Podcasts about Tein

Tein taannoin monologijakson otsikolla Kaikki onnistuneen elämäntapamuutoksen tekemisestä. Huomasin, että siitä tuli eräänlainen keittokirja hyvän kunnon saavuttamiseen. Mutta jotta elämäntaparemontin keittokirja ei homehtuisi kirjahyllyyn vaan sitä myös luettaisiin ja keittoja valmistuisi, pitää muutama peruskivi olla kunnossa. Tässä jaksossa käyn läpi muutoksessa onnistuneiden ja ympäri vuoden hyvässä kunnossa olevien työkalupakkia ja voit poimia sieltä parhaat omaan käyttöösi. Miksi vastuu omasta hyvinvoinnista täytyy kantaa itse ja mitä se tarkoittaa konkreettisesti? Miksi selkeys arjessa auttaa onnistumaan kiireen ja vastuidenkin keskellä? Miten priorisoidaan kun aina tuntuu olevan enemmän tärkeää kuin mihin aika riittäisi? Miten pidetään fokus tekemisessä aikomisen, empimisen ja pelkän innostuksen sijaan? Miksi tarvitsemme sitkeyttä ja periksiantamattomuutta ja miten ne saa valjastettua käyttöön? LinkitOptimal Performance- Hyvinvointiluennot ja verkkovalmennukset: https://www.optimalperformance.fi- Kuntosali ja valmennuskeskus, Helsinki: https://www.opcenter.fi- Kaikki onnistuneen elämäntapamuutoksen tekemisestä: https://open.spotify.com/episode/6FJCkswyC7MbGHkLOpQiwE?si=a00be27b46124feb

Tavaralla on monesti jokin hinta ja moni saattaa jopa yllättyä, että palvelu maksaa. Tietenkään itse ei tarvitse ammattilaisen puolesta tehdä, mutta mitenkä koodi projektissa olisi mahdollista säästää rahaa ja minkälaiset Tein-itse-ja-säästin ratkaisut taas nostavat hintalappua sen laskemisen sijaan? (00:00) Intro (01:18) Aiheen pohjustus (05:21) Kommunikoinnin arvon tunnistaminen (08:13) Neuvotteluiden raamit (12:17) Selkeä kommunikaatio säästömenetelmänä (19:13) Arkisen vatutuksen hinta (22:21) Mieti asioiden todellista hintaa (24:45) Säästäminen on taitolaji (27:43) Loppusanat

Jakson muistiinpanot:vapautasupervoimasi.fi/blog/lanseerausanalyysi

Somber couple of days since our last pod.  We lost an acting legend!  Gene Hackman and his wife Betsy found dead at their Santa Fe estate.  Although up in age still sad to hear.  Now the media and law enforcement are calling the deaths suspicious…is very weird that they were down for “quite some time”.  What happened?  Will get the opinions of everyone.  Bondi released “Phase 1” of the Ep$tein files but what was really released.  It has also been discussed as to how the files were released and to who.  We all knew all of it wasn't comin out but what happens next.  More California mayors cheating the system.  And a boating trip gone bad.  Tune in and join us in the chats or comment after the fact.Follow us on: Instagram, Facebook, Twitter, Apple, SpotifyREMEMBER TO SUBSCRIBE….DOWNLOAD ON ALL YOUR AUDIO PLATFORMS….AND LEAVE A 5 STAR RATING AND REVIEW ON APPLE & SPOTIFY!!!

Building a house in Australia is a dream for many, but what are the essential steps to achieving it? While buying an existing home may seem straightforward, the process of purchasing land and constructing your own house requires careful planning and consideration. Here's how you can navigate building your own home in Australia. - Inn hmun a lawngmi cawk, inn pungsan kanmah duhning tein suaiter cun inn satu sakter cu mi tampi nih chunmang an manh cio mi a si. Cucaah, Australia ah kanmah duhning tein inn sak nak ding caah kan theih dingmi thil ka chim mi rak ngai ve.

Jaksossa mainitut linkit: Kääntyikö myyntisi laskuun 2024? Katso maksuton koulutus, missä kerron 5 salaisuutta, jotka korjaamalla saat myynnit kasvuun 2025 >>> Jakson muistiinpanot: vapautasupervoimasi.fi/blog/Taman-YHDEN-asian-oivaltamalla-tein-taas-ennatysliikevaihdon

Vuonna 1995 kirjoitin sinulle ennenäyn.

Kannattaako aina tehdä itse säästääkseen rahaa? Kimmo osoitti matemaattisia taitojaan kertaamalla suhteellisuusteoriaa. Sanaselityspeliin otti osaa itse toimitusjohtajan äiti. Minnaan iski kaukokaipuu. Kuuntele Aamun Iltapalat!

Entdecke, wie Tee deinen Blutdruck beeinflussen kann. Erfahre, wie du durch regelmäßigen Teegenuss deine Gesundheit verbessern kannst.

We focus once again on the ongoing genocide in Gaza with Delinda Hanley, executive editor of the “Washington Report on Middle East Affairs” who tells the heartrending story of an undertaker in Gaza who since October 8th personally has had to bury over 17,000 people. Then, Ralph welcomes back retired Colonel Lawrence Wilkerson of the Quincy Institute for Responsible Statecraft to widen out the discussion to include the war in Ukraine and contends that “the Pentagon runs America.”Delinda Hanley is news editor and executive director of the Washington Report on Middle East Affairs. She writes extensively for the magazine on an array of topics and her stories have also been published in the Arab News, Saudi ARAMCO World, The Minaret, Islamic Horizons and other U.S. magazines, including The Jewish Spectator. She has written extensively on Palestine, Tunisia, Saudi Arabia, Libya, the emergence of the Muslim voice in Arab politics, and fairness in the mainstream American media.During this (Gaza) crisis, it's been a meeting point for people on the sidewalk. We've had fundraisers, people just come and vent because they're so upset about our U.S. foreign policy. Diplomats come in and vent about how they don't get a say anymore—it's just top-down foreign policy decisions. We've had ex-military people, who served in Iraq, vent. Everyone just comes here and starts to feel a little better because they're talking to like-minded people. The only people who don't come here are the media. We've never had a story about the magazine. It's just verboten.Delinda HanleyWhile most publications depend on advertising to last, we don't have much advertising. Only charities dare to advertise with us because if you're a lawyer or insurance salesman, you get phone calls from our adversaries saying, "That's an anti-Semitic magazine. Don't do that. You won't have our business." We have a real problem with advertising. And also, may I say, we are so happy to send free subscriptions to libraries…Libraries are afraid to have us on their shelves sometimes because they get complaints. Delinda HanleyLawrence Wilkerson is a retired U.S. Army colonel. Over his 31 years of service, Colonel Wilkerson served as Secretary of State Colin Powell's Chief of Staff from 2002 to 2005, and Special Assistant to General Powell when he was Chairman of the Joint Chiefs of Staff from 1989 to 1993. Colonel Wilkerson also served as Deputy Director and Director of the U.S. Marine Corps War College at Quantico, Virginia, and for fifteen years he was the Distinguished Visiting Professor of Government and Public Policy at the College of William and Mary. He is currently a Senior Fellow at the Eisenhower Media Network, senior advisor to the Quincy Institute for Responsible Statecraft, and co-founder of the All-Volunteer Force Forum. AIPAC—the Israeli-government-can-do-no-wrong lobby here—poured over $14 million to defeat Jamaal Bowman, the Democrat from the Bronx and Westchester County just this week in the primary. And it came down to $17,000 an hour they were spending on blanket ads and other media against this super progressive member of Congress who dared a few weeks after October 7th to call for a permanent ceasefire and describe what Netanyahu was doing as genocide.Ralph NaderWe know, all of us know, that the armed forces of the United States are broken. They are broken from years and years of the all-volunteer force, years and years of war, years and years of stupid idiotic war with no purpose, years and years of wounds, PTSD, suicides just off the charts now. And the armed forces are not doing well. Colonel Lawrence WilkersonIn Case You Haven't Heard with Francesco DeSantisNews 6/26/241. In a story that could have been written 200 years ago, independence activists in the French territory of New Caledonia in the Pacific have been sent to mainland France for pre-trial detention, per Al Jazeera. According to this report, these seven detainees include Christian Tein, head of the pro-independence group Field Action Coordination Cell, or CCAT. Tein's lawyer Pierre Ortent said he was “stupefied” that Tein was being being held in France, accusing authorities of “answering to purely political considerations.” A lawyer for another detainee said these actions would only create “martyrs for the independence cause.” Riots broke out in New Caledonia earlier this year when France instituted new rules allowing long-term, non-indigenous residents to participate in independence referenda – which “Indigenous Kanaks feared…would dilute their vote.” France deployed 3,000 soldiers in response. New Caledonia remains on the United Nations list of “non-self-governing territories,” the modern euphemism for imperial colonies.2. Following a decade-long legal battle, the saga of WikiLeaks founder Julian Assange is finally coming to a close. Defending Rights and Dissent reports “On Monday, it was announced that Assange had filed a guilty plea in the US District of Northern Mariana Islands. Assange, who faced 17 counts under the Espionage Act and one count of conspiracy to violate the Computer Fraud And Abuse Act, pled guilty to [a] single count of conspiracy… Assange…will make an appearance in court and be sentenced to time served. He will then return to Australia a free man.” However, Policy Director Chip Gibbons was quick to note “Plea deals…set no legal precedent…the US government's decision to charge Assange under the Espionage Act remains unconstitutional due to the First Amendment's press freedom guarantees.”3. In an interview with Declassified UK, reported by Yahoo News, Independent MP Candidate and former Labour Leader Jeremy Corbyn recounted how he was pressured to give blanket support to military actions by Israel. In the interview, he said “During one extremely hostile meeting of the Parliamentary Labour Party Committee they confronted me and said will you give a blanket undertaking that you, as party leader and potentially prime minister, will automatically support any military action Israel undertakes?” Corbyn responded “no, I will give no such undertaking, because the issue of Palestine has to be resolved and Palestinian people do not deserve to live under occupation…” Corbyn is currently fighting to keep his longtime seat in Islington North after being expelled from the Labour Party by it's reportedly CIA-linked new leader, Keir Starmer.4. British humanitarian group Save the Children has published a new report which finds “Over 20,000 children [are] estimated to be lost, disappeared, detained, buried under the rubble or in mass graves,” in Gaza. A Child Protection Specialist with the group, on the ground in Gaza, is quoted saying “Every day we find more unaccompanied children and every day it is harder to support them…there is no safe place in Gaza… Neighbours and extended family members who have taken in lone children are struggling to meet their basic needs, such as shelter, food, and water. Many are with strangers - or completely alone - increasing the risk of violence, abuse exploitation and neglect.” Jeremy Stoner, the group's regional director for the Middle East, says “Gaza has become a graveyard for children.”5. On Tuesday, a new citizenship law took effect in Germany, allowing new immigrants to obtain a German passport within five years – but only if they declare that the State of Israel has the right to exist, per the Financial Times. This piece notes that the “[German] government…has…sparked anger by…[cracking] down on…criticism of the Israeli government over its conduct in Gaza, fuelling (sic.) a debate over free speech in Germany, particularly among artists and academics. Sabine Döring, Germany's junior minister for higher education, was forced to resign earlier this month after her ministry started exploring legal options to defund the research of German academics who had signed a public letter criticising a police crackdown on anti-Israeli student protests.”6. AP reports Israel's Supreme Court issued a ruling this week that “the military must begin drafting ultra-Orthodox men for compulsory service…[putting] an end to a decades-old system that granted ultra-Orthodox men broad exemptions from military service while maintaining mandatory enlistment for the country's secular Jewish majority.” The exemption from military service for the ultra-Orthodox Haredim has been a long-term flash-point in Israeli society and the issue has only grown more contentious as the recent campaign in Gaza has dragged on. The Netanyahu regime, which rules in coalition with Haredi parties, fought this ruling tooth and nail, claiming that forcing the Haredim to serve would “tear Israeli society apart.” Many speculate that the ruling will cause the ultra-Orthodox parties to leave Netanyahu's coalition, which would precipitate the collapse of his government.7. According to the Pittsburgh Post-Gazette, over 20 elder care facilities in the area have closed in just the last few weeks, which this report ascribes to “The long-term mismanagement of nursing homes by private equity firms,” like the Carlyle Group. Specifically, the paper excoriates how “Private equity firms extract money from nursing homes,” using “sale-leaseback[s]…selling the land out from under the facilities for lump payments…[meaning] Nursing homes are suddenly forced to pay rent or ‘management fees' to occupy facilities they once owned…the same process…that resulted in the bankruptcy of the Red Lobster restaurant chain.” The paper notes that the Biden administration is promulgating a new rule that elder care facilities must disclose their ownership, while acknowledging that “This will hardly solve the problem, but it will allow families to make informed decisions about their loved ones' care.”8. Rumblings suggest Congress may raise the corporate tax rate. POLITICO reports “anti-corporate sentiment is running high among increasingly populist-minded Republicans,” and this article quotes Congressman Chip Roy of Texas saying “There's a bubbling-up concern that we should not be doing the bidding of corporate America.” Roy is reportedly “consider[ing] kicking the corporate rate up to 25 percent, from the current 21 percent, if it means being able to extend breaks for individuals and small businesses.” On the Democratic side, Representative Don Beyer said “Every Democrat thinks the 21 percent corporate rate is far lower than is necessary,” and Senate Finance Chair Ron Wyden added “Western civilization is not going to end if there's some increase.”9. The Guardian reports DC area coffee chain Compass Coffee is “hiring dozens of friends of management, including other local food service executives and an Uber lobbyist, in an effort to defeat a union election.” Compass Coffee United, the union representing these workers, “accused the coffee chain of hiring 124 additional people at cafes that are attempting to unionize…[and] manipulating worker schedules retroactively to try to make the new employees eligible to vote in the union election.” The union has filed an unfair labor practice charge with the NLRB. Senator Bernie Sanders wrote on Twitter “Claiming that a lobbyist from Uber & CEOs from other companies are workers in order to rig a union election is totally absurd & disgusting.”10. Finally, in more labor news, CNN reports Teamsters President Sean O'Brien will speak at the Republican National Convention. Former President Trump wrote on Truth Social “Our GREAT convention will unify Americans and demonstrate to the nation's working families they come first…When I am back in the White House, the hardworking Teamsters, and all working Americans, will once again have a country they can afford to live in and be respected around the world.” Trump and O'Brien previously met at Mar-a-Lago in January. According to Teamsters spokesperson Kara Deniz, “O'Brien's appearance does not represent an endorsement of Trump,” and “O'Brien has requested the opportunity to also speak at the Democratic National Convention…The DNC has yet to accept that request.”This has been Francesco DeSantis, with In Case You Haven't Heard. Get full access to Ralph Nader Radio Hour at www.ralphnaderradiohour.com/subscribe

durée : 00:10:10 - Journal de 18h - En Nouvelle-Calédonie, le transfert vers la métropole de 7 militants indépendantistes kanak embrase de nouveau l'archipel. Plusieurs syndicats et associations sont rassemblés ce dimanche devant le ministère de la Justice à Paris pour exiger leur libération.

durée : 00:10:10 - Journal de 18h - En Nouvelle-Calédonie, le transfert vers la métropole de 7 militants indépendantistes kanak embrase de nouveau l'archipel. Plusieurs syndicats et associations sont rassemblés ce dimanche devant le ministère de la Justice à Paris pour exiger leur libération.

