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In this light-hearted episode of RC Plane Lab, the guys talk about trips to the field, the new UAS test called TRUST, and go over the FAA's rules on what it takes to fly legally for recreational purposes in the US. We'd also like to give a special shout out and say thanks to a listener of ours, James Guyton, for sending Tom a diesel rc airplane engine. Thanks James! Take a moment to fill out our listener survey: https://rcplanelab.com/listener-survey/ We want you to be our guest! Fill out the form: https://rcplanelab.com/guest Support us by becoming a Patron! https://rcplanelab.com/patreon Or Support us by donating through Paypal https://paypal.me/rcplanelab Questions, comments? Email: Ron@rcplanelab.com Tom@rcplanelab.com Text or leave a voicemail: (818) 351-9846 Website: https://rcplanelab.com Forums: https://forums.rcplanelab.com
James takes us to the Outer Limits of the musical universe for the last time. Thanks James, well done that man.
Thanks James! Full ep drops next week.
This episode is more like a talk show, people couldn't look away as it played out live. Someone has REEEAAAAALLLLLY upset my buddy James, the invalid invalid, and well, just see how it plays out...and stay tuned for the abrupt ending. Real emotion on this episode. Thanks James for tuning in, and to Colored Sound for the music. --- Support this podcast: https://anchor.fm/mickmotherwellcomedy/support
What's up everyone! We are back with an amazing special that took both Rich and Tommy by surprised. In this episode the boys caught the right waves with James Violet.Singer/songwriter/performer James Violet from The Voice joins the Just Talk Podcast for an hour of good vibes and delightful conversation. A beautiful old soul with a refreshing take on music, James Violet was an amazing guest to have. Truly an awesome episode to tune in too! Thanks James for taking a moment of your time to come hang out with us! We'll see you in the future my friend.With all of that said, thank you all for listening and watching (whenever it drops hahahaha) for ALL the support and the listens! We truly appreciate you all and we hope y'all are enjoying our content. Thank you all and thank you James once again for joining us! Until next time, we're going silent.Follow James VioletIG: @jamesviolet_Album: https://distrokid.com/hyperfollow/jamesviolet/dont-send-me-flowersFollow us on IG@thejusttalkpodcastSubscribe to us on YouTubehttps://www.youtube.com/channel/UCo40E9rCSueQjDxPl21u8Mg
CLICK TO SUBSCRIBE ON YOUR FAVORITE PODCATCHER. Our Pinkie Pie fan extraordinaire James Anderson joins us once again for hijinks aplenty, this time in Yakyakistan. The yaks are celebrating one of their biggest holidays and Pinkie’s been…”invited” to join in the festivities. There’s vanilla cake, music huts, and stories by the fire, until some ritual stomping triggers an avalanche. That’s when the yaks, stubborn as they are, refuse Pinkie’s help to get their village out from under the snow. And when we say stubborn, we don’t mean some aloof hemming and hawing; we mean Prince Rutherford seems willing to sacrifice his fellow yaks to snow sandwiches and sleeping piles instead of getting some much needed help. We’re dismantling some toxic yak-sculinity (THANKS JAMES!!!) as we watch ”Not Asking for Trouble” this week on Macintosh & Maud! Please subscribe and rate us on iTunes, Podchaser, or your favorite podcast app and use your best pony puns! It's the best way to help us get more listeners and build our community. You can email us with feedback at macintoshandmaud@gmail.com, or you can connect with us on Instagram, Twitter and Facebook. Intro and outro music is "Madgapuff March (rmx) by JS Bach" by Lee Rosevere. Licensed under a CCO 1.0 Universal License. For the song and information about the artist, visit the song page at the Free Music Archive. Clip used of “The Rappin’ Histr’y of the Wonderbolts,” with music by William Anderson and lyrics by Amy Keating Rogers. Copyright 2014 Hasbro, Inc. Sound effects included in this episode downloaded from Freesound: “Deep Horn” from user Vendarro, licensed under a Creative Commons 0 License. “Drill 3.wav” from user jedg, licensed under a Creative Commons 0 License.
Episode #188 with www.levelrideairsuspension.com is brought to you be these Rad Ass Sponsors, please support those that support you. www.painlessperformance.com - Are you ready to upgrade that old brittle wiring harness, well Painless has a chassis harness for you. www.UPcarParts.com - Upgrading my C10 Truck lighting was one of the best things I did to improve my overall safety - I can see at night when I drive now, plus it look really cool. Save 15% when you use "C10Talk15%" at check out. www.classicperform.com - Have you seen the ALL NEW X10 seal spindle from CPP, DAMN SON! - They also have new fuel cells that can be used for both carbureted, and FI motors. Save 10% off your total order by using "C10 Talk" at checkout. www.mar-k.com - The AbSoLuTe leader in C10 Truck molding and trim. Choice the best for your build, choose Mar-K, you will NOT regret it. Part 2 of the C10 Talk, Air Management Series with James Cloke from Level Ride Air Suspension. James has been in the Automotive Air Management business since the early 2000's when he was a dealer for AccuAir. Unhappy with what was out there, he developed his own system, Level Ride, and has brought it to the US. Take a listen and decide for yourself. Thanks James for your time, and for the listeners, thanks for tuning in. Have a GREAT week, Ronnie.
Welcome to Finance and Fury, The Say What Wednesday Edition - Where every week we answer your questions Today's question is from James Hi Louis, Just a question regarding owning your home. Me and my partner would like to eventually own our own home but we are worried about such a large sum of our overall wealth going into a single asset - our future house. How would you correctly diversify your assets in this scenario, were there any strategies to doing this? Especially with house prices at the moment, it really seems like all your eggs will be in one basket - and for a while. What I’ve seemed to gather is that owning your own house is more a lifestyle asset and a liability. All I seem to hear is nothing but expenses / fees / costs, a low amount of capital growth all for a relatively high amount of risk. Was this true? Thanks James – and Awesome points In this episode – we will tackle this using the economic problem and opportunity costs – The economic problem – that we all have limited resources of savings and cash flow – and need to make this work towards achieving our goals Opportunity costs of doing so – what is the next best thing that we could be doing with our financial resources?- I.e. putting your deposit towards long term investments or your cashflow going towards the repayment of a mortgage against doing monthly investments First – What is a home? – a lifestyle asset – is still technically an asset as it has a value – as long as someone else is willing to buy it off you I personally have never really seen a home as a financial asset - because as James pointed out it technically losses you cashflow when it has a mortgage – and even when it doesn’t from a mortgage, if this has been repaid – with rates, body corporate, ongoing maintenance costs for upkeep on the property Classification – Can you live off it? Anything that doesn’t make you a passive income but instead loses you cash flow can't be used for financial independence Technically - a negatively geared investment property can set you back in FI This being said – renting also costs cashflow That is where the decision does come back to lifestyle and the fact that everyone needs somewhere to live. Everyone needs somewhere to live – Property ownership is expensive – a mortgage is normally the biggest expense – PI loans eat a lot of cash flow – but the P component can be treated as forced savings that you can’t use But does decrease your I payments over the long term Sinking deposits of $100k plus into a lifestyle asset – while it may continue to grow in value long term, you can use this to generate a passive income unless you rent a room out – but then Gov will make you pay CGT on your own home if you ever sell Opportunity cost of this is using the lump sum to invest instead and cover your rent Property Capital Growth – I’ve covered this in a few previous episodes (are we in a property bubble and many others) – but Australian property from the mid 1990s has had a meteoric rise Created a situation where people love property out of the expectation of buying and experiencing the same meteoric growth rates – Pre-1990s wasn’t the case – property grew with wages at around 3.5% p.a. from 1890 to 1990 – What changed? Banking regulations and the amount people could borrow thanks to declining interest rates But anyone looking to buy property at this stage and get the same price gains should keep in mind that it is reliant on credit growth from borrowings – so if people can afford to keep increasing the size of a mortgage from say $700,000 to $5.4m in 30 years – we won't get the same price gains – Looking back on the average mortgage growth over the past 30 years – that is what it has been – from $90-100k to $700k in most of Aus – worse in areas of Sydney/Melb – wage growth at record low rates would only be able to cover $1.9m – so I don’t think so – but may be wrong I personally sold off my last property in 2017 – was lucky timing as the market was at the peak in the area I sold – Used the funds to invest and build a further passive income – passive income from investments could already cover my rent – so this went into reinvestment Question of Renting vs Buying – look