Podcast appearances and mentions of Tim Gardner

As for Me and My House (Week 2) - Tim Gardner by Grace Fellowship Church

Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

When We've Offended | Tim Gardner by Grace Fellowship Church

Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Subscribe to our YouTube channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Subscribe to our channel: https://www.youtube.com/gracefellowshipny To give online: https://gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: https://gracefellowship.com Facebook: http://www.facebook.com/gracefellowshipny Instagram: http://www.instagram.com/gracefellowshipny

Mike Switzer interviews Tim Gardner, owner and founder of Lula Drake Wine Parlour in Columbia, S.C., recipient of the 2024 Outstanding Wine and Other Beverages category from James Beard.

Beyond the Headlines: Forgotten Stories of the Bible (Week 2) - Tim Gardner by Grace Fellowship Church

Beyond the Headlines: Forgotten Stories of the Bible (Week 1) - Tim Gardner by Grace Fellowship Church

Columbia, SC's Main Street architecture still has much of the charm of a mid-century movie set. There are jewelry stores, restaurants, hotels, and gift shops in buildings that range from the turn of the 20th Century to modern day. Tucked in among the hustle and bustle is Lula Drake Wine Parlor, which eight plus years ago was just another dusty building awaiting renovation. Now it is a gilded lily that comes alive at night like the culinary theater it is. Sommelier Tim Gardner knows his role as the lead actor, greeting guests in a well-tailored sport coat or sliding behind the bar to offer a taste of champagne with a twinkle in his eye. The crowd fills all available seats as plates of pasta roll out of the kitchen and dusk tucks in the windows at the front of this long, narrow space. In a city that still often struggles to know its own culinary personality, Lula Drake is a self-assured wine parlor with a true welcoming air. In 2023, it was nominated for Outstanding Hospitality by the James Beard Foundation, and this year, not only was it named one of the “Friendliest Places in the South” by Southern Living, Lula Drake won the James Beard Award for Outstanding Wine Program. It all comes back to Tim's love of wine and interest in inviting more people to love it too, and that goes way beyond the liquids in the bottles behind the bar.    Other episodes you might enjoy:  Erin Eisele & James Alford: Cork & Cap Bottle Shop (Aiken, SC) Sarah Pierre: 3 Parks Wine Shop (Atlanta, GA)  

This week Emma talks to Tim Gardner, assistant director of policy at the Health Foundation think tank, about what a new Labour government could mean for general practice and the rest of the NHS.They discuss Labour's plans to shift a greater share of NHS funding to primary care and what that could mean for general practice, what the government needs to do to bring down the NHS waiting list, and whether it can do anything to avert collective action by GPs.Tim also explains where the new government might look to for quick wins on the NHS to show progress in its first 100 days, what improvements could be delivered through reform alone and whether Labour's spending plans during the election will add up to make the changes that are needed to the health service.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen. Useful links Streeting commits to increasing general practice share of NHS fundingBMA calls for GP funding to rise to 15% of NHS budget and new 'family doctor charter'RCGP calls on government to overhaul NHS workforce plan to boost GP numbersMost GPs in England back taking collective action, poll suggests Hosted on Acast. See acast.com/privacy for more information.

We pray this message from June 2, 2024 will bless you!! Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

We pray this message from May 26, 2024 will bless you!! Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

We pray this message from our Halfmoon Campus Pastor, Tim Gardner, on May 19, 2024 will bless you!! Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Tim Gardner is the owner of Lula Drake Wine Parlour on Main Street in Columbia, SC. The story behind the discovery of the location, coming up with the name Lula Drake, and the journey to becoming nationally recognized by the James Beard Foundation is nothing short of magical. Lula Drake is a 2024 James Beard for Outstanding Wine and Other Beverages Program and a 2023 nominee for Outstanding Hospitality.

A new MP3 sermon from Free Grace Baptist Church is now available on SermonAudio with the following details: Title: The Loving Call of Jesus Speaker: Tim Gardner Broadcaster: Free Grace Baptist Church Event: Sunday - AM Date: 3/31/2024 Bible: John 20:1-18 Length: 30 min.

We pray this message from January 28, 2024 will bless you!! Subscribe to our channel: www.youtube.com/gracefellowshipny To give online: gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: gracefellowship.com Facebook: www.facebook.com/gracefellowshipny Instagram: www.instagram.com/gracefellowshipny

Life In The Ruins | Tim Gardner by Grace Fellowship Church

Portland-based NuScale Power has been leading the way for a new generation of nuclear power plants, called small modular nuclear reactors. Last week, the company was in the headlines because it called off plans to build those reactors in Idaho. But what exactly does NuScale intend to do? And why was this news such a big deal? We're listening back to a conversation between executive producer John Notarianni and Reuters energy and environment correspondent Tim Gardner about NuScale's push for a nuclear future. Who would you like to hear on City Cast Portland? Shoot us an email at portland@citycast.fm, or leave us a voicemail at 503-208-5448. Still want more Portland news? Then make sure to sign up for our morning newsletter, Hey Portland, and be sure to follow us on Instagram.  Looking to advertise on City Cast Portland? Check out our options for podcast and newsletter ads at citycast.fm/advertise. Learn more about the sponsor of this episode: The Storm Large Holiday Ordeal at the Aladdin Theater Nov. 24 & 25 Learn more about your ad choices. Visit megaphone.fm/adchoices

