takes some time to educate, to get people familiar with, and get them to integrate these treatments into practice, but there's an enormous opportunity, and I think there is a linkage here. I think when people understand the mechanism, and when they're thoughtful about how these drugs may be working, that that really helps to make the case that the drug should be used, and that people are on board with using them. So I think there's this linkage here, there's the need to both better understand mechanism, and there's the need to have systems of care where these treatments are integrated to provide the benefit that's been so clearly shown in the randomized trials. Dr. Greg Hundley: Very nice. Well, listeners, we want to thank Dr. Subodh Verma, from St. Michael's University in Toronto, and our guest editor, Dr. Chris Granger, from Duke University in Durham, North Carolina, for bringing this paper highlighting that among people with neither diabetes nor significant heart failure but with risk factors for adverse cardiac remodeling, that SGLT2 inhibition with empagliflozin did not, did not, result in a meaningful reduction in LV mass index after 6 months. Well, on behalf of Carolyn, Peder, and myself, we want to wish you a great week, and we will catch you next week on the run. This program is copyright of the American Heart Association 2023. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

On the first episode of the show Abbas and Urjita are joined by stand-up comedian, writer and Bollywood lover Sonali Thakker to revisit Farhan Akhtar's debut feature 'Dil Chahta Hai'. We discuss whether this movie invented the impromptu Goa plan, why rich people were always villains in movies before this, whether the film broke the mould for curly haired heroines, were Aamir and Ayyub Khan's characters two halves of the same coin, was Subodh the ideal guy? and which 90s sitcom connects two characters from this movie. You can read Ankur Pathak's piece about DCH here: https://fiftytwo.in/story/friends/Dil Chahta Hai through the lens of psycho analysis: https://youtu.be/ywsheV06ckgFor more fun, pop culture stuff from the IVM team subscribe to the IVM Pop feed and also check out our Youtube channel: https://bit.ly/3fa2M66Follow Abbas Momin on twitter: https://twitter.com/AbbasMomin& instagram: https://www.instagram.com/abbasmomin88Follow Urjita on Twitter: https://twitter.com/WaniUrjita& instagram: https://www.instagram.com/urjitawaniFollow Sonali on twitter: https://twitter.com/SonaliThakker& instagram: https://www.instagram.com/sonalithakker/ You can listen to this show and other awesome shows on the new and improved IVM Podcasts App on Android: https://ivm.today/android or iOS: https://ivm.today/ios

मराठीतला बायोपिक स्टार अशी ओळख जर सुबोध भावेची करुन दिली तर नक्कीच चुकीचं ठरणार नाही. 'बालगंधर्व','लोकमान्य','डॉ.काशिनाथ घाणेकर' असे एकापेक्षा एक दर्जेदार सिनेमे करुन सुबोधनं महाराष्ट्राच्या लाडक्या व्यक्तिमत्त्वांना अक्षरशः जिवंत करुन पाहणाऱ्या प्रत्येक प्रेक्षकाला धन्य केलं. मालिका,सिनेमा,नाटक,आणि आता ओटीटी प्लॅटफॉरमवरही रुळलेला सुबोध सध्या चर्चेत आहे ते 'बस बाई बस' कार्यक्रमाचं निवेदन करत असल्यानं. या निमित्तानं सुबोध भावेनं सकाळ Unplugged या आमच्या पॉडकास्ट कार्यक्रमाच्या माध्यमातून मनमोकळा संवाद साधला आहे.

Lawyer and former federal prosecutor Subodh Chandra joins us to help wrap our minds around the myriad legal challenges Trump is currently facing, from the January 6 hearings to the multiple investigations taking place in several jurisdictions. Subodh breaks down what a federal search warrant signals, and how much leeway Trump has been given so far to comply with the rule of law (hint: a lot). Subodh's explanation of the current state of Trump's criminal investigations—and his overall optimism that our nation's justice system will prevail—left us feeling fairly hopeful that the former president will, in fact, be held accountable for his crimes, and that we can rest assured that the levers meant to protect and ensure a functioning democracy have not completely disappeared.

In this special Sloika Darkroom episode, our special guest, professional photographer from Dubai, Subodh Shetty is sharing stories and going through a live mint of 60 editions of his special duo TITAN drop. While on air, the edition sold out in a record 3 minutes, with all 60 editions claimed by fans and collectors. ---------------------------------------------- Website: https://sloika.xyz Twitter: https://twitter.com/sloikaxyz Telegram: https://t.me/sloikaxyz Discord: https://discord.gg/FJpYyVPBY2 Instagram: https://instagram.com/sloika.xyz Newsletter: https://sloika.xyz/subscribe

Welcome To The NFT Jungle is a podcast dedicated to NFTs as well as navigating the NFT space so that you can be equipped to make good decisions in this crazy world of NFTs! ❤️ Welcome To The NFT Jungle is the OFFICIAL podcast for “MetaJungle”. The MetaJungle team is developing platform tools to make your NFT experiences better. Join the MetaJungle Discord for free access to information, tools, and resources that will make your NFT collecting a success!

In Episode #54 of Against The Odds, we have Subodh Sankar(Founder of Atta Galatta - Indian bookstore in Koramangala, Bangalore) giving us some perfect and insightful advice for creators(even if you are not one). This episode is a must if you have considered quitting your job to pursue your calling as a creator be it a content creator, entrepreneur, artist, etc. Leave a rating and review if you like what you're hearing! Our Audio Partner(Sennheiser): https://shop.sennheiserindia.com/ You can find all the equipment I use here(Affiliate Links): https://kit.co/akashdamodaran/shooting-recording-equipment Connect with me: Website: https://www.akashdamodaran.com All Podcast links: https://www.akashdamodaran.com/podcast Instagram: https://bit.ly/AkashDamodaran-Instagram Video Podcast Playlist on YouTube: https://youtube.com/playlist?list=PLQoA3JiiMKpBN3nC8l1Ihyk7hZUUTSgM1

