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What if the most transformative thing you can do for your writing craft and author business is to face what you fear? How can you can find gold in your Shadow in the year ahead? In this episode, I share chapters from Writing the Shadow: Turn Your Inner Darkness Into Words. In the intro, curated book boxes from Bridgerton's Julia Quinn; Google's agentic shopping, and powering Apple's Siri; ChatGPT Ads; and Claude CoWork. Balancing Certainty and Uncertainty [MoonShots with Tony Robbins]; and three trends for authors with me and Orna Ross [Self-Publishing with ALLi Podcast]; plus, Bones of the Deep, Business for Authors, and Indie Author Lab. This show is supported by my Patrons. Join my Community at Patreon.com/thecreativepenn  Joanna Penn writes non-fiction for authors and is an award-winning, New York Times and USA Today bestselling author of thrillers, dark fantasy, and memoir as J.F. Penn. She's also an award-winning podcaster, creative entrepreneur, and international professional speaker. What is the Shadow? The ‘creative wound' and the Shadow in writing The Shadow in traditional publishing The Shadow in self-publishing or being an indie author The Shadow in work The Shadow in money You can find Writing the Shadow in all formats on all stores, as well as special edition, workbook and bundles at www.TheCreativePenn.com/shadowbook Writing the Shadow: Turn Your Inner Darkness Into Words The following chapters are excerpted from Writing the Shadow: Turn Your Inner Darkness Into Words by Joanna Penn. Introduction. What is the Shadow? “How can I be substantial if I do not cast a shadow? I must have a dark side also if I am to be whole.” —C.G. Jung, Modern Man in Search of a Soul We all have a Shadow side and it is the work of a lifetime to recognise what lies within and spin that base material into gold. Think of it as a seedling in a little pot that you're given when you're young. It's a bit misshapen and weird, not something you would display in your living room, so you place it in a dark corner of the basement. You don't look at it for years. You almost forget about it. Then one day you notice tendrils of something wild poking up through the floorboards. They're ugly and don't fit with your Scandi-minimalist interior design. You chop the tendrils away and pour weedkiller on what's left, trying to hide the fact that they were ever there. But the creeping stems keep coming. At some point, you know you have to go down there and face the wild thing your seedling has become. When you eventually pluck up enough courage to go down into the basement, you discover that the plant has wound its roots deep into the foundations of your home. Its vines weave in and out of the cracks in the walls, and it has beautiful flowers and strange fruit. It holds your world together. Perhaps you don't need to destroy the wild tendrils. Perhaps you can let them wind up into the light and allow their rich beauty to weave through your home. It will change the look you have so carefully cultivated, but maybe that's just what the place needs. The Shadow in psychology Carl Gustav Jung was a Swiss psychologist and the founder of analytical psychology. He described the Shadow as an unconscious aspect of the human personality, those parts of us that don't match up to what is expected of us by family and society, or to our own ideals. The Shadow is not necessarily evil or illegal or immoral, although of course it can be. It's also not necessarily caused by trauma, abuse, or any other severely damaging event, although again, it can be. It depends on the individual. What is in your Shadow is based on your life and your experiences, as well as your culture and society, so it will be different for everyone. Psychologist Connie Zweig, in The Inner Work of Age, explains, “The Shadow is that part of us that lies beneath or behind the light of awareness. It contains our rejected, unacceptable traits and feelings. It contains our hidden gifts and talents that have remained unexpressed or unlived. As Jung put it, the essence of the Shadow is pure gold.” To further illustrate the concept, Robert Bly, in A Little Book on the Human Shadow,uses the following metaphor: “When we are young, we carry behind us an invisible bag, into which we stuff any feelings, thoughts, or behaviours that bring disapproval or loss of love—anger, tears, neediness, laziness. By the time we go to school, our bags are already a mile long. In high school, our peer groups pressure us to stuff the bags with even more—individuality, sexuality, spontaneity, different opinions. We spend our life until we're twenty deciding which parts of ourselves to put into the bag and we spend the rest of our lives trying to get them out again.” As authors, we can use what's in the ‘bag' to enrich our writing — but only if we can access it. My intention with this book is to help you venture into your Shadow and bring some of what's hidden into the light and into your words. I'll reveal aspects of my Shadow in these pages but ultimately, this book is about you. Your Shadow is unique. There may be elements we share, but much will be different. Each chapter has questions for you to consider that may help you explore at least the edges of your Shadow, but it's not easy. As Jung said, “One does not become enlightened by imagining figures of light, but by making the darkness conscious. The latter procedure, however, is disagreeable and therefore not popular.” But take heart, Creative. You don't need courage when things are easy. You need it when you know what you face will be difficult, but you do it anyway. We are authors. We know how to do hard things. We turn ideas into books. We manifest thoughts into ink on paper. We change lives with our writing. First, our own, then other people's. It's worth the effort to delve into Shadow, so I hope you will join me on the journey. The creative wound and the Shadow in writing “Whatever pain you can't get rid of, make it your creative offering.” —Susan Cain, Bittersweet  The more we long for something, the more extreme our desire, the more likely it is to have a Shadow side. For those of us who love books, the author life may well be a long-held dream and thus, it is filled with Shadow. Books have long been objects of desire, power, and authority. They hold a mythic status in our lives. We escaped into stories as children; we studied books at school and college; we read them now for escape and entertainment, education and inspiration. We collect beautiful books to put on our shelves. We go to them for solace and answers to the deepest questions of life. Writers are similarly held in high esteem. They shape culture, win literary prizes, give important speeches, and are quoted in the mainstream media. Their books are on the shelves in libraries and bookstores. Writers are revered, held up as rare, talented creatures made separate from us by their brilliance and insight. For bibliophile children, books were everything and to write one was a cherished dream. To become an author? Well, that would mean we might be someone special, someone worthy. Perhaps when you were young, you thought the dream of being a writer was possible — then you told someone about it. That's probably when you heard the first criticism of such a ridiculous idea, the first laughter, the first dismissal. So you abandoned the dream, pushed the idea of being a writer into the Shadow, and got on with your life. Or if it wasn't then, it came later, when you actually put pen to paper and someone — a parent, teacher, partner, or friend, perhaps even a literary agent or publisher, someone whose opinion you valued — told you it was worthless. Here are some things you might have heard: Writing is a hobby. Get a real job. You're not good enough. You don't have any writing talent. You don't have enough education. You don't know what you're doing. Your writing is derivative / unoriginal / boring / useless / doesn't make sense. The genre you write in is dead / worthless / unacceptable / morally wrong / frivolous / useless.  Who do you think you are? No one would want to read what you write. You can't even use proper grammar, so how could you write a whole book? You're wasting your time. You'll never make it as a writer. You shouldn't write those things (or even think about those things). Why don't you write something nice? Insert other derogatory comment here! Mark Pierce describes the effect of this experience in his book The Creative Wound, which “occurs when an event, or someone's actions or words, pierce you, causing a kind of rift in your soul. A comment—even offhand and unintentional—is enough to cause one.” He goes on to say that such words can inflict “damage to the core of who we are as creators. It is an attack on our artistic identity, resulting in us believing that whatever we make is somehow tainted or invalid, because shame has convinced us there is something intrinsically tainted or invalid about ourselves.” As adults, we might brush off such wounds, belittling them as unimportant in the grand scheme of things. We might even find ourselves saying the same words to other people. After all, it's easier to criticise than to create. But if you picture your younger self, bright eyed as you lose yourself in your favourite book, perhaps you might catch a glimpse of what you longed for before your dreams were dashed on the rocks of other people's reality. As Mark Pierce goes on to say, “A Creative Wound has the power to delay our pursuits—sometimes for years—and it can even derail our lives completely… Anything that makes us feel ashamed of ourselves or our work can render us incapable of the self-expression we yearn for.” This is certainly what happened to me, and it took decades to unwind. Your creative wounds will differ to mine but perhaps my experience will help you explore your own. To be clear, your Shadow may not reside in elements of horror as mine do, but hopefully you can use my example to consider where your creative wounds might lie. “You shouldn't write things like that.” It happened at secondary school around 1986 or 1987, so I would have been around eleven or twelve years old. English was one of my favourite subjects and the room we had our lessons in looked out onto a vibrant garden. I loved going to that class because it was all about books, and they were always my favourite things. One day, we were asked to write a story. I can't remember the specifics of what the teacher asked us to write, but I fictionalised a recurring nightmare. I stood in a dark room. On one side, my mum and my brother, Rod, were tied up next to a cauldron of boiling oil, ready to be thrown in. On the other side, my dad and my little sister, Lucy, were threatened with decapitation by men with machetes. I had to choose who would die. I always woke up, my heart pounding, before I had to choose. Looking back now, it clearly represented an internal conflict about having to pick sides between the two halves of my family. Not an unexpected issue from a child of divorce. Perhaps these days, I might have been sent to the school counsellor, but it was the eighties and I don't think we even had such a thing. Even so, the meaning of the story isn't the point. It was the reaction to it that left scars. “You shouldn't write things like that,” my teacher said, and I still remember her look of disappointment, even disgust. Certainly judgment. She said my writing was too dark. It wasn't a proper story. It wasn't appropriate for the class. As if horrible things never happened in stories — or in life. As if literature could not include dark tales. As if the only acceptable writing was the kind she approved of. We were taught The Prime of Miss Jean Brodie that year, which says a lot about the type of writing considered appropriate. Or perhaps the issue stemmed from the school motto, “So hateth she derknesse,” from Chaucer's The Legend of Good Women: “For fear of night, so she hates the darkness.” I had won a scholarship to a private girls' school, and their mission was to turn us all into proper young ladies. Horror was never on the curriculum. Perhaps if my teacher had encouraged me to write my darkness back then, my nightmares would have dissolved on the page. Perhaps if we had studied Mary Shelley's Frankenstein, or H.P. Lovecraft stories, or Bram Stoker's Dracula, I could have embraced the darker side of literature earlier in my life. My need to push darker thoughts into my Shadow was compounded by my (wonderful) mum's best intentions. We were brought up on the principles of The Power of Positive Thinking by Norman Vincent Peale and she tried to shield me and my brother from anything harmful or horrible. We weren't allowed to watch TV much, and even the British school drama Grange Hill was deemed inappropriate. So much of what I've achieved is because my mum instilled in me a “can do” attitude that anything is possible. I'm so grateful to her for that. (I love you, Mum!) But all that happy positivity, my desire to please her, to be a good girl, to make my teachers proud, and to be acceptable to society, meant that I pushed my darker thoughts into Shadow. They were inappropriate. They were taboo. They must be repressed, kept secret, and I must be outwardly happy and positive at all times. You cannot hold back the darkness “The night is