In this sermon, Halfmoon Campus Pastor Tim Gardner will guide us through the intricate world of fasting, shedding light on how our expectations can often lead us astray in this spiritual practice. Delve into the nuances of fasting and learn how to align your expectations with the profound purpose it serves in our spiritual lives. We pray this message from September 24, 2023 will bless you!! Thanks for being part of the Grace family!! Subscribe to our channel: https://www.youtube.com/gracefellowshipny To give online: https://gracefellowship.com/give/ To glorify God by making more and better disciples. This is the vision of Grace Fellowship, led by Pastor Rex Keener and based in New York's Capital Region. —— Stay Connected Website: https://gracefellowship.com Facebook: http://www.facebook.com/gracefellowshipny Instagram: http://www.instagram.com/gracefellowshipny

I last spoke to today's guests as part of last year's The State of Reinsurance Special Episode from Monte Carlo. In that documentary-style podcast I spoke to over 20 people, so a one-on-one with this duo to look more closely at their still relatively young business was long overdue. Tim Gardner (left) and Bob Bisset (right) of Lockton Re have been very busy in the last four years since the project to build a challenger reinsurance broker began in earnest. The business has hired over 300 staff, run through $200mn in revenues and became profitable last year and in this episode we check in on how the reinsurance broker's expansion plans are progressing. We also take the temperature on this still relatively hot reinsurance market. The result is a very lively and good-humoured encounter. Tim and Bob are buzzing and are clearly enjoying the considerable challenge of building out and scaling a global reinsurance broker. This is a task others have tried and failed to do and if you listen carefully I think you will hear the tiniest sense of relief in Tim's voice that much of his early vision has been vindicated. I also think that this episode will give you a lot of insight into what Tim and his team are trying to do that is subtly different from some of Lockton Re's peers. Tim and Bob say that getting the people, culture and capabilities right is the key and if you do that the revenue and profit will take care of themselves. That is to say they are just a byproduct and not the goal in itself. Lots of people say these kinds of things, but rarely have I met an executive team that really sounds like they mean it. So listen on and see if you hear what I hear. LINKS: We thank our naming sponsor AdvantageGo: https://www.advantagego.com/

Join us for a spiritually enriching sermon titled "The Essential Checklist for Prayer" by Tim Gardner, Halfmoon Campus Pastor. In this message, we'll delve into the crucial aspects of effective prayer, drawing inspiration from Matthew 6:5-8. Tim will provide invaluable insights on what should be on your prayer checklist to deepen your connection with God and ensure your prayers are not only heard but also answered. Don't miss this practical guide to enhancing your prayer life and drawing closer to the divine.

Meet Tim Gardner, who also goes by the fancier title of Timothy J. Gardner!"Sharing stories of Employees that love what they do, and where they do it"Firstly we delve into Tim's career - from Agency Recruitment, to Internal recruitment, and most recently his transition to being the Employer Branding Manager at RMIT.Being the Employer Branding Edition, we delve deep into the benefits of an effective EVP, and how to bring stories to life without a huge budget.We call out some special mentions, of brands we love - Bunnings, Sportsbet and CSL get some Kudos...We also recommend who you should consult with if you are looking for Marketing Agency support when developing your end-to-end Employer Branding Strategy. Specialist Agencies are the key! Further Kudos to both Businessary and Noble Agency.Finally Tim gives some sound advice to anyone who is currently working in Recruitment, or considering a career in Recruitment. It's a great listen!Enjoy!Join RUBBERBAND today!

On this episode of Public & Society, Ipsos' Kate Duxbury and Anna Quigley are joined by Louise Ansari, Healthwatch, Tim Gardner, Health Foundation and Axel Heitmueller, Imperial College Health Partners. They discuss the current NHS model, trends and developments in the NHS over its 75 years, and what this means for the public and patients. Subscribe to our podcast and YouTube channel to stay up to date with Public & Society episodes and other Ipsos content.

In over 30 major bodybuilding competitions, Ray only failed once to place in the top five. Ray has appeared on more Flexible Magazine covers than any other bodybuilder in the history and also has also featured in many fitness and bodybuilding magazines worldwide. Ray was a co-host on Flex Magazine Workout on ESPN for 5 years as well as hosting bodybuilding competitions for ESPN as a commentator for 8 years. Ray is a prominent spokesman, master of ceremonies and expert commentator for IFBB Pro League & NPC shows, most notably the Mr. Olympia. He is currently the Editor in Chief of DigitalMuscle.com, he continues to promote Hawaii's largest contest, NPC Shawn Ray Hawaiian Classic in Honolulu which he added a Pro Classic Physique Division in 2021z Ray received the Ben Weider "Lifetime Achievement Award" in the summer of 2020 for his contributions to the sport and as an athlete on behalf of the Ben Weider family, promoter, Tim Gardner, Dan Solomon and Ron Wilkins.