Marni and Chris are joined by Reality Rayna aka Marni's daughter Rayna Battista to recap Love on the Spectrum, a reality dating show with neurodiverse contestants. This is Chris's favorite reality dating show because the daters are obsessed with the truth and are authentic. Marni says neurotypical daters do the same things but it's all happening on the inside.   Key takeaways from this episode:   The beauty of honesty in relationships How to be coachable Finding something fun to do for a first date Not taking things personally   Dani & Solomon [4:26]   Dani has her own business, loves animation, and is dead set on finding someone. She holds high standards for herself and others. She is high-functioning on the autism scale. She says she wants a business partner, lover, and best friend!   Solomon is attractive, into spirituality, and also high-functioning on the autism scale. On their first date, Dani & Solomon have crazy physical chemistry. They kiss a lot! But it throws Dani off. She wasn't prepared for so much physical attraction. She got overwhelmed.   Dani exhibits every inner feeling of any woman going on a date with a hot guy. But she has no inner monologue, so she says to Solomon “You are so hot. I love you” and, “I think you are my person” on their first two dates. Then after date number two, she puts on the brakes. She may have sabotaged the relationship and put her guard up because it was too much, too fast.   We sabotage great possibilities because we get emotionally attached and scared. It's a protective mechanism. We need to get clear about what we really want.   Next, Dani goes on a date with Adan. He seems to be everything she is looking for but she doesn't find him attractive.   Subodh, Abbey, Rachel, & David [17:58]   A giant dating lesson from these dates is that dinner is not the best way to get to know another person. Subodh and Abbey went on really fun dates. They both love animals so they went to the zoo. They both enjoyed themselves and it got them out of their comfort zones in a nice way.   Also, the couples used a basic communication style which is what creates connection. Sure, Abbey got nervous when she went out with David because we all get nervous on a date when sharing things about ourselves.   Just because you are neurotypical, doesn't mean you are supposed to know how to make connections and create intimacy.   A great example of how not to take things personally is when David asks Abbey for some of the candy he brought her and she tells him no. He says “OK. It's probably not good for me anyway.” Abbey knows how to say no at the moment which is monumental for not feeling resentment later.   Breaking Up with Dignity and Respect [28:58]   A high-quality person will communicate even when it is bad news. For example, Dani knows it is going to hurt Solomon's feelings when she tells him she isn't interested in dating him again. It is hard for her to do but she respects him enough to tell him.   It is important to be forthright and treat your date the way you want to be treated.   Another example is after the medieval date, James asks Emma if she wants to go out on another date and she says “No. I think we should just be friends.” It is so brave. There are no excuses, only truth.   When you don't say what you feel. You are assuming the other person can't handle the truth. It's disrespectful.   Make a Connection: Visit Our Website Plug Into Your Superpower Retreat — Apply at DatingwithDignity.com/pluginform Join Our Dating Den Facebook Community Here! Learn how to attract your perfect equal...watch our latest training here! Interested in working with us? Book a Breakthrough session at DWDVIP Get a Free Coaching Session with Marni on Our Podcast — Sign up Here to Be a Guest On Our Show Download a Complimentary Copy of our Book — How to Find a Quality Guy Without Going on 200 Dates  

In today's world when looks are more important than ever, too many men still fail to recognize the importance of personal grooming, showing little understanding of how to go about the process. Many men take a slap-dash approach where they drag a comb across their head, splash on some aftershave, and think job done. However, there's a problem here: people will notice your lack of grooming and from that, judge your character. Our guest for today is Subodh Sharma who is the Co-Founder of PinkWoolf.Com which is an indulgent shaving and skincare essentials brand. About Subodh Sharma Subodh Sharma is the Co-Founder of PinkWoolf.com Earlier, he worked with Williams Lea Tag. What made you an entrepreneur? After 22 years of working in BPO companies in Business Development, Operations, and Solution Design, the entrepreneur bug bit me and launched PinkWoolf with Stuti Sharma. My corporate career was fantastic with a lot of learnings. I met really exceptional people along that journey. The PinkWoolf started shaping up after I went through a few skin issues. --- Support this podcast: https://anchor.fm/tbcy/support

Maanshukla | Subodh Ghosh | Social | Horror Hosted on Acast. See acast.com/privacy for more information.

A Show that connects Nepalese Community

Join us this week for another congress highlights episode covering the recent European Society of Cardiology congress, held virtually from 27-30 August 2021. Listen for commentary on the key highlights, including: - Professor Subodh Verma on EMPEROR-Preserved, EMPEROR-Pooled, and a post hoc analysis of SUSTAIN 6 and PIONEER 6 - Professor Darren McGuire on FIGARO-DKD, and new guidelines for heart failure and cardiovascular disease prevention Disclosures: Prof. Darren McGuire declares the following: Clinical trial leadership: AstraZeneca, Boehringer Ingelheim, Eisai Esperion, GlaxoSmithKline, Janssen, Lexicon, Merck & Co. Inc, Novo Nordisk, Sanofi, CSL Behring, Lilly Consultancy: Affimune, Applied Therapeautics, AstraZeneca, Boehringer Ingelheim, Lilly, Merck & Co. Inc, Pfizer Inc, Novo Nordisk, Metavant, Sanofi, Bayer Prof. Subodh Verma declares the following: Research Grants: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Novo Nordisk Speaker Honoraria: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Janssen, Novo Nordisk, Sanofi, Sun Pharma Consultancy: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Janssen, Novo Nordisk All conflicts of interest have been mitigated prior to this activity. Funding statement: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education. References Packer M, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021 Aug 27. doi: 10.1056/NEJMoa2107038. Online ahead of print. [EMPEROR-Preserved] Packer M, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020 Oct 8;383(15):1413-1424. [EMPEROR-Reduced] Packer M, et al. Empagliflozin and Major Renal Outcomes in Heart Failure. N Engl J Med. 2021 Aug 27. doi: 10.1056/NEJMc2112411. Online ahead of print. [EMPEROR-Pooled] Verma S, et al. Neutrophil-to-lymphocyte ratio predicts cardiovascular events in patients with type 2 diabetes: post hoc analysis of SUSTAIN 6 and PIONEER 6. Eur Heart J 2021. In press Pitt B, et al. Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes. N Engl J Med. 2021 Aug 28. doi: 10.1056/NEJMoa2110956. Epub ahead of print. [FIGARO-DKD] Bakris GL, et al. Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med. 2020 Dec 3;383(23):2219-2229. doi: 10.1056/NEJMoa2025845. [FIDELIO-DKD] FIDELITY analysis: Presented by Dr. Gerasimos Filippatos at the European Society of Cardiology Virtual Congress, August 28, 2021. McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Aug 27:ehab368. doi: 10.1093/eurheartj/ehab368. Epub ahead of print.