Ciò che conta per me: te lo racconto per aiutarti a capire cosa estrarre da ciòc he fai.I valori che per me fanno la differenzaIn che modo concepisco il lavoroChe cosa comporta questo per me e per teIn che modo questo può aiutare teIl podcast Collegare i puntini lo trovi qui https://www.spreaker.com/podcast/collegare-i-puntini--5781354Per partecipare all'evento del 5 luglio a Bologna https://pugnimalago.it/strategyear/evento/ Per ricevere i miei appunti personali sul tema VendereValore,  vai qui https://pugnimalago.it/appuntiPer iscriverti a 1annodiVendereValore vai qui https://pugnimalago.it/un-anno-di-vendere-valore/Qui trovi il video del workshop che illustra come migliorare nel 2024https://youtu.be/_b-e8rHmcPUQui trovi il workshop che spiega il tema della strategia https://pugnimalago.krtra.com/c/xD3lpu5SXCZa/kmJoIl videocorso gratuito sul processo di vendita https://www.youtube.com/watch?v=4dOKslfKveI&list=PLsvBLLrj9ZsV-k29B4q2js6fK1xBWe6Yt&index=10&t=56sDove trovi tutti i nostri articoli nel nostro blog https://pugnimalago.it/articoli/Qui trovi tutti i volumi l del progetto 1AnnodiVendereValorePrimo volume https://www.amazon.it/dp/B0B45GTTYLSecondo Volume https://www.amazon.it/anno-Vendere-Valore-Parte-seconda/dp/B0BLQW27KV/Terzo volume https://www.amazon.it/anno-Vendere-Valore-Parte-terza/dp/B0BQGVV3B4/Quarto Volume https://www.amazon.it/Anno-Vendere-Valore-Parte-quarta/dp/B0C1HXZTR1/ref=sr_1_1?I nuovi podcast della scuderia VendereValoreLa prima biopodcastia, che cosa mi ha insegnato la vita e cosa può insegnare anche a te (la tua di vita)https://www.spreaker.com/show/colleghiamo-i-puntiniIl minipodcast del venditore: ogni giorno 90 secondi per impostare correttamente la giornatahttps://www.spreaker.com/show/vedere-valore-dailyLa prima Business Novelcast italiana: le avventure del Codega e dei suoi clienti, per ragionare sulla vita del venditorehttps://www.spreaker.com/show/il-valore-del-venditorePer entrare nel gruppo di discussione sulla vendita La compagnia: https://t.me/joinchat/f3f4aMd5rLhkNWY8Il canale Telegram d Vendere Valore è questo https://t.me/venderevaloreI nostri corsi e libri sono disponibili qui https://pugnimalago.it/in-vendita/Il corso DISC lo trovate qui, con uno sconto speciale del 20%: https://venderevalore.gumroad.com/l/Zzhfe/PodcastVVLa pagina dedicata all'arte della domanda http://pugnimalago.it/artedelladomanda/- Ecco dove trovi i nostri libri* ”Vendere valore. Il colloquio ideale per guidare il tuo cliente verso maggiori profitti" https://amzn.to/2Z4aseM* Franca Malagò Ragazze diamoci da fare lo trovi qui: https://amzn.to/348KHMt* Vendere valore. Il manifesto e il metodo AIUTAhttps://amzn.to/2L9QZT8* L'arte della domandahttps://amzn.to/3hOQ8XL* Il festival della vendita 2020 https://amzn.to/3cCkDPS

Salikoko S. MufweneMondes francophones (2023-2024)Collège de FranceAnnée 2023-2024Colloque - Konstanze Jungbluth : Emergence of "Kust-Portugees" (Coast Portuguese): Encounters along the Gold Coast and beyond in Early Modern TimesIntervenant(s)Konstanze JungbluthProfesseur, Europa-Universität Viadrina, Franfurt (Oder)RésuméHistory shows that creole vernaculars are just ordinary language varieties. Five hundred years ago, dialectal diversity was a well-known fact in Portugal itself. Whenever merchants moved to new places, they needed to create new trading routines including appropriate forms of communication jointly with the locals. Together with their African and, later on, their Asian interlocutors, Portuguese sailors and merchants going native on the continent developed new vernaculars identified as "Kust Portugees", which was also adopted by their European competitors. Dutch companies produced word lists of it that their crews could find handy. It became the lingua franca of that time on the African coast. European and African Portuguese varieties mirror the differences of their ecologies of their encounters and reflect both syncretism and hybridization.Konstanze JungbluthSince 2007: Professor of Linguistics (Pragmatics, Sociolinguistics, Romance Languages), Faculty of Social and Cultural Sciences, European University Viadrina Frankfurt (Oder).Publications:2022 Jungbluth, K./Milano, Frederica de: Address Systems and Social Markes IN: Maiden, M./ Ledgeway, A. (edd.), Cambridge Handbook of Romance Linguistics, Cambridge: CUP, 763-783.2015 Creoles. IN: Jungbluth, K./Milano, Federica de (edd.), Manual of Deixis in Romance Languages; Series: G. Holtus/F. Miret Sánchez (edd.), Manual of Romance Languages 6, Berlin/Boston: MOUTON De Gruyter, 332-356. (submitted): Brokers on the move. Encounters between Europeans and Africans in the Portuguese Seaborne Empire. IN: Enoch Aboh, Salikoko Mufwene (edd.), Uniformitarianism in Genetic Creolistics. Series CALC. CUP.Projects:2020: B/Ordering Cultures. Conference of the KWG, BIG & TEIN, DFG-funded, Frankfurt (Oder).2015-2018>2023: German-Brazilian co-tutelle PhD program Ethnicity in Motion (DAAD-CAPES/EUV-UFF).2014-2015: Beyond Language Boundaries. Use of L1 and L2 in Multilingual Contexts – 1eres i 2nes Llengües en contextos multilingües (DAAD: Univ. de Barcelona UB-EUV).2013-2016: The Impact of Current Transformational Processes on Language and Ethnic Identity: Urum and Pontic Greeks in Georgia (VWStiftung: together with Stavros Skopeteas, Univ. Göttingen & Greek Department of TSU, Georgia).2010: International Conference 1, 2, 3: my Language, your Language, our Language? Language Use in Multilingual Spaces. EUV Frankfurt (Oder), funded by DFG.

Ohio State's spring game will be headlined by a quarterback competition for the second year in a row.While Will Howard entered the spring as the frontrunner to start at quarterback, the competition has heated up over the past five weeks. Not only is Devin Brown pushing Howard for the starting job, but true freshman Julian Sayin is becoming a real factor in the competition, adding intrigue to Saturday's spring game as each of them looks to make their case that they should be Ohio State's starter this season.Jeremiah Smith, Caleb Downs and Ohio State's offensive line will also be in the spotlight on Saturday as Smith and Downs look to keep their hype trains rolling while the Buckeyes continue to evaluate whether they have the pieces they need on the right side of the offensive line. We discuss all of the top storylines entering the spring game on this week's Real Pod Wednesdays.To add a layer of fun to our spring game viewing experience, we also conducted a fantasy draft to pick the offensive skill-position players who we think will have the biggest spring games on Saturday. Each of us drafted one quarterback, one running back, one wide receiver, one tight end and one flex player – which both of us used on a second wide receiver – to build teams that will be scored using standard fantasy football scoring (one point per 25 passing yards, four points per passing touchdown, one point per 10 rushing/receiving yards and six points per rushing/receiving touchdown).Spring Game Fantasy Draft Picks:1. Dan – Jeremiah Smith, WR2. Andy – Quinshon Judkins, RB3. Andy – Carnell Tate, WR4. Dan – Julian Sayin, QB5. Dan – Jelani Thurman, TE6. Andy – Devin Brown, QB7. Andy – Brandon Inniss, WR (Flex)8. Dan – James Peoples, RB9. Dan – Bryson Rodgers, WR (Flex)10. Andy – Gee Scott Jr., TEIn the second half of the show, we discuss the state of Ohio State's running backs room following Monday's news that Dallan Hayden will enter the transfer portal. We wrap up the show by discussing all of the latest news on the Ohio State men's basketball front including the hirings of Joel Justus and Jamall Walker, John Calipari's reported interest in the job that ultimately went to Jake Diebler and the commitment of five-star point guard Marcus Johnson.The full rundown for this week's show:0:07: Quarterback competition is the big spring game storyline, especially with Julian Sayin's progress9:25: We're all excited to watch Jeremiah Smith and Caleb Downs play in the Shoe for the first time14:06: Ryan Day leaving the door open for a transfer addition on right side of offensive line19:54: C.J. Hicks, Sonny Styles, Bryson Rodgers among others to watch in spring game22:10: Drafting our spring game fantasy teams29:35: Ohio State still has the depth it needs at running back even with Dallan Hayden's exit35:43: Expect more transfers next week because that's just the way college football is now39:22: Carlos Locklyn won the introductory press conference42:49: Jake Diebler makes two strong assistant coach hires in Joel Justus, Jamall Walker48:30: Money, timing, long-term upside among factors in OSU hiring Diebler over John Calipari55:12: Ohio State lands a huge piece for the future with commitment of Marcus Johnson

Við forvitnuðumst í dag um nýja próteingjafa á borð við skordýr og örþörunga, en markmiðið með því að nýta þá er að minnka umhverfisáhrif, draga úr sóun, vatnsnotkun og kolefnisspori í framleiðslu á matvörum fyrir fólk og fóðri fyrir dýr. Margrét Geirsdóttir, matvælafræðingur og verkefnastjóri hjá Matís, kemur í þáttinn og sagði okkur frá því hver þróunin er í þessum málum, meðal annars frá framleiðslu og nýtingu á skordýrapróteini, einfrumupróteini og örþörungum. Marche hérað er eitt best geymda leyndarmál Ítalíu segja margir. Þetta rólega og strjálbýla hérað liggur á milli Adríahafsins og öllu þekktari eru nágrannahéruð þess, Toskana og Umbria. Sumir segja að Marche sé eins og Toskana var fyrir 50 árum síðan, hrátt en undurfallegt. Ágústa Sigrún Ágústsdóttir mannauðsstjóri og leiðsögumaður kom til okkar í dag en þetta svæði er í miklu uppáhaldi hjá henni og hún heldur úti ferðasíðunni Flandrr.is. Tónlist í þættinum: Háa c / Moses Hightower (Andri Ólafsson, Daníel Friðrik Böðvarsson, Magnús Trygvason Eliassen og Steingrímur Teague) Ölduslóð / Svavar Knútur (Svavar Knútur) Scenes from an Italian Restaurant / Billy Joel (Billy Joel) UMSJÓN: GUNNAR HANSSON OG GUÐRÚN GUNNARSDÓTTIR

Jaksossa mainitut linkit: #121: Strategia 100,000€ lanseeraukseen ]Näin aion onnistua[ #127: Näin tein lähes 120,000€ myyntiä vajaassa viikossa YHDELLE verkkokurssille #152: Analyysi “epäonnistuneesta” 90,000€ lanseerauksesta Jakson muistiinpanot: vapautasupervoimasi.fi/blog/nain-tein-yli-180,000-myyntia-yhdella-lanseerauksella