DOWNLOAD OUR BRAND NEW REMIX IMPULSE OUT NOW LINK BELOW, www.beatport.com/track/impulse/16359296 Check out this weeks YEAH_UK Radio Recorded LIVE from Brighton & Bristols NO.1 Dance Radio Station DECADANCE Radio. A journey through the medium of Tech House and Techno this set is brought to you by Tim Gardner starting this set by show casing his brand new track - The Night, hopefully out next year! You heard it here first! Keep up to date with our radio shows and more via the DECADANCE APP and the link below, Radio: decadanceradio.com Insta: www.instagram.com/yeah_uk/

We're a sick nation - and the prognosis for the NHS is not good. It's showing all of its 75 years, as patients wait in ambulances outside A&E or struggle to speak to - much less see - their own GP. So what's the remedy? Just more - more money, doctors, nurses, hospitals? Or better systems of provision? And how should we pay for it - could some of us pay when we see our doctor? Tim Gardner, senior policy fellow at the Health Foundation, tells Phil and Roger there need to be tough decisions about how much we value and are willing to pay for our health. Hosted on Acast. See acast.com/privacy for more information.

Thanks for tuning in to this Tuesday edition of RealAg Radio. On today’s show you’ll hear: Mary Robinson, President of Canadian Federation of Agriculture, on a number of different issues from the fertilizer emissions reduction to the upcoming COP27 climate conference; A product spotlight interview with Tim Gardner, market development agronomist with Bayer on DEKALB... Read More

Thanks for tuning in to this Tuesday edition of RealAg Radio. On today’s show you’ll hear: Mary Robinson, President of Canadian Federation of Agriculture, on a number of different issues from the fertilizer emissions reduction to the upcoming COP27 climate conference; A product spotlight interview with Tim Gardner, market development agronomist with Bayer on DEKALB... Read More

DOWNLOAD OUR BRAND NEW REMIX IMPULSE OUT NOW LINK BELOW, www.beatport.com/track/impulse/16359296 Check out this weeks YEAH_UK Radio Recorded LIVE from Brighton & Bristols NO.1 Dance Radio Station DECADANCE Radio. A journey through the medium of Deep House this set is brought to you by Tim Gardner delivering an excellent deep, moody melodic set. Enjoy! Keep up to date with our radio shows and more via the DECADANCE APP and the link below, Radio: decadanceradio.com Insta: www.instagram.com/yeah_uk/

Welcome to this Tuesday edition of RealAg Radio, brought to you by Bayer CropScience. Be sure to check them out at Ag in Motion this week! On today’s episode of the show, you’ll hear: Dr. Andria Jones-Bitton of the University of Guelph, on a recent mental health study from the University of Guelph; Tim Gardner... Read More

Welcome to this Tuesday edition of RealAg Radio, brought to you by Bayer CropScience. Be sure to check them out at Ag in Motion this week! On today’s episode of the show, you’ll hear: Dr. Andria Jones-Bitton of the University of Guelph, on a recent mental health study from the University of Guelph; Tim Gardner... Read More

We pray this message from July3, 2022 will bless you! Thanks for being part of the Grace family! Series: "Fan Fiction", Part 1 of 4 Pastor Tim Gardner Follow us on Social Media: www.instagram.com/gracefellowshipny www.facebook.com/gracefellowshipny www.youtube.com./gracefellowshipny www.gracefellowship.com

This one's for the dads. Whether you have fond memories of time spent with your dad, time spent with a father figure in your life or you remember back to the time you first became a dad. This episode is for you.USA Today's James Brown and Music Journalist Saby Reyes-Kulkarni sat down to discuss the ups and downs, hopes and fears and expectations versus reality of parenting; including becoming a father after 40.Reyes-Kulkarni shares the eye opening moment when he saw himself in his four-and-a-half year old daughter for the first time and what it was like 'arguing with yourself.'Reyes-Kulkarni said of his daughter, "She's very particular. And I like it! Because I have an instant kinship with it, even though it's mostly directed at me."James and USA Today's Tim Gardner discuss what it's like to have and raise twin boys, how priorities shift with children and how his father was a good example of fatherhood.To follow James Brown on Twitter, click here.You can find articles written by Saby Reyes-Kulkarni in Spin, Billboard, Paste, Pitchfork and Bandcamp.To follow Saby Reyes-Kulkarni on Twitter, click here.You can also subscribe to Saby's substack by clicking here.To follow Tim Gardner on Twitter, click here.Episode Transcript available hereAlso available at art19.com/shows/5-ThingsSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

On this episode of the Ipsos podcast, Kate Duxbury and Anna Quigley from Ipsos, together with Tim Gardner from The Health Foundation and Dan Wellings from The King's Fund, discuss public perceptions towards the NHS and Social Care. Some of the topics they cover include: Findings from the first wave of results from the Health Foundation and Ipsos Policy Polling Programme Recent findings from the Expectations Tracker, including the public's current and future expectations of the NHS and Social Care Upcoming findings from the King's Fund British Social Attitudes survey 

Check out this weeks YEAH_UK Radio Recorded LIVE from Brighton's NO.1 Dance Radio Station DECADANCE Radio. Another journey through the medium of Techno! Keep up to date with our radio shows and more via the DECADANCE APP and the link below, Radio: decadanceradio.com Insta: www.instagram.com/yeah_uk/