Rodney Green talks with Dr. Subodh Kumar, Chief Data Officer from World Vision International, about how to view and utilize data through a Jesus-centered way, or in other words, from a Kingdom perspective, where data is a way to listen to and meet with God as revealed in Jesus. Contact Subodh with questions at: mamtasubodh1702@gmail.com or https://www.linkedin.com/in/subodh-kumar-ph-d-74409616/ Toward Laying the Foundation for Christ-Centered Monitoring and Evaluation: https://crdajournal.org/index.php/crda/article/view/417

In this poem poet expressed his worry about a boy's job,whose name is Rupam,this boy badly need a job,so poet urged to everyone to give a job to this boy❤️❤️

In this poem poet expressed a satire towards globalization ❤️❤️

In which Our Corporate Sponsors divert a catastrophic Tempest in a most amusing Fashion. Bibliography: Chattopadhyay, Bodhisattva. Notes on translation of "Runaway Cyclone". https://web.archive.org/web/20140905235504/http://strangehorizons.com/2013/20130930/3bose-f.shtml Mahanti, Subodh. Vigyan Prasar Science Portal: Acharya Jagadis Chandra Bose. https://www.webcitation.org/66u29FUM5?url=http://www.vigyanprasar.gov.in/scientists/JCBOSE.htm

In medicine, a lot of work has been done to encourage person centred care - but can that maxim be extended to the people working within the healthcare system? Subodh Dave has just been elected as dean of the Royal College of Psychiatrists, and joins us fresh from talking at the International conference on physician health to speak about his ambition to humanise medicine. In this podcast, Subodh, Abi and Cat discuss what lessons from the pandemic need to remain, why at this time it's really important to look out for your colleague with family overseas, and how ice cream trucks meant much more than a cold treat. www.bmj.com/wellbeing

Nepali Voice on Plains FM Music and conversation for the Nepalese community

Dr Subodh Kulkarni CyberOptics discusses how they have been performing amidst the virus backdrop, what's driving their business growth and how things keep getting smaller and more complicated. What do they see on the horizon for semiconductor?

Hosts Sachin Shah and Hamilton Morrin discuss the article "Person-centred care and psychiatry: some key perspectives" from the journal. They are joined by the co-author of the article, Professor Subodh Dave. What are the tenets of person-centred care, how do they apply to psychiatric practice, and how can clinicians improve their approach? Read the Open Access article: https://doi.org/10.1192/bji.2020.21 Follow us on Twitter @TheBJPsych #BJPInternational Disclaimer: BJPsych International is not responsible for statements made by podcast contributors. Unless so stated, the content of this podcast does not necessarily reflect the views of the Editor-in-Chief or the Royal College of Psychiatrists.

To encourage and boost Indian Idol 2020 contestants' confidence Marathi superstar Subodh Bhave graced the stage.

শাড়ী সুবোধ সরকারের রচনা #bengali #Reccitation

ঘুষ কবিতা অসামান্য বাস্তব কঠিন নির্মম সমাজে আদর্শবাদী বাবার করুন আত্মহত্যা ...কবিতা ভালো লাগলে অবশ্যই বন্ধুদের মাঝে ছড়িয়ে দেবেন...সংগে থাকুন শুনতে থাকুন বাংলার আড্ডাখানা

বাবা কবিতা সুবোধ সরকারের রচনা...রাজনীতির প্রেক্ষাপটে যেখানে অসংখ্য ছেলে বলি হয় সীমান্তের যুদ্ধে...সেই সব হতভাগ্য ছেলের বাবার করুন আকুতি...যুদ্ধ যুদ্ধই সেখানে নেই দয়া নেই মায়া, আছে শুধু জয় প্রতিষ্ঠা...

The one week expert podcast is where the hosts of the podcast pick a subject and attempt to become experts on it in one week. Each episode discusses their weekly journey. This week's episode is around budgeting. References https://www.freshbooks.com/blog/the-5-step-plan-to-creating-a-balanced-business-budget#:~:text=Create%20a%20Business%20Budget%20in%205%20Simple%20Steps,a%20fixed%20price%20tag%20each%20month%20are%20called https://www.investopedia.com/articles/pf/06/budgeting.asp https://www.investopedia.com/articles/pf/08/small-business-budget.asp https://www.forbes.com/sites/zackfriedman/2019/01/11/live-paycheck-to-paycheck-government-shutdown/#3ec311284f10 https://www.atypicalfinance.com/7-best-budgeting-methods/ https://www.meetcleo.com/ Subodh's Blog on Budgeting - https://medium.com/@Subodhm/lean-agile-budgeting-for-you-30cfcbd323c7 --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Why do we need to bring Entrepreneurial Education to schools? In conversation with 1M1B founder Mr. Manav Subodh and Principal National Public School, Rajaji Nagar Ms. Malathy R Narayan. The world around us is changing very fast, and some of the careers available to children now may not available in the future. We need entrepreneurial education to empower our kids with the skill set that helps them walk different paths. A mindset that fosters problem solving and finding creative solutions that are bigger and better. It encourages kids to be fearless, curious, creative and innovate to design a better world.

Show :- Waah Shu Waat Che YouTube :- https://youtu.be/8k8cX1kJHiM Company :- FOOTLIGHT FEATHERS ENTERTAINMENT App :- https://play.google.com/store/apps/details?id=com.rajtechnologies.FootlightFeathers COMPANY Distribution :- GujjuIndia --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

MASH Podcast offers in-depth episodes covering various artists, designers, architects, photographers and creative practitioners from all over the world. The podcast will feature leading figures from the arts who will lend their voice to deliver crisp and informative episodes. Subscribe to our podcast on Spotify, Apple Podcasts, Google Podcasts.In this episode, Dr. Subodh Kerkar, painter, sculptor, installation artist and the founder of Museum of Goa speaks about how the Ocean became his art and inspiration.