dark and full of terrors.” —George R.R. Martin, A Storm of Swords It turned out that horror was on the curriculum, much of it in the form of educational films we watched during lessons. In English Literature, we watched Romeo drink poison and Juliet stab herself in Zeffirelli's Romeo and Juliet. In Religious Studies, we watched Jesus beaten, tortured, and crucified in The Greatest Story Ever Told, and learned of the variety of gruesome ways that Christian saints were martyred. In Classical Civilisation, we watched gladiators slaughter each other in Spartacus. In Sex Education at the peak of the AIDS crisis in the mid-'80s, we were told of the many ways we could get infected and die. In History, we studied the Holocaust with images of skeletal bodies thrown into mass graves, medical experiments on humans, and grainy videos of marching soldiers giving the Nazi salute. One of my first overseas school field trips was to the World War I battlegrounds of Flanders Fields in Belgium, where we studied the inhuman conditions of the trenches, walked through mass graves, and read war poetry by candlelight. As John McCrae wrote: We are the Dead. Short days agoWe lived, felt dawn, saw sunset glow,Loved and were loved, and now we lie, In Flanders fields. Did the teachers not realise how deeply a sensitive teenager might feel the darkness of that place? Or have I always been unusual in that places of blood echo deep inside me? And the horrors kept coming. We lived in Bristol, England back then and I learned at school how the city had been part of the slave trade, its wealth built on the backs of people stolen from their homes, sold, and worked to death in the colonies. I had been at school for a year in Malawi, Africa and imagined the Black people I knew drowning, being beaten, and dying on those ships. In my teenage years, the news was filled with ethnic cleansing, mass rape, and massacres during the Balkan wars, and images of bodies hacked apart during the Rwandan genocide. Evil committed by humans against other humans was not a historical aberration. I'm lucky and I certainly acknowledge my privilege. Nothing terrible or horrifying has happened to me — but bad things certainly happen to others. I wasn't bullied or abused. I wasn't raped or beaten or tortured. But you don't have to go through things to be afraid of them, and for your imagination to conjure the possibility of them. My mum doesn't read my fiction now as it gives her nightmares (Sorry, Mum!). I know she worries that somehow she's responsible for my darkness, but I've had a safe and (mostly) happy life, for which I'm truly grateful. But the world is not an entirely safe and happy place, and for a sensitive child with a vivid imagination, the world is dark and scary. It can be brutal and violent, and bad things happen, even to good people. No parent can shield their child from the reality of the world. They can only help them do their best to live in it, develop resilience, and find ways to deal with whatever comes. Story has always been a way that humans have used to learn how to live and deal with difficult times. The best authors, the ones that readers adore and can't get enough of, write their darkness into story to channel their experience, and help others who fear the same. In an interview on writing the Shadow on The Creative Penn Podcast, Michaelbrent Collings shared how he incorporated a personally devastating experience into his writing:  “My wife and I lost a child years back, and that became the root of one of my most terrifying books, Apparition. It's not terrifying because it's the greatest book of all time, but just the concept that there's this thing out there… like a demon, and it consumes the blood and fear of the children, and then it withdraws and consumes the madness of the parents… I wrote that in large measure as a way of working through what I was experiencing.” I've learned much from Michaelbrent. I've read many of his (excellent) books and he's been on my podcast multiple times talking about his depression and mental health issues, as well as difficulties in his author career. Writing darkness is not in Michaelbrent's Shadow and only he can say what lies there for him. But from his example, and from that of other authors, I too learned how to write my Shadow into my books. Twenty-three years after that English lesson, in November 2009, I did NaNoWriMo, National Novel Writing Month, and wrote five thousand words of what eventually became Stone of Fire, my first novel. In the initial chapter, I burned a nun alive on the ghats of Varanasi on the banks of the Ganges River. I had watched the bodies burn by night on pyres from a boat bobbing in the current a few years before, and the image was still crystal clear in my mind. The only way to deal with how it made me feel about death was to write about it — and since then, I've never stopped writing. Returning to the nightmare from my school days, I've never had to choose between the two halves of my family, but the threat of losing them remains a theme in my fiction. In my ARKANE thriller series, Morgan Sierra will do anything to save her sister and her niece. Their safety drives her to continue to fight against evil. Our deepest fears emerge in our writing, and that's the safest place for them. I wish I'd been taught how to turn my nightmares into words back at school, but at least now I've learned to write my Shadow onto the page. I wish the same for you. The Shadow in traditional publishing If becoming an author is your dream, then publishing a book is deeply entwined with that. But as Mark Pierce says in The Creative Wound, “We feel pain the most where it matters the most… Desire highlights whatever we consider to be truly significant.” There is a lot of desire around publishing for those of us who love books! It can give you: Validation that your writing is good enough Status and credibility Acceptance by an industry held in esteem  The potential of financial reward and critical acclaim Support from a team of professionals who know how to make fantastic books A sense of belonging to an elite community Pride in achieving a long-held goal, resulting in a confidence boost and self-esteem Although not guaranteed, traditional publishing can give you all these things and more, but as with everything, there is a potential Shadow side. Denying it risks the potential of being disillusioned, disappointed, and even damaged. But remember, forewarned is forearmed, as the saying goes. Preparation can help you avoid potential issues and help you feel less alone if you encounter them. The myth of success… and the reality of experience There is a pervasive myth of success in the traditional publishing industry, perpetuated by media reporting on brand name and breakout authors, those few outliers whose experience is almost impossible to replicate. Because of such examples, many new traditionally published authors think that their first book will hit the top of the bestseller charts or win an award, as well as make them a million dollars — or at least a big chunk of cash. They will be able to leave their job, write in a beautiful house overlooking the ocean, and swan around the world attending conferences, while writing more bestselling books. It will be a charmed life. But that is not the reality. Perhaps it never was. Even so, the life of a traditionally published author represents a mythic career with the truth hidden behind a veil of obscurity. In April 2023, The Bookseller in the UK reported that “more than half of authors (54%) responding to a survey on their experiences of publishing their debut book have said the process negatively affected their mental health. Though views were mixed, just 22%… described a positive experience overall… Among the majority who said they had a negative experience of debut publication, anxiety, stress, depression and ‘lowered' self-esteem were cited, with lack of support, guidance or clear and professional communication from their publisher among the factors that contributed.” Many authors who have negative experiences around publishing will push them into the Shadow with denial or self-blame, preferring to keep the dream alive. They won't talk about things in public as this may negatively affect their careers, but private discussions are often held in the corners of writing conferences or social media groups online. Some of the issues are as follows: Repeated rejection by agents and publishers may lead to the author thinking they are not good enough as a writer, which can lead to feeling unworthy as a person. If an author gets a deal, the amount of advance and the name and status of the publisher compared to others create a hierarchy that impacts self-esteem. A deal for a book may be much lower than an author might have been expecting, with low or no advance, and the resulting experience with the publisher beneath expectations. The launch process may be disappointing, and the book may appear without fanfare, with few sales and no bestseller chart position. In The Bookseller report, one author described her launch day as “a total wasteland… You have expectations about what publication day will be like, but in reality, nothing really happens.” The book may receive negative reviews by critics or readers or more publicly on social media, which can make an author feel attacked. The book might not sell as well as expected, and the author may feel like it's their fault. Commercial success can sometimes feel tied to self-worth and an author can't help but compare their sales to others, with resulting embarrassment or shame. The communication from the publisher may be less than expected. One author in The Bookseller report said, “I was shocked by the lack of clarity and shared information and the cynicism that underlies the superficial charm of this industry.” There is often more of a focus on debut authors in publishing houses, so those who have been writing and publishing in the midlist for years can feel ignored and undervalued. In The Bookseller report, 48 percent of authors reported “their publisher supported them for less than a year,” with one saying, “I got no support and felt like a commodity, like the team had moved on completely to the next book.” If an author is not successful enough, the next deal may be lower than the last, less effort is made with marketing, and they may be let go. In The Bookseller report, “six authors—debut and otherwise—cited being dropped by their publisher, some with no explanation.” Even if everything goes well and an author is considered successful by others, they may experience imposter syndrome, feeling like a fraud when speaking at conferences or doing book signings. And the list goes on … All these things can lead to feelings of shame, inadequacy, and embarrassment; loss of status in the eyes of peers; and a sense of failure if a publishing career is not successful enough. The author feels like it's their fault, like they weren't good enough — although, of course, the reality is that the conditions were not right at the time. A failure of a book is not a failure of the person, but it can certainly feel like it! When you acknowledge the Shadow, it loses its power Despite all the potential negatives of traditional publishing, if you know what could happen, you can mitigate them. You can prepare yourself for various scenarios and protect yourself from potential fall-out. It's clear from The Bookseller report that too many authors have unrealistic expectations of the industry. But publishers are businesses, not charities. It's not their job to make you feel good as an author. It's their job to sell books and pay you. The best thing they can do is to continue to be a viable business so they can keep putting books on the shelves and keep paying authors, staff, and company shareholders. When you license your creative work to a publisher, you're giving up control of your intellectual property in exchange for money and status. Bring your fears and issues out of the Shadow, acknowledge them, and deal with them early, so they do not get pushed down and re-emerge later in blame and bitterness. Educate yourself on the business of publishing. Be clear on what you want to achieve with any deal. Empower yourself as an author, take responsibility for your career, and you will have a much better experience. The Shadow in self-publishing or being an indie author Self-publishing, or being an independent (indie) author, can be a fantastic, pro-active choice for getting your book into the world. Holding your first book in your hand and saying “I made this” is pretty exciting, and even after more than forty books, I still get excited about seeing ideas in my head turn into a physical product in the world. Self-publishing can give an author: Creative control over what to write, editorial and cover design choices, when and how often to publish, and how to market Empowerment over your author career and the ability to make choices that impact success without asking for permission Ownership and control of intellectual property assets, resulting in increased opportunity around licensing and new markets Independence and the potential for recurring income for the long term Autonomy and flexibility around timelines, publishing options, and the ability to easily pivot into new genres and business models Validation based on positive