at the option of what is the interest cost, rates, BC is applicable, and spending on upkeep versus rental price Rent V Buy – in Aus with the price of property – I prefer renting if it is an apartment in the city – or house in the surrounding suburbs – why? Example – Apartment I am in at the moment is worth about $650k-$700k – pay just under $2k p.m. in rent – For same property at a 3.5% interest rate – would be paying $1,500 p.m. in interest at under 3.5% - assuming a 20% deposit of around $130k – but add on Body Corporate and rates – additional $5k p.a. ($420 p.m.) – total interest bill and minimum expenses are the same as the rent – But opportunity cost of the $130k tied up in the deposit – use this for an investment instead that provides a passive income Then add on the principal amount of $820 p.m. – at minimum – cashflow wise I am better off by around $1,362 per month – or $16,300 p.a. to direct towards investments This example doesn’t include the capital works or sinking funds requirement on the place either - This all being said – this is a financial decision - But lifestyle considerations come into play – most people want to own their own place to live long term – avoids dealing with tenancy issues, dealing with real estate agents or the owners selling out of the blue Comes down to security and ability to make amendments to the property as you like – renovate or paint a wall Lifestyle isn’t financial though – it is what you want to achieve to suit what you want If apartment living is what you like – then buying apartments to live in long term can work Have to buy for now and the future – Property (even your own) is a long term thing – if you are planning on having kids/starting a family – and want to move to a bigger home in a few years but are buying now – may as well save more and buy a bigger home Why? Transaction costs – stamp duty, agents fees Example – Buying an $800,000 place in NSW – stamp duty of $31,777. When you sell it – agents fees of around $20k – so a minimum of around $50k to buy and sell – 6.5% of the value – No guarantees that prices will jump up that much in the time you might want to turn around The risk – Shouldn’t view your own PPR as a speculative risk Speculative risk is that you lose money on it in the short term through volatility – you are buying for the long term Buying at $900k to see the valuations drop to $800k sucks – but as long as you don’t need to sell – what does it matter? The risk of owning a PPR is that it eats all of your cash flow up – through having too large a mortgage or interest rates rising – if this is the case and you have nothing left in cashflow to make additional repayments or to direct towards investments – that can be a risk Everyone needs somewhere to live – but once you retire you also need something to live off – super or investments – Worst case – Age pension which isn't a guarantee How would you correctly diversify your assets in this scenario, are there any strategies to doing this? The option is using your own property as an investment vehicle – Not advice but a strategy – Create a separate loan facility as an investment loan – and push all your cash/savings into this – Then draw the months worth of savings that you would have invested anyway to invest – debt recycling Not for everyone – and now not a great time to do it due to markets being at all-time highs The economic problem of cash flow – This is limited in most situations – as disposable incomes are the restricting factor Mortgage repayments versus investing the funds PI repayments - Interest component is covering the costs of interest – the principal is repaying the loan – and is what saves you interest long term – but at the moment rates are low – not expected to go anywhere for a little while – say you could make P repayments over 5 years and Opportunity cost factors (such as paying down debt versus investing) and also diversification factors Own home shouldn’t be treated as an asset – centrelink doesn’t as you don’t live off it but live in it The Question – Doing what is right for you long term Me personally – wouldn’t buy an apartment – BC costs and no land to property price ratio – For me land is what is important – now building a new deposit to buy a few hectares of land around 30-40mins from the city – as for me having access to own food that can be grown and fresh water has been my plan for over a year now Summary DO the numbers – Look at your cash flow – and opportunity cost But also – your lifestyle considerations come into play Thanks for the question James Thank you for listening to today's episode. If you want to get in contact you can do so here: http://financeandfury.com.au/contact/
No, sorry, starting areas. We’re talking about starting areas. Well, James and EJ are talking about starting areas and I’m dying in a corner. Whatever. Thanks James for stepping up! You can find James on our discord server! Next week: … Continue reading →
Has tabletop role-playing game prep changed for us over the years? If so, why? It depends on the game. Be it a one shot, a campaign or con event, game prep may be different for each. Thanks James for posing the question. Announcements Evercon.org – some BSer’s are running games at the con, be great... The post How Much Role-Playing Game Prep? appeared first on Gaming and BS RPG Podcast.
Today Axel and his guest co-host Andy (@Gopher1977) chat about their initial reactions to Watchmen Season 1 Episode 7 entitled An Almost Religious Awe. Article mentioned on the show (Thanks James): https://www.hollywoodreporter.com/live-feed/watchmen-season-1-episode-7-an-almost-religious-awe-explained-1258567 Music by Chorizo Slim from Strange Boogie: https://chorizoslim.bandcamp.com/album/strange-boogie-part-1 https://chorizoslim.bandcamp.com/album/strange-boogie-pt-2-3 Thank you Ready for the logo Become a Patron: http://Patreon.com/DVR (Welcome Elena) Join our Facebook Group: https://www.facebook.com/groups/DailyDVR … Continue reading "Watchmen S1E7 Initial Reaction with Andy"
113 Pinks and Blues: Questions From the Nation!, Using Your Five Senses Episode 113: Show Notes Pinks and Blues: Questions From the Nation!, Using Your Five Senses Nation!, once a again friend of show James McDonald, CWT is trying to help us become better water treaters. James wants to know “how do we use our five senses to be better water treaters?” While I answer his question, I don’t think there is just one answer. After listening to this episode, ask yourself these questions: How would you answer, “how do we use our five senses to be better water treaters”? What can you do differently now you are thinking about your 5 senses? How can I protect my 5 senses? This question just goes to show how it’s not always the tough technical questions that make us better. It’s thinking about the common, everyday things that truly make us better at our job. Thanks James! If you have a question for me to answer on Scaling UP! H2O or if you want to be featured on Scaling UP! H2O with your question, simply click on the “Leave Voicemail” button on the left side of our homepage, or go the show ideas page. Key Points From This Episode: Episode Sponsor: Radical Polymers [0:00:23] Question from James McDonald [0:03:36] Sense of "Sight" [0:06:19] Fight or Flight Reaction (Smell) [0:10:41] Normal Vs Abnormal Sound (Hearing) [0:14:32] Sense of "Taste" [0:17:12] Sense of "Touch" [0:22:28] And A Lot More! Tweetables: How do we use our five senses to be better water treaters? @James McDonald @traceblackmore #scalinguph2o #scalingup #scalinguppodcast #scalingupnation #PinksandBlues #BoilerSurging #CWT #ASHRAE #AWT #ScalingUPandbeyond #fivesenses How do we use our five senses to make sure that everything we’re doing is the right thing and that we are continuously getting better in a safe way? @traceblackmore #scalinguph2o #scalingup #scalinguppodcast #scalingupnation #PinksandBlues #BoilerSurging #CWT #ASHRAE #AWT #ScalingUPandbeyond #fivesenses "Ask questions before acting." @traceblackmore #scalinguph2o #scalingup #scalinguppodcast #scalingupnation #PinksandBlues #BoilerSurging #CWT #ASHRAE #AWT #ScalingUPandbeyond #fivesenses "We must take care of our five senses; they help us in our jobs and help us enjoy life." @traceblackmore #scalinguph2o #scalingup #scalinguppodcast #scalingupnation #PinksandBlues #BoilerSurging #CWT #ASHRAE #AWT #ScalingUPandbeyond #fivesenses #TraceBlackmore Links Mentioned On This Episode: Episode Sponsor: Radical Polymers Michael Standish on LinkedIn Ep 14: The One with Mike Standish Ep 21: The One with James McDonald 049 The One with James McDonald, Again James McDonald on LinkedIn
This week's episode was suggested by James Norlem of Nebraska! Thanks James!The story of Voltron started in 1984, and has seen a number of sequels and reboots over the years. But this week, we're going back to the original series that started it all to find out who this giant robot is, where he came from, and if he's single and date-able or not. So grab a couple friends and form your own robot while we explore the lore behind Voltron!
Welcome Special Guest Jacob as we talk about persecution. Thanks James for your question! --- Support this podcast: https://anchor.fm/gottaquestion/support
BitPay interviewed me at Consensus this year about my involvement in Bitcoin and the evolution of the blockchain space over the years. Thanks James from BitPay for the interview!
Radio and podcasting veteran James Cridland joins us to talk about his journey, where we are in podcasting and where we are going. We discuss the influx of large companies into podcast, the continued importance of indies and why we should be optimistic about the future. You can find James' site at Podnews.net Thanks James!