This episode of Sol Curry with Rima Sadashiv Amarapurkar features Subodh Bhave who is not only known as a thinking actor, but is also one of the most popular actors of Maharashtra... His legendry portrayals of Bal Gandharv, Lokmanya Tilak, Kashinath Ghanekar and Directorial Venture Katyar Kaljaat Ghusli have made him a talent to reckon with. सोल करी विथ रिमा सदाशिव अमरापूरकर च्या या भागात,सुबोध भावे आपल्याशी बोलणार आहेत. एक विचार करणारा अभिनेता म्हणून ओळखले जाणारे सुबोध,महाराष्ट्रातील सर्वात लोकप्रीय अभिनेता आहे... बालगंधर्व,लोकमान्य टिळक,काशिनाथ घाणेकर या व्यक्तिरेखा समर्थपणे साकारणारे सुबोध एक गुणी दिग्दर्शक सुद्धा आहेत,हे कट्यार काळजात घुसली च्या यशाने दाखवून दिलं आहे... Listen To Sol Curry & Other podcasts by Ep.Log Media on www.eplog.media Follow Us on Instagram @eplogmedia Mail us for feedback/partnership on bonjour@eplog.media See omnystudio.com/listener for privacy information.

Have you ever Googled , what's the difference between Blog and a website ? It seems interesting. Whenever I asked newbie digital marketers about it they felt confused..... Really then I ask them to Google it. I advise them to Google what ever questions raised in their mind. There knowledge well expand. Follow me on Instagram/twitter @subodhvrma

Many people who wants to start their career in blogging, youtuber and content creation confused which topic should they choose to deliver. They don't know the difference between Niche and micro niche. In this podcast I had differentiated. Listen to the podcast and stay listening my upcoming podcast episode.

Hey, welcome to my channel Subodh Verma Show. This is your host Subodh Verma. My degree says I am a mechanical engineer, but proudly say I am digital marketer. Being an engineer to digital marketer journey is quite complicative. whatever knowledge I'm grabbing as a digital marketer, social media experts I am going to share with you guys in this channel. You can follow me different social media platforms like Facebook Instagram Pinterest Twitter LinkedIn. search my name or my username @subodhvrma