Lehrpredigt

Becky Winslow, BS, PharmD Host and Pharmacogenomics Medical Science Liaison; Behnaz Sarrami, MS, PharmD, Host and Pharmacogenomics Medical Science Liaison; Thierry Dervieux, PharmD, PhD, Chief Scientific Officer at Prometheus Laboratories Disclaimer: Behnaz Disclaimer: These are my personal views and opinions, and I am not speaking on behalf of Castle Biosciences, Inc. Becky Disclaimer: These are my personal views and opinions, and I am not speaking on behalf of any other entity.   Transcription:  1 00:00:06,190 --> 00:00:19,620 You're listening to the Pharmacy podcast Network in a world where one size fits all medications dominate the pharmaceutical industry. 2 00:00:20,079 --> 00:00:24,750 Precision medicine brings a ray of hope for those seeking customized health care. 3 00:00:25,350 --> 00:00:32,830 Pharmacists have a unique opportunity to help people in need of specialized testing to ensure medications work as intended. 4 00:00:33,540 --> 00:00:44,680 Welcome to PGX for pharmacists where we unravel the wonders of precision medicine and its potential to revolutionize the way we approach pharmacy care. 5 00:00:45,169 --> 00:00:52,790 Get ready to uncover the secrets behind pharmacogenomics and how it's transforming lives one genome at a time. 6 00:00:52,799 --> 00:00:53,189 Hello, 7 00:00:53,200 --> 00:00:53,950 everyone. 8 00:00:54,159 --> 00:00:55,080 I'm your host, 9 00:00:55,090 --> 00:00:56,389 Doctor Becky Winslow. 10 00:00:56,409 --> 00:01:09,860 And you're listening to the PGX for Pharmacist podcast that we magazine recognized in 2021 as the ninth most listened to genetics podcasts in the world on the PGX for Pharmacist podcast. 11 00:01:09,870 --> 00:01:16,690 We explore all things pharmacogenomics related and our mission is to educate and advocate for PGX. 12 00:01:16,769 --> 00:01:23,849 We accomplish this mission through exclusive interviews with highly qualified and well experienced pharmacogenomics. 13 00:01:23,860 --> 00:01:29,720 Industry leaders such as today's special guest and my name is Baas Sami, 14 00:01:29,730 --> 00:01:32,739 the co-host of PGX for Pharms podcast, 15 00:01:32,750 --> 00:01:33,860 Pharmacogenomics, 16 00:01:33,870 --> 00:01:36,819 medical science liaison and a mentor to pharmacist. 17 00:01:36,889 --> 00:01:40,239 Connect with us on linkedin and let's get a conversation going. 18 00:01:40,269 --> 00:01:46,720 We want to hear from you and how you're impacting pharmacogenomic stakeholders and what you have learned throughout your journey. 19 00:01:48,510 --> 00:01:49,010 Ok. 20 00:01:49,019 --> 00:01:50,819 So without any further ado, 21 00:01:50,839 --> 00:01:54,769 I'm extremely pleased to introduce to our audience. 22 00:01:54,919 --> 00:01:56,059 Doctor Theory Devo, 23 00:01:57,239 --> 00:02:01,129 the Chief Scientific Officer at Prometheus Laboratories, 24 00:02:01,139 --> 00:02:08,139 and Perme Prometheus Laboratories is a reference clinical laboratory that's focused on the diagnosis, 25 00:02:08,149 --> 00:02:13,330 prognosis and monitoring of immune mediated inflammatory diseases. 26 00:02:13,970 --> 00:02:14,229 So, 27 00:02:14,240 --> 00:02:14,649 thank you, 28 00:02:14,660 --> 00:02:17,759 Doctor De for joining us on the podcast. 29 00:02:17,770 --> 00:02:18,589 Today. 30 00:02:18,600 --> 00:02:23,190 I'm excited to share your and Prometheus's story with our audience. 31 00:02:23,649 --> 00:02:25,630 Um in particular, 32 00:02:25,639 --> 00:02:45,369 I'm excited about you sharing your career journey as a farm D phd and Chief scientific officer and designer of the Predictor PK AD A which is a precision guided dosing test for the optimization of Humira Remicade and their bio cylinders. 33 00:02:46,119 --> 00:02:46,449 So, 34 00:02:46,460 --> 00:03:04,220 one of Bana's and my main goals for this episode of the PGX for Pharmacist podcast is to expand our audience's notion of what a PGX test looks like and to inspire them to think bigger than the traditional box PGX test. 35 00:03:04,229 --> 00:03:08,020 Most of them or most of you are uh familiar with. 36 00:03:09,020 --> 00:03:09,429 So, 37 00:03:09,440 --> 00:03:22,179 Doctor D uh I'd like to start the podcast by having our guests um introduce themselves and elaborate on how you are a pharmacogenomics expert. 38 00:03:23,619 --> 00:03:23,800 Yeah, 39 00:03:23,809 --> 00:03:24,250 thank you, 40 00:03:24,259 --> 00:03:25,759 Becky for having me. 41 00:03:25,770 --> 00:03:26,850 Uh uh Yes. 42 00:03:26,860 --> 00:03:27,289 So I am a, 43 00:03:27,300 --> 00:03:30,820 I am a pharmacist uh with uh a family who is a, 44 00:03:30,830 --> 00:03:33,039 a doctorate in pharmacokinetics. 45 00:03:33,539 --> 00:03:44,520 Uh I completed my studies in France and I came as a postdoc uh fellow uh to work in the United States about 20 years ago to work on the pharmacogenomic of anti cancer agents, 46 00:03:44,929 --> 00:03:49,160 uh primarily uh six Maturin as well as methotrexate. 47 00:03:49,169 --> 00:03:50,550 After my post doc, 48 00:03:50,770 --> 00:03:52,960 uh I moved uh in industry for promet. 49 00:03:53,490 --> 00:04:01,429 So I have a large experience in uh uh the implementation of pharmacogenetics testing in immune mediated inflammatory disease. 50 00:04:01,509 --> 00:04:12,550 Our lab Rome was the first uh clinical laboratory in the United States to offer the fin uh metyl transfer genotyping as well as the thin metabolites. 51 00:04:12,559 --> 00:04:13,029 So, 52 00:04:13,050 --> 00:04:21,989 uh uh of uh of 70 publications in the field and uh I'm very uh very excited to have uh to be on the postcard with you uh uh today. 53 00:04:23,660 --> 00:04:24,220 All right. 54 00:04:24,230 --> 00:04:27,359 So thank you for qualifying yourself as an expert. 55 00:04:27,369 --> 00:04:27,619 So, 56 00:04:27,630 --> 00:04:32,839 let's jump right in and delve into your current PGX work. 57 00:04:32,850 --> 00:04:33,279 So, 58 00:04:33,489 --> 00:04:36,540 if you'll tell us um a little about Prometheus, 59 00:04:36,549 --> 00:04:38,000 specifically, 60 00:04:38,010 --> 00:04:40,350 what is Prometheus's mission? 61 00:04:40,359 --> 00:04:43,799 And how are you guys going about accomplishing your mission? 62 00:04:44,760 --> 00:04:44,980 Yeah, 63 00:04:44,989 --> 00:04:45,700 sure. 64 00:04:45,709 --> 00:04:47,459 Uh So Promet is a, 65 00:04:47,470 --> 00:04:52,790 is a reference uh clinical laboratory based in Southern California in San Diego. 66 00:04:53,230 --> 00:04:56,809 Uh The company has been there for uh over 25 years. 67 00:04:56,820 --> 00:05:03,950 We are uh specialize in the differential diagnosis of autoimmune G I disease uh disorders, 68 00:05:04,059 --> 00:05:06,019 uh gastrointestinal disorder, 69 00:05:06,230 --> 00:05:08,619 uh and inflammatory bowel disease. 70 00:05:08,980 --> 00:05:10,299 And over the years, 71 00:05:10,309 --> 00:05:16,600 we have developed a portfolio of a differentiated solution to facilitate the diagnosis, 72 00:05:16,609 --> 00:05:17,470 the prognosis, 73 00:05:17,480 --> 00:05:18,429 the monitoring, 74 00:05:18,660 --> 00:05:21,910 as well as therapy selection with pharmacogenetics testing, 75 00:05:21,920 --> 00:05:24,730 which we are offering to our clinical laboratory. 76 00:05:24,829 --> 00:05:26,350 And most importantly, 77 00:05:26,410 --> 00:05:27,299 uh recently, 78 00:05:27,309 --> 00:05:35,660 we are uh uh developing some uh uh testing solution with the credit topic care test to optimize treatment to uh biologics. 79 00:05:36,470 --> 00:05:37,130 Ok. 80 00:05:37,140 --> 00:05:37,329 Well, 81 00:05:37,339 --> 00:05:37,450 that, 82 00:05:37,459 --> 00:05:38,049 that's great. 83 00:05:38,059 --> 00:05:46,100 Can you also tell us uh about the Prois Library of Precision Medicine Tests for inflammatory bowel disease for patients? 84 00:05:46,109 --> 00:05:49,230 how they benefit medication therapy management. 85 00:05:49,239 --> 00:05:56,429 Stakeholders across the IB DS patients journey from diagnosis to treatment to disease, 86 00:05:56,440 --> 00:06:02,049 monitoring through remission and how they differ from other lab tests for IBD and his treatments. 87 00:06:02,709 --> 00:06:03,209 Yes. 88 00:06:03,220 --> 00:06:03,369 So, 89 00:06:03,380 --> 00:06:04,399 so we uh our, 90 00:06:04,410 --> 00:06:10,100 our clinical laboratory offers some uh highly specialized test to facilitate the, 91 00:06:10,109 --> 00:06:16,779 the diagnostic of uh to facilitate the differential diagnosis of uh uh inflammatory bowel disease. 92 00:06:16,790 --> 00:06:22,359 So we are following uh testing solution with uh serological testing, 93 00:06:22,529 --> 00:06:23,799 for example, 94 00:06:23,809 --> 00:06:38,410 uh uh piana as as as well as uh macro microbial uh uh antibodies that are present uh uh in Crohn's disease as well as uh over uh auto uh auto antibodies that are present in er colitis. 95 00:06:39,339 --> 00:06:43,684 These are conditions that are uh uh somewhat difficult to treat. 96 00:06:43,704 --> 00:06:49,994 Uh And uh we are uh uh offering those tests to uh help uh gastroenterologist. 97 00:06:50,015 --> 00:06:51,114 Uh uh first of all, 98 00:06:51,125 --> 00:07:03,434 to establish a differential diagnosis of IBD as compared to other uh condition typically uh uh irritable bowel syndrome as well as over gastrointestinal disorder. 99 00:07:03,445 --> 00:07:05,635 When the diagnostic is established, 100 00:07:05,910 --> 00:07:31,839 uh we offer uh testing to uh establish a prognosis where we're gonna in inform the clinician that the patient has a more aggressive uh disease that will require more aggressive treatment where uh we can uh provide the testing solution to initiate uh uh the most appropriate therapy for uh for the patient uh with uh a testing where we are uh basically uh you know, 101 00:07:31,850 --> 00:07:36,559 establish de determining some genotyping with the fit transferal genotyping. 102 00:07:36,570 --> 00:07:37,279 For example, 103 00:07:37,290 --> 00:07:40,250 where we can uh indicate that the patient is, 104 00:07:40,260 --> 00:07:45,079 is likely uh to present with a side effect to those medication. 105 00:07:45,399 --> 00:07:46,170 And once you know, 106 00:07:46,179 --> 00:07:47,799 the the treatment is initiative, 107 00:07:47,809 --> 00:08:16,089 we have a portfolio of solution uh to facilitate the monitoring of the disease of the inflammatory bowel disease as well as the dosing optimization with uh uh the answer test which uh measure blood level uh for uh uh monoclonal antibodies that are indicated in the treatment of IB start with starting with Infliximab Adalimumab as well as uh Tein and vidal. 108 00:08:16,980 --> 00:08:24,040 So we have a comprehensive portfolio to uh to surround the clinician with uh a variety of testing solution. 109 00:08:24,049 --> 00:08:30,250 With our goal being to improve the uh the outcome uh of patients with uh with diabetes. 110 00:08:30,260 --> 00:08:34,520 And I think that the pharmacist has a very important role to play from that perspective. 111 00:08:35,179 --> 00:08:36,039 So theory, 112 00:08:36,049 --> 00:08:40,239 could you elaborate for us more on the predictor test? 113 00:08:40,249 --> 00:08:42,758 Um especially since you designed that test, 114 00:08:42,768 --> 00:08:44,218 we'd really like to know, 115 00:08:44,489 --> 00:08:45,039 um you know, 116 00:08:45,049 --> 00:08:49,638 what did that take and what role does it play in your suite of testing? 117 00:08:51,049 --> 00:08:51,270 Yeah. 118 00:08:51,280 --> 00:08:51,890 Sure. 119 00:08:51,900 --> 00:08:52,510 So the, 120 00:08:52,520 --> 00:08:52,570 the, 121 00:08:52,580 --> 00:08:52,989 the, 122 00:08:53,000 --> 00:08:53,229 the, 123 00:08:53,239 --> 00:08:59,960 the predictor test is uh uh is uh is utilized when the patient is receiving treatment. 124 00:09:00,280 --> 00:09:18,190 It's been speci specifically designed to optimize uh biological uh uh disease modifiers such as Infliximab adalimumab that are co therapies in the treatment of inflammatory bowel disease as well as other immune uh mediated inflammatory. 125 00:09:18,200 --> 00:09:21,549 This is what the test does is to you connect the blood specimen, 126 00:09:22,229 --> 00:09:23,049 uh you know, 127 00:09:23,059 --> 00:09:24,750 with dosing information. 128 00:09:25,039 --> 00:09:41,989 And what we do is to uh uh provide guidance uh to clinician with uh respect of the best dose to give in order to achieve the best the level which is the most consistent with uh uh the disease control that needs to be achieved for the patient. 129 00:09:42,169 --> 00:09:43,729 Typically a vast majority, 130 00:09:43,739 --> 00:09:46,159 about two third of a third to two third, 131 00:09:46,169 --> 00:09:54,669 a third of patient uh tend to be uh uh unresponsive uh to this uh very expensive medication. 132 00:09:54,989 --> 00:09:57,960 Uh Not because they don't have the uh you know, 133 00:09:57,969 --> 00:09:59,289 typically because they have a, 134 00:09:59,299 --> 00:09:59,590 you know, 135 00:09:59,599 --> 00:10:05,599 pharmacokinetic uh suboptimal pharmacokinetic uh that makes them uh you know, 136 00:10:05,609 --> 00:10:09,440 unresponsive because uh not enough drug has been given. 137 00:10:09,450 --> 00:10:18,469 So what we do with a predictor test is to basically estimate the pa the pharmacokinetic uh parameter for the patient. 138 00:10:18,750 --> 00:10:24,729 And from then uh re report the best dose uh to give in order to achieve the, 139 00:10:24,760 --> 00:10:31,570 the level which is consistent with the uh the most uh uh effective disease control to be achieved for the patient. 140 00:10:32,169 --> 00:10:33,059 So we are offering, 141 00:10:33,070 --> 00:10:38,049 we have developed a test for the Infliximab as well as Adalimumab which is Humira, 142 00:10:38,909 --> 00:10:41,309 but these are antimony causes factor. 143 00:10:41,460 --> 00:10:49,549 And we are also developing the test for vidur as well as uh is that are widely used also in the treatment of, 144 00:10:49,559 --> 00:10:51,969 of uh inflammatory bubble disease. 145 00:10:51,979 --> 00:10:52,669 Wow, 146 00:10:52,679 --> 00:10:55,450 uh for MET is a suite of tests. 147 00:10:55,460 --> 00:11:00,940 Goes well beyond um the PGX testing that our audience is most familiar with, 148 00:11:01,299 --> 00:11:08,679 uh which typically only includes snips for cyp genes and some pharmacodynamic genes. 149 00:11:08,690 --> 00:11:31,424 This is really exciting um genes and biomarkers related to immunology are not commonly found in what I call the box PGX tests such as those uh made by large uh laboratory manufacturing companies um where the panel has a set number of genes and uh you know, 150 00:11:31,434 --> 00:11:36,054 it was developed by a larger laboratory for maybe smaller laboratories use. 151 00:11:36,729 --> 00:11:39,010 So my understanding, 152 00:11:39,020 --> 00:11:53,729 having talked with you extensively theory is that immunology has fewer PGX test available because it's actually more difficult say than oncology to research and develop tests. 153 00:11:53,739 --> 00:11:54,119 So, 154 00:11:54,130 --> 00:12:00,729 could you elaborate for our audience on the difficulties that are associated with immunology, 155 00:12:00,739 --> 00:12:05,830 research and developing tests uh for immunology versus say oncology? 156 00:12:06,330 --> 00:12:06,530 Yeah, 157 00:12:06,539 --> 00:12:07,049 sure. 158 00:12:07,059 --> 00:12:09,969 So in uh in immunology, 159 00:12:09,979 --> 00:12:11,590 as compared to oncology, 160 00:12:11,599 --> 00:12:17,169 there is no such a thing such as a somatic mutation where for example, 161 00:12:17,179 --> 00:12:18,429 you're gonna have a behalf, 162 00:12:18,440 --> 00:12:18,659 you know, 163 00:12:18,669 --> 00:12:20,349 that indicates that the patient, 164 00:12:20,679 --> 00:12:20,919 you know, 165 00:12:20,929 --> 00:12:25,239 is likely to benefit or not from some treatment in immunology. 166 00:12:25,250 --> 00:12:26,750 This is far more complicated, 167 00:12:26,760 --> 00:12:28,830 complicated for the reason, 168 00:12:29,239 --> 00:12:31,020 starting with uh the fact that, 169 00:12:31,030 --> 00:12:31,179 you know, 170 00:12:31,190 --> 00:12:36,219 the response to this uh medication uh are multifactorial. 171 00:12:36,260 --> 00:12:37,820 And the fact that uh you know, 172 00:12:37,830 --> 00:12:39,380 the mutation that uh the, 173 00:12:39,390 --> 00:12:39,619 the, 174 00:12:39,630 --> 00:12:45,190 the single nucleotide polymorphism in the GM line which uh uh you know, 175 00:12:45,200 --> 00:12:52,429 can potentially associate with uh with outcome uh uh uh uh a lo in advance, 176 00:12:52,440 --> 00:12:58,359 meaning that uh they're gonna have a weak association uh with a response to those medications. 177 00:12:58,369 --> 00:13:09,609 So there is a necessity in immunology to combine multiple genetic polymorphism together in order to achieve uh some uh performances characteristics that will make uh you know, 178 00:13:09,619 --> 00:13:09,859 the, 179 00:13:09,869 --> 00:13:10,380 the, 180 00:13:10,390 --> 00:13:10,520 the, 181 00:13:10,530 --> 00:13:13,219 the clinician uh you know, 182 00:13:13,419 --> 00:13:15,619 uh order the test and most importantly, 183 00:13:15,630 --> 00:13:15,840 the, 184 00:13:15,849 --> 00:13:16,179 the, 185 00:13:16,190 --> 00:13:17,739 the payer to pay for the test. 186 00:13:17,750 --> 00:13:20,469 So this field has been uh you know, 187 00:13:20,479 --> 00:13:20,679 is, 188 00:13:20,690 --> 00:13:21,705 is moving for, 189 00:13:21,715 --> 00:13:21,994 you know, 190 00:13:22,005 --> 00:13:24,575 there are some tests that are being developed right now. 191 00:13:24,924 --> 00:13:39,034 But the biggest challenge is to be able to achieve again the the threshold of uh of performance that makes the test is variable enough uh to be uh again ordered by the clinician and the utilize uh to the benefit of the patient. 192 00:13:39,659 --> 00:13:41,200 I couldn't agree with you more. 193 00:13:41,210 --> 00:13:53,489 Um I've worked on the payer side or market access side of pharmacogenomics and even uh with a box test for which there's um a lot of research data available, 194 00:13:53,500 --> 00:13:55,119 even with those, 195 00:13:55,130 --> 00:13:59,760 it's sometimes difficult uh to get payers um to see the value. 196 00:13:59,770 --> 00:14:01,640 So I absolutely agree with you. 197 00:14:01,940 --> 00:14:03,679 Um The fact that you guys are, 198 00:14:03,690 --> 00:14:11,789 are uh investing in producing the data necessary says a lot about your laboratory. 199 00:14:11,979 --> 00:14:12,559 Um you know, 200 00:14:12,570 --> 00:14:15,380 and how committed you are to this testing and, 201 00:14:15,390 --> 00:14:17,320 and how you believe in the testing. 202 00:14:18,039 --> 00:14:23,640 So I just want to make sure that our audience recognizes that, 203 00:14:24,359 --> 00:14:24,619 you know, 204 00:14:24,630 --> 00:14:31,820 Prometheus doesn't simply provide tests to determine if drugs for IBD will be effective and safe. 205 00:14:32,190 --> 00:14:36,900 Um And maybe what the dose of the drug should be for the patient, 206 00:14:36,909 --> 00:14:40,219 but you have that whole suite of tests. 207 00:14:40,229 --> 00:14:47,380 Um the diagnostic test for the differential diagnosis all the way through remission. 208 00:14:48,030 --> 00:14:53,390 So can you elaborate you elaborated on it some in the previous question? 