11/16/21 Titan Talk with John Tsikouris: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media - Injectable Peptide BPC 157 can help with injuries joints, muscles and tendons - Is it better to do cardio before or after strength training to lose fat and build muscle? - U.S. Republicans move to decriminalize marijuana at federal level Titan Weekly Newsletter Poll: Do you have any nagging injuries or problems with joints, muscles or tendons? No, none at all. - 13% Yes, I have some issues but nothing major. - 16% Yes, I take OTC medications for it. - 27% Yes, I take non-Titan doctor prescribed medications. - 22% Yes, I take Titan therapies (BPC 157, TB 500, etc). - 19% UPCOMING EVENTS: Nov 19 & 20: Tim Gardner's - NPC Atlantic Coast Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme Jan 23: Festivals of Speed St. Petersburg   Our current weekly newsletter: https://conta.cc/3EUy7S0 Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm bpc #bpc157 #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #peptide #aminos #vitamins #medicalscience #bodybuilding Click here for our link to the New patient Paperwork to get started with Titan & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

11/12/21 Titan Lifestyle with Big Dru & John: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media -  Prometheus - Lose weight, feel great! - Turns out, energy drinks are even worse for you than we thought - FDA recalls 2.2 million at-home coronavirus tests due to false positives - Computer-controlled brain implant enhances mental function in human trial - Which med specialties have the worst lifestyles? UPCOMING EVENTS: Nov 19 & 20: Tim Gardner's - NPC Atlantic Coast Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme Jan 23: Festivals of Speed St. Petersburg   Our current weekly newsletter: https://conta.cc/3EUy7S0 Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm bigdru #druborden #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #peptide #aminos #vitamins #medicalscience #bodybuilding Click here for our link to the New patient Paperwork to get started with Titan & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

11/9/21 Titan Talk with John Tsikouris: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media - Prometheus - Lose weight, feel great! - Eating protein 4 times a day combined with fasting may help you burn belly fat faster than calorie cutting alone, research suggests. - Former Mr. Olympia Shawn Rhoden dies at 46. Titan Weekly Newsletter Poll: Is your body summer ready yet? 25% - Yes. 28% - Not yet, I'm still working on it. 46% - No, not yet. I need help, what can Titan do to help? UPCOMING EVENTS: Nov 19 & 20: Tim Gardner's - NPC Atlantic Coast Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme Jan 23: Festivals of Speed St. Petersburg   Our current weekly newsletter: https://conta.cc/3EUy7S0 Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm injectables #prometheus #fatburn #weightloss #peptide #therapy #libido #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #aminos #vitamins #medicalscience #bodybuilding Click here for our link to the New patient Paperwork to get started with Titan Medical & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

11/5/21 Titan Lifestyle with Big Dru & John: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media - Boost your immune system, recovery, blood flow, liver protection/detoxification & more with injectable Nectar Of The Gods. - Dwayne Johnson Vows to Ban Real Guns From All His Film Sets After 'Rust' Fatal Shooting - Gov. DeSantis Saves Christmas by Rerouting Cargo Ships from California to Florida UPCOMING EVENTS: * Nov 19 & 20: Tim Gardner's - NPC Atlantic Coast
 * Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme
   Our current weekly newsletter: https://conta.cc/2ZG9BFj Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm bigdru #druborden #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #peptide #aminos #vitamins #medicalscience #bodybuilding Click here for our link to the New patient Paperwork to get started with Titan & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

11/2/21 Titan Talk with John Tsikouris: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media - Boost your immune system, recovery, blood flow, liver protection/detoxification & more with injectable Nectar Of The Gods. - Can Specific Foods or Diets Boost Your Testosterone Levels? - Startups Are Rushing to Prescribe a New Weight Loss Drug, But Questions Remain Titan Weekly Newsletter Poll:  Do you take anything to boost your immune system? 34% - Titan Therapies (Nectar of the Gods, Titan Complete, Glutathione etc) 38% - Over the counter supplementation, oral vitamins, gummies, etc. 11% - I don't take anything for my immune system, please give me more info. 15% - Do I really need to worry about boosting it? UPCOMING EVENTS: * Nov 19 & 20: Tim Gardner's - NPC Atlantic Coast * Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme   Our current weekly newsletter: https://conta.cc/2ZG9BFj Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm glutathione #antioxidants #therapy #libido #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #peptide #aminos #vitamins #medicalscience #bodybuilding Click here for our link to the New patient Paperwork to get started with Titan & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

10/5/21 Titan Talk with John Tsikouris: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media Titan Weekly Newsletter Poll: Did you know that HRT (Hormone Replacement Therapy) works for men and women? No - 43% (10) Yes - 56% (13) UPCOMING EVENTS: Oct 7-10: Olympia 2021 in Orlando Oct 13: Tampa International Airport Annual Employee Health & Wellness Event Oct 23: Tim Gardner's NPC Hurricane Bay Nov 20: Tim Gardner's - NPC Atlantic Coast Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme Our current weekly newsletter: https://conta.cc/2Ya4lII Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm olympia #news #therapy #biotin #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #peptide #aminos #vitamins #medicalscience Click here for our link to the New patient Paperwork to get started with Titan & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