Dr Carolyn Lam:                Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and it's editors. We're your co-hosts, I'm Dr Carolyn Lam, associate editor from The National Heart Center and Duke National University of Singapore. Dr Greg Hundley:             And I'm Greg Hundley, associate editor for Circulation and director of The Pauley Heart Center at VCU Health in Richmond, Virginia. Dr Carolyn Lam:                Guess what Greg? Right after this we have a double feature discussion. It is all about dapagliflozin with some really, really important self-analyses from the DECLARED-TIMI 58 trial and about heart failure in Type 2 Diabetes with dapagliflozin. But, all of that coming right up only after we have our chat. So Greg, what do you have for us today? Dr Greg Hundley:             My first article is going to be from Dr Mintu Turakhia at the VA Palo Alto healthcare system at Stanford University and is going to discuss the practice variation in anticoagulation prescription and outcomes after device-detected atrial fibrillation. It's a study that has insights from the VA Health Administration. This study evaluated the relationship between oral anticoagulant prescription practice variation in response to new device detected atrial fibrillation and the association to outcomes.                                                 As you know Carolyn, there are no clearly defined thresholds of AF burden, for which to initiate oral anticoagulation. Dr Carolyn Lam:                Interesting, so what did they find, how did they do this? Dr Greg Hundley:             Carolyn, the investigators performed a retrospective cohort analysis using data from the Veterans Health Administration linked to remote monitoring data that included day level AF burden. They included patients with cardiac implantable electronic devices and remote monitoring from the years 2011 through 2014. A CHA2DS2-VASc score of greater or equal to 2, and no prior stroke or oral anticoagulant receipt in the preceding 2 years. They determined the proportion of patients prescribed oral anticoagulants within 90 days following new device-detected AFib across a range of AFib thresholds. Greater than or equal to 6 minutes, all the way up to greater than 24 hours. And they examined sight variation in oral anticoagulation prescription. Dr Carolyn Lam:                And so? What did they find? Dr Greg Hundley:             Well, you ask among 10,212 patients with defibrillators, proportion receiving oral anticoagulation varied based on device detected AF burden. For example, for those greater than or equal to 6 minutes, it was roughly 13% of individuals, for those greater than 24 hours, 27% of individuals received oral anticoagulants. Importantly, there was a substantial sight variation in oral anticoagulation prescription after device-detected atrial fibrillation, for example, greater than one hour. The median was 16%, but it ranged from as low as 3% up to highs of 67%. And so, in adjusted models, oral anticoagulant prescription after device-detected AFib of greater than 24 hours was associated with reduced stroke risk and has a ratio of 0.28, p-value's 0.02, although, the propensity adjusted model was significant when AFib lasted at least 6 minutes.                                                 So, in conclusion, among veterans with implanted devices, device-detected atrial fibrillation is common. There is large practice variation in 90-day oral anticoagulation initiation after new device-detected AFib with low rates of treatment overall, even for episodes greater than 24 hours. Remember, we said that rate was 27%. The strongest association of oral anti-coagulation with reduction in stroke was observed after device-detected Afib of greater than 24 hours. And what this study shows, is that randomized trials are needed to perform these observational findings.                                                 So, Carolyn, how about your next study? Dr Carolyn Lam:                Well, from anti-coagulants to anti-hypertensives. I'm going to tell you about the 6-month results if the RADIANCE Hypertension Solo Trial. Dr Greg Hundley:             Oh, so, what was the RADIANCE Hypertension Solo Trial? Can you remind us? Dr Carolyn Lam:                Glad you asked. So the trial was the one that demonstrated a greater reduction in daytime ambulatory systolic blood pressure at 2 months by endovascular ultrasound renal denervation compared with a sham procedure among patients who were not treated with anti-hypertensive medications. So the current paper, led by Michel Azizi from Université Paris-Descartes and colleagues, now report the 6-month results following the addition of a recommended, standardized, stepped-care anti-hypertensive treatment to the randomized endovascular procedure under continued blinding to the initial treatment.                                                 Now, remember these were patients with uncontrolled combined systolic and diastolic hypertension who were initially off medications for two months following randomization. Now, between two and five months, if the monthly measured home blood pressure was more than 135/85, the stepped-care antihypertensive treatment approach was recommended and consisted of sequential addition of, for example, amlodipine 5mg a day, then a standard dose of an angiotensin-converting-enzyme inhibitor, or an ARB, and hydrochlorothiazide at 12.5mg a day, followed by sequential uptitration of the hydrochlorothiazide and amlodipine.                                                 So, what did they find? At 6 months, 65% of the patients in the original renal denervation group were being treated by this stepped-care approach, versus 84.5 in the sham group. And the average number of antihypertension medications and defined-daily doses were all less in the renal denervation group than the sham group.                                                 Now, despite less intensive antihypertensive treatment, the renal denervation group had reduced daytime ambulatory systolic blood pressure to a great extent than the sham group. Importantly, there were no major adverse events in either group through 6 months. The blood pressure lowering effect of endovascular ultrasound renal denervation was maintained at 6 months with less prescribed antihypertension medications compared with the sham control. And what this means is if safety is maintained in larger studies with longer follow-up, renal denervation could be a promising adjunct therapy for patients with hypertension. Dr Greg Hundley:             Wow, so we're getting back toward renal denervation? How about that?                                                 Carolyn, my next paper jumps into the world of basic science. This is a study from Kari Alitalo at the University of Helsinki, and it involves endothelial cells and how they regulate physiological cardiomyocyte growth versus VEGFR2 mediated paracrine signaling. The study evaluates the role of bidirectional endothelial cells and cardiomyocyte cross-talk via cardiokine and angiocrine signaling as it pertains to the regulation of cardiac growth and homeostasis in pathological cardiac hypertrophy. The expansion of the cardiac vasculature to maintain adequate supply of oxygen and nutrients is a key determinant of whether the heart grows in a physiological compensated manner, or a pathological decompensated manner.                                                 Understanding how an excess of angiogenesis induces cardiac hypertrophy and how endothelial cells regulate cardiomyocyte homeostasis, could provide novel therapeutic targets for heart failure. Dr Carolyn Lam:                Ah, this is something very close to my heart. So Greg tell us, how did they establish the link between the endothelial cells and cardiomyocytes? Dr Greg Hundley:             The investigators demonstrated that both endothelial cell deletion of vascular endothelial growth factor receptor 1 and AAV-mediated delivery of the VEGFR1's specific ligands, VEGF-B or BGIF, into the myocardium increased the coronary vasculature and induced cardiomyocyte hypertrophy in adult mice.                                                 The resulting cardiac hypertrophy was a physiological as indicated by preserved cardiac function and exercise capacity and lack and pathological gene activation. Also, the investigators demonstrated that the reported changes were mediated by increased VEGF signaling via endothelial VEGFR2 and found that the notch and ERBb pathways are involved in transducing signals for endothelial cell cardiomyocyte cross-talk in response to angiogenesis.                                                 So clinically, the relevance of the findings are highlighted nicely in an editorial by professor Issei Komuro at the University of Tokyo Hospital. First, he emphasizes that cross-talk between the endothelial cell VEGFR2 and cardiomyocyte ErbB signaling pathways coordinates cardiomyocyte hypertrophy with angiogenesis and contributes to physiological cardiac growth. And understanding whether factors could modify this process may impact the treatment down the road of pathologic hypertrophy. Dr Carolyn Lam:                Oh interesting! Well you know what, Greg, I've got a preclinical one for you too, and this time looking at the role of inflammation in atherosclerosis and specifically at the role of the adaptive immune response and T-cells.                                                 So, Greg, let me remind you that when we looked at CANTOS and Canakinumab we were actually looking at the role of the innate immune response. And here is where I had planned this very nice, complicated quiz for you, Greg, about the innate versus the adaptive immune response in the various cells. Would you like to take the quiz? Dr Greg Hundley:             You know what? I think I'm going to pledge that I'm already going to get a D or an F, so why don't you enlighten us? Dr Carolyn Lam:                Now alright, remember that the CD4 T-cells are assumed to be activated by our antigens derived from modified proteins such as oxidized LDL, and these are presented via MHC class II molecules in the context of cytokine signaling, remember those? What I didn't realize is that it hadn't been assumed that atherosclerosis involves a loss of tolerance against these modified self-antigens, generated in response to hypercholesterolemia and that presentation of such antigens on these MHC class II cells, then lead to activation of proatherogenic Th1 cells. So, that was the assumptions, but this was really studied in detail by the authors, Dr Wigren from Scania University Hospital and Lund University in Sweden and their colleagues, who addressed the role of CD4 T-cells in a real novel, unconventional way. And they did this by crossing MHC class ii deficient mice with atherosclerosis-prone ApoE-deficient mice.                                                 Now the result of these double deficient mice was almost complete void of CD4 T-cells. However, despite the lack of these T-cells and inflammation, these mice developed larger atherosclerotic lesions in the aortic root area of the heart than their ApoE-deficient counterparts. Cell transfer and blocking antibody studies also, then supported these findings and suggested that loss of regulatory T-cells is the most important cause of aggravated atherosclerosis in the double-deficient mice.                                                 So, overall these observations demonstrate that deficiency of activation of the adaptive immune responses through MHC class ii is associated with increased development of atherosclerosis, and the findings have important implications for our understanding the possible risks and benefits of immunosuppressive therapy in patients with cardiovascular disease. Now this is discussed in a beautiful editorial by Dr Slütter and Kuiper and they are from Leiden, the Netherlands.                                                 So, Greg, interesting stuff, huh? Dr Greg Hundley:             You bet! Let's go on and here a little bit more about diabetes. Dr Carolyn Lam:                And dapagliflozin coming right up.                                                 Today's feature discussion is all about SGLT2 inhibitors both in heart failure and atherosclerotic disease. A huge discussion because we have two papers, and they're all coming from the DECLARE-TIMI 58 trial. I am so pleased to have the corresponding author, Dr Stephen Wiviott from the TIMI study group at Brigham Women's hospital in Boston, Massachusetts, as well as the first author of one of the papers, and that is Dr Eri Kato, who was at the TIMI study group and is now at Kyoto University, as well as the editorialist for these two papers, Dr Subodh Verma from University of Toronto, and our deputy editor, Dr Darren McGuire from UT Southwestern.                                                 All-star cast, all-star papers. So, Steve, could you start by telling us about the DECLARE-TIMI 58 trial, just to set the background please? Dr Stephen Wiviott:        So DECLARE, for people who don't know, was a large, randomized trial of 17,000+ patients with diabetes, comparing the SGLT2 inhibitor dapagliflozin to placebo. And the patients could be enrolled if the patients had either an established cardiovascular disease, meaning secondary prevention, or simply risk factors for cardiovascular disease with primary prevention.                                                 Patients that were treated with dapagliflozin or placebo were followed for a period of just over 4 years and there were co-primary endpoints. Those were cardiovascular death and hospitalization for heart failure, and the second co-primary endpoint was MACE, major adverse cardiovascular events, a combination of cardiovascular death, MI, or stroke.                                                 And what we saw, initially, this was a safety trial to demonstrate the safety of this diabetes agent according to worldwide guidelines. We saw that there was certainly non-inferiority for MACE, so it was safe with regard to MACE, but we did see a statistically significant reduction in cardiovascular death and hospitalization for heart failure driven predominantly by a large reduction in hospitalization for heart failure, and we also saw consistent with the other SGLT2 inhibitors, a significant reduction in the progression of renal disease. And so we had the opportunity to follow up with a couple of important papers that were published in circulation. Dr Carolyn Lam:                Thanks, Steve. And at this point I would love to invite Eri to tell us, because we just heard that the heart failure hospitalization signal is very strong. What did you do in your analysis? Dr Eri Kato:                         So previously, SGLT2 inhibitors including dapagliflozin have shown to reduce hospitalization for heart failure, now we wanted to take a step further and explore those who are at high risk. So, the aim of our study was to evaluate whether the clinical benefit of dapagliflozin is greater in patients with HFrEF, heart failure with reduced ejection fraction, compared with patients without HFrEF.                                                 