209 00:14:53,400 --> 00:15:01,229 But um can you tell us the difference between how you had to actually develop the test? 210 00:15:01,520 --> 00:15:02,530 Um You didn't, 211 00:15:02,539 --> 00:15:03,059 in other words, 212 00:15:03,070 --> 00:15:10,659 purchase a test from another manufacturer with the biomarkers that you include in your testing. 213 00:15:10,669 --> 00:15:16,830 Can you elaborate on how much more difficult it is to to develop a test from scratch? 214 00:15:18,169 --> 00:15:18,320 Yeah, 215 00:15:18,330 --> 00:15:18,659 sure. 216 00:15:18,669 --> 00:15:18,809 I mean, 217 00:15:18,820 --> 00:15:22,070 this is this is challenging for multiple and first of all, 218 00:15:22,080 --> 00:15:23,130 you need to have the, 219 00:15:23,419 --> 00:15:27,450 you need to have a clinical data set available with specimen available. 220 00:15:27,460 --> 00:15:28,159 Uh you know, 221 00:15:28,169 --> 00:15:28,780 in front, 222 00:15:28,859 --> 00:15:29,770 obviously, 223 00:15:29,859 --> 00:15:30,890 available. 224 00:15:31,200 --> 00:15:35,890 Uh So we are leveraging a pro meters a large bi bank of specimen. 225 00:15:36,299 --> 00:15:37,190 Uh as I said, 226 00:15:37,200 --> 00:15:39,719 Prometheus has been founded 25 years ago. 227 00:15:39,729 --> 00:15:40,599 So over the, 228 00:15:40,760 --> 00:15:41,919 the past two decades, 229 00:15:41,929 --> 00:15:54,849 we have been able to assemble a large uh substrate of data and specimen which we are uh uh using to uh uh establish our proof of concept if you will. 230 00:15:54,859 --> 00:16:07,559 And then when we have uh identify some genetic polymorphism that are uh adequately uh associated with uh uh disease outcome and disease progression as well as uh toxicity. 231 00:16:07,969 --> 00:16:11,469 Then we are entering validation phase where we are uh you know, 232 00:16:11,570 --> 00:16:14,789 using validation cohorts where we are again, 233 00:16:14,969 --> 00:16:22,630 combining multiple modalities together uh patient demographic as well as genetic marker together with theological marker. 234 00:16:22,640 --> 00:16:23,190 Actually, 235 00:16:23,500 --> 00:16:27,419 to come up with some Multivariate models that are uh again, 236 00:16:27,429 --> 00:16:39,250 bringing the performances characteristics of the pharmacogenomic test or its combination with our marker to the level where it's supposed to be in the first place to meet uh uh payer. 237 00:16:39,650 --> 00:16:41,190 And uh obviously, 238 00:16:41,200 --> 00:16:41,760 again, 239 00:16:41,770 --> 00:16:45,320 the patient uh to the benefit of the patient and to, 240 00:16:45,330 --> 00:16:46,619 to improve its outcome, 241 00:16:46,739 --> 00:16:47,429 the outcome. 242 00:16:48,340 --> 00:16:53,380 I think what you're describing really is the future of pharmacogenomics. 243 00:16:53,390 --> 00:16:54,599 Um In other words, 244 00:16:54,609 --> 00:17:03,419 not singing out pharmacogenomics as you know the end all and be all in the treatment paradigm. 245 00:17:03,559 --> 00:17:08,040 But using a PGX test in combination with, 246 00:17:08,050 --> 00:17:09,069 like you mentioned, 247 00:17:09,250 --> 00:17:11,160 other serological tests, 248 00:17:11,170 --> 00:17:12,959 maybe other genetic tests. 249 00:17:13,290 --> 00:17:14,890 Um But you know, 250 00:17:14,900 --> 00:17:25,869 I think what we want our audience to really wrap their heads around is that PGX is just a piece of that larger puzzle um from diagnosis to treatment to, 251 00:17:25,880 --> 00:17:26,910 to remission. 252 00:17:27,239 --> 00:17:29,880 So I think you guys are absolutely, 253 00:17:29,890 --> 00:17:31,579 you're already in the future. 254 00:17:31,589 --> 00:17:32,849 In other words, 255 00:17:32,859 --> 00:17:33,130 you know, 256 00:17:33,140 --> 00:17:39,689 you're already providing all these different uh tests um like you mentioned to, 257 00:17:39,699 --> 00:17:44,310 to facilitate from diagnosis to remission to remission. 258 00:17:44,660 --> 00:17:45,520 That's correct. 259 00:17:45,530 --> 00:17:45,829 Yeah. 260 00:17:46,349 --> 00:17:55,089 So um you've given us so much great information about uh the tests that that you guys offer. 261 00:17:55,329 --> 00:18:02,060 Can you explain to our audience um your newest test? 262 00:18:02,069 --> 00:18:03,859 Uh the responder test. 263 00:18:04,150 --> 00:18:12,979 And um what role it will play in the paradigm from the diagnosis of IBD to remission? 264 00:18:14,050 --> 00:18:14,260 Yeah, 265 00:18:14,270 --> 00:18:14,760 sure. 266 00:18:14,770 --> 00:18:15,569 So we, 267 00:18:15,579 --> 00:18:18,069 we are doing things a little bit different than other. 268 00:18:18,079 --> 00:18:19,489 We do believe that uh you know, 269 00:18:19,500 --> 00:18:21,449 the it has to be simple. 270 00:18:21,459 --> 00:18:24,189 Uh uh We can obviously construct some very, 271 00:18:24,199 --> 00:18:33,530 very complex algorithm and there are some tests that do that with a very sophisticated machine learning based tools that are available using neural networks, 272 00:18:33,540 --> 00:18:33,729 you know, 273 00:18:33,739 --> 00:18:34,790 those sorts of things. 274 00:18:34,800 --> 00:18:39,729 But we have taken on a different approach where with the responder test, 275 00:18:39,739 --> 00:18:40,329 we are basically, 276 00:18:40,339 --> 00:18:45,160 we are taking an approach which is very simple to address the first and foremost. 277 00:18:45,170 --> 00:18:53,020 Most important aspect of responding uh predicting response to uh to medication is the pharmacokinetics. 278 00:18:53,280 --> 00:19:03,250 Uh You cannot be responding to a drug if the drug is not given and you obviously cannot respond to a drug if the drug is not metabolized adequately. 279 00:19:03,359 --> 00:19:06,349 And this is what we are doing with the responder test. 280 00:19:06,579 --> 00:19:09,010 We are addressing some uh uh you know, 281 00:19:09,020 --> 00:19:11,630 fundamental issues with those uh biologist, 282 00:19:11,640 --> 00:19:12,410 for example, 283 00:19:12,660 --> 00:19:15,170 uh the anti tumor necrosis factors. 284 00:19:15,180 --> 00:19:15,650 So, 285 00:19:15,750 --> 00:19:19,199 such as uh Infliximab and Adalimumab, 286 00:19:19,209 --> 00:19:23,050 it is well known uh that uh uh those drugs, 287 00:19:23,060 --> 00:19:25,689 first of all are prone to immunization. 288 00:19:25,989 --> 00:19:36,949 Uh Meaning that uh uh the drug itself uh is recognized by the immune system uh and digested by the antigen presenting cells. 289 00:19:36,959 --> 00:19:42,209 If you will uh where you gonna have uh uh an immune uh uh response, 290 00:19:42,380 --> 00:19:56,979 uh mounted a cancer drug to produce uh immunogen that will severely impact its pharmacokinetics where the labels will be inadequate to produce uh the desired uh anti-inflammatory effects. 291 00:19:56,989 --> 00:19:57,150 So, 292 00:19:57,160 --> 00:19:58,890 we are with the risk conductors, 293 00:19:58,900 --> 00:20:01,040 we are combining two things together. 294 00:20:01,189 --> 00:20:07,959 First of all is the genetic test itself which uh predicts the risk of immun immunization. 295 00:20:07,969 --> 00:20:18,010 The name of the test is on HL A uh DQ A 105 ali uh that uh uh promotes the presentation of the, 296 00:20:18,020 --> 00:20:19,130 of the, 297 00:20:19,140 --> 00:20:19,910 of Infliximab, 298 00:20:20,010 --> 00:20:20,750 for example, 299 00:20:20,760 --> 00:20:32,130 to the T cell repertoire in order to uh promote the Ronon expansion and the formation of the anti antibodies together with uh another dimension which is the clearance, 300 00:20:32,140 --> 00:20:33,670 which is as important. 301 00:20:33,949 --> 00:20:36,209 Uh One of the key issue is the, 302 00:20:36,219 --> 00:20:36,770 the, 303 00:20:36,780 --> 00:20:41,239 the monoclonal antibodies and uh such as Infliximab or Adalimumab. 304 00:20:41,329 --> 00:20:42,280 But in fact, 305 00:20:42,290 --> 00:20:45,890 a neon antibodies that those drugs are uh you know, 306 00:20:45,900 --> 00:20:49,010 cleared and consumed uh from the, 307 00:20:49,020 --> 00:20:50,949 from the central compartment if you will, 308 00:20:50,959 --> 00:20:54,520 since we are doing a little bit of uh uh pharmacokinetics here. 309 00:20:54,530 --> 00:20:56,020 And uh uh you know, 310 00:20:56,030 --> 00:21:06,670 if the patient present who is uh a high degree of inflammatory burden is gonna have uh the patient will have a high clearance and that's gonna worsen uh in the, 311 00:21:06,680 --> 00:21:13,939 in the presence again of the HL AD Q A 105 genetic marker that uh associate with uh immunization. 312 00:21:13,949 --> 00:21:16,859 So I but this is a combination of both, 313 00:21:17,199 --> 00:21:19,359 these are the predictive factors of pharmacokinetic, 314 00:21:20,359 --> 00:21:38,209 which we combine together where the patient presenting with a risk of immunization as well as accelerated clearance due to the fact that the patient has high inflammation or due to the fact that they are so intrinsic pharmacokinetic properties that makes that the patient, 315 00:21:38,219 --> 00:21:38,300 you know, 316 00:21:38,310 --> 00:21:39,479 will clear the drug very, 317 00:21:39,489 --> 00:21:40,260 very fast. 318 00:21:40,560 --> 00:21:41,670 For example, 319 00:21:41,680 --> 00:21:46,819 due to the inefficient uh recirculation of the drug itself with the new, 320 00:21:46,869 --> 00:21:46,930 the, 321 00:21:46,939 --> 00:21:50,599 the the in the reticular on the system. 322 00:21:50,920 --> 00:21:51,619 Together, 323 00:21:51,630 --> 00:22:02,109 those patients presenting with uh uh together these uh poor prognostic factor of pharmacokinetic origin will tend to be severely underdose, 324 00:22:02,380 --> 00:22:06,719 will not be responding to the drug uh adequately as and they, 325 00:22:06,729 --> 00:22:10,719 and they probably should in the first place if you are able to address uh you know, 326 00:22:10,729 --> 00:22:12,270 the the the exposure. 327 00:22:12,439 --> 00:22:14,079 So what we do with this test, 328 00:22:14,089 --> 00:22:21,640 we will be able to inform uh the clinic that the patient is at risk of achieving, 329 00:22:21,650 --> 00:22:30,829 of achieving suboptimal pharmacokinetics and therefore being able to adjust the dose uh uh to start with more adequately. 330 00:22:30,839 --> 00:22:38,650 So that the the the proper uh exposure is achieved uh during induction to again to, 331 00:22:38,660 --> 00:22:39,040 to, 332 00:22:39,050 --> 00:22:39,380 to, 333 00:22:39,390 --> 00:22:40,890 to achieve a better outcome. 334 00:22:41,040 --> 00:22:47,270 And I think the pharmacist will have a very important role to play here in terms of absolutely, 335 00:22:47,280 --> 00:22:51,239 that information is priceless in the management of these medications. 336 00:22:51,250 --> 00:22:54,930 So thanks for elaborating on that. 337 00:22:56,010 --> 00:22:59,040 And if I may add in our previous conversation, 338 00:22:59,050 --> 00:23:00,810 uh before the recording of podcast, 339 00:23:00,819 --> 00:23:08,869 we had discussed um you guys' robust platform for collaborating with payers to obtain market access and reimbursements for the test. 340 00:23:09,109 --> 00:23:14,109 But without stealing the Thunder from uh Prometheus market access and reimbursement team, 341 00:23:14,199 --> 00:23:22,619 can you please uh briefly detail how Prometheus has proactively worked with payers to solve the problem. 342 00:23:22,920 --> 00:23:27,349 Um the population health problem by building the evidence payers want, 343 00:23:27,359 --> 00:23:41,170 want to see um about your test before you go to the market and then build the test and then hope the payers will see the value and the result and then that will improve the market access and reimbursement for your um precision medicine test. 344 00:23:42,160 --> 00:23:42,339 Yeah. 345 00:23:42,349 --> 00:23:43,180 So briefly I can, 346 00:23:43,189 --> 00:23:43,579 I'm, 347 00:23:43,589 --> 00:23:46,619 I'm probably not the right person to answer that question. 348 00:23:46,630 --> 00:23:47,369 We have a very, 349 00:23:47,380 --> 00:23:52,400 very efficient market access group uh uh pro meters that does a splendid job. 350 00:23:52,410 --> 00:23:59,780 But uh uh uh what I can tell you that we have an evidence uh uh development plan in place where we, 351 00:23:59,790 --> 00:24:14,000 we are establishing the clinical utility of our testing solution by demonstrating uh the payer value uh with respect of uh patient management and uh uh and the, 352 00:24:14,010 --> 00:24:16,630 and the impact of our technology on the, 353 00:24:16,640 --> 00:24:18,119 on physician behavior. 354 00:24:18,430 --> 00:24:21,319 Uh We have uh uh already uh you know, 355 00:24:21,329 --> 00:24:25,160 commercialized uh two of those tests for which we have initiated, 356 00:24:25,170 --> 00:24:29,040 initiated the Power studies uh that uh uh you know, 357 00:24:29,050 --> 00:24:32,000 already provide uh you know, 358 00:24:32,104 --> 00:24:34,484 differentiated and the value to, 359 00:24:34,494 --> 00:24:35,915 to the payer where we are, 360 00:24:35,925 --> 00:24:36,025 the, 361 00:24:36,035 --> 00:24:46,005 the clinicians are basically using our technology to make treatment decision uh as well as uh some prospective clinicality study which we are initiating, 362 00:24:46,145 --> 00:24:47,555 initiating to. 363 00:24:47,564 --> 00:24:48,574 Um uh again, 364 00:24:48,584 --> 00:24:49,425 demonstrate the, 365 00:24:49,435 --> 00:24:49,915 the, 366 00:24:49,925 --> 00:24:50,244 the, 367 00:24:50,255 --> 00:24:53,594 the payer value you uh uh we can certainly follow up with, 368 00:24:53,604 --> 00:24:58,755 uh you can certainly follow up with our market access group uh uh as appropriate there. 369 00:24:58,765 --> 00:25:00,765 Uh They can fill you with more information. 370 00:25:01,349 --> 00:25:01,589 No, 371 00:25:01,599 --> 00:25:02,520 that totally makes sense. 372 00:25:02,530 --> 00:25:03,310 That totally makes sense. 373 00:25:03,319 --> 00:25:10,890 But um we're excited that you're also farm d So how did you get to this role of outside the box path? 374 00:25:10,900 --> 00:25:11,550 There? 375 00:25:11,640 --> 00:25:17,530 There may be a pharmacist student or pharmacist wanting to switch or transition into a role such as yours, 376 00:25:17,540 --> 00:25:19,609 which is a Chief Scientific Officer. 377 00:25:19,619 --> 00:25:20,609 I want to learn more. 378 00:25:20,619 --> 00:25:23,920 So how would you um can you talk a little bit about that? 379 00:25:24,560 --> 00:25:24,780 Well, 380 00:25:24,790 --> 00:25:26,270 we are clinical laboratories. 381 00:25:26,280 --> 00:25:29,400 So in order to uh uh to be in my role, 382 00:25:29,410 --> 00:25:34,020 you need to have uh uh you need to have expertise in clinical laboratory science. 383 00:25:34,030 --> 00:25:36,140 So for the students is basically, 384 00:25:36,150 --> 00:25:36,300 you know, 385 00:25:36,310 --> 00:25:40,770 to do the family degree and then complete the family degree with uh a doctorate, 386 00:25:40,780 --> 00:25:40,930 you know, 387 00:25:40,939 --> 00:25:44,260 which is uh focus on clinical laboratory science. 388 00:25:44,270 --> 00:25:46,079 So you can achieve uh uh you know, 389 00:25:46,089 --> 00:25:47,640 the all the elements you need to be, 390 00:25:47,650 --> 00:25:48,219 for example, 391 00:25:48,229 --> 00:25:53,189 board certified uh as uh as as medical laboratory director. 392 00:25:53,199 --> 00:25:55,160 So you can uh uh so, 393 00:25:55,170 --> 00:25:55,589 uh yeah, 394 00:25:55,599 --> 00:25:56,030 this is, 395 00:25:56,040 --> 00:25:56,400 this is, 396 00:25:56,410 --> 00:25:57,209 this is uh you know, 397 00:25:57,219 --> 00:25:59,160 a great opportunity I think for pharmacies, 398 00:25:59,170 --> 00:26:10,800 there is an absolute need to uh have the clinical pharmacist provide uh uh drug information to healthcare professional as well as uh assist patient with the monitoring of their disease, 399 00:26:10,810 --> 00:26:15,229 the effectiveness of the therapy and um and uh you know, 400 00:26:15,239 --> 00:26:16,060 monitoring the, 401 00:26:16,069 --> 00:26:20,969 the side effect and the toxicity from uh from those uh those medication. 402 00:26:24,650 --> 00:26:24,959 Well, 403 00:26:24,969 --> 00:26:32,119 the I know our audience is going to have uh additional questions for you. 404 00:26:32,130 --> 00:26:32,540 I mean, 405 00:26:32,989 --> 00:26:35,609 you've provided them with so much great information, 406 00:26:35,619 --> 00:26:44,959 but it's only the beginning of what they could possibly learn um about um the testing that you do for IBD and, 407 00:26:44,969 --> 00:26:46,729 and even your career path. 408 00:26:47,050 --> 00:26:47,530 So, 409 00:26:47,540 --> 00:26:49,300 if you wouldn't mind telling us, 410 00:26:49,310 --> 00:26:51,359 um because we have to wrap up, 411 00:26:51,369 --> 00:26:52,670 unfortunately, 412 00:26:53,150 --> 00:26:55,810 this episode of the podcast, 413 00:26:55,819 --> 00:27:00,250 uh could you tell us how our audience members might be able to contact you directly. 414 00:27:01,260 --> 00:27:01,449 Yeah, 415 00:27:01,459 --> 00:27:07,079 I can be contacted on my uh on my email at TT W at como slab dot com. 416 00:27:07,949 --> 00:27:08,810 All right. 417 00:27:09,069 --> 00:27:09,300 Well, 418 00:27:09,310 --> 00:27:14,290 thank you again so much uh for joining us on this episode. 419 00:27:14,300 --> 00:27:15,290 We really, 420 00:27:15,300 --> 00:27:29,530 really hope that our listeners um ideas of not only what PGX can be but how PGX can be utilized in a comprehensive testing suite. 421 00:27:29,709 --> 00:27:35,670 We really hope that our a our audience will um listen in and learn this information. 422 00:27:36,280 --> 00:27:37,869 Um And to our audience, 423 00:27:37,880 --> 00:27:39,439 thank you for tuning in. 424 00:27:39,449 --> 00:27:42,619 We really hope that you've learned from this episode. 425 00:27:43,130 --> 00:27:46,339 Uh We do a whole lot of PG Xing here on this podcast. 426 00:27:46,349 --> 00:27:48,380 We talk about PGX Science, 427 00:27:48,390 --> 00:27:52,030 clinical application and the business of PGX. 428 00:27:52,260 --> 00:27:54,880 So we'd love to hear about from you. 429 00:27:55,099 --> 00:27:56,479 I love to hear from you. 430 00:27:56,489 --> 00:27:58,439 Um What can we teach you? 431 00:27:58,449 --> 00:28:00,920 What more can we teach you through our podcast? 432 00:28:00,930 --> 00:28:12,349 So please drop us a message on linkedin and let us know and please share this link to this podcast link episode with everyone so they can tune in and listen to the PGX for promises podcast. 433 00:28:12,520 --> 00:28:15,369 Leave us a review on Apple podcast or Spotify. 434 00:28:15,459 --> 00:28:18,130 And you can also visit us on PGX four, 435 00:28:18,140 --> 00:28:22,989 the number four Rx dot com to listen to all our other episodes. 436 00:28:23,000 --> 00:28:23,079 Well, 437 00:28:23,089 --> 00:28:23,790 thank you. 438 00:28:24,199 --> 00:28:28,750 Thanks for your interest in PGX and for spending some time with us. 439 00:28:28,760 --> 00:28:35,670 Please share this podcast and leave us a review on Apple podcasts or Spotify for all of our episodes. 440 00:28:35,680 --> 00:28:39,390 Please visit PGX for Rx dot com. 441 00:28:39,569 --> 00:28:43,380 That's PGX for Rx dot com.  