10/22/21 Titan Lifestyle with Big Dru & John: - Our social media: https://linktr.ee/TitanMedicalCenter - Live Q&A on @Titanmedical social media - Take your bedroom fun to the next level with our Wonder Woman & Superman Libido Enhancers - Apple Will Require Unvaccinated Employees to Undergo COVID-19 Tests Daily - Eating mushrooms seems to lower depression risk - Former US Pres Trump to Launch TRUTH Social That Could Rival Facebook/Twitter - Netflix co-CEO on Dave Chappelle fallout: I screwed up. UPCOMING EVENTS: Oct 23: Tim Gardner's NPC Hurricane Bay Oct 31: Festivals of Speed Orlando at the Ritz-Carlton Nov 19 & 20: Tim Gardner's - NPC Atlantic Coast Dec 4: Cars & Couture: 11th Annual Collector's Gala James Bond Theme Our current weekly newsletter: https://conta.cc/3aLaIFq Text: titanmedical to: 22828 to get on our emailing list! Titan podcasts: https://titanmedicallifestylepodcast.fireside.fm therapy #libido #livestream #immunesystem #johntsikouris #titan #titanmedical #health #medicalcenter #peptide #aminos #vitamins #medicalscience #bodybuilding Click here for our link to the New patient Paperwork to get started with Titan & our full list of social media! https://linktr.ee/TitanMedicalCenter And of course you can call/text anytime for more info: 727-389-3220 or http://titanmedicalcenter.com/ We service NATIONWIDE! Text:titanmedical to:22828 to get on our emailing list About Titan Medical Center: We offer Hormone Replacement Therapy, Medical Weight Loss, Injectable Vitamin & Amino Therapies, Relationship, Bedroom Enhancing Therapies, On-Site or Nationwide Blood Work Testing, Peptide Therapies, In-House IV Therapy, & Primary Care. We are based in Tampa, Florida but YES we service NATIONWIDE! We can help you enhance your life and performance while operating at optimal health levels. We have medical doctors and start with blood work testing to get you on the right track! Some of our therapies are available without blood work testing. Call Titan Medical Center to learn how you can have a healthier, stronger life. We offer telemedicine (via FaceTime or Skype) from the comfort of your own home where you will see a licensed medical provider. Our Titan therapies are doctor prescribed & shipped directly to your doorstep from a licensed US pharmacy!

Welcome to Neurotech Pub, hosted by Paradromics Inc and SynBioBeta. In this episode, host and Paradromics CEO, Matt Angle, speaks with Tim Harris, Cindy Chestek, and Philip "Flip" Sabes about the big programmatic challenges in neurotechnology. We talk about the differences between labs, startups, and large research consortia. We discuss the difference between neuroscience and neuroengineering, and Tim explains how one of the biggest breakthroughs in neurophysiology was the product of….lawyers.Check out full video with transcript here: https://www.paradromics.com/podcast/neurotech-pub-episode-1-biologists-engineers-and-lawyers 2:04 Jester King Brewery, Dripping Springs, TX | 3:03 Bell Labs | 7:31  Michael Jordan | 9:05 Krishna Shenoy and Reid Harrison | 9:49 Stevenson's Law | 12:10 The Utah Array | 13:43 Neuropixels | 14:06 Dendrites by Nelson Sprusten, Greg Stuart, and Michael Häusser | 24:47 Low-power neural signal processing by Chestek Lab | 26:54 Spike sorting, Dimensionality, and Decoding | 27:30 Neural Task Complexity | 28:43 A 16-beam system that records ~1,000 neurons @ ~10 Hz | 32:16 The Braingate clinical trials | 34:15 Using Muscles as Bioelectronic Amplifiers in Peripheral Nerve Applications | 35:28 Jack Judy, University of Florida | 37:59 Touch Sensation | 38:06 DARPA HAPTIX Program | 39:22 Muscle Taco | 41:22 Janelia Research Campus | 45:59 Steliglitz Lab | 50:50 Power Consumption | 54:31 Eddie Chang and Chang Lab | 55:20 Buzsaki Paper | 55:45 BioRxiv pre-print on the Paradromics Argo System | 56:16 NeuroGrid: Recording Action Potentials from the Surface of the Brain | 1:01:30 Physical Principles for Scalable Neural Recording | 1:02:03 Pierebone lab's work with DARPA |1:04:18 Carbon Fiber Ultramicroelectrodes | 1:05:05 IMEC work with nanolaminate | 1:05:05 Picosun and Brown University |1:05:16 Stuart Cogan | 1:05:18 Michel Maharbiz | 1:07: 08 Takashi Kozai and Daryl Kipke | 1:09:44 Utah Array, Blackrock Microsystems | 1:12:29 DBS for Depression | 1:18:37 The Sewing Machine | 1:22:32 Paradromics Laser Surgical Tool | 1:22:42 Recent Papers from Schaefer and Melosh Group | 1:23:46 Tim Gardner's work on Carbon Fiber Arrays | 1:23:54 Mechanics of Microwire Penetration | 1:25:38 FDA scientists work on Accelerated Aging | Want more? Follow Paradromics & Neurotech Pub on Twitter  Follow Matt A, Tim Harris, Cindy Chestek, and Philip "Flip" Sabes on Twitter