So, we used data from the DECLARE-TIMI 58, which you just heard, which included a broad spectrum of patients with Type 2 diabetes, and was also unique that it is the only SGLT trial to date that has detailed the information of these ejection fractions. So, for this study, for our study trying to find patients by the presence or absence of HFrEF, which was defined as having ejection fraction less than 45%, which is pre-specified ejection fraction couplings, and the key outcome in each was cardiovascular death or hospitalization for heart failure, its components, and of course, mortality. But we also additionally looked at MACE and renal composite endpoints.                                                 There are several interesting findings. First, is that dapagliflozin reduced the risk of hospitalization for heart failure regardless of ejection fraction, including those with preserved ejection fraction.                                                 Second, is we have observed lower rates of cardiovascular death in all-cause mortality with dapagliflozin in patients with HFrEF, but not in those without HFrEF.                                                 So, in patients with HFrEF, there was a significant 45% reduction in cardiovascular death, and 41% reduction in all all-cause mortality with dapagliflozin. And I'd like to highlight that these were achieved on top of high-proportional use of conventional evidence-based heart failure therapies, and that it did not increase any adverse events.                                                 And third, and finally, there were lower rates of renal composite endpoints with dapagliflozin regardless rejection fraction, and once again, it improves patients with preserved rejection fraction.                                                 So, to summarize, our results showed a robust mortality benefit in patients with HFrEF, but also showed that dapagliflozin is beneficial in full spectrum patients with diabetes, regardless of ejection fraction. Dr Carolyn Lam:                Thank you Eri, that's beautifully summarized, but could I just clarify? These were patients not just with a reduced ejection fraction, but with heart failure? And how was that determined? Dr Eri Kato:                         We collected data at the baseline and the heart failure was collected based on the medical record. Dr Carolyn Lam:                So, I just wanted to clarify that it wasn't just rEF, but HFrEF, but the HF part was a medical record. So, Darren, I know you thought a lot about this stuff, so what do you think? Is there still equipoise for these heart failure trials, or how do you think this adds? Dr Darren McGuire:        First, as deputy editor of Circulation, I'm thrilled that were attracting these excellent diabetes-related publications, we've had a track record of several years now of capturing many of the key analyses and certainly these two papers we're talking about today qualify among the very best we've had, and I've also had the privilege of working with these investigators on the executive committee at DECLARE. And to the investigators and the credit of the sponsor, we observed these heart failure signals in other trials as DECLARE was ongoing, and we actually made a modification during the trial to begin to collect as much as we could pre-randomization ejection fraction data. And we were able to capture on roughly one-third of the patients, pre-trial EF data and we took any way it was measured and any time of when it was measured, and there are some limitations to that, but this now represents the largest data set where we can stratify the outcomes by some measure of ejection fraction.                                                 And I have to say I was really surprised by these results; that the cardiovascular death benefits were amplified in patients with heart failure with reduced ejection fraction, but not in those with heart failure with preserved ejection fraction, as these medications are relatively modest, diuretic agents I anticipated the opposite, honestly, that heart failure would preserve ejection fraction that is much more volume-sensitive may have incremental benefits from these medications.                                                 So, I was surprised by this, it was a little bit upside-down from what I expected. I know Subodh and Carolyn you've both thought a lot about this as well, I'd be interested in your opinions. Did you expect that heart failure with reduced ejection fraction would drive these clinical results? Dr Carolyn Lam:                Subodh, I'm going to let you go first. Dr Subodh Verma:           First and foremost, I appreciate the opportunity the circulation gave both myself and Professor McMurray to write the editorial to these very important pre-specified analyses from DECLARE.                                                 I actually see the results not only as interesting and tantalizing as you already discussed, but I actually see a lot of consistency between the two phenotypes, if I may, in that there is a heart failure signal or reduction in heart failure hospitalizations that appears to be consistent between the two groups, right? People with an EF of less than 45 with or without heart failure and then on the other side, people without reduced ejection fraction. They're both responsive in terms of reductions in heart failure hospitalization, so it brings into question that is this differences that we're seeing with respect to mortality, a reflection of a difference in phenotypic responsiveness to an SGLT2 inhibitor, or is this simply a reflection of increasing placebo event rates and a response based on baseline of entry in one group versus the other.                                                 So, as has been nicely outlined by the authors, the placebo event rate for CB death and heart failure and the placebo group would have pass, if I may, was about 5 times lower than those with heart failure with reduced ejection fraction. And it might be that as we go up the pyramid of risk, whether that risk is defined based on a TIMI risk score, whether it's based on a post-MI versus stable CAV risk score, or whether it's defined based on GFR, or whether, finally, it's defined based on the event rates for CV death and heart failure, that the higher the event rate, the higher the probability of demonstrating a CV death benefit, but that old strategies are actually demonstrating a consistent benefit on the overall driver of that outcome, which in this case, is a reduction in heart failure.                                                 So, that's what we sort of said in the editorial as well that we think that it may be a bit premature at this point to reach a conclusion that one group is responsive, and the other group is not responsive. But, as you rightfully said, Darren, it is entirely feasible through these analyses to hypothesize that one of the alternative hypotheses could be that there is a greater responsiveness in HFrEF compared to HFpEF. I actually don't understand the mechanisms of it, if that was the pieces I would have a difficult time explaining it based on the overall biology and sort of current understanding of these agents.                                                 But, I would say let’s wait: dapa heart failure is just around the corner. That trial will enroll people with documented heart failure with reduced ejection fraction. I think 4,774 patients that are being randomized on top of base, on top of RNA, on top of MRA, etc. who still have heart failure and who have a BP that's elevated so the definitive proof for this, at least from a rough standpoint, will be forthcoming. And then there are numerous HFpEF studies that are ongoing. There's Emperor Preserve and there's Deliver, and they have characterized the HFpEF population with a little bit more granularity and clarity. And I think we will be able to then look at, specifically, is there a HFpEF group that has the same event rate for CV death and heart failure, and compare that population to a HFrEF group at the same level of risk and whether there is differences in the responsiveness to be definitive about whether this is a matter of risk, threshold, or whether this is a true representation phenotypically. Dr Carolyn Lam:                Subodh is a hard act to follow. So, I will answer your question directly, but maybe not with so many words, because it's already been said, Darren. And I'll just say I expected this benefit to be in both, I wouldn't have said one versus the other, but because we do know that in trials and with prospective studies that HFpEF outcomes are lower, especially mortality is lower, compared to HFrEF. I do wonder if it's a power issue, but the most important message--and this is coming from me also being on the steering on the committee of both DELIVER and EMPEROR Preserve--that please, this doesn't mean that we don't need the trials. I really really think that there's equipoise there still and we need to look at the DEDICATED HFpEF trials.                                                 But, moving on from the concept of risk stratification, I would like to go on and talk about the next paper. About the DECLARE sub-study of those with a prior MI. So, Steve, could you tell us, why did you do this, and what did you find? Dr Stephen Wiviott:        I think that what we've seen as a pattern across the three SGLT2 inhibitor trials including CANVAS, EMPEROR, Outcome, and DECLARE, was that there seems to be, as Subodh has said, reductions that are relatively consistent in heart failure and renal outcomes. But there was what appears to be ischemic outcomes, the MACE outcomes, cardiovascular death, MI and stroke.                                                 In fact, in a meta-analysis that we published at the same time as the primary paper for DECLARE, we demonstrated that there was an interaction between the primary prevention in the population, those without established cardiovascular disease, and the secondary prevention population as it relates to MACE, where the benefits for MACE seem to be in the secondary prevention population.                                                 So, this was seen in DECLARE as well, and so we hypothesized that the population of patients who had myocardial infarction as their entering condition may be particularly at high risk for MACE and it may potentially be that that was driving the benefit. And so, what we did was we stratified the patients based on history of prior myocardial infarction versus none, turned out that there was about 3,500 patients in the trial who had had a prior myocardial infarction. As would be expected from what's known about the conditions, the event rates for those patients in the placebo arm were much higher, about 2.5 times higher than patients without myocardial infarction for MACE, also true for CV death and hospitalization for heart failure.                                                 And then what we saw when we looked at the treatment outcomes was that there tended to be a greater reduction in MACE for patients with prior myocardial infarction. In fact, for the MACE outcome, we saw about a 16% reduction in MACE with patients with prior MI compared to reduction with patients without prior MI. And so, the combination of this higher risk, also a tendency towards a greater relative benefit lead to a much greater absolute benefit, where, in fact, we saw about a 2.5% reduction in MACE over the four-year period for patients with prior MI, compared to a 0% reduction for patients without prior MI.                                                 And, in fact, when we broke this down to three groups: patients with prior MI, patients with atherosclerotic cardiovascular disease without prior MI, and then patients with no atherosclerotic vascular disease, essentially, we saw the same thing, which is that patients with MI were the ones who had the greatest benefit in terms of MACE. And this was almost entirely driven by reductions in myocardial infarction.                                                 Now, I would say in contradistinction, as we look at heart failure reductions, the relative benefits for heart failure were similar among these groups, but because the risk was higher in the patients with prior MI, and of course the absolute benefits were greater in the MI population, and similar for renal outcome. So, I think that this sort of extends what we have previously known that patients with atherosclerotic cardiovascular disease were at higher risk intended to have greater benefit with the SGLT2 inhibitors on MACE events that the core of that appears to be those patients with myocardial infarction. Dr Carolyn Lam:                Thanks, Steve, that was just so clearly explained. Darren, in the last couple of minutes could I ask you to give us the take-home messages from these two studies, and maybe just, what next? Dr Darren McGuire:        I think the take-home message from these two studies in the context of the overall field of SGLT2 inhibitor data, I think the picture's becoming relatively clear and Subodh stated in eloquently before and is reviewed in the editorial is that I think across the board, and independent of how you define higher versus lower risk subsets, this class of medications in general and dapagliflozin, and these studies appear to have augmented benefit, the greater the risk. Whether that greater risk is defined by prior myocardial infarction, or heart failure with reduced ejection fraction, or decreased EGFR, these are all states where various sub studies have consistently shown across the three compounds where we have outcomes data that the treatment benefits are amplified in the higher risk patients.                                                 And it's not just an absolute risk reduction that's augmented based on baseline risk, but there appears to be an interaction where the relative risk reduction is also amplified. And so, it's really a remarkable field and it's providing therapeutic options in these really high-risk subsets of patients where we've really been handicapped up until now with these antihyperglycemic therapies for type ii diabetes. Dr Carolyn Lam:                Thank you everybody for joining us today. This was truly a bonanza feature discussion, didn't I tell you?                                                 You've been listening to Circulation on the Run, thank you for listening today and don't forget to tune in again next week.                                                 This program is copyright American Heart Association 2019  