reader reviews and money earned Personal growth and learning through the acquisition of new skills, resulting in a boost in confidence and self-esteem A sense of belonging to an active and vibrant community of indie authors around the world Being an indie author can give you all this and more, but once again, there is a Shadow side and preparation can help you navigate potential issues. The myth of success… and the reality of experience As with traditional publishing, the indie author world has perpetuated a myth of success in the example of the breakout indie author like E.L. James with Fifty Shades of Grey, Hugh Howey with Wool, or Andy Weir with The Martian. The emphasis on financial success is also fuelled online by authors who share screenshots showing six-figure months or seven-figure years, without sharing marketing costs and other outgoings, or the amount of time spent on the business. Yes, these can inspire some, but it can also make others feel inadequate and potentially lead to bad choices about how to publish and market based on comparison. The indie author world is full of just as much ego and a desire for status and money as traditional publishing. This is not a surprise! Most authors, regardless of publishing choices, are a mix of massive ego and chronic self-doubt. We are human, so the same issues will re-occur. A different publishing method doesn't cure all ills. Some of the issues are as follows: You learn everything you need to know about writing and editing, only to find that you need to learn a whole new set of skills in order to self-publish and market your book. This can take a lot of time and effort you did not expect, and things change all the time so you have to keep learning. Being in control of every aspect of the publishing process, from writing to cover design to marketing, can be overwhelming, leading to indecision, perfectionism, stress, and even burnout as you try to do all the things. You try to find people to help, but building your team is a challenge, and working with others has its own difficulties. People say negative things about self-publishing that may arouse feelings of embarrassment or shame. These might be little niggles, but they needle you, nonetheless. You wonder whether you made the right choice. You struggle with self-doubt and if you go to an event with traditional published authors, you compare yourself to them and feel like an imposter. Are you good enough to be an author if a traditional publisher hasn't chosen you? Is it just vanity to self-publish? Are your books unworthy? Even though you worked with a professional editor, you still get one-star reviews and you hate criticism from readers. You wonder whether you're wasting your time. You might be ripped off by an author services company who promise the world, only to leave you with a pile of printed books in your garage and no way to sell them. When you finally publish your book, it languishes at the bottom of the charts while other authors hit the top of the list over and over, raking in the cash while you are left out of pocket. You don't admit to over-spending on marketing as it makes you ashamed. You resist book marketing and make critical comments about writers who embrace it. You believe that quality rises to the top and if a book is good enough, people will buy it anyway. This can lead to disappointment and disillusionment when you launch your book and it doesn't sell many copies because nobody knows about it. You try to do what everyone advises, but you still can't make decent money as an author. You're jealous of other authors' success and put it down to them ‘selling out' or writing things you can't or ‘using AI' or ‘using a ghostwriter' or having a specific business model you consider impossible to replicate. And the list goes on… When you acknowledge the Shadow, it loses its power Being in control of your books and your author career is a double-edged sword. Traditionally published authors can criticise their publishers or agents or the marketing team or the bookstores or the media, but indie authors have to take responsibility for it all. Sure, we can blame ‘the algorithms' or social media platforms, or criticise other authors for having more experience or more money to invest in marketing, or attribute their success to writing in a more popular genre — but we also know there are always people who do well regardless of the challenges. Once more, we're back to acknowledging and integrating the Shadow side of our choices. We are flawed humans. There will always be good times and bad, and difficulties to offset the high points. This too shall pass, as the old saying goes. I know that being an indie author has plenty of Shadow. I've been doing this since 2008 and despite the hard times, I'm still here. I'm still writing. I'm still publishing. This life is not for everyone, but it's my choice. You must make yours. The Shadow in work You work hard. You make a living. Nothing wrong with that attitude, right? It's what we're taught from an early age and, like so much of life, it's not a problem until it goes to extremes. Not achieving what you want to? Work harder. Can't get ahead? Work harder. Not making a good enough living? Work harder. People who don't work hard are lazy. They don't deserve handouts or benefits. People who don't work hard aren't useful, so they are not valued members of our culture and community. But what about the old or the sick, the mentally ill, or those with disabilities? What about children? What about the unemployed? The under-employed? What about those who are — or will be — displaced by technology, those called “the useless class” by historian Yuval Noah Harari in his book Homo Deus? What if we become one of these in the future? Who am I if I cannot work? The Shadow side of my attitude to work became clear when I caught COVID in the summer of 2021. I was the sickest I'd ever been. I spent two weeks in bed unable to even think properly, and six weeks after that, I was barely able to work more than an hour a day before lying in the dark and waiting for my energy to return. I was limited in what I could do for another six months after that. At times, I wondered if I would ever get better. Jonathan kept urging me to be patient and rest. But I don't know how to rest. I know how to work and how to sleep. I can do ‘active rest,' which usually involves walking a long way or traveling somewhere interesting, but those require a stronger mind and body than I had during those months. It struck me that even if I recovered from the virus, I had glimpsed my future self. One day, I will be weak in body and mind. If I'm lucky, that will be many years away and hopefully for a short time before I die — but it will happen. I am an animal. I will die. My body and mind will pass on and I will be no more. Before then I will be weak. Before then, I will be useless. Before then, I will be a burden. I will not be able to work… But who am I if I cannot work? What is the point of me? I can't answer these questions right now, because although I recognise them as part of my Shadow, I've not progressed far enough to have dealt with them entirely. My months of COVID gave me some much-needed empathy for those who cannot work, even if they want to. We need to reframe what work is as a society, and value humans for different things, especially as technology changes what work even means. That starts with each of us. “Illness, affliction of body and soul, can be life-altering. It has the potential to reveal the most fundamental conflict of the human condition: the tension between our infinite, glorious dreams and desires and our limited, vulnerable, decaying physicality.” —Connie Zweig, The Inner Work of Age: Shifting from Role to Soul The Shadow in money In the Greek myth, King Midas was a wealthy ruler who loved gold above all else. His palace was adorned with golden sculptures and furniture, and he took immense pleasure in his riches. Yet, despite his vast wealth, he yearned for more. After doing a favour for Dionysus, the god of wine and revelry, Midas was granted a single wish. Intoxicated by greed, he wished that everything he touched would turn to gold — and it was so. At first, it was a lot of fun. Midas turned everything else in his palace to gold, even the trees and stones of his estate. After a morning of turning things to gold, he fancied a spot of lunch. But when he tried to eat, the food and drink turned to gold in his mouth. He became thirsty and hungry — and increasingly desperate. As he sat in despair on his golden throne, his beloved young daughter ran to comfort him. For a moment, he forgot his wish — and as she wrapped her arms around him and kissed his cheek, she turned into a golden statue, frozen in precious metal. King Midas cried out to the gods to forgive him, to reverse the wish. He renounced his greed and gave away all his wealth, and his daughter was returned to life. The moral of the story: Wealth and greed are bad. In Charles Dickens's A Christmas Carol, Ebenezer Scrooge is described as a “squeezing, wrenching, grasping, scraping, clutching, covetous, old sinner.” He's wealthy but does not share, considering Christmas spending to be frivolous and giving to charity to be worthless. He's saved by a confrontation with his lonely future and becomes a generous man and benefactor of the poor. Wealth is good if you share it with others. The gospel of Matthew, chapter 25: 14-30, tells the parable of the bags of gold, in which a rich man goes on a journey and entrusts his servants with varying amounts of gold. On his return, the servants who multiplied the gold through their efforts and investments are rewarded, while the one who merely returned the gold with no interest is punished: “For whoever has will be given more, and they will have an abundance. Whoever does not have, even what they have will be taken from them.” Making money is good, making more money is even better. If you can't make any money, you don't deserve to have any. Within the same gospel, in Matthew 19:24, Jesus encounters a wealthy man and tells him to sell all his possessions and give the money to the poor, which the man is unable to do. Jesus says, “It is easier for a camel to go through the eye of a needle than for someone who is rich to enter the kingdom of God.” Wealth is bad. Give it all away and you'll go to heaven. With all these contradictory messages, no wonder we're so conflicted about money! How do you think and feel about money? While money is mostly tied to our work, it's far more than just a transactional object for most people. It's loaded with complex symbolism and judgment handed down by family, religion, and culture. You are likely to find elements of Shadow by examining your attitudes around money. Consider which of the following statements resonate with you or write your own. Money stresses me out. I don't want to talk about it or think about it. Some people hoard money, so there is inequality. Rich people are bad and we should take away their wealth and give it to the poor.  I can never make enough money to pay the bills, or to give my family what I want to provide. Money doesn't grow on trees.  It's wasteful to spend money as you might need it later, so I'm frugal and don't spend money unless absolutely necessary. It is better and more ethical to be poor than to be rich. I want more money. I read books and watch TV shows about rich people because I want to live like that. Sometimes I spend too much on things for a glimpse of what that might be like.  I buy lottery tickets and dream of winning all that money.  I'm jealous of people who have money. I want more of it and I resent those who have it. I'm no good with money. I don't like to look at my bank statement or credit card statement. I live off my overdraft and I'm in debt. I will never earn enough to get out of debt and start saving, so I don't think too much about it. I don't know enough about money. Talking about it makes me feel stupid, so I just ignore it. People like me aren't educated about money.  I need to make more money. If I can make lots of money, then people will look up to me. If I make lots of money, I will be secure, nothing can touch me, I will be safe.  I never want to be poor. I would be ashamed to be poor. I will never go on benefits. My net worth is my self worth. Money is good. We have the best standard of living in history because of the increase in wealth over time. Even the richest kings of the past didn't have what many middle-class people have today in terms of access to food, water, technology, healthcare, education, and more. The richest people give the most money to the poor through taxation and charity, as well as through building companies that employ people and invent new things. The very richest give away much of their fortunes. They provide far more benefit to the world than the poor.  I love money. Money loves me. Money comes easily and quickly to me. I attract money in multiple streams of income. It flows to me in so many ways. I spend money. I invest money. I give money. I'm happy and grateful for all that I receive. The Shadow around money for authors in particular Many writers and other creatives have issues around money and wealth. How often have you heard the following, and which do you agree with? You can't make money with your writing. You'll be a poor author in a garret, a starving artist.  