Tim Gardner is the relatively new CEO of Lockton Re and has been tasked by the Lockton group with building up a challenger reinsurance broking operation of significant scale. The MMC-JLT and now Aon-Willis M&A activity has given this venture a significant timing boost and there is a palpable sense of a once in a generation opportunity for independents to stake their claim on a share of this lucrative global market. I quizzed Tim on every aspect of his strategy to make Lockton Re a credible new player in the reinsurance broking space. He was clear and forthright in all his answers, so I commend this episode to anyone looking to get an inside view of the current reinsurance intermediary landscape.

Dr Carolyn Lam:                Welcome to "Circulation On The Run," your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, Associate Editor, from the National Heart Center, and Duke National University of Singapore. Our featured paper today is so important for cardiac surgeons and their patients. It answers a question of whether targeting a higher versus a lower blood pressure during cardiopulmonary bypass helps to prevent cerebral injury. Curious? Well, more soon right after these summaries.                                                 In the first original paper this week, MicroRNA-22 is shown to be a novel mediator of vascular smooth muscle cell, phenotypic modulation, and neointima formation. Co-first authors, Drs. Yang and Chen, co-corresponding authors, Dr. Zhang from Zhejiang University and Dr. Xiao from Queen Mary University of London and their colleagues used wire injury mouse models to show that MicroRNA-22 controls vascular smooth muscle cell phenotype and injury-induced arterial remodeling by modulating multiple target genes, including methyl-CpG-binding protein 2, histone deacetylase 4, and ecotropic virus integration site 1 protein homolog.                                                 The authors observed that MicroRNA-22 expression was suppressed in human femoral arteries with atherosclerotic plaques, and that there was an inverse relationship between MicroRNA-22 and its target genes in healthy and diseased arteries. Furthermore, local delivery of MicroRNA-2 in the injured arteries prevented adverse arterial remodeling, thus suggesting that site-specific delivery of MicroRNA-22 mimics may be a potential therapy for in-stent restenosis.                                                 The next paper adds to our understanding of the pathobiology of pulmonary hypertension related to left-sided heart failure and importantly adds histomorphometric evidence from human lung specimens at autopsy or surgery.                                                 First author Dr. Fayyaz, corresponding author Dr. Redfield, and colleagues from the Mayo Clinic studied patients with heart failure with preserved or reduced ejection fraction and pulmonary hypertension and compared these to normal controls, as well as patients with primary pulmonary veno-occlusive disease.                                                 They found that patients with heart failure and pulmonary hypertension had global pulmonary vascular remodeling with thickening of the media and intima in arteries and thickening of the intima in veins and small pulmonary vessels compared to normal control subjects.                                                 This venous and small-vessel intimal thickening was more severe than the arterial intimal thickening in heart failure with a pattern that was similar to patients with pulmonary veno-occlusive disease. In fact, the severity of pulmonary hypertension correlated most strongly with venous and small vessel remodeling rather than arterial remodeling.                                                 These findings expand our understanding of the pathobiology of pulmonary hypertension in heart failure. It also suggests that pulmonary venous remodeling in heart failure may predispose to worsening alveolar edema with pulmonary vasodilators as in primary pulmonary veno-occlusive diseases.                                                 Are there sex and race differences in the lifetime risk of HFpEF versus HFrEF? First author Dr. Pandey, corresponding author Dr. Berry from UT Southwestern Medical Center, and their colleagues used participant level data from two large respective cohort studies, the Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis to determine remaining lifetime risk estimates for heart failure with preserved and reduced ejection fraction at different index ages.                                                 They found that compared to women, men have a higher lifetime risk of HFrEF, heart failure reduced ejection fraction with a similar lifetime risk of HFpEF, or heart failure preserved ejection fraction. Compared with blacks, non-blacks have a similar lifetime risk of developing HFrEF but a higher risk of HFpEF.                                                 Lifetime risks of HFpEF and HFrEF were similar and substantially higher in those with versus without antecedent myocardial infarction.                                                 In summary, these findings provide novel insights on sex and race differences in the lifetime risks of HFpEF and HFrEF, and may help health policymakers in appropriate resource allocation for targeting HFpEF and HFrEF specific preventive therapies at the at-risk population.                                                 What are evidence-based blood pressure targets during pediatric cardiopulmonary resuscitation? Well, first and corresponding author Dr. Berg from Children's Hospital of Philadelphia and his colleagues studied a multi-center population of children with invasive arterial blood pressure monitoring during in-hospital ICU cardiac arrest, and the Collaborative Pediatric Critical Care Research Network Intensive Care Units, between 2013 and 2016.                                                 They found that a mean diastolic blood pressure greater or equal to 25 millimeters of mercury during cardiopulmonary resuscitation in infants, and greater or equal to 30 millimeters of mercury in children 1 year old or greater, was associated with a 70% greater likelihood of survival to hospital discharge, and a 60% higher likelihood of survival with a favorable neurologic outcome.                                                 On the other hand, survival rates were markedly lower with mean diastolic pressures less than 20 in infants and less than 25 in children 1 year or older. Thus, clinicians should consider targeting diastolic blood pressure of 25 or greater in infants, and 30 or greater in children 1 year old or older during cardiopulmonary resuscitation when invasive arterial blood pressure is monitored.                                                 