Why Dave Decided to talk to James Smiley: James reached out to Dave recently and asked if he could do this second podcast with him because of all the things he’s had the opportunity he’s been accomplishing. The best part about it all is that most of what he wants to talk about is the little things everybody easily forgets that makes the biggest difference. Networking happens to be one of those things. James has found he does better than most people because of the QUALITY of the relationships he builds through something he’s always focused on: contribution. Tips and Tricks for You and Your Business: (2:48) The systems for high leverage (4:10) “Contribute” from James Smiley’s perspective (6:30) The Highest Leverage Move comes from using other people with contribution in mind (10:54) James Funnel Hacked his way onto Russell’s radar. Who’s radar do you want to find yourself on? (12:44) Your webpage should highlight exactly what your dream client is looking for, get those stats on there. (15:02) Selling Kevin Harrington when he only gives you 11 minutes (16:20) Network to Network (19:00) Who’s the gatekeeper to your networking (21:38) Network with those you know you are able to contribute to (24:54) Understand how the person you want to meet with thinks (28:00) The Long-Term Play Quotable Moments: (2:22) “What I’ve noticed through life, whether it’s through working with sales, working with sales teams, or helping solopreneurs is there’s a way to create leverage, extremely high leverage, and it’s a system.” (6:54) “So you can see, if you don’t start thinking about the word ‘contribute’ but you start thinking about using other people’s platform or money, the whole system doesn’t work.” (13:24) “There’s a lot of little things like that which I started doing. And you know you never really know if anybody is seeing it, but chances are if you’re doing the right thing they’re going to take a peak at you.” (16:10) “‘I’ve seen your videos and I like it’, those little phrases show me that my little personal branding and marketing out there synergized with him. So it allowed the conversation to move forward because he had more trust with me.” (20:57) “You have to be on point, like when they look at your stuff would they think ‘James is one of us’?” (22:48) “Networking to network is incredibly huge, especially if you figure out how do I honestly contribute” (30:07) “If you contribute to people in the right way, the relationships and all the things that happen, you can take over your Dream 100 in a way that you never thought possible.” Other Tidbits: A quote from our dear James Smiley, “IF YOU’RE NOT USING CLICKFUNNELS, WHAT ARE YOU DOING?!?” If your main goal is to make money off of somebody and not improve their lives, business, relationships, health, etc. then they’re going to find out. Once they find out, they’ll find somebody else sooner or later. Tony Robbins, Russell Brunson, James Smiley, and all these other people have 24 hours in their day just like the rest of us. What they’ve done differently though is they’ve found out how to leverage their time to “hockey stick” up. Get the numbers to make yourself “one of us”. You must contribute sincerely for any form of networking to have a lasting effect. Important Links: www.JamesSmiley.comFunnelHackerRadio.com FunnelHackerRadio.com/freetrial FunnelHackerRadio.com/dreamcar ---Transcript--- Speaker 1: 00:00 Welcome to funnel hacker radio podcast, where we go behind the scenes and uncover the tactics and strategies top entrepreneurs are using to make more sales, dominate their markets, and how you can get those same results. Here's your host, Dave Woodward. Everybody. Welcome back to funnel hacker Speaker 2: 00:18 radio. This is going to be a ride of your life guys, because I have the opportunity having the one and only Mr James Smiley back on the show. James, welcome to the show again. Woo. What's up? I am so excited. So for those of you guys don't may not know James Out. We did a podcast a while back and I want to make sure you understand this is a guy who's been around for a long time in this whole digital marketing space. He's done over $210 million dollars in digital marketing. I actually in his early twenties, actually I IPO to SAS company, which is super, super cool. Something I have yet to do and has worked with three of the fortune 10 companies. This guy basically knows what he's talking about and he approached me and said, you know, Dave, we did this awesome podcast awhile back, but I've done all these cool things recently and I want to talk about some of the stuff way back when that everyone's already forgotten about and I thought, I love all the deep dark secrets of things that people have forgotten about. So with all that said, James, take us away and let's just see where this is going to go today. Speaker 3: 01:10 Awesome man. Well, I appreciate you. Appreciate Click funnels. If you're not using click funnels, what are you doing? So, um, we ever since it came out, we've moved everything there and it's just been awesome. Appreciate you, appreciate the community and all you guys and gals out there and everything that's going on in the funnel hacker world. So, um, but yeah, you know, one of the things that I've been sharing with our coaching students, you know, we've been super fortunate or blessed or everyone to call it to. We brought on a hundred and three students since me and you last talked, I think it was an August of last year, around the 2017, um, and we do a 15,000 and $5,000. We did a hundred and three students and one of the biggest things that people have been wanting to know and, and it is like how do I get, how do I, how do. Speaker 3: 02:01 Because like, like in business, you know, you, like you have people who have like regular acceleration, right? They just like if you were to graph it, they have a gradual growth or maybe it's like staggered up and down lows and highs. But then there's like those hockey stick moments, right? Where like somebody goes from where they're at and the hockey stick way up and then they plateau and then the hockey stick again. And so what I've noticed through life, whether it was sells, uh, working my own sales teams, running, running with a big company or helping solo preneurs is um, there's a way to create high leverage, like, like extremely high leverage. Um, and it's a system that I really, to be totally honest, I learned it from chat from Chet Holmes who started the dream 100 stuff. And this was a system that he, uh, talked about in, in a VIP session that I was at a, um, I was at a thing with Tony Robbins in chat. I want to say it was like 2013 or 2004. And um, and I learned this, but he's like, this is so, so good that I don't publish this because people can really take it the wrong way. And so, uh, so I wanted to share, Speaker 2: 03:13 have to understand, we talked a lot about dream 100 and even just don't understand the depth of dream 100. It's so much more than just creating a list and send them out a package. So much deeper than that. And Russell spent a whole bunch of time at our traffic secrets course that we did in October down in Phoenix and just blew everyone's mind. And that's why when you were talking to me about this whole idea of, of it being used for good as well as for evil, it truly, truly is and can be. So with that caveat, I want to make sure you guys understand when we're talking about this, we assume that you guys are gonna use this for good and that you're not going to turn this around and uh, destroy people's lives with it. But with that, I really want to kind of dive in. Jane's really kind of go into this whole idea as far as contributing. I know that was one thing that we were talking about. What exactly does that really, really mean from your eyes? Speaker 3: 04:00 So this was back in a chalkboard day. There wasn't whiteboards. And so, um, uh, Chad had wrote the word contribute. He said everything I'm going to now for the next hours, if you don't understand this word, you're going to screw up everything I'm going to tell you because people are going to realize at some point you're taking advantage of them. And when they realize that everything you just did is going to come crashing down on me and then the rebuild, that reputation could take you years, you know, or you may never be able to recover from that. And so, um, so he really, he sat us down and he said, I want you to think about, do you actually have the best intentions for the other person before you do anything before you contact them for you, follow any of this stuff if you don't, if your main goal is to make money, he goes, I promise you this is not gonna work. Speaker 3: 04:52 And it may work on one person, but he goes, eventually it's gonna catch up with you. And when somebody realizes you're taking advantage of them, it's over. And so he really, Harper was work contribute. And that's where this whole system starts with what I teach our coaching students. I'm glad to share this with everyone out there that like what I'm about to share with you, if you don't have that, that, that mindset of like, I want to do this to help someone else more than helping me. Right? Like if, if I can't find that gratitude, like even in this, you know, like, like I reached out to you, um, and I'm using the same process I'm going to share, you're going to see like I'm using the same process, but in my heart I'm like, if I can't, if I don't have complete gratitude, like in me just being able to network with Dave, help his community, how, you know, like if I can't contribute into your world from a pure perspective than everything that I'm doing is going to come crashing down, you know. Speaker 3: 05:52 And so, um, so that's really where this whole starts out is, you know, really focusing on contributing to people. Okay. So that's kind of, there's really a five step system. Um, and so I can just run through those real quick. Is that the awesome? Yeah. Okay. So number one is contributed. So you got to think about like how you come up with your dream 100 lists, all the standard stuff that Russell talks about in his book and all that stuff. Like, like come up with your dream list. Okay. Then then you think, okay, like how do I carve out a few of these people in like, like the most strategic ones, the ones that I can get the highest leverage move. And so I'm just a side note. A lot of people say, well, what is the highest leverage move means basically highest levers. Move means how do you, how do you use other people's stuff? Speaker 3: 06:33 So I called P. A lot of people are opm, other people's money, opt other people's time. But you've got to think more but more. Okay. You can use other people's data, you can use other people's relationships, you can use other people's platforms, you can use other people's intellectual property. You like infinite, right? Um, and so, so, so you can see how like if you don't start thinking about the word contribute, but then you start thinking, how do I use other people's platform or how to use other people's money. Like the whole system becomes warped, right? It becomes about me, about, you know, um, and, and I'm not actually adding value into the community. And so, um, so like, like the, the way that I've seen people get real hockey stick growth, whether it was a company, a sells startup, whatever is they figure out how do I create the highest leverage move with my time or, or with, uh, with, with, with my investment or with whatever, with whatever the asset is. Speaker 3: 07:36 And so I'm like, if I were to go out today, uh, like you, you and I both know, like, like, uh, me, you, Russell, Gary Vaynerchuk, Tony Robbins, we all have the same amount of time. We all have the same amount of, of like no one had 35 hours today. Everyone had the same, you know, 10, 12, 15 hours to work. Like we all had the same amount of time. The only thing is some people figured out how to create more leverage with their time. Right? And