You can't write ‘good quality' books and make money. If you make money writing, you're a hack, you're selling out. You are less worthy than someone who writes only for the Muse. Your books are commercial, not artistic. If you spend money on marketing, then your books are clearly not good enough to sell on their own. My agent / publisher / accountant / partner deals with the money side. I like to focus on the creative side of things. My money story Note: This is not financial or investment advice. Please talk to a professional about your situation. I've had money issues over the years — haven't we all! But I have been through a (long) process to bring money out of my Shadow and into the light. There will always be more to discover, but hopefully my money story will help you, or at least give you an opportunity to reflect. Like most people, I didn't grow up with a lot of money. My parents started out as teachers, but later my mum — who I lived with, along with my brother — became a change management consultant, moving to the USA and earning a lot more. I'm grateful that she moved into business because her example changed the way I saw money and provided some valuable lessons. (1) You can change your circumstances by learning more and then applying that to leverage opportunity into a new job or career Mum taught English at a school in Bristol when we moved back from Malawi, Africa, in the mid '80s but I remember how stressful it was for her, and how little money she made. She wanted a better future for us all, so she took a year out to do a master's degree in management. In the same way, when I wanted to change careers and leave consulting to become an author, I spent time and money learning about the writing craft and the business of publishing. I still invest a considerable chunk on continuous learning, as this industry changes all the time. (2) You might have to downsize in order to leap forward The year my mum did her degree, we lived in the attic of another family's house; we ate a lot of one-pot casserole and our treat was having a Yorkie bar on the walk back from the museum. We wore hand-me-down clothes, and I remember one day at school when another girl said I was wearing her dress. I denied it, of course, but there in back of the dress was her name tag. I still remember her name and I can still feel that flush of shame and embarrassment. I was determined to never feel like that again. But what I didn't realize at the time was that I was also learning the power of downsizing. Mum got her degree and then a new job in management in Bristol. She bought a house, and we settled for a few years. I had lots of different jobs as a teenager. My favourite was working in the delicatessen because we got a free lunch made from delicious produce. After I finished A-levels, I went to the University of Oxford, and my mum and brother moved to the USA for further opportunities. I've downsized multiple times over the years, taking a step back in order to take a step forward. The biggest was in 2010 when I decided to leave consulting. Jonathan and I sold our three-bedroom house and investments in Brisbane, Australia, and rented a one-bedroom flat in London, so we could be debt-free and live on less while I built up a new career. It was a decade before we bought another house. (3) Comparison can be deadly: there will always be people with more money than you Oxford was an education in many ways and relevant to this chapter is how much I didn't know about things people with money took for granted. I learned about formal hall and wine pairings, and how to make a perfect gin and tonic. I ate smoked salmon for the first time. I learned how to fit in with people who had a lot more money than I did, and I definitely wanted to have money of my own to play with. (4) Income is not wealth You can earn lots but have nothing to show for it after years of working. I learned this in my first few years of IT consulting after university. I earned a great salary and then went contracting, earning even more money at a daily rate. I had a wonderful time. I traveled, ate and drank and generally made merry, but I always had to go back to the day job when the money ran out. I couldn't work out how I could ever stop this cycle. Then I read Rich Dad, Poor Dad by Robert Kiyosaki, a book I still recommend, especially if you're from a family that values academic over financial education. I learned how to escape the rat race by building and/or accumulating assets that pay even when you're not working. It was a revelation! The ‘poor dad' in the book is a university professor. He knows so much about so many things, but he ends up poor as he did not educate himself about money. The ‘rich dad' has little formal education, but he knows about money and wealth because he learned about it, as we can do at any stage in our lives. (5) Not all investments suit every person, so find the right one for you Once I discovered the world of investing, I read all the books and did courses and in-person events. I joined communities and I up-skilled big time. Of course, I made mistakes and learned lots along the way. I tried property investing and renovated a couple of houses for rental (with more practical partners and skilled contractors). But while I could see that property investing might work for some people, I did not care enough about the details to make it work for me, and it was certainly not passive income. I tried other things. My first husband was a boat skipper and scuba diving instructor, so we started a charter. With the variable costs of fuel, the vagaries of New Zealand weather — and our divorce — it didn't last long! From all these experiments, I learned I wanted to run a business, but it needed to be online and not based on a physical location, physical premises, or other people. That was 2006, around the time that blogging started taking off and it became possible to make a living online. I could see the potential and a year later, the iPhone and the Amazon Kindle launched, which became the basis of my business as an author. (6) Boring, automatic saving and investing works best Between 2007 and 2011, I contracted in Australia, where they have compulsory superannuation contributions, meaning you have to save and invest a percentage of your salary or self-employed income. I'd never done that before, because I didn't understand it. I'd ploughed all my excess income into property or the business instead. But in Australia I didn't notice the money going out because it was automatic. I chose a particular fund and it auto-invested every month. The pot grew pretty fast since I didn't touch it, and years later, it's still growing. I discovered the power of compound interest and time in the market, both of which are super boring. This type of investing is not a get rich quick scheme. It's a slow process of automatically putting money into boring investments and doing that month in, month out, year in, year out, automatically for decades while you get on with your life. I still do this. I earn money as an author entrepreneur and I put a percentage of that into boring investments automatically every month. I also have a small amount which is for fun and higher risk investments, but mostly I'm a conservative, risk-averse investor planning ahead for the future. This is not financial advice, so I'm not giving any specifics. I have a list of recommended money books at www.TheCreativePenn.com/moneybooks if you want to learn more. Learning from the Shadow When I look back, my Shadow side around money eventually drove me to learn more and resulted in a better outcome (so far!). I was ashamed of being poor when I had to wear hand-me-down clothes at school. That drove a fear of not having any money, which partially explains my workaholism. I was embarrassed at Oxford because I didn't know how to behave in certain settings, and I wanted to be like the rich people I saw there. I spent too much money in my early years as a consultant because I wanted to experience a “rich” life and didn't understand saving and investing would lead to better things in the future. I invested too much in the wrong things because I didn't know myself well enough and I was trying to get rich quick so I could leave my job and ‘be happy.' But eventually, I discovered that I could grow my net worth with boring, long-term investments while doing a job I loved as an author entrepreneur. My only regret is that I didn't discover this earlier and put a percentage of my income into investments as soon as I started work. It took several decades to get started, but at least I did (eventually) start. My money story isn't over yet, and I keep learning new things, but hopefully my experience will help you reflect on your own and avoid the issue if it's still in Shadow. These chapters are excerpted from Writing the Shadow: Turn Your Inner Darkness Into Words by Joanna Penn  The post Writing The Shadow: The Creative Wound, Publishing, And Money, With Joanna Penn first appeared on The Creative Penn.

Read Online“The sabbath was made for man, not man for the sabbath. That is why the Son of Man is lord even of the sabbath” Mark 2:27–28Today's Gospel should console those who struggle with a legalistic and scrupulous mindset. This is an easy trap to fall into for those who desire to keep God's commandments and remain faithful to His holy will. Despite the best intentions, it's easy for those who are deeply sincere in their fidelity to God to misunderstand how best to please and glorify Him. One common trap is to think that meticulous observance of the external Law is sufficient. While obedience to God's Law is essential, it is equally important to understand the authentic requirements of His Law—what it truly demands and what it does not.Today's Gospel takes place toward the beginning of Jesus' public ministry, after He had named His Twelve Apostles and begun preaching and healing. As they walked to another town on the Sabbath so Jesus could continue His mission, they passed through a field. The Apostles, being hungry, forged a path through the grain and picked some of it to eat. When the Pharisees saw them doing this, they seized the opportunity to condemn them, saying, “Look, why are they doing what is unlawful on the sabbath?” (Mark 2:24).Without getting too philosophical, it's important to understand what we call God's Eternal Law. The Eternal Law encompasses reality—physical, moral, and spiritual truths. All that God has established as true must be our guide through life. The goal of the evil one is to deceive us by leading us into a false understanding of that reality.Traditionally, the Eternal Law has been divided into two distinct aspects: the Natural and Divine Laws. The Divine Law is all that is known only through divine revelation—all that the Scriptures reveal, especially through Christ's humanity and mission. The Natural Law, on the other hand, is written upon creation itself, including our own human nature. Natural Law is written on our consciences and discerned through reason. For example, we instinctively know it is wrong to lie, steal, and murder. Though God's Divine Law confirms this through the Ten Commandments, these basic moral truths are already evident to us when we reflect clearly.In today's Gospel, the Apostles' actions were perfectly aligned with right reason—the Natural Law—showing how their choices reflected God's design for human flourishing. They were eating grain as they journeyed with Jesus so He could continue His mission. Their need for sustenance, especially while in service to Christ, took precedence over rigid legalistic interpretations of the Sabbath. The Pharisees, however, mistook the Sabbath for an end in itself. They focused solely on external observance and failed to understand that the Sabbath was instituted as a gift for humanity—a day for rest, worship, and renewal in communion with God.What's freeing and beautiful to note is that the Natural Law, written on our human reason, and the Divine Law, revealed through the Scriptures, are in perfect harmony. Both flow from God. Through His mission, Jesus shows us how the Divine Law elevates and perfects the Natural Law, orienting both toward love and mercy. The Pharisees' legalism obscured this harmony, reducing the Law to a burdensome set of rules rather than as a pathway to life and freedom.Reflect today on your own approach to God's Law. If you find it burdensome, reevaluate your thinking. Properly understood and embraced, God's Law is not a weight; it's the source of freedom. The Sabbath, in particular, invites us to rest and trust in God's providence. When we live according to the Eternal Law—both Natural and Divine—we discover harmony within our souls that refreshes and elevates us. Resolve to follow God's Law with love, avoiding both scrupulosity and laxity, and you will find the freedom and joy for which you were created.Divine Law-Giver, all that You have spoken and established is Truth. You are the Source of Truth and Truth Itself. Please free me from both laxity and scrupulosity as I strive to live in accord with Your will. May I find in Your Law the pathway to freedom and joy. Jesus, I trust in You.Source of content: catholic-daily-reflections.comCopyright © 2026 My Catholic Life! Inc. All rights reserved. Used with permission via RSS feed.