Tein yhtä toista sarjaa varten haastattelun kuuluisan filosofin ja tekoälyasiantuntijan Nick Bostromin kanssa. Päätimme julkaista haastattelun raakaversion täällä. Nickin kirjasta Superintelligence on jo melkein 10 vuotta, ja hän on aktiivisesti jatkanut tekoälyn kehityksen ja riskien pohdintaa Oxfordin yliopiston Future of Humanity Institutessa. Tässä lyhyessä haastattelussa puhumme juuri näistä riskeistä. Voisiko tekoäly uhata koko ihmiskuntaa? --- ▶️ Jaksot videon kera Youtubesta: http://www.youtube.com/c/Futucastpodcast

Direct Talk - Suoraa puhetta ohjaamisesta Podcast by Finn Andersson Jakso 7: Pete Veijalainen https://peteveijalainen.com/ "Kaikki mitä olen koskaan ammatillisesti suunnitellut, tai pyrkinyt jotain kohti, ei ole toteutunut. Kaikki on mennyt kuninkaallisesti perseelleen. Mutta kaikkien niiden yritysten, pyrkimysten ja peruutettujen sekä lopetettujen projektien sivujuonteena, kuin vahingossa on syntynyt hauska, värikäs ja vaiherikas ura joka on toivottavasti vasta välitilin päätösvaiheessa." Peten ei pitänyt edes ryhtyä mainoselokuvaohjaajaksi, vaan suunnitelmissa oli aivan muut hommat. Mutta lähes vahingossa tekoon tullut Veikkaus "Mäkihyppy" -filmi aloitti hänen uran muuttaen elämän suuntaa seuraavaksi 20 vuodeksi - niin hyvässä kuin pahassa. https://www.youtube.com/watch?v=oZzbgmoVZkc Pete toinen esille nostama ohjaus on Rovio "Angry Birds", joka hänen mielestään toimii esimerkkinä lähes täydellisestä mainoselokuvaprosessista. Tämä paljon kiitosta saanut teos kuvaa ohjaajanäkökulmasta mainostoimisto-ohjaaja-asiakas-yhteistyön merkitystä onnistumisen kautta. https://www.youtube.com/watch?v=biHa8WSrCOw Merkityksellisiä ohjaajia Petellä on lukemattomia mutta... Musiikkivideopuolelta: Spike Jonze - lähes kaikki tuotanto Elokuvapuolelta ( ei varmaan kovin yllättävä ) Christopher Nolan Sekä lukematon määrä kokeellista alakulttuurin roskaa tuutanneita indie-ohjaajia. Mitä sekavampaa, sen parempaa. Sama mieltymys musiikkipuolella, pidän valtavasti mainstream-kulttuurin ytimen läpi tunkeutumisesta kohti kokeellista ja eksperimentaalista esim.: Clowncore https://www.youtube.com/watch?v=kdA0mW-9jRs Ja tietenkin Nature Danger Gang! Parasta elämäniloa ja riemua pimenevään syksyyn japanista: https://www.youtube.com/watch?v=H0hpLhw1Moc Kaupallinen urani musiikkivideoissa päättyi tosiaan Teräsbetoni yhtyeen missä miehet ratsastaa-videoon. https://www.youtube.com/watch?v=TheV9eBTT3Q (Ei ikävä kyllä ole ”directors cut”) Teräsbetoni oli Euroviisuihin tarkoitettu jättisatsaus levy-yhtiöltä, joka päättyi Warner Recordsin lakimiesten tiukkoihin vaatimuksiin offline leikkauksen suhteen sekä iltalehtien lööppiin ”Kohuohjaaja tuhosi Teräsbetonin Euroviisumahdollisuudet”. (Olen tästä lööpistä edelleen hyvin ylpeä). Asko Kallonen totesi hankkeen jälkeen, että et enää tee koskaan musiikkivideota tässä maassa. Tein heti perään Eleanoora Rosenholmin ”Ambulanssikuskitar” videon joka voitti aikoinaan OMVF:ssa. Mutta siinä Asko oli oikeassa, en tosiaan ole tehnyt Teräsbetonin jälkeen yhtään musiikkivideota ns isoille levy-yhtiöille sen jälkeen. https://www.youtube.com/watch?v=CKRgfQl4ZuE Indie-kuplassa on ollut paljon palkitsevampaa sekoilla tuon kokemuksen jälkeen. Ps. Tähän jaksoon iski sama soundiongelma, joka vaivasi myös Viivi Huuska podia - nimittäin rikkinäinen muistikortti! Jaksothan koostuu kolmesta osasta ja onneksi kolmannen näytökseen sain soundin taas toimimaan! Kaksi ensimmäistä jouduin valitettavasti kaapimaan kameran apuäänistä, mutta siitä huolimatta kannattaa kuunnella, koska Peten läppä on timanttia. Antoisia kuunteluhetkiä siis. Tässä podcastissa käsitellään mainoselokuvamaailmaa ohjaajien näkökulmasta. Ammatista kertomassa niin tuoreet, kuin pitkänlinjankin tekijät. Vieraiden kanssa käydään läpi heidän ammatillista tarinaansa jakaen samalla myös matkan varrella kertynyttä arvokasta oppia eteenpäin kuulijoille. Vinkit, linkit ja videot laitetaan jokaisen jakson yhteyteen ja niistä voi inspiroitua, niin alan opiskelijat kuin konkaritkin. Keskustelut käydään Finn Anderssonin hellässä ohjauksessa, jossa hän antaa kollegoidensa puhua avoimesti työstään näkijöinä ja tekijöinä alalla, jolla on vaikutusta kulttuuriimme ja käyttäytymiseemme. Juttelun lomassa kaivaudutaan tarinankerronan syövereihin, puhumalla ennen kaikkea mainoselokuvaohjaamisesta mutta myös näkemyksestä, ideoista, visuaalisuudesta, oleellisen kiteyttämisestä, äänen merkityksestä, luovuudesta, ryhmätyöstä, asiakkaista, mainostoimistoista ja mediamaailmasta, tv:stä ja somesta, paineen siedosta, ilosta, pelosta, tunteista, huumorista, jatkuvasta kilpailemisesta, voittamisesta, häviämisestä, tuloksista, tutkimisesta, luottamuksesta, varmuudesta, genreistä, merkityksellisyydestä, päätösten tekemisestä, intuitiosta, sekuntipelistä, markkinoinnista, palkinnoista, budjeteista, itsensä myymisestä, yhteistyöstä, johtamisesta... Oikeastaan kaikesta mitä työssämme ohjaajina käymme läpi. Tervetuloa tutustumaan intohimo- ja kutsumustyötä tekevien tyyppien maailmaan. Kiitokset: Vierailusta: https://peteveijalainen.com/ Kaikesta some-avusta Virpille: https://www.vanelja.com/ Studion valaisujeesistä Mustoselle: https://www.jeannoel.net/ Mun kasvokuvasta Tevalle: http://tevajarvi.com/ Kameralainasta: Riballe: https://www.ristovauras.com/

Avoi 163nak Melbourne Cup cu tlamtling tein Flemington rangcit zuamnak ah an tuah. Ram pumpi ningin a dirter khotu le zapi nih an sunsakmi Melbourne Cup rangcit zuamnak ah tei Ireland ram mi, Jockey Mark Zahra nih pakhatnak a hmuh.

Noniin vihdoin pääsin katsomaan elokuvan yhdestä kotimaisen viihteen ikonisimmista hahmoista, eli Pertti ”Spede” Pasasesta.   Olen ollut iso Spede fani jo nuoresta pitäen, jolloin näin Uuno elokuvia, tai Spede Showta, tai jotain niistä lukuisista muista leffoista tai sarjoista tai kun katsoimme koko perheen voimin Speden Spelejä tv:stä. Tein jopa koulussa Spede esitelmän, silloin kun hän kuoli.  Tästä syystä halusinkin ehdottomasti nähdä tämän leffan, mutta hieman pääsi venymään ennen kuin lopulta pääsin sen näkemään. Ja tottakai arvostelua siitä piti tehdä, varsinkin kun sitä monesti jo minulta kysyttiin.  Oletko sinä nähnyt tämän? Mitä mieltä? Mitä mieltä näyttelijöistä? Entä mikä on sinun suosikki Spede leffa tai sarja? 