That wraps up our summaries for this week. Now for our featured discussion.                                                 Does a higher versus a lower blood pressure target during cardiopulmonary bypass surgery reduce the risk of cerebral injury? Well, the feature paper today provides some answers, and we have the first and corresponding author, Dr. Anne Vedel from University of Copenhagen with us today, as well as our associate editor, Dr. Timothy Gardner, who's a cardiac surgeon from University of Pennsylvania.                                                 Thank you so much for being with us today and this was a terrific trial, a very difficult trial to carry out. Could you please tell us a bit more about it? Dr Anne Vedel:                 Cerebral injury is an important complication after cardiac surgery with the use of cardiopulmonary bypass. Up to half of our patients suffer these perioperative silent strokes. Therefore, in Copenhagen we conducted a trial investigating the importance of two distinct blood pressure levels during cardiopulmonary bypass. Now, on this subject of optimal perfusion strategy during bypass, there are many opinions, but also a stunning lack of convincing evidence, for instance, when it comes to blood pressure management.                                                 Now, the question is whether normal physiological principles, such as cerebral autoregulation therapy, whether they apply during bypass, or if perfusion pressure indeed does play a less important role when blood flow is mechanically provided in an uncomplicated and sufficient way by the heart and lung machine.                                                 So, in a patient on the assessor-blinded randomized trial, we allocated patients to a higher or a lower MAP target, 70 to 80, or 40 to 50 millimeters of mercury, respectively, by titrating intravenous norepinephrine during bypass.                                                 Pump flow levels were set at 2.4 liters per minute per square meter of body surface, and our primary outcome was the total volume of new ischemic cerebral lesions, expressed as a baseline MRI, and opposed to the difference between the baseline MRI and the postop MRI on day three to six. Secondary outcomes were a number of new ischemic lesions and newer psychological test evaluations.                                                 Now among the 197 patients enrolled who were scheduled for coronary artery bypass, or heart valve repair surgery, or a combination of both, we found that 53% of patients in the low target group as opposed to 56 in the high target group had new cerebral lesions on their postop cerebral MRI.                                                 The primary outcome of volume of new cerebral lesions was comparable between groups, and so was the total number of newer lesions. No significant difference was observed in stroke rates in frequencies of postoperative cognitive dysfunction, or in severe adverse event rate.                                                 Therefore, we concluded that among patients undergoing on-pump cardiac surgery, targeting higher versus a lower mean arterial pressure did not seem to affect the volume or number of new infarcts. Dr Carolyn Lam:                Wow, thank you so much, Anne. Tim, you think about these issues a lot more than I do as a non-surgeon. Could you tell me what your insights were? Dr Tim Gardner:                You know, it's a very difficult study to do a randomized control trial in this environment, and they're really to be congratulated for doing it. As Anne acknowledges, this is not an area where randomized trials are very frequent.                                                 The first thing about the trial, I think, is a growing awareness among all of us that there seems to be a lot of imaging evidence of what we call injury or changes based on diffusion-weighted imaging in patients after cardiopulmonary bypass. This is not the first study that shows that.                                                 But the question is are these incidental, trivial lesions? I'd have to, again, ask Anne to clarify how many of the patients in either group, what percentage had what we would consider evidence of overt strokes? Dr Anne Vedel:                 Well, overt strokes, as opposed to silent strokes, 1 patient in the lower target group had stroke and 6 patients in the high target group, which corresponds to 1 as opposed to 7%. Dr Tim Gardner:                That was not quite statistically significant difference but headed in that direction with the assumption that if you have a larger sample size there might be, in fact, some association with overt stroke using the high target vasopressor approach, is that right? Dr Anne Vedel:                 We can only speculate. But as you do, yes, I agree. Dr Tim Gardner:                To go back to the original question, the significance of these, well, you were referring to as silent strokes. Can you comment on the clinical significance there? We hear of silent heart attack. What is a silent stroke and what are the implications of that long term for patients? Dr Anne Vedel:                 In other fields of research on the silent strokes, it's been shown that they correlate to both frequency of postoperative cognitive dysfunction and also later development of mild cognitive impairment and dementia. But these kinds of results, there isn't enough research in the field of cardiac study for us to say the same. But those are the implications from other research fields. Dr Tim Gardner:                But you can understand from the perspective of a cardiac surgeon, and this concern has been expressed and talked about in the literature for 20 years or more, the possibility that even what seems to be, with no injury apparent and no overt stroke, there may be some neurological consequence to cardiopulmonary bypass.                                                 