In this episode, the witches welcome the quiet, hopeful turning of the wheel with a deep dive into Imbolc, the ancient Celtic festival that marks the halfway point between the Winter Solstice and the Spring Equinox. Traditionally celebrated around February 1st and 2nd, Imbolc is a threshold moment, when the land is still cold and dark, but the return of the light has begun. Laylla and Chelle explore Imbolc's roots, its meaning of “in the belly,” and its long association with new life, purification, and preparation.They talk about the goddess Brigid, her sacred flame, poetry, prophecy, and craft, as well as her deep connections to hearth, milk, and inspiration. The conversation also weaves in other powerful figures of the season, including the Cailleach, whose weather on Imbolc foretells the length of winter, and Danu, whose fertile waters and ancient presence remind us that life is already stirring beneath the surface. From there, the episode turns practical. Laylla and Chelle talk about how to celebrate Imbolc today, from candle magic to house cleansing and protection work. They explore why cleaning and warding at Imbolc is so powerful, especially when the festival aligns with a full moon, and share a wealth of simple but potent practices including ritual sweeping, boundary-setting, witch bottles, mirror wards, eggshell protection, and working with house spirits.The episode also includes a detailed look at Brigid's Fire Tarot Spread, a ten-card layout shaped like a rising flame that helps you see what you're building, what's stirring, and what you're truly reaching for as the year unfolds toward Beltane. Grounded, hopeful, and deeply intentional, this episode invites you to tend your inner fire, clear winter's residue, and prepare your space, your spirit, and your magic for the season of growth ahead.Got a question? Send the witches a message here!Support the showWant to send us a letter? Witchy things to review?We have a mailing address!Back on the BroomstickPO Box 106Salem MA 01970Email: backonthebroomstick@gmail.comYoutube FacebookInstagramBack on the Broomstick Website

Doctors have long recommended regular cervical cancer screenings. Traditionally doctors perform these exams using a speculum, which often say is uncomfortable and, for many, quite painful. Some recent developments could make a large number of these screenings easier. In early January, the Health Resources and Services Administration, which is part of the Department of Health and Human Services, updated its guidelines to say that self-administered tests are an acceptable way to screen for human papillomavirus. HPV is a sexually-transmitted disease that causes the majority of cervical cancer cases. OB-GYNs are hopeful that at-home testing will make cervical cancer screenings easier to access…. and significantly more comfortable. Guests: Dr. Linda Eckert, professor of Obstetrics and Gynecology at the University of Washington School of Medicine Related links: New Guidelines Endorse Self-Swab Alternative to Pap Smear for Cervical Cancer Testing - The New York Times Cervical Cancer Risk Factors | Cervical Cancer | CDC The FDA has approved an at-home HPV test. What you need to know : NPR Thank you to the supporters of KUOW, you help make this show possible! If you want to help out, go to kuow.org/donate/soundsidenotes Soundside is a production of KUOW in Seattle, a proud member of the NPR Network.See omnystudio.com/listener for privacy information.

Mary Kelly Jagim, principal consultant at CenTrak,  describes the role and benefits of real-time location services (RTLS) and how indoor GPS can improve facility management, patient safety, and staff morale. The use of RTLS in the development of smart hospitals helps mitigate staff burnout by reducing time-wasting tasks, such as searching for equipment, and by providing safety features like badge access and tracking.  This technology is also being used to enhance the human touch in the clinical setting by providing more accurate, real-time patient location information and updates to clinical staff and family members.   Mary explains, "So, let's say we're talking about a medium to large hospital with lots of people in the building, lots of equipment in the building, lots of things that they might be able to leverage real-time location systems for. And so those organizations are generally looking for a formal deal. They want to be able to keep track of equipment, and they want to provide a safe environment with a security solution for their staff. They might also want to look at safety around hand hygiene, so they're seeking a solution to make sure staff are washing their hands. We also might be looking at medication and other safety measures through environmental monitoring that we can provide. And then, in addition to that, they might be looking at getting into integration with their electronic health record and be able to incorporate patient flow."   "RTLS-enabled patient flow ensures they can always see the actual location of their patients. Traditionally, they're used for seeing the assigned room, but that might not actually be where the patient is at that point in time. So, we can offer things like that, and that can be a real patient experience satisfier. And then you can also help with electronic health record integration, we can help them to capture major milestone pieces. " #HealthTech #SmartHospitals #PatientSafety #HealthcareInnovation #RTLS #RealTimeLocationSystems #AIinHealthcare #PatientExperience #HealthcareEfficiency #MedicalTechnology #DigitalHealth #AI #Burnout #Safety #StaffDuress #PatientCare CenTrak.com Download the transcript here

Mary Kelly Jagim, principal consultant at CenTrak,  describes the role and benefits of real-time location services (RTLS) and how indoor GPS can improve facility management, patient safety, and staff morale. The use of RTLS in the development of smart hospitals helps mitigate staff burnout by reducing time-wasting tasks, such as searching for equipment, and by providing safety features like badge access and tracking.  This technology is also being used to enhance the human touch in the clinical setting by providing more accurate, real-time patient location information and updates to clinical staff and family members.   Mary explains, "So, let's say we're talking about a medium to large hospital with lots of people in the building, lots of equipment in the building, lots of things that they might be able to leverage real-time location systems for. And so those organizations are generally looking for a formal deal. They want to be able to keep track of equipment, and they want to provide a safe environment with a security solution for their staff. They might also want to look at safety around hand hygiene, so they're seeking a solution to make sure staff are washing their hands. We also might be looking at medication and other safety measures through environmental monitoring that we can provide. And then, in addition to that, they might be looking at getting into integration with their electronic health record and be able to incorporate patient flow."   "RTLS-enabled patient flow ensures they can always see the actual location of their patients. Traditionally, they're used for seeing the assigned room, but that might not actually be where the patient is at that point in time. So, we can offer things like that, and that can be a real patient experience satisfier. And then you can also help with electronic health record integration, we can help them to capture major milestone pieces. " #HealthTech #SmartHospitals #PatientSafety #HealthcareInnovation #RTLS #RealTimeLocationSystems #AIinHealthcare #PatientExperience #HealthcareEfficiency #MedicalTechnology #DigitalHealth #AI #Burnout #Safety #StaffDuress #PatientCare CenTrak.com Listen to the podcast here

Connect to John Gilroy on LinkedIn   https://www.linkedin.com/in/john-gilroy/ Want to listen to other episodes? www.Federaltechpodcast.com Today, we have an experienced tech veteran, Bob Stevens from GitLab, offering insights on how he sees the federal government overcoming three main technology challenges in 2026. Challenge ONE:   Software improvement on scale. Stevens observed that everyone has seen AI's ability to review code. It has passed the basic phase, and now, in 2026, it cannot only review code but also identify security vulnerabilities, ensure compliance, and even generate documentation. This means that older, expensive-to-maintain systems can be transitioned to more flexible, economical cloud models. Challenge TWO:   Going away from reacting. The word "continuous" has been the goal for cyber defenders for the past several years. Fortunately, AI is allowing that noble goal to be put into practice. When applied appropriately, newer technology can achieve lower breach rates and faster threat response times. Challenge THREE:   emergence of a "universal" developer. Traditionally, requirements would be gathered by an intermediary and then translated into instructions for software developers. Stevens shows how newer AI-based approaches can eliminate that intermediary step. In other words, a pilot can precisely describe what they want in an avionics system, and the developers can work from that description. That means solving domain-specific problems with traditional development skills. Ideally, subject matter experts directly translate their knowledge into functional software systems. Some call this the "universal" developer approach. Stevens emphasized the importance of AI, security, and flexibility for future developers. GitLab's DevSecOps platform integrates AI across the entire software development process.

Travis Timmons shares with host Andrew Stotz how a decade of frustration running his physical therapy practice turned into joy once he discovered Deming's philosophy and embraced systems thinking. Through PDSA cycles, clearer processes, and genuine team involvement, he transformed Fitness Matters from chaotic growth to a scalable organization getting stellar outcomes. His story shows how small businesses can create stability, joy in work, and remarkable results by improving the system rather than pushing harder.   TRANSCRIPT   0:00:02.1 Andrew Stotz: My name is Andrew Stotz and I'll be your host as we continue our journey into the teachings of Dr. W. Edwards Deming. Today I'm here with featured guest Travis Timmons. Travis, are you ready to tell us about your Deming journey?   0:00:19.7 Travis Timmons: Hey Andrew, thanks for having me. And yeah, very excited to share our journey and how impactful it's been on both our company, but also me personally and my family. So, super excited to kind of share where we started before Deming and where we're at today. So I'll just dive right in if that sounds like a good...   0:00:39.9 Andrew Stotz: Yeah. And I think just for the audience here, I'll just mention that Travis is physical therapist, founder and president of Fitness Matters in Columbus, Ohio, going on his 27th year of business. And you know, you and I have had some discussions. You've had a lot of great things that you've written and we've gone through and I think it's really an exciting story, particularly for a small mid sized business owner who's just frustrated as hell that things aren't going the way that they want. And I think your frustration a long time ago was a driving force. So I'm excited for you to share your story. So yeah, take it away.   0:01:22.6 Travis Timmons: Yeah, very excited. Yeah, 2000 is when we started, January 2000. So coming up on 27 years, as you mentioned, do physical therapy and wellness. And the first 10 years I was in business, pretty good at being a physical therapist. Started my own business and had no idea how to run a business. I knew a lot about physical therapy, but just kind of shooting from the hip in regard to business. Spent about a decade struggling, frustrated. We were growing, but growing slowly, growing chaotically. No process, it was just a, it was a heavy burden, to be honest with you. We were growing, but it was kind of Herculean effort on my part.   0:02:10.1 Andrew Stotz: I'm just curious how you were feeling at that time. Like there's gotta be a better way or this is the way business is and I just gotta muscle through this or how were you feeling at the time?   0:02:21.0 Travis Timmons: I was feeling frustrated and isolated. Didn't quite know where to turn. Yeah, I guess that's how, and just a burden. Didn't want to let the team down, I did not want the business to fail. I knew we had something different to offer. Just really had no idea how to scale that in a professional way. And along the journey was very fortunate to have a client who had a very successful business, took me under his wing. Ray Crook is his name. Started mentoring me and as luck would have it, he was familiar with Dr. Deming and a very long story short, after several meetings with him over time, some mentoring, I'd read the book along the way, the E-Myth Revisited and had some learnings from that book that really jumped out at me and came to the conclusion, both with reading that book and some feedback from Ray of basically, hey, it's time to grow up and turn this into a real business. If you're going to do this, let's do it right. And at that, around that time he introduced me to Kelly Allen with the Deming Institute. And you know, so we were 10 years into some chaos, had really no process, just would try stuff, see if it stuck or didn't.   0:03:43.5 Travis Timmons: If that didn't work, didn't really have any way to measure if stuff was working well. So really just a lot of chaos. And became introduced to Deming through Kelly Allen about 10 to 11 years into our journey and man, was that a breath of fresh air in terms of like having a direction to go in. After a few meetings with Kelly, him getting a better understanding of what was important to me, I think him just really understanding that I was serious about wanting to turn our organization into a large, professionally run and well run organization that would have a positive impact on people's lives, both team members and clients. I think he kind of, I think that we were so bad off he took pity on me to begin with, just to be honest with you, and he was like, man, this guy needs a lot of help. He could do some good in the world with what the services they have to offer. But if he doesn't figure out how to run a business professionally, they're never going to scale.   