Becky Winslow, BS, PharmD Host and Pharmacogenomics Medical Science Liaison; Behnaz Sarrami, MS, PharmD, Host and Pharmacogenomics Medical Science Liaison; Thierry Dervieux, PharmD, PhD, Chief Scientific Officer at Prometheus Laboratories In this episode of the PGX for Pharmacists Podcast, Dr. Thierry Dervieux, Dr. Behnaz Sarrami, and I discuss Dr. Dervieux's career as a PharmD, PhD, and chief scientific officer who has designed a pharmacogenomics test prescribers may use to optimize biosimilars for autoimmune gastrointestinal diseases. Dr. Dervieux will illustrate to our audience pharmacogenomics' potential beyond Tier 1 and 2 genetic testing by describing the clinical validity and utility of his laboratory's suite of tests in the autoimmune gastrointestinal disease diagnosis and treatment market. Behnaz and I hope this episode will inspire pharmacists interested in pharmacogenomics to think beyond the boxed PGx test most laboratories offer when they think about PGx and consider all the biological systems in which genetics impacts drugs' efficacy and safety. Disclaimer: Behnaz Disclaimer: These are my personal views and opinions, and I am not speaking on behalf of Castle Biosciences, Inc. Becky Disclaimer: These are my personal views and opinions, and I am not speaking on behalf of any other entity.   Transcription: 1 00:00:06,190 --> 00:00:19,620 You're listening to the Pharmacy podcast Network in a world where one size fits all medications dominate the pharmaceutical industry. 2 00:00:20,079 --> 00:00:24,750 Precision medicine brings a ray of hope for those seeking customized health care. 3 00:00:25,350 --> 00:00:32,830 Pharmacists have a unique opportunity to help people in need of specialized testing to ensure medications work as intended. 4 00:00:33,540 --> 00:00:44,680 Welcome to PGX for pharmacists where we unravel the wonders of precision medicine and its potential to revolutionize the way we approach pharmacy care. 5 00:00:45,169 --> 00:00:52,790 Get ready to uncover the secrets behind pharmacogenomics and how it's transforming lives one genome at a time. 6 00:00:52,799 --> 00:00:53,189 Hello, 7 00:00:53,200 --> 00:00:53,950 everyone. 8 00:00:54,159 --> 00:00:55,080 I'm your host, 9 00:00:55,090 --> 00:00:56,389 Doctor Becky Winslow. 10 00:00:56,409 --> 00:01:09,860 And you're listening to the PGX for Pharmacist podcast that we magazine recognized in 2021 as the ninth most listened to genetics podcasts in the world on the PGX for Pharmacist podcast. 11 00:01:09,870 --> 00:01:16,690 We explore all things pharmacogenomics related and our mission is to educate and advocate for PGX. 12 00:01:16,769 --> 00:01:23,849 We accomplish this mission through exclusive interviews with highly qualified and well experienced pharmacogenomics. 13 00:01:23,860 --> 00:01:29,720 Industry leaders such as today's special guest and my name is Baas Sami, 14 00:01:29,730 --> 00:01:32,739 the co-host of PGX for Pharms podcast, 15 00:01:32,750 --> 00:01:33,860 Pharmacogenomics, 16 00:01:33,870 --> 00:01:36,819 medical science liaison and a mentor to pharmacist. 17 00:01:36,889 --> 00:01:40,239 Connect with us on linkedin and let's get a conversation going. 18 00:01:40,269 --> 00:01:46,720 We want to hear from you and how you're impacting pharmacogenomic stakeholders and what you have learned throughout your journey. 19 00:01:48,510 --> 00:01:49,010 Ok. 20 00:01:49,019 --> 00:01:50,819 So without any further ado, 21 00:01:50,839 --> 00:01:54,769 I'm extremely pleased to introduce to our audience. 22 00:01:54,919 --> 00:01:56,059 Doctor Theory Devo, 23 00:01:57,239 --> 00:02:01,129 the Chief Scientific Officer at Prometheus Laboratories, 24 00:02:01,139 --> 00:02:08,139 and Perme Prometheus Laboratories is a reference clinical laboratory that's focused on the diagnosis, 25 00:02:08,149 --> 00:02:13,330 prognosis and monitoring of immune mediated inflammatory diseases. 26 00:02:13,970 --> 00:02:14,229 So, 27 00:02:14,240 --> 00:02:14,649 thank you, 28 00:02:14,660 --> 00:02:17,759 Doctor De for joining us on the podcast. 29 00:02:17,770 --> 00:02:18,589 Today. 30 00:02:18,600 --> 00:02:23,190 I'm excited to share your and Prometheus's story with our audience. 31 00:02:23,649 --> 00:02:25,630 Um in particular, 32 00:02:25,639 --> 00:02:45,369 I'm excited about you sharing your career journey as a farm D phd and Chief scientific officer and designer of the Predictor PK AD A which is a precision guided dosing test for the optimization of Humira Remicade and their bio cylinders. 33 00:02:46,119 --> 00:02:46,449 So, 34 00:02:46,460 --> 00:03:04,220 one of Bana's and my main goals for this episode of the PGX for Pharmacist podcast is to expand our audience's notion of what a PGX test looks like and to inspire them to think bigger than the traditional box PGX test. 35 00:03:04,229 --> 00:03:08,020 Most of them or most of you are uh familiar with. 36 00:03:09,020 --> 00:03:09,429 So, 37 00:03:09,440 --> 00:03:22,179 Doctor D uh I'd like to start the podcast by having our guests um introduce themselves and elaborate on how you are a pharmacogenomics expert. 38 00:03:23,619 --> 00:03:23,800 Yeah, 39 00:03:23,809 --> 00:03:24,250 thank you, 40 00:03:24,259 --> 00:03:25,759 Becky for having me. 41 00:03:25,770 --> 00:03:26,850 Uh uh Yes. 42 00:03:26,860 --> 00:03:27,289 So I am a, 43 00:03:27,300 --> 00:03:30,820 I am a pharmacist uh with uh a family who is a, 44 00:03:30,830 --> 00:03:33,039 a doctorate in pharmacokinetics. 45 00:03:33,539 --> 00:03:44,520 Uh I completed my studies in France and I came as a postdoc uh fellow uh to work in the United States about 20 years ago to work on the pharmacogenomic of anti cancer agents, 46 00:03:44,929 --> 00:03:49,160 uh primarily uh six Maturin as well as methotrexate. 47 00:03:49,169 --> 00:03:50,550 After my post doc, 48 00:03:50,770 --> 00:03:52,960 uh I moved uh in industry for promet. 49 00:03:53,490 --> 00:04:01,429 So I have a large experience in uh uh the implementation of pharmacogenetics testing in immune mediated inflammatory disease. 50 00:04:01,509 --> 00:04:12,550 Our lab Rome was the first uh clinical laboratory in the United States to offer the fin uh metyl transfer genotyping as well as the thin metabolites. 51 00:04:12,559 --> 00:04:13,029 So, 52 00:04:13,050 --> 00:04:21,989 uh uh of uh of 70 publications in the field and uh I'm very uh very excited to have uh to be on the postcard with you uh uh today. 53 00:04:23,660 --> 00:04:24,220 All right. 54 00:04:24,230 --> 00:04:27,359 So thank you for qualifying yourself as an expert. 55 00:04:27,369 --> 00:04:27,619 So, 56 00:04:27,630 --> 00:04:32,839 let's jump right in and delve into your current PGX work. 57 00:04:32,850 --> 00:04:33,279 So, 58 00:04:33,489 --> 00:04:36,540 if you'll tell us um a little about Prometheus, 59 00:04:36,549 --> 00:04:38,000 specifically, 60 00:04:38,010 --> 00:04:40,350 what is Prometheus's mission? 61 00:04:40,359 --> 00:04:43,799 And how are you guys going about accomplishing your mission? 62 00:04:44,760 --> 00:04:44,980 Yeah, 63 00:04:44,989 --> 00:04:45,700 sure. 64 00:04:45,709 --> 00:04:47,459 Uh So Promet is a, 65 00:04:47,470 --> 00:04:52,790 is a reference uh clinical laboratory based in Southern California in San Diego. 66 00:04:53,230 --> 00:04:56,809 Uh The company has been there for uh over 25 years. 67 00:04:56,820 --> 00:05:03,950 We are uh specialize in the differential diagnosis of autoimmune G I disease uh disorders, 68 00:05:04,059 --> 00:05:06,019 uh gastrointestinal disorder, 69 00:05:06,230 --> 00:05:08,619 uh and inflammatory bowel disease. 70 00:05:08,980 --> 00:05:10,299 And over the years, 71 00:05:10,309 --> 00:05:16,600 we have developed a portfolio of a differentiated solution to facilitate the diagnosis, 72 00:05:16,609 --> 00:05:17,470 the prognosis, 73 00:05:17,480 --> 00:05:18,429 the monitoring, 74 00:05:18,660 --> 00:05:21,910 as well as therapy selection with pharmacogenetics testing, 75 00:05:21,920 --> 00:05:24,730 which we are offering to our clinical laboratory. 76 00:05:24,829 --> 00:05:26,350 And most importantly, 77 00:05:26,410 --> 00:05:27,299 uh recently, 78 00:05:27,309 --> 00:05:35,660 we are uh uh developing some uh uh testing solution with the credit topic care test to optimize treatment to uh biologics. 79 00:05:36,470 --> 00:05:37,130 Ok. 80 00:05:37,140 --> 00:05:37,329 Well, 81 00:05:37,339 --> 00:05:37,450 that, 82 00:05:37,459 --> 00:05:38,049 that's great. 83 00:05:38,059 --> 00:05:46,100 Can you also tell us uh about the Prois Library of Precision Medicine Tests for inflammatory bowel disease for patients? 84 00:05:46,109 --> 00:05:49,230 how they benefit medication therapy management. 85 00:05:49,239 --> 00:05:56,429 Stakeholders across the IB DS patients journey from diagnosis to treatment to disease, 86 00:05:56,440 --> 00:06:02,049 monitoring through remission and how they differ from other lab tests for IBD and his treatments. 87 00:06:02,709 --> 00:06:03,209 Yes. 88 00:06:03,220 --> 00:06:03,369 So, 89 00:06:03,380 --> 00:06:04,399 so we uh our, 90 00:06:04,410 --> 00:06:10,100 our clinical laboratory offers some uh highly specialized test to facilitate the, 91 00:06:10,109 --> 00:06:16,779 the diagnostic of uh to facilitate the differential diagnosis of uh uh inflammatory bowel disease. 92 00:06:16,790 --> 00:06:22,359 So we are following uh testing solution with uh serological testing, 93 00:06:22,529 --> 00:06:23,799 for example, 94 00:06:23,809 --> 00:06:38,410 uh uh piana as as as well as uh macro microbial uh uh antibodies that are present uh uh in Crohn's disease as well as uh over uh auto uh auto antibodies that are present in er colitis. 95 00:06:39,339 --> 00:06:43,684 These are conditions that are uh uh somewhat difficult to treat. 96 00:06:43,704 --> 00:06:49,994 Uh And uh we are uh uh offering those tests to uh help uh gastroenterologist. 97 00:06:50,015 --> 00:06:51,114 Uh uh first of all, 98 00:06:51,125 --> 00:07:03,434 to establish a differential diagnosis of IBD as compared to other uh condition typically uh uh irritable bowel syndrome as well as over gastrointestinal disorder. 99 00:07:03,445 --> 00:07:05,635 When the diagnostic is established, 100 00:07:05,910 --> 00:07:31,839 uh we offer uh testing to uh establish a prognosis where we're gonna in inform the clinician that the patient has a more aggressive uh disease that will require more aggressive treatment where uh we can uh provide the testing solution to initiate uh uh the most appropriate therapy for uh for the patient uh with uh a testing where we are uh basically uh you know, 101 00:07:31,850 --> 00:07:36,559 establish de determining some genotyping with the fit transferal genotyping. 102 00:07:36,570 --> 00:07:37,279 For example, 103 00:07:37,290 --> 00:07:40,250 where we can uh indicate that the patient is, 104 00:07:40,260 --> 00:07:45,079 is likely uh to present with a side effect to those medication. 105 00:07:45,399 --> 00:07:46,170 And once you know, 106 00:07:46,179 --> 00:07:47,799 the the treatment is initiative, 107 00:07:47,809 --> 00:08:16,089 we have a portfolio of solution uh to facilitate the monitoring of the disease of the inflammatory bowel disease as well as the dosing optimization with uh uh the answer test which uh measure blood level uh for uh uh monoclonal antibodies that are indicated in the treatment of IB start with starting with Infliximab Adalimumab as well as uh Tein and vidal. 108 00:08:16,980 --> 00:08:24,040 So we have a comprehensive portfolio to uh to surround the clinician with uh a variety of testing solution. 109 00:08:24,049 --> 00:08:30,250 With our goal being to improve the uh the outcome uh of patients with uh with diabetes. 110 00:08:30,260 --> 00:08:34,520 And I think that the pharmacist has a very important role to play from that perspective. 111 00:08:35,179 --> 00:08:36,039 So theory, 112 00:08:36,049 --> 00:08:40,239 could you elaborate for us more on the predictor test? 113 00:08:40,249 --> 00:08:42,758 Um especially since you designed that test, 114 00:08:42,768 --> 00:08:44,218 we'd really like to know, 115 00:08:44,489 --> 00:08:45,039 um you know, 116 00:08:45,049 --> 00:08:49,638 what did that take and what role does it play in your suite of testing? 117 00:08:51,049 --> 00:08:51,270 Yeah. 118 00:08:51,280 --> 00:08:51,890 Sure. 119 00:08:51,900 --> 00:08:52,510 So the, 120 00:08:52,520 --> 00:08:52,570 the, 121 00:08:52,580 --> 00:08:52,989 the, 122 00:08:53,000 --> 00:08:53,229 the, 123 00:08:53,239 --> 00:08:59,960 the predictor test is uh uh is uh is utilized when the patient is receiving treatment. 124 00:09:00,280 --> 00:09:18,190 It's been speci specifically designed to optimize uh biological uh uh disease modifiers such as Infliximab adalimumab that are co therapies in the treatment of inflammatory bowel disease as well as other immune uh mediated inflammatory. 125 00:09:18,200 --> 00:09:21,549 This is what the test does is to you connect the blood specimen, 126 00:09:22,229 --> 00:09:23,049 uh you know, 127 00:09:23,059 --> 00:09:24,750 with dosing information. 128 00:09:25,039 --> 00:09:41,989 And what we do is to uh uh provide guidance uh to clinician with uh respect of the best dose to give in order to achieve the best the level which is the most consistent with uh uh the disease control that needs to be achieved for the patient. 129 00:09:42,169 --> 00:09:43,729 Typically a vast majority, 130 00:09:43,739 --> 00:09:46,159 about two third of a third to two third, 131 00:09:46,169 --> 00:09:54,669 a third of patient uh tend to be uh uh unresponsive uh to this uh very expensive medication. 132 00:09:54,989 --> 00:09:57,960 Uh Not because they don't have the uh you know, 133 00:09:57,969 --> 00:09:59,289 typically because they have a, 134 00:09:59,299 --> 00:09:59,590 you know, 135 00:09:59,599 --> 00:10:05,599 pharmacokinetic uh suboptimal pharmacokinetic uh that makes them uh you know, 136 00:10:05,609 --> 00:10:09,440 unresponsive because uh not enough drug has been given. 137 00:10:09,450 --> 00:10:18,469 So what we do with a predictor test is to basically estimate the pa the pharmacokinetic uh parameter for the patient. 138 00:10:18,750 --> 00:10:24,729 And from then uh re report the best dose uh to give in order to achieve the, 139 00:10:24,760 --> 00:10:31,570 the level which is consistent with the uh the most uh uh effective disease control to be achieved for the patient. 140 00:10:32,169 --> 00:10:33,059 So we are offering, 141 00:10:33,070 --> 00:10:38,049 we have developed a test for the Infliximab as well as Adalimumab which is Humira, 142 00:10:38,909 --> 00:10:41,309 but these are antimony causes factor. 143 00:10:41,460 --> 00:10:49,549 And we are also developing the test for vidur as well as uh is that are widely used also in the treatment of, 144 00:10:49,559 --> 00:10:51,969 of uh inflammatory bubble disease. 145 00:10:51,979 --> 00:10:52,669 Wow, 146 00:10:52,679 --> 00:10:55,450 uh for MET is a suite of tests. 147 00:10:55,460 --> 00:11:00,940 Goes well beyond um the PGX testing that our audience is most familiar with, 148 00:11:01,299 --> 00:11:08,679 uh which typically only includes snips for cyp genes and some pharmacodynamic genes. 149 00:11:08,690 --> 00:11:31,424 This is really exciting um genes and biomarkers related to immunology are not commonly found in what I call the box PGX tests such as those uh made by large uh laboratory manufacturing companies um where the panel has a set number of genes and uh you know, 150 00:11:31,434 --> 00:11:36,054 it was developed by a larger laboratory for maybe smaller laboratories use. 151 00:11:36,729 --> 00:11:39,010 So my understanding, 152 00:11:39,020 --> 00:11:53,729 having talked with you extensively theory is that immunology has fewer PGX test available because it's actually more difficult say than oncology to research and develop tests. 153 00:11:53,739 --> 00:11:54,119 So, 154 00:11:54,130 --> 00:12:00,729 could you elaborate for our audience on the difficulties that are associated with immunology, 155 00:12:00,739 --> 00:12:05,830 research and developing tests uh for immunology versus say oncology? 156 00:12:06,330 --> 00:12:06,530 Yeah, 157 00:12:06,539 --> 00:12:07,049 sure. 158 00:12:07,059 --> 00:12:09,969 So in uh in immunology, 159 00:12:09,979 --> 00:12:11,590 as compared to oncology, 160 00:12:11,599 --> 00:12:17,169 there is no such a thing such as a somatic mutation where for example, 161 00:12:17,179 --> 00:12:18,429 you're gonna have a behalf, 162 00:12:18,440 --> 00:12:18,659 you know, 163 00:12:18,669 --> 00:12:20,349 that indicates that the patient, 164 00:12:20,679 --> 00:12:20,919 you know, 165 00:12:20,929 --> 00:12:25,239 is likely to benefit or not from some treatment in immunology. 166 00:12:25,250 --> 00:12:26,750 This is far more complicated, 167 00:12:26,760 --> 00:12:28,830 complicated for the reason, 168 00:12:29,239 --> 00:12:31,020 starting with uh the fact that, 169 00:12:31,030 --> 00:12:31,179 you know, 170 00:12:31,190 --> 00:12:36,219 the response to this uh medication uh are multifactorial. 171 00:12:36,260 --> 00:12:37,820 And the fact that uh you know, 172 00:12:37,830 --> 00:12:39,380 the mutation that uh the, 173 00:12:39,390 --> 00:12:39,619 the, 174 00:12:39,630 --> 00:12:45,190 the single nucleotide polymorphism in the GM line which uh uh you know, 175 00:12:45,200 --> 00:12:52,429 can potentially associate with uh with outcome uh uh uh uh a lo in advance, 176 00:12:52,440 --> 00:12:58,359 meaning that uh they're gonna have a weak association uh with a response to those medications. 177 00:12:58,369 --> 00:13:09,609 So there is a necessity in immunology to combine multiple genetic polymorphism together in order to achieve uh some uh performances characteristics that will make uh you know, 178 00:13:09,619 --> 00:13:09,859 the, 179 00:13:09,869 --> 00:13:10,380 the, 180 00:13:10,390 --> 00:13:10,520 the, 181 00:13:10,530 --> 00:13:13,219 the clinician uh you know, 182 00:13:13,419 --> 00:13:15,619 uh order the test and most importantly, 183 00:13:15,630 --> 00:13:15,840 the, 184 00:13:15,849 --> 00:13:16,179 the, 185 00:13:16,190 --> 00:13:17,739 the payer to pay for the test. 186 00:13:17,750 --> 00:13:20,469 So this field has been uh you know, 187 00:13:20,479 --> 00:13:20,679 is, 188 00:13:20,690 --> 00:13:21,705 is moving for, 189 00:13:21,715 --> 00:13:21,994 you know, 190 00:13:22,005 --> 00:13:24,575 there are some tests that are being developed right now. 191 00:13:24,924 --> 00:13:39,034 But the biggest challenge is to be able to achieve again the the threshold of uh of performance that makes the test is variable enough uh to be uh again ordered by the clinician and the utilize uh to the benefit of the patient. 192 00:13:39,659 --> 00:13:41,200 I couldn't agree with you more. 193 00:13:41,210 --> 00:13:53,489 Um I've worked on the payer side or market access side of pharmacogenomics and even uh with a box test for which there's um a lot of research data available, 194 00:13:53,500 --> 00:13:55,119 even with those, 195 00:13:55,130 --> 00:13:59,760 it's sometimes difficult uh to get payers um to see the value. 196 00:13:59,770 --> 00:14:01,640 So I absolutely agree with you. 197 00:14:01,940 --> 00:14:03,679 Um The fact that you guys are, 198 00:14:03,690 --> 00:14:11,789 are uh investing in producing the data necessary says a lot about your laboratory. 199 00:14:11,979 --> 00:14:12,559 Um you know, 200 00:14:12,570 --> 00:14:15,380 and how committed you are to this testing and, 201 00:14:15,390 --> 00:14:17,320 and how you believe in the testing. 202 00:14:18,039 --> 00:14:23,640 So I just want to make sure that our audience recognizes that, 203 00:14:24,359 --> 00:14:24,619 you know, 204 00:14:24,630 --> 00:14:31,820 Prometheus doesn't simply provide tests to determine if drugs for IBD will be effective and safe. 205 00:14:32,190 --> 00:14:36,900 Um And maybe what the dose of the drug should be for the patient, 206 00:14:36,909 --> 00:14:40,219 but you have that whole suite of tests. 