to me that is like the true essence of d, 100. It's like how do you create more leverage with your time? And so typically it's using other people's whatever, right? Other people's time, money, network, email list, facebook page, podcast, a coaching group, whatever. And uh, and then in return, like, you know, like, like you're helping them, they're helping you. Speaker 3: 08:27 Okay. So number one contributed to the number two thing that chat started showing us and I've summarized it up into this is okay. So like if I carve out like 10 people that I want to talk to that I really need to network with. Okay. So like, let me just be totally honest here. Okay. I could say Russel, I could say, um, there's some people on Shark tank that I wanted to get ahold of. There's some people, you know, there's, there's some key individuals, right? So, okay. So the first thing I need to do is actually write out like how can I actually contribute into Russell's world? I literally did this a couple years ago. I was like, okay, like what could I do to be different? Like, how can I contribute to him versus like, you know, every time I see him, like, hey man, I got this thing, I got this idea, you know, and you know what man, like if we just partnered up, I give you 50 slash 50 men, you know, and I'm like, come on now like how many people are or be one of those people who's like, you know what, me and my product is so good. Speaker 3: 09:22 Russell. Like if I just got sales I would be good. It's like you just like, I can't, you know what I mean? Like you can't believe it is. I literally got an email from a guy who's actually has a lot of fame, uh, people would know him and you'll be at funnel hacking live and everything else. And it was interesting because he's like, listen, before I fire up to funnel hacking, live on a fly over to meet with, with Russell and just kind of go through a couple of things with the real fast. I'm like, why? And what is the value? Russ is going to get out of this besides, you are going to come to the office. I mean, it was just interested in like, oh, you know what, it doesn't work that way. Yeah. And so, okay, so contributing number one. Number two is I need to figure out how to summarize data that my d 100 is going to, uh, it'd be impressed by. Speaker 3: 10:13 Okay. So this, this one really shocked me because I was like, why is this so important? Okay. So like one thing that, one of the things I've learned around Internet psychology through the years is numbers tend to mean more than just words. Okay? So it's a reason why people will say like, we've reached x amount of people, right? Instead of saying, uh, you know, like even Louie's started here, it's like, hey, you can say, Hey James Smiley's a good digital marketer or a great digital marketer, but when you say numbers, he's done this amount of sales. He's done this, he's done. You know what I mean? It, it registers in people's mind fast. Okay? So if I'm going to really drive a highest leverage move d, 100 strategy, I need to think about how do I move numbers to the forefront of my marketing so that when I'm going to, she's Russell for an example, when Russell, if he eventually ever looked at my site or sees my webpage or sees my facebook page that he will see a number that means something to him or he'll go, oh, like, like chet used to say, you want them to, you want them to start saying he's one of us. Speaker 3: 11:16 Like, so I love that analogy because I think that's really super critical. It's, I were just talking about our to calm a couple of word winters. We have 411 two Comma Club award winners right now. And so it's nice because it again, it groups you into that. Now you're there. One of us. I love that announced. That's great. Yeah. Yeah. And so, um, so like, so like I started a by the way. So Larson told me to, to talk about this more because I told him how I, how I got to know you guys. And Russell, and he was like, dude, this is one of the smartest 100 strategies ever. He's like, you gotta talk about this more. So, um, so, uh, so because I told him how is using data that I thought Russell would like. So like I'd listen to those podcasts, I'd watched all this stuff and I'm like, okay, he's saying like he wants, this is way back when he's like, I want to be the fastest growing SAS company. Speaker 3: 12:11 So then I started using like language, like, uh, I was a part of iop on one of the fastest growing sas companies in Silicon Valley. Like specifically saying that I feel like if I knew Todd Russell, like somebody saw it, they'd be like, oh, he's one of us like in subliminally. Right? Um, and so, uh, but, uh, but for, for other people that might mean like, like, like in the btby world, like somebody may not be interested in how much revenue you make, they may be interested in how many distributors you have or, or maybe they're more interested how many customers you have or something like that. So like, I try to encourage people, like on your website, have data that summarizes something that you, that your dream client is going to go, wow, this. I'm impressed by this. So I heard Tony Rob Russell say once on his podcast, he said, Tony Robin, he has spoken to 10,000 B, two b sales reps. Speaker 3: 13:03 okay? Somewhere. He said that on a podcast and he was impressed by it. Well, I knew because a corporate recruiter had told me this, I had spoken to 12,000 B, two b sales rep. I was like, yes, I'm going to put this on the front of my homepage if Russell ever received that. James is one of us, you know what I mean? And so, um, there was a lot of like little things like that that I started doing and um, and then so and I didn't know, like you never know, like if somebody really seeing it or not, but, but chances are if you're doing the right things, sooner or later they're going to take a peek at you. Right? And, and if these are the little things that make somebody start calling, oh, maybe, maybe he's like us, you know? Um, okay. So the third thing, Speaker 2: 13:44 I'm going to step back on that because I think that helping people understand that they're one of us is such a huge, a huge thing in networking, um, because you'll talk to people talk about, well there's a level b level c level type of relationships. And uh, again, you were talking about Steve Larsen and his whole big thing is, you know, you can reach one level up as I've heard him referred that a million times and I think it's important that as you get to know what your, what your group or your level is, what does that one level above you, what's that one level below you? And whether it's, again, whether you mentioned as far as revenue or, or contacts or whatever the number is, but realize that everybody has some number. I guess these days, a lot of people, as far as we're dealing with a lot of influencers and their numbers are you. How many youtube followers? Yeah. How many instagram, facebook, whatever. That may be, and those numbers basically say, okay, you're one of us and I think this, oh, critical that, and I appreciate James that you mentioned. It's not just revenue, it's not just these numbers can be anything, but the key here is numbers, numbers or something. People very quickly can just, it's a scale and they say, okay, that's, I'm in that same area. I'm in that you're, you're one of us or you're better me or one lower than me, Speaker 3: 14:52 whatever it might be. They at least know where they fit. And I think that's the big thing with a lot of marketing is people want to know where do I fit in this ecommerce or this whole cosmos here. Yeah. I recently struck a big partnership with Kevin Harrington from Shark tank and I won't talk about the whole details, but one of the things I will say is I knew the specific type of numbers he wanted to see and so I move those to the forefront of my marketing, of my, of my personal branding. And um, so I got on a call with him one day and he's never talked to me before and he goes, James, I've heard a lot about you. And he goes, ah, he goes, but I, I hate to tell you this, I got to cut this call short. He goes, I have 11 minutes, pitch me, go. Speaker 3: 15:35 I was like 15, I have 11. Exactly. He's like, yes, you have 11. Go in. And I was like, okay. So long story short, in 11 minutes I struck a big deal with them in the other people on the phone were like, we never seen nothing like that. Even even, um, uh, Kevin's brother Brian or his son Brian was like, okay, I seen all the pits people pitching. I've never seen minutes. And um, but the reason is because I had him preframe through all this stuff. I'm telling you, like I had preframe because of the data. And he said little phrases. He's like, I've seen some of your stuff. I've seen some of your videos. And I like it. Like those little phrases tell me that my little personal branding and marketing out there, it's synergizing with him and that's how I got on the phone with them. Speaker 3: 16:20 And so it allowed the conversation to move forward because he had, he had a little bit more trust with me because he was kept thinking. I think James is kind of like one of us, you know? Um, okay. And then. So number three is, I'm a check called this something else, can't remember, but I call it network with the network. Okay. So like when I wanted to become friends with Russell, I'm like, man, this is gonna be like, hard to get to know Russel, right? So, um, I was like, okay, like this is a total chet holmes strategy. I'm like, okay, who are all the people around Russell? And remember this is like two or three years ago, okay, who I guarantee you I could get ahold of them. And then so I was listening to the podcast and he's like, Oh yeah, I'm hiring this kid named Steve. Speaker 3: 17:04 I'm like, I bet you I can get ahold of that kid. I'm not kidding you. That's the first thing I thought. I'm like, I guarantee you, I get a hold of that kid. Like he's a Newbie, you know what I mean? So, and then I started looking up and I'm like, this is no joke. I'm like, oh, there's, there's this dave guy. Oh, this is Dave Woodward Guy. There's this guy named todd. There's, um, then I, and then I realized there's John Parks. Um, and then like back then he was talking about certain inner circle people. So he had mentioned I'm a funnel that some guy named Henry had done for him and I had no, he didn't even mention Henry's name, so I like, googled, looked on his friend list, like figuring out who the hell is this Henry Guy because he just talked about Henry Henry must be a friend. Speaker 3: 17:47 And so like what I did was I started figuring out how do I contribute to sincerely until all these people's lives. So, I'm not kidding you like this a little bit embarrassing, but it totally like I had you Larson had all you guys on my list and I was like, okay, how do I like sincerely, like, like add into these people's lives. Okay. And then, um, so when I first told, I told, I told this at the, uh, at a mastermind I was with Steve and I said it from stage one. I said this, Steve Goes, that happened, that really happened. Let me tell you what happened. So I told. So the whole idea here, okay, is that someday, maybe you guys will all be talking to Russell in. Somebody will be like, well we should try to get into btby and then someone will be like, why? I notice James Smiley Guy, but I don't know, like nobody really knows him. And then somebody else in the circle would be like, James James Smiley. Like the guy, you know that guy. Oh yeah, he's totally cool. And then somebody else would be like, James Smiley. And this also like the idea is that like everyone kind of knows james and Russell's like, who the heck is named Smiley God? Why do I not know James Smiley? Speaker 2: 18:58 Seriously? Oh my gosh. I can tell you that networking with a network is probably the most understated issue. And people just don't understand how important that is. I've seen that so often in my gosh, in my own business over