0:04:44.0 Andrew Stotz: And it's interesting that you reached out. I mean, there's a lot of people that are stuck in that situation and they really don't, either they don't reach out or they're afraid to reach out or you know, maybe they think there's no solution or nobody's going to help me. And you know, certainly when you're small, you also don't have huge budgets to hire people to come in and fix your business. You know, I'm just curious, like what drove you to even reach out?   0:05:09.8 Travis Timmons: I think I was fortunate enough to, A, have the mentor with Ray. And then secondly, have always been a believer in you got to check your ego at the door and know that you don't know everything. I think I've seen Business owners that are afraid to admit they don't know everything and so they keep things insulated and that just doesn't get you anywhere.   0:05:35.7 Andrew Stotz: Yeah.   0:05:36.3 Travis Timmons: So I just was fortunate kind of how I was raised as arrogance isn't a good thing, so check your ego at the door and learn from, learn from people smarter than you. And so I kind of took that fully at heart and like, all right, I have no idea how to run a business. I need to learn how to do that from really smart people. Read a lot of business books over the years, but the Deming philosophy, when I was introduced to that at the two and a half day seminar, went to that. I got to the Deming two and a half day in, I think that was 2013. So I was 13 years into the entire journey by the time I had met with Kelly, done some learning. And then at a time where the Deming two and a half day was offered in Ohio to where I could get to it, to your point earlier, budget plays into things for small businesses. So I was able to drive to that one and that two and a half day seminar just opened my eyes up to things that I knew in my heart but had no idea how to make that happen.   0:06:46.2 Travis Timmons: And what I mean by that, Andrew, is one of the key things I took away from that first two and a half day is Deming's belief that roughly 96% of issues within an organization are not people issues, but they're process and system issues. And that aligned with my worldview of if you hire good people, which we did, they show up every day wanting to do a good job as long as they have a good system and process to work within something that's professionally put together. So that was takeaway number one that really resonated with me. And the person responsible for said system is me. There's no passing the buck as the owner. And that resonated with me. It's a big responsibility to own a business in terms of the people and clients you're responsible for. And there's no passing the buck. You're responsible for the system at the end of the day.   0:07:42.3 Andrew Stotz: Yeah. I remember when I was 24 attending Deming seminar, when I was working for Pepsi, and it was a little bit different situation than yours. I could see, though, the same thing resonated with me. I could see that people were hemmed in by the system. And even though many people in the factory had really good intentions and they wanted to do a better job, they literally couldn't because they didn't have the tools or the budget or the this or the that. And a lot of times it's easy for senior management, particularly in a big company, to say figure it out, your job is to figure it out. But that only goes so far and there's eventually a point of exasperation for people working in a company that, like, I just, there's a limit here and I'm not going to kill myself trying to do something that I can't change. And so it just, I was coming from a very different perspective as an employee in a huge company versus you at a perspective of, this is my company, I set the rules.   0:08:46.5 Travis Timmons: Yeah, can do whatever we want. And you mentioned something there. It reminds me of a quote from that first two and a half day, and it still sticks with me a decade and a half later. Almost a lot of businesses complain about the term. We have a lot of dead wood in terms of employees. And the quote, I remember Kelly sharing this, it's like, well, did you hire dead wood? Because if you did, that's on you. Or did you hire live wood and kill it and that's on you from your standpoint of, from a system. And I'm like, man, 100% true. And I hired, I had good people on our team, but we didn't have good processes to keep from killing that live wood I would say. So, yeah. And to your point on budget, yeah, I had and still do have quite a bit different budget than Pepsi. Right. So one of the other things that jumped out at me early on that made Deming very approachable and something I could engage with very easily as a small business owner was the concept of PDSAs, the Plan-Do-Study-Act.   0:09:58.5 Travis Timmons: That was a game changer for us because I was like, all right, I don't have to hire a big business consultant. We don't have to hire or pay for a bunch of software. There's very simple things we can do via the Plan, Do Study Act PDSA method that we can create systems or improve upon systems and those little experimental ways and not have to bet the farm. You know, you see a lot of businesses that try to go through these huge transformative activities, bring in a new software to fix all their problems. Things that are very expensive with no real way of understanding what their aim is, what their theory is, or even if it'll work. So, yeah, your comment on budget there, I think, is what makes Deming so approachable for any size organization, but the budget's really not a limit from the PDSA standpoint. So those were some of my key takeaways very early on on my first two and a half day Deming, it was an eye opener and just really resonated with how, how I saw the world in terms of from a human level. Just had zero idea as a physical therapist with no business training on how to implement and run a professional organization.   0:11:13.8 Travis Timmons: So as things evolved, kind of went from the kind of the term chaos to process. So after that two and a half day, I went back to our team, which was small at the time. I think we had, we were a very small company at the time. I think we had 10 employees, nine or 10 team members at the time and just presented to them like, hey, this is going to be how we run our organization. There's this thing I heard about this guy called Dr. Deming. Some of it's going to seem a little odd, but this is how we're going to do things. And just started out early on, like just with PDSA, educated them on what that meant and we're all going to work on things together. So immediately it started enforcing a culture of improvement and collaboration and voice. Rather than Travis just coming up with random ideas, we worked on them together, made the system visible and then put some experiments in place. I talked to them about operational definition. That was a new term to me and gave them some examples. We wanted every client to have a good visit with us.   0:12:29.2 Travis Timmons: What in the heck does a good visit mean? Right. We didn't have an operational definition of that, so we created an operational definition of this is a good visit at Fitness Matters. So those were some fun things early on.   0:12:42.3 Andrew Stotz: I'm curious. There's two things, the first one is for someone that really doesn't know anything about PDSA, the Plan, Do, Study, Act process or cycle. Could you give an example either of one that you did early on or one that you think is the best illustration of the application of PDSA so people can understand what you're saying, because I know it's a big part of what one of the, let's say, tools that you've used in your process.   0:13:10.1 Travis Timmons: Yeah, one of the early on ones we did that was fun to do with the team because it changed our pricing model for our private pay team. Quick example, like we do personal training and Pilates muscle activation technique. Traditionally in that world, people buy those visits one at a time or you'll buy a package of 10 or 20 at a time at a discounted rate, volume, volume pricing, right. So we had that, we had 10 pack and 20 pack of personal training. We had a 10 pack and 20 pack of Pilates, same for muscle activation technique. And we had clients that would do sometimes all three of those services, but for them to be able to optimize their discount, they had to buy a 20 pack of Pilates, a 20 pack of personal training, and then the same with muscle activation technique. So after learning some things with Dr. Deming at the two and a half day that Kelly presented at, it's like we got to be easier to do business with. Be easy to do business with and how can we do that? So our PDSA was how can we change our pricing model on the private pay services to be easier to do business with and optimize how clients can move in our system freely.   0:14:25.9 Travis Timmons: So part of the concept of PDSA is you trial it, you put your whole theory together of what you think will be true. How are you going to study it? How long are you going to try it? So we had four clients that we knew well, that we told them, we're trying this new pricing model. Would you be willing to experiment on this with us? So we didn't roll it out company wide. We just tried it with a small segment, and we called it Fitness Matters Dollars and the do the Fitness Matters Dollars package. Then the client could use that discounted bundle of money for any of our services. So the discount applied to any of the services they did rather than having to buy a bunch of different packages. So the beauty of it is you can try it small. Had we gotten it wrong, we could have thrown it out and only five clients would have experienced the error. And they knew they were part of an experiment and they were happy to help us improve. It was a big win. That was 12 years ago. That's still how we do our pricing today.   0:15:29.1 Travis Timmons: It makes it very easy for clients to optimize their health within our system and not have to spend a bunch of money with us and have a lot of monetary resistance moving about our system. So that's one example that comes to mind.   0:15:41.4 Andrew Stotz: That's a good one. And I think if you think about, let's say an accountant may say, well, but wait a minute, the cost of three different services is different and that's the idea of how do we simplify this for the client, and that's interesting. Now, did you write it down, did you go to a Whiteboard. How did you actually go through that process?   0:16:02.9 Travis Timmons: Oh, that's 13 years ago. You're testing my...   0:16:06.5 Andrew Stotz: Oh, well, you can think about a current one, too.   0:16:09.6 Travis Timmons: 12 years ago. Yeah. When we're doing a current one, we'll get together as a team. Like, we're having our annual team off-site the end of January. And we'll come up, we try to come away with three, maybe four PDSAs as a team, and we'll write it up on the whiteboard. What's the problem we're trying to solve? Another key quote I've learned from Kelly Allen over the years is "the problem named, is the problem solved." So we want to make sure we're naming the right problem first. What really is the problem? So we talk about that through our entire company so that I'm getting feedback from all pieces of the system and then we'll map it out. Sometimes we'll do fishbone charts to look where in the process are we trying to do an experiment? And then there's the PDSA kind of chart that we'll use for bigger ones so we can study it. What's our aim? What's our theory? What do we think is going to happen with this experiment? How long are we going to study it, and what's our expected outcome? So part of the PDSA magic, as you know, is what are you trying to accomplish by what method, in what time frame, and what do you think is going to happen so you can go back and test your theory after you've studied it? So, yeah, sometimes we, if it's something bigger system-wide, we put it down on paper. We have a PDF that's fillable for each new PDSA.   0:17:35.5 Andrew Stotz: And for some people listening, they may think, well, I mean, isn't that what business does? I mean like owner comes up with an idea and says, yeah, I think we could try this and see what happens. Right. And ultimately everybody's kind of poking in the dark in business. We're not given a manual nobody really knows what we're doing. What's the difference between the way that you are poking in the dark, trying to hey, let's try this, let's try that compared to the PDSA.   0:18:08.5 Travis Timmons: I don't think I learned that till my second Deming two and a half day. So the second time I went, I took some senior team members with me so we could get more eyes around what in the world is this Deming person, who is Dr. Deming? What's this System of Profound Knowledge? To answer your question, I think the realization I had that I didn't have before, kind of going down the Deming journey is I didn't view our business as an entire system. I lacked that awareness of system view versus pieces and parts view. Pre-Deming, there's a problem over here and you go chase that fire and then another problem pop up over here, and to your point like there's lots of books out there on how to solve problems or you know, you hear like there's books out there on ownership thinking. And you know, it's like, well, do you have a culture and a system and by what method do you give people the ability to have that ownership thinking? Yeah, I think that's was the big aha of looking at the entire system. Whereas previously I was looking at it in silos and only trying to solve problems when a fire arose rather than system operationally efficient, trying to get efficient and optimizing the entire system. So that was probably one of the big aha's for me. Didn't happen day one. But as I got to understand Deming more, the system view of how it all has to be working together for optimization just changes your lens totally.   