207 00:14:40,229 --> 00:14:47,380 Um the diagnostic test for the differential diagnosis all the way through remission. 208 00:14:48,030 --> 00:14:53,390 So can you elaborate you elaborated on it some in the previous question? 209 00:14:53,400 --> 00:15:01,229 But um can you tell us the difference between how you had to actually develop the test? 210 00:15:01,520 --> 00:15:02,530 Um You didn't, 211 00:15:02,539 --> 00:15:03,059 in other words, 212 00:15:03,070 --> 00:15:10,659 purchase a test from another manufacturer with the biomarkers that you include in your testing. 213 00:15:10,669 --> 00:15:16,830 Can you elaborate on how much more difficult it is to to develop a test from scratch? 214 00:15:18,169 --> 00:15:18,320 Yeah, 215 00:15:18,330 --> 00:15:18,659 sure. 216 00:15:18,669 --> 00:15:18,809 I mean, 217 00:15:18,820 --> 00:15:22,070 this is this is challenging for multiple and first of all, 218 00:15:22,080 --> 00:15:23,130 you need to have the, 219 00:15:23,419 --> 00:15:27,450 you need to have a clinical data set available with specimen available. 220 00:15:27,460 --> 00:15:28,159 Uh you know, 221 00:15:28,169 --> 00:15:28,780 in front, 222 00:15:28,859 --> 00:15:29,770 obviously, 223 00:15:29,859 --> 00:15:30,890 available. 224 00:15:31,200 --> 00:15:35,890 Uh So we are leveraging a pro meters a large bi bank of specimen. 225 00:15:36,299 --> 00:15:37,190 Uh as I said, 226 00:15:37,200 --> 00:15:39,719 Prometheus has been founded 25 years ago. 227 00:15:39,729 --> 00:15:40,599 So over the, 228 00:15:40,760 --> 00:15:41,919 the past two decades, 229 00:15:41,929 --> 00:15:54,849 we have been able to assemble a large uh substrate of data and specimen which we are uh uh using to uh uh establish our proof of concept if you will. 230 00:15:54,859 --> 00:16:07,559 And then when we have uh identify some genetic polymorphism that are uh adequately uh associated with uh uh disease outcome and disease progression as well as uh toxicity. 231 00:16:07,969 --> 00:16:11,469 Then we are entering validation phase where we are uh you know, 232 00:16:11,570 --> 00:16:14,789 using validation cohorts where we are again, 233 00:16:14,969 --> 00:16:22,630 combining multiple modalities together uh patient demographic as well as genetic marker together with theological marker. 234 00:16:22,640 --> 00:16:23,190 Actually, 235 00:16:23,500 --> 00:16:27,419 to come up with some Multivariate models that are uh again, 236 00:16:27,429 --> 00:16:39,250 bringing the performances characteristics of the pharmacogenomic test or its combination with our marker to the level where it's supposed to be in the first place to meet uh uh payer. 237 00:16:39,650 --> 00:16:41,190 And uh obviously, 238 00:16:41,200 --> 00:16:41,760 again, 239 00:16:41,770 --> 00:16:45,320 the patient uh to the benefit of the patient and to, 240 00:16:45,330 --> 00:16:46,619 to improve its outcome, 241 00:16:46,739 --> 00:16:47,429 the outcome. 242 00:16:48,340 --> 00:16:53,380 I think what you're describing really is the future of pharmacogenomics. 243 00:16:53,390 --> 00:16:54,599 Um In other words, 244 00:16:54,609 --> 00:17:03,419 not singing out pharmacogenomics as you know the end all and be all in the treatment paradigm. 245 00:17:03,559 --> 00:17:08,040 But using a PGX test in combination with, 246 00:17:08,050 --> 00:17:09,069 like you mentioned, 247 00:17:09,250 --> 00:17:11,160 other serological tests, 248 00:17:11,170 --> 00:17:12,959 maybe other genetic tests. 249 00:17:13,290 --> 00:17:14,890 Um But you know, 250 00:17:14,900 --> 00:17:25,869 I think what we want our audience to really wrap their heads around is that PGX is just a piece of that larger puzzle um from diagnosis to treatment to, 251 00:17:25,880 --> 00:17:26,910 to remission. 252 00:17:27,239 --> 00:17:29,880 So I think you guys are absolutely, 253 00:17:29,890 --> 00:17:31,579 you're already in the future. 254 00:17:31,589 --> 00:17:32,849 In other words, 255 00:17:32,859 --> 00:17:33,130 you know, 256 00:17:33,140 --> 00:17:39,689 you're already providing all these different uh tests um like you mentioned to, 257 00:17:39,699 --> 00:17:44,310 to facilitate from diagnosis to remission to remission. 258 00:17:44,660 --> 00:17:45,520 That's correct. 259 00:17:45,530 --> 00:17:45,829 Yeah. 260 00:17:46,349 --> 00:17:55,089 So um you've given us so much great information about uh the tests that that you guys offer. 261 00:17:55,329 --> 00:18:02,060 Can you explain to our audience um your newest test? 262 00:18:02,069 --> 00:18:03,859 Uh the responder test. 263 00:18:04,150 --> 00:18:12,979 And um what role it will play in the paradigm from the diagnosis of IBD to remission? 264 00:18:14,050 --> 00:18:14,260 Yeah, 265 00:18:14,270 --> 00:18:14,760 sure. 266 00:18:14,770 --> 00:18:15,569 So we, 267 00:18:15,579 --> 00:18:18,069 we are doing things a little bit different than other. 268 00:18:18,079 --> 00:18:19,489 We do believe that uh you know, 269 00:18:19,500 --> 00:18:21,449 the it has to be simple. 270 00:18:21,459 --> 00:18:24,189 Uh uh We can obviously construct some very, 271 00:18:24,199 --> 00:18:33,530 very complex algorithm and there are some tests that do that with a very sophisticated machine learning based tools that are available using neural networks, 272 00:18:33,540 --> 00:18:33,729 you know, 273 00:18:33,739 --> 00:18:34,790 those sorts of things. 274 00:18:34,800 --> 00:18:39,729 But we have taken on a different approach where with the responder test, 275 00:18:39,739 --> 00:18:40,329 we are basically, 276 00:18:40,339 --> 00:18:45,160 we are taking an approach which is very simple to address the first and foremost. 277 00:18:45,170 --> 00:18:53,020 Most important aspect of responding uh predicting response to uh to medication is the pharmacokinetics. 278 00:18:53,280 --> 00:19:03,250 Uh You cannot be responding to a drug if the drug is not given and you obviously cannot respond to a drug if the drug is not metabolized adequately. 279 00:19:03,359 --> 00:19:06,349 And this is what we are doing with the responder test. 280 00:19:06,579 --> 00:19:09,010 We are addressing some uh uh you know, 281 00:19:09,020 --> 00:19:11,630 fundamental issues with those uh biologist, 282 00:19:11,640 --> 00:19:12,410 for example, 283 00:19:12,660 --> 00:19:15,170 uh the anti tumor necrosis factors. 284 00:19:15,180 --> 00:19:15,650 So, 285 00:19:15,750 --> 00:19:19,199 such as uh Infliximab and Adalimumab, 286 00:19:19,209 --> 00:19:23,050 it is well known uh that uh uh those drugs, 287 00:19:23,060 --> 00:19:25,689 first of all are prone to immunization. 288 00:19:25,989 --> 00:19:36,949 Uh Meaning that uh uh the drug itself uh is recognized by the immune system uh and digested by the antigen presenting cells. 289 00:19:36,959 --> 00:19:42,209 If you will uh where you gonna have uh uh an immune uh uh response, 290 00:19:42,380 --> 00:19:56,979 uh mounted a cancer drug to produce uh immunogen that will severely impact its pharmacokinetics where the labels will be inadequate to produce uh the desired uh anti-inflammatory effects. 291 00:19:56,989 --> 00:19:57,150 So, 292 00:19:57,160 --> 00:19:58,890 we are with the risk conductors, 293 00:19:58,900 --> 00:20:01,040 we are combining two things together. 294 00:20:01,189 --> 00:20:07,959 First of all is the genetic test itself which uh predicts the risk of immun immunization. 295 00:20:07,969 --> 00:20:18,010 The name of the test is on HL A uh DQ A 105 ali uh that uh uh promotes the presentation of the, 296 00:20:18,020 --> 00:20:19,130 of the, 297 00:20:19,140 --> 00:20:19,910 of Infliximab, 298 00:20:20,010 --> 00:20:20,750 for example, 299 00:20:20,760 --> 00:20:32,130 to the T cell repertoire in order to uh promote the Ronon expansion and the formation of the anti antibodies together with uh another dimension which is the clearance, 300 00:20:32,140 --> 00:20:33,670 which is as important. 301 00:20:33,949 --> 00:20:36,209 Uh One of the key issue is the, 302 00:20:36,219 --> 00:20:36,770 the, 303 00:20:36,780 --> 00:20:41,239 the monoclonal antibodies and uh such as Infliximab or Adalimumab. 304 00:20:41,329 --> 00:20:42,280 But in fact, 305 00:20:42,290 --> 00:20:45,890 a neon antibodies that those drugs are uh you know, 306 00:20:45,900 --> 00:20:49,010 cleared and consumed uh from the, 307 00:20:49,020 --> 00:20:50,949 from the central compartment if you will, 308 00:20:50,959 --> 00:20:54,520 since we are doing a little bit of uh uh pharmacokinetics here. 309 00:20:54,530 --> 00:20:56,020 And uh uh you know, 310 00:20:56,030 --> 00:21:06,670 if the patient present who is uh a high degree of inflammatory burden is gonna have uh the patient will have a high clearance and that's gonna worsen uh in the, 311 00:21:06,680 --> 00:21:13,939 in the presence again of the HL AD Q A 105 genetic marker that uh associate with uh immunization. 312 00:21:13,949 --> 00:21:16,859 So I but this is a combination of both, 313 00:21:17,199 --> 00:21:19,359 these are the predictive factors of pharmacokinetic, 314 00:21:20,359 --> 00:21:38,209 which we combine together where the patient presenting with a risk of immunization as well as accelerated clearance due to the fact that the patient has high inflammation or due to the fact that they are so intrinsic pharmacokinetic properties that makes that the patient, 315 00:21:38,219 --> 00:21:38,300 you know, 316 00:21:38,310 --> 00:21:39,479 will clear the drug very, 317 00:21:39,489 --> 00:21:40,260 very fast. 318 00:21:40,560 --> 00:21:41,670 For example, 319 00:21:41,680 --> 00:21:46,819 due to the inefficient uh recirculation of the drug itself with the new, 320 00:21:46,869 --> 00:21:46,930 the, 321 00:21:46,939 --> 00:21:50,599 the the in the reticular on the system. 322 00:21:50,920 --> 00:21:51,619 Together, 323 00:21:51,630 --> 00:22:02,109 those patients presenting with uh uh together these uh poor prognostic factor of pharmacokinetic origin will tend to be severely underdose, 324 00:22:02,380 --> 00:22:06,719 will not be responding to the drug uh adequately as and they, 325 00:22:06,729 --> 00:22:10,719 and they probably should in the first place if you are able to address uh you know, 326 00:22:10,729 --> 00:22:12,270 the the the exposure. 327 00:22:12,439 --> 00:22:14,079 So what we do with this test, 328 00:22:14,089 --> 00:22:21,640 we will be able to inform uh the clinic that the patient is at risk of achieving, 329 00:22:21,650 --> 00:22:30,829 of achieving suboptimal pharmacokinetics and therefore being able to adjust the dose uh uh to start with more adequately. 330 00:22:30,839 --> 00:22:38,650 So that the the the proper uh exposure is achieved uh during induction to again to, 331 00:22:38,660 --> 00:22:39,040 to, 332 00:22:39,050 --> 00:22:39,380 to, 333 00:22:39,390 --> 00:22:40,890 to achieve a better outcome. 334 00:22:41,040 --> 00:22:47,270 And I think the pharmacist will have a very important role to play here in terms of absolutely, 335 00:22:47,280 --> 00:22:51,239 that information is priceless in the management of these medications. 336 00:22:51,250 --> 00:22:54,930 So thanks for elaborating on that. 337 00:22:56,010 --> 00:22:59,040 And if I may add in our previous conversation, 338 00:22:59,050 --> 00:23:00,810 uh before the recording of podcast, 339 00:23:00,819 --> 00:23:08,869 we had discussed um you guys' robust platform for collaborating with payers to obtain market access and reimbursements for the test. 340 00:23:09,109 --> 00:23:14,109 But without stealing the Thunder from uh Prometheus market access and reimbursement team, 341 00:23:14,199 --> 00:23:22,619 can you please uh briefly detail how Prometheus has proactively worked with payers to solve the problem. 342 00:23:22,920 --> 00:23:27,349 Um the population health problem by building the evidence payers want, 343 00:23:27,359 --> 00:23:41,170 want to see um about your test before you go to the market and then build the test and then hope the payers will see the value and the result and then that will improve the market access and reimbursement for your um precision medicine test. 344 00:23:42,160 --> 00:23:42,339 Yeah. 345 00:23:42,349 --> 00:23:43,180 So briefly I can, 346 00:23:43,189 --> 00:23:43,579 I'm, 347 00:23:43,589 --> 00:23:46,619 I'm probably not the right person to answer that question. 348 00:23:46,630 --> 00:23:47,369 We have a very, 349 00:23:47,380 --> 00:23:52,400 very efficient market access group uh uh pro meters that does a splendid job. 350 00:23:52,410 --> 00:23:59,780 But uh uh uh what I can tell you that we have an evidence uh uh development plan in place where we, 351 00:23:59,790 --> 00:24:14,000 we are establishing the clinical utility of our testing solution by demonstrating uh the payer value uh with respect of uh patient management and uh uh and the, 352 00:24:14,010 --> 00:24:16,630 and the impact of our technology on the, 353 00:24:16,640 --> 00:24:18,119 on physician behavior. 354 00:24:18,430 --> 00:24:21,319 Uh We have uh uh already uh you know, 355 00:24:21,329 --> 00:24:25,160 commercialized uh two of those tests for which we have initiated, 356 00:24:25,170 --> 00:24:29,040 initiated the Power studies uh that uh uh you know, 357 00:24:29,050 --> 00:24:32,000 already provide uh you know, 358 00:24:32,104 --> 00:24:34,484 differentiated and the value to, 359 00:24:34,494 --> 00:24:35,915 to the payer where we are, 360 00:24:35,925 --> 00:24:36,025 the, 361 00:24:36,035 --> 00:24:46,005 the clinicians are basically using our technology to make treatment decision uh as well as uh some prospective clinicality study which we are initiating, 362 00:24:46,145 --> 00:24:47,555 initiating to. 363 00:24:47,564 --> 00:24:48,574 Um uh again, 364 00:24:48,584 --> 00:24:49,425 demonstrate the, 365 00:24:49,435 --> 00:24:49,915 the, 366 00:24:49,925 --> 00:24:50,244 the, 367 00:24:50,255 --> 00:24:53,594 the payer value you uh uh we can certainly follow up with, 368 00:24:53,604 --> 00:24:58,755 uh you can certainly follow up with our market access group uh uh as appropriate there. 369 00:24:58,765 --> 00:25:00,765 Uh They can fill you with more information. 370 00:25:01,349 --> 00:25:01,589 No, 371 00:25:01,599 --> 00:25:02,520 that totally makes sense. 372 00:25:02,530 --> 00:25:03,310 That totally makes sense. 373 00:25:03,319 --> 00:25:10,890 But um we're excited that you're also farm d So how did you get to this role of outside the box path? 374 00:25:10,900 --> 00:25:11,550 There? 375 00:25:11,640 --> 00:25:17,530 There may be a pharmacist student or pharmacist wanting to switch or transition into a role such as yours, 376 00:25:17,540 --> 00:25:19,609 which is a Chief Scientific Officer. 377 00:25:19,619 --> 00:25:20,609 I want to learn more. 378 00:25:20,619 --> 00:25:23,920 So how would you um can you talk a little bit about that? 379 00:25:24,560 --> 00:25:24,780 Well, 380 00:25:24,790 --> 00:25:26,270 we are clinical laboratories. 381 00:25:26,280 --> 00:25:29,400 So in order to uh uh to be in my role, 382 00:25:29,410 --> 00:25:34,020 you need to have uh uh you need to have expertise in clinical laboratory science. 383 00:25:34,030 --> 00:25:36,140 So for the students is basically, 384 00:25:36,150 --> 00:25:36,300 you know, 385 00:25:36,310 --> 00:25:40,770 to do the family degree and then complete the family degree with uh a doctorate, 386 00:25:40,780 --> 00:25:40,930 you know, 387 00:25:40,939 --> 00:25:44,260 which is uh focus on clinical laboratory science. 388 00:25:44,270 --> 00:25:46,079 So you can achieve uh uh you know, 389 00:25:46,089 --> 00:25:47,640 the all the elements you need to be, 390 00:25:47,650 --> 00:25:48,219 for example, 391 00:25:48,229 --> 00:25:53,189 board certified uh as uh as as medical laboratory director. 392 00:25:53,199 --> 00:25:55,160 So you can uh uh so, 393 00:25:55,170 --> 00:25:55,589 uh yeah, 394 00:25:55,599 --> 00:25:56,030 this is, 395 00:25:56,040 --> 00:25:56,400 this is, 396 00:25:56,410 --> 00:25:57,209 this is uh you know, 397 00:25:57,219 --> 00:25:59,160 a great opportunity I think for pharmacies, 398 00:25:59,170 --> 00:26:10,800 there is an absolute need to uh have the clinical pharmacist provide uh uh drug information to healthcare professional as well as uh assist patient with the monitoring of their disease, 399 00:26:10,810 --> 00:26:15,229 the effectiveness of the therapy and um and uh you know, 400 00:26:15,239 --> 00:26:16,060 monitoring the, 401 00:26:16,069 --> 00:26:20,969 the side effect and the toxicity from uh from those uh those medication. 402 00:26:24,650 --> 00:26:24,959 Well, 403 00:26:24,969 --> 00:26:32,119 the I know our audience is going to have uh additional questions for you. 404 00:26:32,130 --> 00:26:32,540 I mean, 405 00:26:32,989 --> 00:26:35,609 you've provided them with so much great information, 406 00:26:35,619 --> 00:26:44,959 but it's only the beginning of what they could possibly learn um about um the testing that you do for IBD and, 407 00:26:44,969 --> 00:26:46,729 and even your career path. 408 00:26:47,050 --> 00:26:47,530 So, 409 00:26:47,540 --> 00:26:49,300 if you wouldn't mind telling us, 410 00:26:49,310 --> 00:26:51,359 um because we have to wrap up, 411 00:26:51,369 --> 00:26:52,670 unfortunately, 412 00:26:53,150 --> 00:26:55,810 this episode of the podcast, 413 00:26:55,819 --> 00:27:00,250 uh could you tell us how our audience members might be able to contact you directly. 414 00:27:01,260 --> 00:27:01,449 Yeah, 415 00:27:01,459 --> 00:27:07,079 I can be contacted on my uh on my email at TT W at como slab dot com. 416 00:27:07,949 --> 00:27:08,810 All right. 417 00:27:09,069 --> 00:27:09,300 Well, 418 00:27:09,310 --> 00:27:14,290 thank you again so much uh for joining us on this episode. 419 00:27:14,300 --> 00:27:15,290 We really, 420 00:27:15,300 --> 00:27:29,530 really hope that our listeners um ideas of not only what PGX can be but how PGX can be utilized in a comprehensive testing suite. 421 00:27:29,709 --> 00:27:35,670 We really hope that our a our audience will um listen in and learn this information. 422 00:27:36,280 --> 00:27:37,869 Um And to our audience, 423 00:27:37,880 --> 00:27:39,439 thank you for tuning in. 424 00:27:39,449 --> 00:27:42,619 We really hope that you've learned from this episode. 425 00:27:43,130 --> 00:27:46,339 Uh We do a whole lot of PG Xing here on this podcast. 426 00:27:46,349 --> 00:27:48,380 We talk about PGX Science, 427 00:27:48,390 --> 00:27:52,030 clinical application and the business of PGX. 428 00:27:52,260 --> 00:27:54,880 So we'd love to hear about from you. 429 00:27:55,099 --> 00:27:56,479 I love to hear from you. 430 00:27:56,489 --> 00:27:58,439 Um What can we teach you? 431 00:27:58,449 --> 00:28:00,920 What more can we teach you through our podcast? 432 00:28:00,930 --> 00:28:12,349 So please drop us a message on linkedin and let us know and please share this link to this podcast link episode with everyone so they can tune in and listen to the PGX for promises podcast. 433 00:28:12,520 --> 00:28:15,369 Leave us a review on Apple podcast or Spotify. 434 00:28:15,459 --> 00:28:18,130 And you can also visit us on PGX four, 435 00:28:18,140 --> 00:28:22,989 the number four Rx dot com to listen to all our other episodes. 436 00:28:23,000 --> 00:28:23,079 Well, 437 00:28:23,089 --> 00:28:23,790 thank you. 438 00:28:24,199 --> 00:28:28,750 Thanks for your interest in PGX and for spending some time with us. 439 00:28:28,760 --> 00:28:35,670 Please share this podcast and leave us a review on Apple podcasts or Spotify for all of our episodes. 440 00:28:35,680 --> 00:28:39,390 Please visit PGX four Rx dot com. 441 00:28:39,569 --> 00:28:43,380 That's PGX four Rx dot com.  