Subodh, a software engineer leading the QUIC team in Menlo Park, joins us for episode 11 and talks with Mihaela and Pascal about Android networking. If you've never given much attention to the network protocols your app is using, listen to Subodh why you should give it a second though. You'll hear about how the Android networking stack has evolved over the years, why zero round-trip time matters on mobile and what it's like to contribute to a network protocol specification (spoiler: it's TLS 1.3). Brush up on your networking knowledge and tune in for this new episode! For feedback, please reach out on Twitter at @insidefbmobile, Instagram at insidefbmobile or drop us an email at mobilepodcasts@fb.com. Topics discussed - https://www.reactiflux.com/transcripts/react-native-team/ - https://www.reddit.com/r/reactnative/comments/av7vw3/future_ama_the_react_native_team_will_be_hosting/ - https://github.com/react-native-community/discussions-and-proposals/issues/64#issuecomment-446098249 - https://facebook.github.io/react-native/blog/2019/03/01/react-native-open-source-update - https://code.fb.com/developer-tools/mark-harman-harlan-d-mills-award/ Timestamps Intro 00:00 News 00:16 React Native OSS Update 00:25 React AMA 00:54 Relay 3.0 01:25 Sapienz 01:39 The Diff 02:40 Magma 03:22 Interview Prelude 04:03 Subodh Intro 05:02 First Projects 06:02 What got you interested in security? 07:18 Whitehat 08:15 FB Android networking 6 years ago 09:49 HTTPS enforcement 11:09 Evolution of the mobile networking stack 12:08 Certificate Pinning 15:07 Adopting system-level APIs 18:00 WebView security 20:29 TLS 1.3 features 21:32 Encrypted SNI 25:44 What's next after TLS 1.3? 27:46 Header compression flaws 28:34 QUIC 31:19 Standards Contributions (link) 40:07 mvfst 43:00 Low-level API UX 48:50 Katran: https://code.fb.com/open-source/open-sourcing-katran-a-scalable-network-load-balancer/ 52:20 Wrap-up 54:11 Outro 55:19 Bloopers 58:52  