0:19:51.5 Andrew Stotz: So you've talked about PDSA, you've talked about operational definitions, you've talked about systems thinking, three core principles. One last thing on PDSA is like, I wonder what percent of the total value of doing PDSA comes from doing PDSA. In other words, the actual part of forcing yourself to get people in a room to discuss what's the problem, the Fishbone diagram, think about what's our aim, what's our theory, what's our hypothesis? Let's write that down. How are we going to study that? How we know if our hypothesis was true and you know, that type of thing. And sometimes I, after listening to you, I was thinking it, I suspect that a large amount of the final benefit you get from a PDSA is really front end loaded in all the work that you do to set it up.   0:20:48.3 Travis Timmons: Yeah, yeah. Going back to your comment earlier Andrew, on when you were at Pepsi, if I heard you correctly, you didn't really have the ability to share voice or to have an impact on the system. I think you're spot on, the PDSA itself, a couple things, number one as a small business owner, you got to check your ego at the door. Your team sees stuff happening that you don't have visibility on and they're probably going to have better ideas on how to fix it than you might if you're removed from it a step or two. And then the culture of like, oh, Travis is going to listen to my ideas. I find value in that. And then when we implement a change, like nobody likes change. Right? But when you've worked on it collectively as a team and you're ready to move forward with it, that's a game changer. You're not pushing a string at that point. Everybody's leaning in because they understand they're part of the solution and you're allowing that. Where a lot of businesses are top down, command and control, that doesn't usually work very well. So yeah, I think you're spot on, Andrew.   0:22:02.5 Travis Timmons: I think that so much happens with the PDSA process from a culture and team involvement. And if you don't have that, you're going to have a hard time retaining team members, in my opinion.   0:22:16.9 Andrew Stotz: So you look like a pretty relaxed guy compared to probably what you were like many years ago when this all was going on. Maybe take us through. Okay, so you're implementing these things and what's happening, what changes are happening, what transformation is going on with you and with your organization?   0:22:36.9 Travis Timmons: Yeah, so it's a multi-year process that we went through. Still a lot of work, you know, it's not like, hey, this just solves every problem. It just changes all the lenses you look through and you have a by what method path. Here's how we are going to think about our business. So that got rid of a lot of confusion for me. I knew how we were going to go from this size business to my, we had a BHAG, Big Hairy Audacious Goal from Good to Great. We wanted to have four facilities. At the time I went through Deming, we had one. We wanted to have four facilities or more to see if we could replicate our high level of care, team member engagement, all those things. So we were working, I was working just as many hours then. It just was not frustrating, it was exciting. It was a lot of collaboration that was energizing and everything as we scaled got easier. I was not going to be able to scale our business with what I was doing because had I scaled it, the headaches would have just been out of control. The loss of revenue, like there would have just been so much inefficiency on our organization.   0:24:00.4 Travis Timmons: So I would say for that next from 2013 through 2018, we got really locked in. So we spent about, I was a little conservative at the time. I was also in Army National Guard, so had a trip across the pond and just wasn't quite at a point where I could financially roll the dice and start multiplying locations and stuff like that. But around 2018, 2019, we got to the point where the team knew Deming well. I felt like we put a lot of systems, processes in place that were replicatable and I'm like, all right, here comes a real big PDSA. We're going to go get another clinic, we're going to go do another location, and we're going to test it. So that was a big PDSA. A lot of the ones we had done up to that were small. At some point you got to go a little bigger. And we were very confident in our model. So we acquired a practice in our town and like, hey, 80% of what they do is what we do, 20% is not Deming and service lines and stuff like that. So our theory, our PDSA, was can we acquire and put Fitness Matters, culture and process in place and grow?   0:25:26.3 Travis Timmons: And we did. We were very successful with that. I had team member retention with that. You know, a lot of times when you buy out another business kind of, people head for the doors, including the owner. That owner is still working with us six years later, then we started growing. It's like, all right, here we go. We can do another one. We can do another one. Put leadership in place at each location that understand Deming. We have our processes written down. We have operational definitions written down. People know what PDSA is. If they're new to our team, it takes them about six months to figure out what all these acronyms mean. So now we're going quicker since, you know, since in the last four years, as an example, we've tripled our physical therapy volume and doubled our private pay wellness volume. And in the service line, that's fairly fast growth. Probably not fast in the IT world, but in the service line growth in a very competitive market with how physical therapy and referrals work. There aren't many private practices left out there because it's so competitive where we're thriving.   0:26:41.4 Andrew Stotz: It seems like a hard business. It seems like a hard business to scale because there's this personal aspect, there's this interaction. You know, think about the exact opposite. I don't know, let's say Instagram or whatever. There's zero personal interaction. It can scale to billions. What are the constraints to growth that you feel in your business.   0:27:03.3 Travis Timmons: So constraints are reimbursement from health insurance, referrals from physicians, because health care is consolidating. So a health care system buys up smaller organizations, physicians, and then they have physical therapy within those systems and then they're highly encouraged to refer their physical therapy in-house. So that's a big challenge for us. So we don't, we're not owned by physicians. So we have to, we have to be the best at what we do for physicians and clients to want to choose us. So one of the things Dr. Deming really big on at quality, right. You have to continually have a system that has improving quality as you grow. And the way we grow is we have our outcomes. So how well a patient does at the end of a plan of care is roughly 35% higher than national average. We're 35% above the competition because of our processes, our system, our clients, how we look at integrating our clients from the first visit, the first phone call, follow-on visits, the entire, again, thinking back to that system conversation. And I think a lot of businesses, if they haven't been exposed to Deming, they miss that very critical piece of, if your sales isn't aligned with your implementation, isn't aligned with your billing process, anywhere along that service line, going through that fishbone, if it's all not good, like we could give excellent physical therapy care, but if we have a horrible billing system, we lose clients, end of story. If we have a horrible process of answering the phone to schedule evaluations, we're out of business.   0:29:00.0 Travis Timmons: Could have the best physical therapists in the world. So, yeah, that's what it's allowed us to do from a scaling and fun standpoint. And kind of now almost 27 years in we're at a point where, one of the litmus tests I had, like, if we do this well, if we really are all-in on Deming and it's system process definitions and we have it mapped out, this should run without Travis. And I see a lot of business owners are the choke point. Like they want to be the problem solver for everything. Everything has to flow through them, slow stuff down. You're not getting all of the information from your team that could solve problems so much quicker. So one of my litmus tests early on was like, if this really works well, the business should run without me present certainly for weeks and weeks at a time. And we're there. So that's why I look Relaxed now. I didn't look this relaxed a decade ago. So, it's fun, it's fun.   0:30:11.5 Andrew Stotz: I was looking for my Out of the Crisis book, but I went online and I wanted to highlight two of the 14 points because it's something that you mentioned about improving your process and all of that. And the first one is the first point and you know, it's the first point for a reason. And number one is "create constancy of purpose towards improvement of product and service with the aim to become competitive and stay in business and provide jobs." And number five is "improve constantly and forever, the system of production and service to improve quality and productivity and thus constantly decrease costs." So how do you embody that in your business, this, because when I first read the "constancy of purpose," I originally thought it meant pick your direction and stay constant with that. But then I started to realize, no, no, it's about how are we improving our product and service.   0:31:18.9 Travis Timmons: Yeah. So if you're not evolving with, technology is everywhere. Right. So if you're not paying attention to that within how it impacts your business and constantly trying to optimize how technology interfaces with your business, you're in trouble. So, like, we're right now getting ready to, I'd say once a year we do something fairly large within technology. Next year we're going to probably be changing our documentation software because there's a newer one out there that instead of having four different softwares we have to interface with, there'll be one. So that cuts down on rework, that cuts down on learning time for a new team member. There's less resistance for clients to understand how scheduling and billing work. So I don't know if I'm answering your question, Andrew, but I think from a standpoint of, I think it was Jack Welch I heard say years ago in an interview, "there's two ways a business is going. You're either growing or you're dying." And that resonated with me, there's no sitting still because if you do, you're going to get run over. So that's always looking through, can we make it easier to schedule?   0:32:40.0 Travis Timmons: Like right now we don't offer online scheduling for physical therapy. We will in 2026. And if we don't figure that out, it could be a reason that we would eventually go out of business. So I just looked through that mindset. There's always somebody coming after you.   0:32:58.7 Andrew Stotz: Yeah, yeah, that's...   0:33:00.3 Travis Timmons: Complacency doesn't work.   0:33:01.3 Andrew Stotz: I like to think about when I was young and I took a break and I stood still. I was standing on the flat ground, no problem. But now with my 87 year old mother, if she goes one day, two days, three days without movement, she's going backwards and it's harder to catch back up. And I start to realize she's operating on a plane that has been slanted against her. And eventually the slant will win against all of us. But in the world of business if you think, well it's not about growing or dying, well, there's someone out there trying to take your business by providing a better product or service. And that's just the reality that actually is invigorating to know that, and as Dr. Deming said to have a great competitor is such a valuable thing. If you're just poking around and you're doing okay in market you're probably not going to improve as much. So that the focus on improvement is something that I just find really fascinating. There's another question that I have which is these days, way I look at like the job of leadership is that it's like imagine a very strong magnet ahead of you and you're constantly pulled to that magnet.   