So just to move on from that because I agree that we just don't have any reliable information that these silent strokes result in late or permanent injury, I think again the finding that manipulating the blood pressure, which seems to be intuitively beneficial in patients, especially elder patients, did not, in fact, show any benefit and, in fact, may have been associated with a slight increase in overt stroke. Is that a fair conclusion from your study? A summary of your study? Dr Anne Vedel:                 I would say it is a fair conclusion, and surprisingly so. The question is whether it is the blood pressure or the means that we apply to have this increase in blood pressure that is the point of interest here. Dr Tim Gardner:                You mean whether, in fact, using the norepinephrine, the vasoconstrictor, to increase the blood pressure whether that itself, it certainly didn't benefit, it may have been a problem. Dr Anne Vedel:                 Exactly. That's what I speculate might be the case. But I also think it's fair to say at this point that this is somewhat artificial physiological scenario, the cardiopulmonary bypass. Dr Tim Gardner:                I agree with that, that you're controlling blood flow and the patient is exposed to a lower hemoglobin and oxygen-carrying capacity and so on. But I think what struck me about your findings, or strikes me about your findings, is what appears to be in many of the patients, the low target patients, pretty effective autoregulation of the cerebral circulation, despite the artificiality of cardiopulmonary bypass.                                                 I think that's, again, something that has been not well known or well accepted by many people, thinking that if you lower body temperature, you lower hemoglobin, autoregulation may not be enough to maintain good cerebral perfusion. It looks like this study shows that in these patients, autoregulation worked fine. Is that fair? Dr Anne Vedel:                 Yes. Or sufficient blood flow was delivered. All in all, what's new in our study, I think, is that hypertension per se shouldn't necessarily be considered a proxy for hyperperfusion during bypass. Dr Tim Gardner:                Yeah, that's a very good qualification. So none of your patients, despite being in their mid to late 60s had evidence of carotid artery disease or whatever? Those patients were excluded from the trial, is that right? Dr Anne Vedel:                 No, that's not correct. We didn't screen for carotid artery disease because we don't routinely do that in our institution. As we describe in our discussion, we included quite a heterogeneous study sample by enrolling the patients that came to us. We didn't screen and we didn't exclude these patients that you mention. Dr Tim Gardner:                Do you know how does your group handle a patient that is known to have carotid artery disease, comes in with a known either prior endarterectomy or established disease? Do those patients, are they treated any differently either as a result of the study or just in general?                                                 Because that is a targeted group of patients, at least in my own experience, that we would be more concerned about allowing autoregulation to be the determinant, feeling that if there is a fixed stenosis in the carotid artery that we might need to increase the mean arterial pressure. Dr Anne Vedel:                 I can certainly understand your point and, of course, it is a concern in our center, as well. But having said that, there were no patients in the PPCI trial that came to us with a history of carotid artery disease, so it wasn't a concern for us in this study. Dr Tim Gardner:                That would be one point that I would make that we probably should pay attention to patients who do come for surgery and have known significant obstructive extracranial disease, but I understand that you didn't specifically have those patients or were aware of those patients.                                                 I think that this is a very useful study for us concerned about the possibility of inducing cerebral injury with cardiopulmonary bypass. To some people it's sort of counterintuitive that increasing perfusion pressure didn't improve the tolerance of patients to cardiopulmonary bypass but that's why you did the study. I think it's a very notable and important report that's going to be in circulation.                                                 The significance of these "silent infarcts" is merely something that we have to sort of sort out. I know you said that silent infarcts, as I agree, are associated with or presumed to be predictive of later cognitive dysfunction, dementia and so on. It really is a concerning message if that's the main message that comes out of these imaging studies. Because these are patients that, obviously, didn't have heart surgery for no reason, there was obviously a compelling indication for patients to have it.                                                 You would hate to re-ignite this concern as we had in and around year 2000 when the group at Duke was talking about writing about patients who had cognitive decline after cardiac surgery, were going to end up being demented five or 10 years down the line, so, that's from the perspective of a cardiac surgeon. Let's stick with the evidence but let's follow-up and see how predictive these silent infarcts are and what the consequences are long term. Do you think that's fair, Anne? Am I making a fair statement? Dr Anne Vedel:                 I absolutely do think it's fair. And for a cardiac surgeon as yourself, I would find it very interesting to see that these kind of studies are also conducted in TAVR patients where you have sometimes a 200% incidence of these silent strokes.                                                 I mean you have a good taste as a cardiac surgeon if you only see them in 50% of your patients, understand me correctly, but I don't necessarily think that this high incidence, it's high, yes, but compared to other patient groups, such as TAVR patients, it's not necessarily that bad. Dr Tim Gardner:                Right. Anne, I don't know whether you've seen the editorial that's going to accompany your paper, but it's very good. It's very supportive of your study and has some good comments. You'll be pleased with the editorial, I believe, if you haven't seen it. Dr Anne Vedel:                 Thank you very much. I'm happy to hear that. I know we do things a bit controversially over here in Copenhagen, compared to many centers in the U.S. Dr Tim Gardner:                That is not what the editorialists think. An anesthesiologist from Stanford and a neurologist from Penn, they have a very good commentary on your study and the whole field, so you'll be pleased. Anne Vedel:                       I'm very happy to hear that. Thank you. Carolyn Lam:      Well, listeners, I'm sure you learned a lot. Thank you for joining us today, and don't forget to tune in again next week.