the years I've noticed that that has been a huge, huge opportunity for me. A kind of also goes back as far as making sure you understand who the gatekeepers are, that you network with the gatekeepers and that's your, you're nice to the gatekeepers. And it's, it's so funny because uh, I mean literally Russell's my officer like four feet apart. I mean I stepped through the glass and it's, it'll be funny where he'll get the same package I will get and I know exactly what people are like, well, if I can't get to Russ, I'll get to dave first and then I'll use dave to get to Russell. And I like, I know the game, but I think it's cool that people are playing the game because I think that's how it's so critical. More people who know you, who have a point of reference in a frame of reference for you, the easier it is to have those types of conversations when, when again, the name comes up, it's not like it's going to come up all the time, but when it does, you want there to be a positive relationship with that, with your name or whoever else that might be. Speaker 3: 20:04 Yeah. Yeah. So, um, so I, uh, uh, I, I said that from stage one time [inaudible] Larson stopped. Everything goes to, he goes, that literally happened one time. He's like, we were talking about like a new version of the website or something like that. And he's like, that literally happened. He's like, two or three of us knew who you were. And Russell said, who's James? I don't know. Yeah. And, and, and, and so I didn't say any of this, but we all know, like people like Russell use the internet, use their phone like with somewhere within the next 24 hours, the next hour, I guarantee you, he looked up to see who the heck is James. Sure. So, so like every one of the listeners to understand like, this is why having your stuff on point in having data summary, because I mean you don't have like an hour for this guy to look at your stuff and you might have in seconds. Speaker 3: 20:55 So you gotta be on point and so you gotta think like, okay, like what is this person? If they were to look at my stuff for 20 seconds, would they go, James is one of us, you know? And so, um, the, so the, and the whole thing around network when the network is like understanding that first word contribute. So it's like how do I actually add value to Steve? How do I add value to John? And so like, I'm like, I didn't know John at all. But um, so there's two little hacks that I've learned over the years or we're doing this over 10 years with network, with a network. One is finding somebody who is, um, I don't know if it's right to say, but finding someone who's younger is easier to network with in finding someone who's an up and comer is definitely easier like it because not only that, you can contribute into those people's world really, really fast. Speaker 3: 21:45 Like you can tell them stuff, help them, give them encouragement. Um, you know, like, like I've sent, I won't say who, but there's multiple people on that list. I've sent them big deals, I've sent them, you know, I signed a deal and I broke or the services out to them. I like message. I'm like, Hey, um, you know, I got this deal in a, all you need is this, this and this, and I can wire you $8,000 right now. Like what? Like, who is James Smiley? Like I don't even know who this person is, right? But, but now, like I built longterm relationships with those people, um, in like, uh, in, like when you really do that, right? It's almost like this becomes flawless because you become friends with the people who your dream 100 person is friends with, you know what I mean? And um, and so, and it's a really cool thing because you don't have to push your way in, you don't have to try to, you know, insert yourself. Speaker 3: 22:37 Like it just happens kind of organically, you know. Um, and so, so anyway, um, so yeah, so networking with the network is, is, is unbelievably huge, especially if you can figure out like, how do I honestly contribute. Okay. Um, one like 32nd story I'll tell you about something I did with John Mckay was I bought 'em fill your funnel a number of years ago. Okay. And um, you know, like I thought that was a lot until, you know, like, like it was like 30, 3,500 bucks or something like that. And it was like, it was awesome. Right. And so, like here I am in this group and I wasn't going to be totally honest. Okay. I wasn't 100 percent sure how I was going to use that content. But one, okay, there's a couple of things I realized. Number one, John was in there, it was messaging in the group a lot. Speaker 3: 23:25 And so like every time John would say something, I would back them up, you know what I mean? Like, like, uh, and so I was, I kind of became friends with them in there, you know, and then I would post like a testimonial or two of like something cool that I did based on something he said. And so I think just over time, like I don't, I don't, I don't think like me and John are like, know we don't really talk a lot, but I will tell you like the few times we do talk it's like he, I think he's like, he's Kinda cool. Like James is like one of us, you know. And um, and so, but I first met him in this group. So I want to say something like, I bought my way in to a relationship with somebody like that because I figured if I bought my way into this, the people that are in there managing this are probably going to be people who Russell knows. Speaker 3: 24:12 You see what I'm saying? Oh, I totally agree. Like whereas some people they just go into it with the, you know, they don't think about those kinds of. Yeah, you know what I mean? They don't think like, not only that, like you're in a group of couple of hundred people who are, you just spent like $3,000 on something. Like you're in a group of cash buyers. Like why would you complain of 80? Like there's, you can build friendships, relationships, all those kind of things. But um, but anyway, but that's, that's like my, the first time I really interacted with John, I just saw, I was like, how do I contribute? How do I contribute? How do I make this fun? How to make this engaging for him. Okay. And then the fourth one is, this was a little bit psychological, but it's like the most ideal thing is if you can understand how the person thinks, because one thing I did not know is I did not know or even think Russell was an introvert. Speaker 3: 25:05 Never thought that. And um, and so I'm glad. Like I would listen to him and go, man, like this dude's an introvert. Okay. So like if I ever meet him, the last thing I want to do is come up to him like, oh my God. You know what I mean? Like in, in the few times I've seen I'd been around him and seeing people approach him. I'm just sitting there laughing, going, I have no idea. Like they're well meaning good people, but they have no idea. Like, you know, I was at the Mellon texts event, I think, and Russell's crushed it there. And uh, and then he was out in the hallway I think, and there was like 20 people around him in a circle. And so I walked by that day I walked by, um, and uh, and so I'll just Kinda, just for time I'll, I'll put four and five are kind of similar. Speaker 3: 26:00 So a four is like, you want to start mirroring the person. This is a lot of Tony Robbins stuff like marrying the person. So like, um, so one of the things that I did at that event was a, I noticed that you guys would always have a camera person and a lot of times it's you or somebody like holding the b roll camera, right? The vlogging camera will like, I'm message John Before that event. And I said, hey dude, I'm, what camera are you guys using? And he said, I don't know man, let me check it out. Because we were friends. He was like, dude, let me check it out. So he came back and told me the camera you're using so that I told my camera girl, I'm like, hey, they're using this camera, go buy it. And then she was like, Hey, I can get one that's just slightly better. Speaker 3: 26:43 I'm like, that'll be even better. Like the upgraded version that will be better. And then, uh, so we bought the same tripod. It's the same camera. And guess who, the only two people at this event were who had camera people, you and me. And so I did that. So because I knew that I would be in the vicinity of Russell and I wanted to try to get his attention in a non, like, you know what I mean? I wanted to try to get an intention and so I was like talking to Caleb and people like that. And I remember seeing Russell in the corner of his eye look over at us and he's like, I guarantee you he's probably going, who's the other dude with the camera? With a camera person following them around. Like, who the hell does this guy like, I don't know, maybe he knew, maybe he didn't. Speaker 3: 27:29 But um, uh, but I distinctly remember him, like continuing to look over and we would connect a little bit. And then, um, uh, so when he was out in the hallway, uh, I, I saw him and I told him, I camera goes, I was a communications committee. And I was like, Hey, so, so we walked out and uh, and so I'm walking out, my camera person is following me and there's literally 20 people around, Russell and I can just tell he's like, I mean everybody, I'm sure it was like super nice and cool, but he was just drained. He was just like, dude, get me out of here somebody. And so I walked by him and he kind of looks at me out of the corner of his eye and uh, and he just kinda like opened his shoulder just I think he just wanted to see, like if I was going to say it, say what's up or whatever. Speaker 3: 28:14 And uh, and of course, like I'm looking at him, so I reach over and lean in really, really softly. We shake hands in, right when we shake hands, that whole group went dead silent. Oh sure. Everybody was like, what the heck is this guy? Right? Like, Russell just stopped the conversation to have shake somebody's hand. And uh, and I remember shaking his hand in and I said, hey man, I said very soft and comp because I understand his personality. And I'm trying to like mayor his personality or how he thinks and so I was like, hey man, I appreciate you letting Steve Come to my event. He crushed it on stage. Thank you so much for, for letting him do that and I just appreciate you. Basically I just told the guy, thank you, that's all I did, you know, and I just remember him looking at me and he was just like, he just said thank you James. Speaker 3: 29:06 And he's like, thank you for doing that. And it was just like really cool like bonding moment and um, and so, so it was just, it was, it was the coolest thing because like all that work had built up to a, to a handshake, you know what I mean? There's so much value in that and I think so often people are in this game for the short term and it's like, what can you do for me? What can you do for me? What can you, for me? And like that's not how this game works. This is a long longterm play. Yeah. Yeah. I appreciate that a ton. Jane's. Yeah. And so I guess I'll, I'll kinda wrap it in this way and saying that, um, you know, you guys featured how you, how we were using click funnels and be to be on the clickfunnels.com home page for a while. Speaker 3: 29:50 I will tell you of 103 students, we had a majority of them, the original, because we survey, a majority of them had said, well, we saw you on the clickfunnels site. We looked you up. So I just want this whole conversation and coming full circle if you contribute to people in the right way, like the relationships and all the things that happen, like you can win over your dream 100 in a way that you never thought possible just by contributing into their world it just by adding value into the world. And so anyway, um, so yeah man, I'm super grateful and thankful for you guys. I mean just to, uh, to share a number like our practice, that coaching practice that's $766,000 and, and, and, and I'll say like all that happened because we, we, we focus on contributing. I love that, you know, so I appreciate