Subodh Sharma is a professor of computer science at IIT Delhi, one of the most prestigious universities in India. While he’s not teaching, Subodh conducts research into the formal verification of distributed systems, and his work on the automated formal verification of smart contacts has drawn international interest. I called up Subodh because I was looking for someone to explain an approach to writing software called the actor model. The actor model essentially involves sandboxing tasks in such a way that complexity is minimized and all behaviors of a software system can be known under all conditions. Currently the actor model is applied to the management of telecommunications networks through the Erlang language, and also in secure servers. Understanding the way robust distributed systems are constructed assists in the assessment of platform designs and gives us a view into the future of the ultimate distributed system - the Third Web.

गोहत्या की अफवाह पर हिंसक हुई भीड़ ने सोमवार को उत्तरप्रदेश के बुलंदशहर में पुलिस इंस्पेक्टर सुबोध कुमार सिंह की सिर में गोली मारकर हत्या कर दी। गोली लगने के बाद भी भीड़ उन्हें पीटती रही। #उत्तरप्रदेश,#सुबोधकुमारसिंह,#गोहत्या, Log On To Our Official Website : http://www.lehren.com Download LEHREN App For Android: Android Play Store Link : https://goo.gl/xtpQgq Facebook : https://bit.ly/LehrenFacebook Twitter: https://bit.ly/LehrenTwitter

If you love Street food like Vada pav, dabeli, misal pav or pav bhaji then definitely you have been to Mumbai and if not then you don't have to go to Mumbai for that anymore. It is very much available in Mumbai style here in London. And the guys who are doing it right are the visionaries Subodh Joshi and Sujay Sohani the founders of Shree Krishna Vada pav aka SKVP. With a turnover of Half a million Sterling and 3 branches across London, their vision is to bring Vada Pav as a regional food of India to the Multinational diaspora of London. I caught up with Sujay and Subodh in their flagship restaurant in Hounslow to discuss their success story and future roadmap of the brand they have worked tirelessly to create.

Subodh Tiwari spricht über "Yogatherapie und ihre Wirkungen aus der yogatherapeutischen Arbeit am Kaivalyadhama Yogatherapie Institut". Live-Mitschnitt von dem Yoga Kongress 2009 im Haus Yoga Vidya Bad Meinberg. https://www.yoga-vidya.de/center/haus-bad-meinberg/start/. Subodh Tiwari ist Leiter des Kaivalyadhama Instituts, eine der führenden Yogatherapie Institutionen Indiens. Die Yogatherapie bei Yoga Vidya ist auch inspiriert von der Arbeit von Kaivalyadham.

Subodh Tiwari spricht über "Yogatherapie und ihre Wirkungen aus der yogatherapeutischen Arbeit am Kaivalyadhama Yogatherapie Institut". Live-Mitschnitt von dem Yoga Kongress 2009 im Haus Yoga Vidya Bad Meinberg. https://www.yoga-vidya.de/center/haus-bad-meinberg/start/. Subodh Tiwari ist Leiter des Kaivalyadhama Instituts, eine der führenden Yogatherapie Institutionen Indiens. Die Yogatherapie bei Yoga Vidya ist auch inspiriert von der Arbeit von Kaivalyadham.

On Thursday, February 11, a team of scientists from the LIGO Scientific Collaboration, short for Laser Interferometer Gravitational-Wave Observatory, announced that they had heard and recorded the sound of two black holes colliding a billion light-years away, a fleeting chirp that fulfilled the last prediction of Einstein’s general theory of relativity. (source: New York Times)At the very same time, our "own" particle physicist Subodh Patil was on stage, talking about how to achieve breakthrough based on years of scientific research.We thought the coincidence was too beautiful not to invite him back on stage, along with another researcher and long-time lifter Anaïs Rassat, and tell us more about this groundbreaking discovery!Don't hesitate to also check out the official Einstein 100 website mentioned by Anaïs during the interview.Recorded on February 11, 2016, in Geneva.

Subodh Patil, research physicist at the University of Geneva and CERN, uncovering the fundamental physics that gave rise to the Big Bang.In this first talk of the session Enter the Anti-Disciplinary Space, Subodh Patil introduces the realm of creativity and discovery, from the point of view of a physicist, building on the learnings of thousands of years of scientific research.What does it take to achieve a breakthrough? Is there any standard model for creativity?Recorded on February 11, 2016, in Geneva.

Subodh Tiwari spricht ein paar Grussworte anlässlich des 1. internationalen Yoga-Kongresses bei Yoga Vidya. Mehr Videos und Infos auf http://www.yoga-vidya.de

Subodh Tiwari spricht ein paar Grussworte anlässlich des 1. internationalen Yoga-Kongresses bei Yoga Vidya. Mehr Videos und Infos auf http://www.yoga-vidya.de