Susipažįstame su spaudos publikacijomis kultūros tema spaudoje.Pasaulio kultūros įvykių apžvalga.Minint 100- ąsias Janinos Monkutės-Marks gimimo metines Kėdainiuose surengta pirmoji tarptautinė pluošto meno paroda „Įkvėpimas“.Šiaulių „Aušros“ muziejus kviečia į pažintį su restauravimo dirbtuvėmis.Lietuvos nacionaliniame operos ir baleto teatre jau beveik baigta renovacija. Ar darbai vyko pagal planą ir lapkričio pradžioje teatras spės pradėti sezoną?20 metų gimtadienį švenčianti LRT KLASIKA klausytojams dovanojo 8 valandų muzikinę miego patirtį „Ką spanavai?“. Kaip po 8 valandas trukusio kūrinio atlikimo jaučiasi jo kūrėjai?Pasaulinę muzikos dieną LDK Valdovų rūmuose buvo pagerbti 2023- ųjų „Auksinio disko“ laureatai.Domanto Razausko muzikiniai atradimai.Ved. Marius Eidukonis

Heinolalaisella Kusmikulla oli jännittäviä käänteitä jo menomatkallaan katuruoan EM-kisoihin Saksan Saarbrückeniin. European Street Food Awards -tapahtumassa kilpailtiin 16 eri maan edustajien kesken katukeittiömestaruuksista. Kusmiku vei nimiinsä parhaan jälkiruoan mestaruuden. - Sain viime kesänä pizzavaunulla idean päähäni. Tein mansikka-mascarpone-suklaa -yhdistelmää vaunulla ja se oli aika hitti. Se oli täydellinen makean ja suolaisen yhdistelmä, kun pohja on suolainen ja hapanjuureen tehty, muisteli Leppänen. Kesän aikana Kusmikussa mietittiin, millaisella Suomeen vivahtavalla jälkiruokareseptillä Saksaan lähdettäisiin kisaamaan. - Tuli mieleen, että mitäs jos yhdistäisimme lakritsin ja vadelman. Teimme muutamia koepaistoja ja ensimmäinen versio ei ollut todellakaan sellainen, että sillä olisi päässyt lähellekään tuomaripöytää. Muutaman pienen viilauksen jälkeen makea pizza oli idean ja reseptin kehittäjän mukaan täydellinen. "Onneksi se uskalsitte tavallaan pakottaa meidät maistamaan annosta lakritsin kanssa", kommentoivat asiakkaat Saksassa Leppäsen mukaan. "Tämä on tosi riski tuoda näin vahvoja skandinaavisia makuja meidän nenän eteen", tokaisivat puolestaan tuomarit lakrtsipizzan nähtyään. Kuuntele koko haastattelu.

Choras „Ąžuoliukas“ mini Lietuvos choro dirigento pedagogo, choro įkūrėjo Hermano Perelšteino 100-metį ir kviečia į maestro pegerbimui skirtą ambicingą koncertą.Tradicinė Grigorijaus Kanovičiaus literatūrinė premija Jonavoje įteikta rašytojai Agnei Žagrakalytei.Gražų jubiliejų pasitinka legendinės roko grupės „Bix“ lyderis, prodiuseris Saulius Urbonavičius–Samas. Nuo vaikystės tikras maištautojas, tapęs vienu populiariausių veidų šou pasaulyje - laidoje „Pakeliui su klasika“.Klasikinės muzikos naujienose: Metropoliteno operos užsakymas ukrainiečių kompozitoriui, įteiktas šių metų „Praemium Imperiale“ muzikos prizas, Niujorko filharmonijos gauta įspūdingo dydžio dovana ir incidentas Liucernos festivalyje.Smuikininkas ir aranžuotojas, žinomas akademinės muzikos atlikėjas, laimėjęs ne vieną konkursą, ilgametis Šv. Kristoforo kamerinio orkestro koncertmeisteris, pedagogas Vytautas Mikeliūnas akademine muzika neapsiriboja – smuikininkas nuolat domėjosi džiazu ir domisi iki šiol. Kuo žavi tokia įvairovė pačiam muzikui? Kaip užbūrė džiazas „čiurlioniuką“? Pokalbis su Vytautu Mikeliūnu rubrikoje „Be kaukių“.Ved. Gabija Narušytė

Hey, it's Raysean from the Raysean Gadson Anime Podcast or R-GAP for short, and today we've got Kyle from the Super Dope Podcast joining us to dive into the 22nd tournament in the OG Dragon Ball series. We'll dish out six things we loved about it and one thing we didn't, plus chat about our favorite and least favorite fights. Buckle up and enjoy the ride! In this tournament, Goku, Krillin, and Yamcha have been training hard. They face off against formidable opponents, including Tien Shinhan and Chiaotzu, in a battle that escalates to epic proportions. The rules are clear: no killing, no weapons, and no cheap shots. The action heats up as Tien seeks revenge and aims to secure victory. My likes? Well, I appreciate Jackie Chan getting serious, Goku's power revelation, and the intense tri-beam move. But there's a downside too—Man-Wolf's quirky defeat left me scratching my heads. Despite that, the Tein vs. Master Roshi fight stole the show with its memorable moments and unexpected twists. Thanks for tuning in, don't forget to like and share, and check out our social media for more content and guest updates! Guest link https://linktr.ee/dbsuperdope --- Send in a voice message: https://podcasters.spotify.com/pod/show/raysean-gadson/message Support this podcast: https://podcasters.spotify.com/pod/show/raysean-gadson/support

Good Morning, Nan tho tha hna maw? Tuzing zong morning devotion i hrawm ti dingin kan in sawm hna. A kan hruaitu: Saya Vannawl Lian Tlangtar: Zei Ruangah Dah Zumhtlak Tein Nun Kan Herh? Lunglawmhnak ngan pi he, CAPT - CEBC Arts Production Team -- Music By Peder B. Helland

Jako kluk tragicky přišel o maminku, později ho sexuálně zneužíval třídní učitel. Ze všeho se ale dokázal dostat a dnes se snaží pomáhat ostatním. Založil spolek Klubovna Naděje a každý dnem mu vyjde stejnojmenná kniha. Hostem pořadu Až na dřeň byl Tomáš Paprštein.Všechny díly podcastu Až na dřeň můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.

Úspěšní čeští podnikatelé Pavel Machálek a Jerry Javornický začali v roce 2013 pomocí AI a ML vyhodnocovat dostupná data ze satelitních snímků. Dnes má SpaceKnow desítky zajímavých business casů pro finanční instituce nebo obranný průmysl a část kapacity věnuje i výzkumným aktivitám pro Evropskou kosmickou agenturu. Unikátní technologie automatizovaně pozná stovky objektů, zpracovává biliony pixelů a na denní bázi sleduje asi 200 000 lokalit po celém světě

Suoraa puhetta johtaa tällä kertaa Ruben Stiller. Keskustelijoina ovat Mika Pantzar, Taru Tujunen ja Maija Vilkkumaa. Puheenjohtaja kysyy: Ovatko kaikki poliitikkojen syrjähypyt yhteiskunnallisesti merkittäviä asoita, joista on uutisoitava? Ritarit vastaavat: Eivät ole. Maija Vilkkumaa on valinnut aiheekseen elinkeinoministeri Mika Lintilän Whatsapp-tilin kohtalon. Taru Tujunen on lukenut sisäministerön tuoretta riskiarviota ja kertoo, mitä puutteita hän siitä löysi. Mika Pantzarin aiheena on tekoäly ja joidenkin alan ihmisten harmistuminen tekoälyn saamaan kritiikkiin.

Dam lonak nih a kan phak tik ah man tlawm tein kan i thlop le zohkhenh khawh cio nak hnga, cozah bawmhnak le thil dang bawmhnak pawl kan theih herh mi thil ka chim mi a dihdong tiang rak ngai ve.

Good Morning Nan tho tha hna maw? Tuzing zong morning devotion i hrawm ti dingin kan in sawm hna. A kan hruaitu: Rev. Dr. Van Bawi Kam Tlangtar: Ralring Tein Na Caan Hmang Lunglawmhnak ngan pi he, CAPT - CEBC Arts Production Team -- Music By Peder B. Helland

Kum 18 in 39 kar hi lungthin a derthawm mi an tam bik tiin hlathlainak an tuahmi nih a langhter caah lungthin lei ngandamnak he pehtlaiin bawmh na herh a si ahcun caan a tlai hlan ah bawmhnak na kawl a herh.

Happy Monday! Nan tho tha hna maw? CEBC Podcast, Zumhtlak Saltha in Morning Devotion tuah ti dingin kan in sawm hna. A kan hruaitu: Saya Steven Van Biak Thang Tlangtar: Tha Tein Na Lungthin Kilveng Nan zate Bawipa nih thluachuah in pe hna seh, Amen! CAPT, Zumhtlak Saltha. -- Music by Peder B. Helland

Od šesti let žil prakticky jen s otcem. Matka byla vážně nemocná, dlouhodobě hospitalizovaná a o dva roky později zemřela. Pro oba následovalo náročné období. „Tatínek i já jsme se uzavřeli do sebe, měli jsme svůj vnitřní svět. Dával mi to nejlepší, co uměl, ale ta ztráta byla bolestná,“ vzpomíná na své dětství Tomáš Paprštein. Emocionální prázdno mu pomohl zaplnit nástup do turistického oddílu, v němž získal ztracený pocit bezpečí a ve vedoucím Matějovi, který byl zároveň jeho třídním učitelem, nejlepšího kamaráda. „Přítele“, který zneužil důvěry dospívajícího chlapce a stal se jeho sexuálním predátorem. Zatímco dnes třicetiletý Paprštein si prošel sebepoškozováním, depresemi a terapie se stala nedílnou součástí jeho života, pachatel pohlavního zneužívání učí dál.

Tefillos Rosh Hashanah #1- Uvchen Tein Pachdecho (Elul 5782)

April 10,2022 - CEBC Zarhpini Bawipa thangthatnak ah kan senior pastor Rev. Dr. Thawngling Mualhlun nih Joshua 9 hmang in "RALRING TEIN" timi thawngthabia a kan hrawmhmi a si.

Australia ram upadi umtuning hi zapi zaran caah lung a tuai ngai tikah thiamsang le hngalhnak a ngeimi pawl bawmh hal an hau theo tawn. Asinain, bawmhtu sihni sawmnak ah phaisa tam ngai a dih. Cu tikah a mi kip nih liamnak phaisa an ngei tawn lo. Sihmansehlaw, upadi he a pehtlaimi thil na buaipinak ah a lak tein bawmhnak na hmuh khawh nak lam a um.

Tefillos Rosh Hashanah #1- Uvchen Tein Pachdecho, Malchuyos (Elul 5781)

US ram hruaitu nih riantuan hram an thok lai ah biakamnak an tuah tawn. US ram hruaitu thar a si dingmi Joe Biden zong Jan 20 ah riantuan hramthoknak caah biakamnak cu a tuah ve lai. Tam deuh in hun ngai ve dingin kan sawm.

Nejčastěji se očekává, že odpovědnost a péči o dítě s postižením po rozvodu rodičů nese žena. Tento rozhovor je ale věnován otcům. Lukáš Poplštein se od dcery Lindy po rozvodu neodvrátil a pečuje o ni dál. Bližší informace najdete na stránkách podcastu: www.needo.cz/needo-talks/

US ram chung ramkulh vialte, ramkulh 50 nih thimfung an thlakmi cu an rel dih cikcek hnu ah phungning tein thimfung tam deuh a hmutu le teinak ahmutu cu US ram thimnak tawlreltu nih thanhnak an tuah cang.

Rikhamnak cu duhsah ralrin bu tein thlahdorh thluahmah a hun si cang ko nain – Prime Minister Scott Morrison nih a chimmi cu minung nih pumpak thianghlim tein an um le taksa pum ihlatnak cu pehzulh ding a si peng rih ko lai tiah a ti.

COVID-19 ruangah Australia ah a ummi kumkhua upa cang mi hna cu lengchuak kho loin innchungah an i erh zungzal, asinain kan ngan a dam le kan thawn khawhnak ding caah kan pum nih a herh ningin kan cawlcangh i lungdai hnangam tein kan um khawh a biapi ngai. Asile tam deuh in hun ngai hna usih.

Ramdang hmunthar pem tik ah, a thar in thil tuahding le cawnding an tampi tawn. Australia ah kum saunawn a um cangmi na si zongah, zeitindah hi thil hi tuahning a si ti hngalh lo in na um cang khi a um tawn ko lai dah. Cutikah, mipem nih mah le miphun khat, holhkhat a hmangmi he naihniam tein um an duh mi hi khuaruahhar ding cu a si lem lo. Sihmahsehlaw, mah le mibu, miphun hawi he naihniam tein khuasak tintuk tti hi na caah a thabikmi a si ko maw? Asile, tamdeuh in hun ngai ve.

Khawrawnarungrul a karh a tlawmdeuhnak hnga caah tiah nangmah cu hmundang tein pumpak pheu chung na si lai tiah nawlngeitu nih an in chimh ko nain, nawl ngaih lo in na um a si ahcun, tangka dantatnak a silole thonginn thlakkhawh a si. SBS Hakha Chin tamdeuh in hun ngai ve.

Corona-virus a chuahnak khua, Wuhan ah a tangmi Australia rammi hna cu an taannak khua in chanhchuah le lak an si cang. Tuluk ram khualai bak in vanlawng tual pawng a simi Exmouth, Western Australia ah a ummi tiang vanlawng mawngh cu, khualtlawn caan a sau ngai mi a si. Khualtlawngmi 243 cu vanlawng a hme deuhmi in le tilawng in Christmas Tikulhnak lei ah thial an si lai, hi tikulh ahhin a tlawmbik zarhhnih cu hmundang tein chiah an si lai.