you guys man so much. Speaker 3: 30:48 Well James, thank you. And I appreciate you being so kind to contribute to our audience and our community as well. So any other parting words? Um, appreciate you guys, man. Appreciate your audience and everything. I'm a Jane Smiley Dot Tom is the homepage and all that stuff. If you guys want to check out anything but uh, whoever, whoever it is that you, uh, your dream client is, you know, if you got that person, I would just say this to any of your followers. If you have that person or those people at that company and it like it, it's like it doesn't leave you, it doesn't leave your mind. You're like, I got to meet that person. I got to. If I could just get that relationship. To me that's, that's like the confirmation in your heart that you're supposed to build that relationship, right? Like the fact that like, I'm not thinking about that person. I guarantee you no one else is like you. You are the person who was supposed to build that relationship. The fact that it doesn't leave the fact that you wake up, you go to bed, you in meetings, you're daydreaming about that person or that relationship like that is the person that you're supposed to meet and work with and if you focus on contributing, you can get there. Oh, I love it. Well James, thanks again, James Smiley.com. Check them out. Thanks James. We'll talk soon. Appreciate it. Speaker 4: 32:03 Hey everybody. Thank you so much for taking the time to listen to podcasts. If you don't mind, could you please share this with others, rate and review this podcast on itunes. It means the world to me where I'm trying to get to as a million downloads here in the next few months and just crush through over $650,000 and I just want to get the next few 100,000 so we can get to a million downloads and see really what I can do to help improve and and get this out to more people. At the same time, if there's a topic, there's something you'd like me to share or someone you'd like me to interview, by all means, just reach out to me on facebook. You can pm me and I'll be more than happy to take any of your feedback as well as if people would like me to interview more than happy to reach out and have that conversation with you. So again, go to Itunes, rate and review this, share this podcast with others and let me know how else I can improve this or what I can do to make this better for you guys. Thanks.
James de Lemos: Welcome everyone to Circulation on the Run my name is James de Lemos, I am the executive editor for Circulation based at UT Southwestern in Dallas and I will be filling in for Carolyn today as we discuss this year's surgery themed issue. I would like to welcome Dr Marc Ruel, the chairman of cardiac surgery at the University of Ottawa and a long-time editor of the Circulation of surgery themed issue, as well as Dr Tim Gardner, professor of cardiac surgery at The University of Pennsylvania and our leader at Circulation on the editor team for issues related to cardiac and vascular surgery. Marc and Tim, welcome and thanks for all your tremendous work in this issue. Dr Marc Ruel: Thanks James for having us. Dr Tim Gardner: Thank you. Glad to be here. James de Lemos: Why don't we start Marc with your thoughts on how this issue comes together, how it came to be, you picked the papers and how we ended up with this terrific issue. Dr Marc Ruel: It’s been a really important year for surgery and for this issue, as some of you may know the supplement which used to be the old designation of this issue has been changed to the surgery themed issue in about 2014 or so where the new Circulation leadership and what we tried to do every year is to bring the very best, not only of cardiovascular surgical science but also of clinical care and pearls around clinical and surgical care. So, I think this year we have had probably more than 60 submissions sent to us. Tim and I have looked at those very closely and you as well, James, we really wanted to get the feedback and the approach from not only cardiac surgeons but also from cardiologists and cardio vascular care specialist around those. We've tried to select the best of science and also some papers that we feel would be very useful with regards to providing new clinical pearls for surgeons and anyone in the circle of care around cardiovascular surgery. Dr Tim Gardner: If I could just add, James, of course we have other papers that have been submitted by surgeons that are published or that deal with cardiac surgical or vascular surgical topics during the year, this particular issue is very much focused on cardiac surgery but throughout the year we have plenty of submissions of manuscripts by surgeons about surgery about surgically related topics and so on. So, I am actually kept quite busy reviewing and commenting and consulting on manuscript submissions of Circulation. There are plenty of papers over the course of the year that relate to surgical topics. James de Lemos: Wonderful, I think you will see, as we talk about these papers, really that what Marc and Tim are talking about in terms of papers that are broadly relevant to cardiac surgeons and cardio vascular providers really rings true. Let’s walk through the issue, its set up like most of our issues begins with a couple of opinion pieces, a brief frame of reference, articles about important topics. Marc, do you want to talk about the Domanski paper, talk about revascularization for ischemic cardiomyopathy? Dr Marc Ruel: Absolutely, we've asked experts, namely Mike Farkouh and Micheal Domanski, to provide us where their thoughts regarding the optimal treatment on patients with LV dysfunction and severe coronary disease. What many of us would call an ischemic cardiomyopathy, which may be construed as a misnomer or as an accurate term, I will not debate on this today, but certainly it remains a very vexing clinical problem. I think we could all agree that the last niche where we still see very high in terms of treatment for coronary disease this is probably mortality and kind of an inability to provide for a tangible result. Once LV dysfunction has set in and the present of CAD the outcomes are poor, and it took years and literally almost ten years for the STICHES trials to show a benefit for surgical treatment. This is relatively all study now and it has to be put in context and I then that Mike and Mike are doing this extremely well in terms of providing the caveat, for instance, STICHES at its inception added had a 5% mortality rate around CABG, so we know that the modern outcome are probably better than that. It’s very difficult to actually decipher what sound be the mainstay of treatment for each challenging patient and I think the frame of reference provided by Dr Farkouh and Domanski is extremely useful in helping with that. James de Lemos: Tim we have another frame of reference that is also provocative. Trying to make a case that we think about in patients with hypertrophic cardiomyopathy with obstruction early surgical procedures to relieve the obstruction. Do you want to tell the readers a little bit about this opinion piece and what your thoughts on it are? Dr Tim Gardner: Sure James, this is a really nice frame of reference article from both doctors Martin and Barry Maron and then their European contributor Paolo Spirito and the point of their opinion paper is that the surgical art for managing this very difficult obstructive cardiomyopathy syndrome has reached the point where we really shouldn't wait until patients are in extremist or in class 3 or 4 status in term of syndromic problems and can consider earlier surgery for these patients. They make the very important point which I think we have to except is that for patients to do well with this operation they need to be in a center where there is experienced surgery and experienced surgeons, but the point is now that the state of the art for managing obstructive cardiomyopathy is as such that good result are obtained and patients should be offered this surgery when appropriate, but earlier, in order to avoid the challenges of end stage cardiomyopathy and difficulty relieving the obstruction, so this is a really important opinion piece. It’s great to see our cardiology colleagues who are experts in this field make this point based on well published data from centers like the Mayo Clinic. James de Lemos: Moving now to the original articles, we've got 5 original articles, maybe Marc we can start with your thoughts on 2 articles related to revascularization, one in coronary disease and one identifying a really novel approach for treating type A aortic dissection with malperfusion. Dr Marc Ruel: I think that's well said James, the first of these original papers will be likely somewhat controversial. The first author is Dr Bo Yang and essentially it is a series from Michigan where they look at just shy of 600 patients with acute Type A Aortic Dissection, of whom 135 were identified to have malperfusion syndrome. Essentially defined by the authors as something slightly different than malperfusion per say but really malperfusion accompanied with evidence of necrosis in one of the organs. Their approach has been new and somewhat controversial in that they have brought these patients first to the interventional radiology suite in order to fenestrate in many cases or at least open the culprit artery or the culprit perfusion territory that leads to malperfusion syndrome and then depending on how the patient is doing they would then proceed to open repair as soon as 24 hours afterwards or they may wait longer in someone where there is no sign of improvement yet prior to moving to the ER, so they have found this has not only improved the results with regards to in hospital mortality after operative repair type A aortic dissection, but also to allow them to better discern or differentiate should I say between patients in whom malperfusion may lead to a futile situation and who then may be avoided from undergoing a very complex and difficult OR so would argue this is probably the first such large organized, well documented series of such an approach and I think it will lead to some head scratching, this being said it must be remembered that the goal standard for Type A aortic dissection is dealing with the intrapericardial aorta first and hoping that the perfusion gets better from this and everyone knows that the results of this approach are not fantastic. We know that even in the best centers, including the latest data from Germany such an approach has about a 20% mortality rate so clearly there are ways that we can improve with Type A aortic dissection and this paper may be a strike in the right direction. James de Lemos: The other revascularization paper addresses that, I would say also a quite controversial topic which is how many atrial grafts are optimal in patients that are undergoing surgical revascularization? Dr Marc Ruel: This is a paper from Toronto where the Ontario ICES database was used and several papers actually dozens and dozens of papers have come out previously from this well established and well allocated database. Steve Fremes who is the senior author and one of his trainees, Dr Rocha and the team of authors got together and decided to look at the impact of 3 versus 2 arterial grafts in patients undergoing cabbage with regards to survival. They have very nice, very compelling follow up information and they basically carry out 2 exercises. First, they wanted to see if the 3,000 patients or so had 3 or more arterial grafts had a better outcome than the 8,000 patients or so who had 2 arterial grafts and frankly they found there was no significant difference with regards to survival at 8 years and freedom from MACCE at 8 years. However, when they compare those 9 or 8,000 patients or so who had 2 arterial grafts to the rest of 40,000 or so patients who had 1 arterial graft and completions with veins they found that again there was a survival benefit. This last finding is not new and its obviously subject to indication biases as well as expertise bias as we've seen in many of the observational perspectives studies around multiple arterial grafting. But I think the concept of comparing 2 versus 3 arterial grafts is very novel in surely in this paper is being addresses with very high scientific related from the numbers and the quality of the follow up that's been brought to the exercise. James de Lemos: I've really been struggling, I love your thoughts and Tim, your thoughts on how to reconcile the data in space. I really am having a hard time getting my head around what seems to be conflicting data about the number of arterial grafts in what an optimal CABG looks like in 2018 with the evidence that we have. What are your thoughts on that question? Dr Tim Gardner: I think that this supports the concept that 2 arterial grafts whenever possible for some patients, younger patients perhaps 3 but I think the important point is, multiple arterial grafting should be attempted and carried out whenever possible. I leave the is 3 better than 2 to some future study or future review that can be more precise about that. Dr Marc Ruel: This being said I think we don't view efficiently coronary surgery as being an area of expertise and many centers including very strong academic centers may not necessarily marry the concept that coronary surgery has to be something with the dedicated expertise. I think when we look at those observational perspectives series we see the effect of it may be the expertise bias, but it may be more than just 2 or 3 arterial grafts, they may be the whole wrapping of care that comes with it including optimizing beta blockers and managing diabetes etc. So, I think it may be more than purely conduits but definitely, as Tim said, 2 arterial grafts are probably better than just 1 and the jury is still out on whether 3 is better than 2. James de Lemos: Excellent. Switching gears now Tim, an area that obviously you have tremendous experience and expertise we've got 2 innovative papers addressing surgery for individuals who have congenital heart disease. Can you update us on what we are publishing here? Dr Tim Gardner: Sure, the one study focuses on the risks of pulmonary valve surgery in adult patients who underwent a correction of tetralogy of Fallot earlier in life. This is a growing population actually we refer to as young adult with congenital heart disease and in many centers they are more numerous in terms of the patients groups than infants because this group has been successfully treated early in life, but this particular group of patients, patients who have had tetralogy of Fallot repaired and end up with what the author calls right ventricular outflow disfunction generally regurgitation through the outflow tract pulmonary valve sometimes obstruction, these patients then face significant clinical challenges in death from heart failure, right ventricular failure or arrhythmias in their late 20's and 30's. We have been focusing now on the timing and the type of pulmonary valve replacement. Dr Tim Gardner: Now there is catheter replacement options available, but when to do this and how to minimize risk is really the focus of this one paper that describes a four multi-center study looking at predictors of risk for these patients. Sort of a hypothesis generating paper, but it is an important study none the less, focusing on how to identify patients with right ventricular out flow tract dysfunction and who should have pulmonary valve replacement and when that should optimally be done. It a very good study. The other important study that we have is that the other age spectrum of neonates and this is a study that is based on a review of data from the pediatrics heart health information systems database, led by the group at the Children's Hospital Philadelphia. Looking at variations in pre-operative care and management of neonates with transposition of the great arteries. This was a little controversial actually when we reviewed it among the editors because the suggestion is that earlier surgery this would be in the first week of life and more perhaps aggressive use of atrial balloon septostomy seems to improve outcomes. This is a generally low risk population, the point of the paper is that these pretty good results can be improved by paying more attention to the timing of surgery and the appropriate use of balloon septostomy. It’s sort of a quality improvement perspective based on a large database and I think it’s a very nice study and undoubtedly creates additional attention to this particular area. James de Lemos: Marc, our last original paper is a really novel issue engineering approach to creating vascular conduits, can you tell the readers briefly what happens to her in this paper? Dr Marc Ruel: Indeed. It’s a paper from Stanford, from Joe Woo’s lab and the first author is Daniel von Bornstädt. Essentially, as you say it’s a very innovative novel approach to try to recreate a bioengineered blood vessel. We surely know there's quite a need for such off the shelf conduits, not only in cardiac surgery but also in vascular and vascular surgery and even for things such as AV fistulas and others. It’s really interesting to see that this is what I would call transitional science at its best and surgeons have had an important role over, as you know, centuries in helping develop this and many discoveries have come from surgical labs, especially a few decades ago. In any case, what Joe and his team have performed is to try to use clinically applicable methods to derive and create a bioengineered blood vessel and they started first with human aortic smooth muscles cells and skin fibroblasts which are literally easy to get and they used those to constructs bi-level cell sheets, they then used a 22 gauge angiocath needle so that the sheets would be wrapped around this in order to lead to a tubular vessel construct. Then the next problem has been traditionally that those bioengineered vessels would burst out with atrial pressure. What Joe's team came up with is to use a commercially available adhesive, so a glue essentially, which is dermabond which typically we use after any form of surgery to keep the incision together and they put dermabond on the surface of this sheet wrapped around an angiocath needle to act as a temporary external scaffold. They then led this into a bioreactor and implanted it in series of 20 rats as a femoral artery interposition graft. The results were excellent. Essentially, patency was perfect and there was a full vascular maturity with all 3 layers of blood vessel that you would expect including an intima that had been formed as a result of the experiment. I think this is all very promising because none of the methods here are involving something that would have non-autologous issues, or you could easily see this being used with a patient’s own cells in order to achieve an autologous. I think this is obviously small vessels, there are 22-gauge needle is not a big conduit, you’re not going to bypass an LED with this, but I think it’s a start and it’s all done using transitional or clinically applicable methods. I guess the next step would be moving to a large animal model and certainly I think we should stay tuned to see where this leads us. James de Lemos: I think that's exactly my thinking as well about that discussion and really leads us into some of the issues that come up in the review paper that you are a co-author on new strategies for surgical revascularization. I think this basic in translational science piece is designed to address some of the limitations of current revascularization and you all did a really beautiful job covering some new more clinically ready strategies in your papers. Can you just tell us very briefly what you all covered in that review paper? Dr Marc Ruel: Indeed, this is a paper that was kind of aiming at being a state of the art around CABG and rapidly the focus was reshaped towards kind of new strategies around surgical myocardial revascularization. Initially we have a section on OPCAB on this and that and minimizing the inflammatory effects of the pump and quickly it became apparent that the desire of Circulation and this themed issue was to focus it more on really what are the up and coming improvements around surgical coronary revascularization. This paper focuses on essentially 4 main areas. One is hybrid coronary revascularization, the second one is less invasive coronary surgery, the third one is the use of multiple arterial grafts to which we eluded a little earlier during this podcast and fourth is the use of an aortic coronary surgery, essentially meaning bypass surgery performed without any manipulation of the aorta. James de Lemos: As we think about innovation in terms of conduits, the procedure itself, the other aspect that's covered in our last paper is can we make the procedure safer perhaps by modifying our use of anti-platelet therapies based on meshment of the platelet phenotype and Tim do you want to bring us home by just telling us a little bit about what we learned from Paul Gurbel and his group of platelet experts? Dr Tim Gardner: Well we learnt a lot about platelet science and appropriately so Dr Gurbel is a well-recognized expert in platelet physiology or platelet management and this is a really quite a challenging area because many of our patents come to surgery especially for coronary surgery already on platelet inhibitor agents and what Dr Gurbel and his co-authors showed in this paper is that although there is somewhat limited data there can be and should be platelet function testing and with an appropriate understanding of platelet inhibition drugs that we may be able to limit the time between removal of these or discontinuation of these platelet inhibitor drugs and the necessary surgery which will improve outcomes and reduce bleeding in patients requiring urgent CABG surgery. It’s a very useful update and it is a good example of a paper that isn't written by surgeons, but really applies very much to the cardiac surgical treatment of coronary artery disease James de Lemos: I really like the very practical tables and figures that lay out the potential tests that surgeons or anesthesiologists may consider for assessing this and even how one might implement. I would like to bring us to conclusion now, first I want to acknowledge, Sara O'Brien at the Circulation office for her amazing work together with Marc and Tim pulling this issue together, making sure that we have a consistent high quality issue with wonderful figures and tables and it really came together beautifully and thank you both for joining me today and the podcast I think it’s obvious that we've got an issue that all of you listen to this podcast need to actually pull out the issue or download it because we have a co-host of wonderful papers to look at and cardiac surgery thriving at Circulation. As we've talked about this is the tip of the iceberg, this themed issue, we've got great content coming, issue after issue. We are already open for business next year’s issue, so please send us your best cardiac surgery research. Please pay attention to these important papers and apply them in your practice because I think many of them are already directly applicable. Marc given your leadership role in the issue do you want to bring us home and make any concluding remarks? Dr Marc Ruel: I think your points are very well taken James and I want to reintegrate that if I speak on behalf of the cardiovascular surgical community, we are very thankful to the leadership with Circulation. James, Joe, Tim and many others and obviously the support from the staff in clearly establishing that cardiovascular surgery is a very important therapeutic mentality and the overall scope in the broad scope of cardiovascular therapeutics. Dr Carolyn Lam: You've been listening to Circulation on the Run. Don't forget to tune in again next week.
James Pendle, The Introvert Dad, shares what life looks like as an introverted parent. I appreciate his willingness to be open in a few areas he struggles in; in his personal relationships with his kids and partner. He is also names how he has overcome some obstacles in his work. Listen in to see what life looks like as an introverted dad. To learn more about James, he can be found at the links below. Thanks James! https://www.youtube.com/channel/UCVbDMs-RpgyG8b425iYur6Q https://www.facebook.com/HighDefinition15/ http://www.introvertdad.com/
Everything in history has either a good or bad connotation. The Agricultural Revolution: good. The Rise of Big Data: bad. But what if we're wrong? Yuval gave me an example. And showed me just how wrong we might be about our own human evolution. (Also, if you like what you hear, make sure to check out the full episode with Yuval Noah Harari. Thanks - James). I write about all my podcasts! Check out the full post and learn what I learned at jamesaltucher.com/podcast. Links & Resources: 21 Lessons for the 21st Century by Yuval Noah Harari Sapiens: A Brief History of Humankind by Yuval Noah Harari Homo Deus: A Brief History of Tomorrow by Yuval Noah Harari Visit Yuval's website www.ynharari.com Yuval’s course on Coursera Also Mentioned: "The Ultimate Guide to Self Publishing," which you can get for free right now by visiting jamesaltucher.com/publish. This guide will tell you how I made money self-publishing, why I think everyone should publish a book (it can be 100 pages or 10 pages, doesn't matter), how this can help your career and help you financially and so much more. Check it out at jamesaltucher.com/publish Thanks so much for listening! If you like this episode, please subscribe to “The James Altucher Show” and rate and review wherever you get your podcasts: Apple Podcasts Stitcher iHeart Radio Spotify Follow me on Social Media: Twitter Facebook Linkedin Instagram See omnystudio.com/listener for privacy information.
In this episode we got a question about the Blue Yeti vs the Audio-Technica AT2020. I explain my perspective on why I HATE (Just Kidding) the Blue Yeti. Thanks James for the question! If you want to get on the show just connect with 'Earl Hall Studio' on Skype and leave your question via voice mail (just like James did) :-) Get 10 days free to the Voice Over Domination Course at www.voiceoverdomination.com --- Support this podcast: https://anchor.fm/earl-hall/support
We found a new HappyLifer and decided to interview this pretty cool and weird young man. Did we just invent a new oxymoron? "Cool" and "weird" aren't two words you hear together a lot. However, I think Dylan's weird is what actually makes him cool, and I think the same is true with all of us as well. It wasn't planned, but I find it interesting that last week we interviewed Tony and this week the interview of Dylan kind of turned in to an interview of Stevo as well. I don't think I'm narcissistic, it's just where the podcast took flight...weird! Special thanks to James Kocian, for his permission to use his really cool music. These tunes really made this pod in my opinion. Thanks James! Check out more of his music here https://soundcloud.com/james-kocian) The songs we use in this episode are "Christmas the Whole Year Round" by Sabrina Carpenter and "The Secret of Christmas" by Bing Crosby. We don't own the rights to either. www.HappyLife.lol www.Facebook.com/HappyLifeStudios www.Instagram.com/HappyLife_Studios www.Twitter.com/HappyLifStudios www.PayPal.me/StevoHays
This one was really wide ranging. Everything for Itera race to Type 1 Diabetes to the economics of adventure racing. Thanks James. This weeks links Itera Adventure Race http://www.itera.co.uk/ James Run Across England http://www.youtube.com/watch?v=liVEO0AgHdY
GUEST: JIM FLORENTINE, Stop The Insanity!, RIP MCA, Scooter Scandal, Thanks James, Alex Wrekk, Portland Button Works, Marc Maron, Adomian, Honk If You Love Kobe, Pranking, Kentucky Derby Picks, World Of Crazy, Handcuffed Smoker, Dancing In Prison Yeah, Zookeeper Saves Monkey, Hair Straightener, Yeah Honk
How the World Works (and What Jesus Does Through Us to Overcome It)
I CAN HEAR THE HARMONY was produced with music by Alexye Nov entitled "Appeal to Heavens" found at music.Mevio.com. HORIZONTAL RIVER RUSH has music by 2006 Pl@stic Soul entitled "005-1 electric guitar" found at music.Mevio.com. SOFT BALL RAIN has music by Origen entitled "Dance of the Clouds" found at music.Mevio.com. SUMMER STORM uses music by Kevin Macleod entitled "Deliberate Thought" found at Incompetech.com. I COULD BE A RIVER is produced with music by Kevin Macleod entitled "Music Box Theme" found at Incompetech.com. I'M MORE THAN I AM uses music by Avaendil (James Worlton) who gave us special permission to use it. Thanks James! Avaendil's music is found at Jamendo.com. GOD IS A POEM was produced with music by Anne Davis entitled "Elevator Music" found at music.Mevio.com. I PUT GOD'S PRISM TO MY EYE has music by Avaendil (James Worlton) entitled "Remembrances" found at Jamendo.com. Special permission was granted to use this. RAIN CHILD was produced with music by Kendra Springer entitled "Hope" found at Jamendo.com. SATURDAY MORNING SPIRIT RISE has music by Jason Shaw entitled "Pop Tune" found at Audionautix.com. SOMETIMES I FEEL SO FRAGILE was produced with music by Jason Shaw entitled "Spanish Summer" found at Audionautix.com.
Vincent, Dick, Alan, and Jennifer Drahos tackle the Hendra virus disease outbreak in Australia, AIDS-like disease in wild chimps, return of polio type 2 in Nigeria, the influenza pandemic wave, and rabies in three countries. Links for this episode: Hendra virus killing horses in Australia AIDS-like disease in wild chimps [ NY Times ] Polio type 2 returns in Nigeria Influenza pandemic wave [Branswell ] Rabies in Ukraine , South Africa , and USA Cell phones turned into fluorescent microscopes [Thanks, Jim!] HIV-1 vaccine trial in South Africa [Thanks Duncan!] Forum discussion on flu vaccine [Thanks James!] The Brain Science Podcast [Thanks Jim!] WHO note on H1N1 vaccine safety CDC information on H1N1 vaccines Hans Christian Orsted Weekly Science Picks Jennifer Art of Science 2009 Vincent Nobel Intent Dick Diversity of Life by EO Wilson Alan MediaWiki (install tips )
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