0:34:37.7 Andrew Stotz: That magnet is the average, the consensus what everybody's doing. And you can't help but feel that force. And if you don't realize that you're being affected by that force, you're just being pulled into it. And what I mean by that is if you say, well, what if we tried something different, a different way of doing something and then you go to customers, no, sorry, your competitor does this. If you don't do that, I'm not going to give you the business. And so you're naturally drawn towards the center or towards consensus, but what you're doing is trying to pull your business and yourself and your thinking and your team away from that and saying there's a different way. And how hard is that?   0:35:24.4 Travis Timmons: It's hard. You have to have a different lens. Comment earlier, the problem named is the problem solved. One of the things, I love that analogy. I've never heard it described that way. In physical therapy it's very common for a physical therapist to have two or three patients scheduled at the same time because the problem that was named by most organizations is poor arrival rate. And if you have holes in your schedule you're not getting paid. So they look at that as a revenue loss. So to answer your question, that's where our industry is. Like you got a double, triple book or you're going to have lower revenue. Well, what that does is it increases, in my opinion, increases the likelihood that people are not going to come because they're going to have a bad experience, they're going to have poor outcomes. Physicians are going to stop referring because their patients aren't getting better. So problem named is the problem solved? And we pulled, I like that magnet. I'm going to use that one. But pulled away and said, no, if we provide one on one care at a very high level and the entire system works well for the patient, they're going to show up, they're going to continue to show up.   0:36:49.0 Travis Timmons: They're going to be happy to pay for the service we're offering because it's going to be exceptional. And because they show up, they're going to get better. And because they get better, they're going to go tell their doctor and then more doctors are going to refer to us. And that's thinking much differently. So that gets to the problem name, problem solved. Or using your magnet example, we are like, physicians come and talk to us all the time. They're like, are you really only seeing the patients one-on-one? Are you really doing that? Because nobody else says they can do that. It's like, yes, we are. That's exactly how we're doing it. And that's why you're here talking to us right now. Because it's so much different. You can't, there's some things that are just immeasurable. Like Dr. Deming talks about that quite a bit. We don't have to market, we don't spend... I shouldn't say, we don't have to market. We don't spend nearly the amount of money on marketing that our competitors do because we have physicians saying, hey, what's different over there? That's invisible. Right? That's invisible.   0:37:56.9 Andrew Stotz: And they weren't saying that in the beginning, but over the time they got that...   0:38:01.4 Travis Timmons: Yeah, yeah. It's a process, but you know, like the flywheel. We use that flywheel example. And now it's like, we're having a hard time hiring enough team members to keep up with the growth. One of the other thing's, "joy in work." Dr. Deming talks about joy in work a lot. And that's to your question earlier about continual improvement and jobs. So we exist, there's a lot of burnout in healthcare. You can't hardly open a business article.   0:38:37.7 Andrew Stotz: Seems paradoxical.   0:38:40.4 Travis Timmons: But it's because two and three patients at a time burdened with administrative stuff. So we also exist because, man, it's so fun when you have a team member join you from one of those other organizations and we've had eight new team members we've hired since July. And I have what I call a fresh eyes lunch with them a month in. And every one of them has said, my spouse can't believe how much happier and more enjoyable I am to be around. If that doesn't motivate you to want to continue to grow, I don't know what does. So that's the joy in work piece that Dr. Deming talked about a lot.   0:39:24.6 Andrew Stotz: And let's now talk about one other thing, which is I was just talking, I gave a speech last night in Bangkok to some business owners and then we had a dinner out and I was explaining to them that like, there's a disease that's come from America, not from Wuhan, China, in this case. It's come America, it's spread all across Thailand. And you really have to be careful with this disease. It's a deadly disease. And I said, and particularly Thailand, where there's harmony. People enjoy working together. They want a fun environment, they want to make friends at work. It's a little, it's very different from a US work environment where it's like, go there, deliver, go home, separate lives. That's not the way Thai people see work. And the disease is, the disease of individual KPIs and saying everybody, by optimizing each individual, we are optimizing the whole. And I'm trying to get them to realize like, there's another way. And I'm curious I'm sure if you're getting people from the bigger institutions and stuff, they're being KPI'd to death. And how do you, how do you manage the idea that I don't want to optimize the individual, I want to optimize the whole system, but yet I also want employees to know they gotta do a good job. So how do you manage that?   0:41:03.2 Travis Timmons: It's hard when somebody comes, because you're right, there's a lot of PTSD. I've got an example from today. So we turned on, within our system, there's a net promoter score that can be sent out to patients automatically after their first couple visits with us. And we turn it off and on from time to time just to get the voice of the customer, right. I think Dr. Deming talks about the voice of the customer and who all. So it's like, hey, we haven't done that in a while. We're going to turn it back on. And there were several therapists that were like, wait a minute, you're scoring me? And then if I get a low score, I'm in trouble. So we have to spend a lot of time educating the team on some of that old head trash. It's like, no, this is to study the system and where we can improve either improving our operational definition, whatever it is, give the team member tools on how to handle a difficult client. But to your point, you have, people's brains are so wired in the way you just described. So part of it is we, we let them know up front, like, here's why we don't have employee of the month at Fitness Matters.   0:42:15.4 Travis Timmons: Here's why we don't have the parking lot for employee of the month at Fitness. Like, all of those rewards, how all of the negative unintended consequences that can go along with that. Like even giving an individual an award in a group setting. Like, we had a team who's one of my clinic directors, the business she came from before, they had like a WWE, like the heavyweight wrestling, big champion belt. They had one of those. And each week somebody would give the belt to whoever they thought was the best employee that week. And she didn't get it for like two months in a row. And she was crushed. She's like, people don't like me. So it's fun to talk about the negative unintended consequences of the individual reward, the individual competitions. We could talk for an hour about motivating via monetary motivation. That's probably a whole nother podcast. But to answer your question, we have to make it very known why we don't do those things. Because as much as people hate some of that stuff, they also expect it. Yeah, why don't, why don't we have employee of the month? You mean I'm not going to get in trouble if I get a low net promoter score from one patient?   0:43:34.3 Travis Timmons: It's like, no, we know we hire good people. We know you do your best job every day. They could be upset because their billing didn't go correctly. So we just need to know. So I don't know if that answers your question, but it's a big thing because you do have to still track KPIs or you're out of business. Like, you do have to know what's going on within your system to measure it. It's just that concept of we all are responsible for the output of the system and the system has to produce exceptional results.   0:44:06.7 Andrew Stotz: Yeah, yeah.   0:44:07.9 Travis Timmons: And we have to have a weight by what method. We have to have a system to create whether you're doing plumbing, electrical work. Like if you're going to scale a business, you have to have a repeatable product that can scale.   0:44:23.2 Andrew Stotz: Yeah. And one of the answers to that too is if you believe 94% of the problems come from the system, then even when an employee is identified as having a bad net promoter score, then the question is, does the 94% apply in that situation? Well, generally yes. And so let's dig in. I have some people that ask me like my, one of the guys last night at this event works for a bank and they have put KPIs into everything. And he was saying, I just can't escape. But another guy was like, well, I have my own business and I can do what I want. I've implemented KPIs, but what should I do? I said the first step in disentangling yourself from this individual KPI situation is just to disconnect compensation to the KPI. So just right there, there's still incentive for the employee to do something bad for the organization to do their best. But when you remove that compensation aspect, you've really taken away a huge part of the incentive. So even if you have to keep KPIs, take away the tie to compensation and then they say, well, that's the whole reason why we're supposed to do it is have the tie to compensation.   0:45:44.5 Andrew Stotz: And I said, yes, it's a little bit of a circular references cannot be resolved.   0:45:49.7 Travis Timmons: Right. Yeah. And I think we even give examples to the team as much as we can around why we don't do those type of things. Here's what would happen. And most people have worked in organizations when you point it out to them. So again, Dr. Deming talks about making the system visible. Point it out to them. If I bonused you like you see this, this used to be a thing at car dealerships. When you're buying a car, hey, you're going to get a call to rate your experience with me. If you don't give me a 10, it's going to impact my pay. And you're like, what? So we talk about that like hey, the net promoter score. If we did the same thing here and bonused you on every 10, then you're going to be bothering your patients to fill that survey out. Or if you're afraid they're going to give you low score, you're not going to, you're going to encourage them not to do it. And then me as the owner, I'm not going to hear about system breakdowns. So to answer your, I think it's an important thing that a lot of businesses like number one, don't tie compensation to your KPIs.   0:46:58.3 Travis Timmons: Like just, it's an output of the system and then explaining it to them and giving examples over time because their brains even though they hated it, like we don't do performance reviews, annual performance review. And people hate them. And I still get asked like hey, when are you doing my annual performance review? It's like do you want to do one? Well no.   0:47:21.2 Andrew Stotz: Yeah. We dropped performance appraisals in 2016 in my coffee business here in Thailand and we never looked back. We didn't come up with any particular stunning replacement. We just knew it was bad and we were willing to just walk away from what was bad. I want to wrap up and just get into the... What are the, let's talk about kind of extrinsic versus intrinsic. There's some external factors that we can say this Deming implementation provided these benefits to our company and then there's this internal or intrinsic benefits that you're getting. Maybe you can go through some of those benefits of where you're at now, what you're able to do now and we'll close it on that note of kind of what's the hope for somebody that's stuck in the situation. They're the entrepreneurial seizure, they're the technician, they're great at physical therapy, they start their physical therapy business and they're just scaling chaos basically. Tell us about, give us hope.   0:48:37.8 Travis Timmons: Yeah, no, happy to, the reason I have had the opportunity to speak in a lot of different settings about Dr. Deming and the reason I do it is because it's brought so much joy to me personally and to a ever growing team. It's having a positive impact on lives and the more I can do that, that gets to the intrinsic motivation. So the joy in work, there's a lot of bad organizations out there that just suck the life out of people. So that's my intrinsic motivation at this stage of the game of if Fitness Matters is bigger, so more jobs, there's more people having a positive experience in life and our outcomes being 35% higher, our community is getting healthier. So that's the intrinsic motivation at this stage. It's fun. I know again, we're not perfect. So continuous improvement to our conversation earlier. But the intrinsic motivation is the busier Fitness Matters gets, the busier Fitness Matters gets because of high outcomes and it's positive experience for more people in life. Extrinsically, I guess that gets to community outcomes. So that's intrinsic and extrinsic. You know, extrinsically, if you get this figured out, it's very easy to scale a business.   0:50:06.0 Andrew Stotz: And tell us about your scale, where are you at or where are your averages versus national averages? You know, what have you accomplished that's driving that external factors, let's call it.   0:50:19.4 Travis Timmons: Yeah. So a couple things. One, externally, a practice like ours nationally on average is growing at 9% to 10%. We're currently clipping along at 25% to 30%. So you know, that flywheel effect and chaos is no longer there. So we have process, so it's easier to scale. The other extrinsic piece is because of our outcomes and continuing scale, we're able to negotiate better rates with our insurance companies to reinforce our strong desire to keep one-on-one care model. So Deming talks about who all is part of your system. So insurance companies are part of our system and we don't have a lot of control over them. But because our data is so powerful externally, we have been able to negotiate higher rates than most of our competitors because our data speaks for itself.   0:51:23.2 Andrew Stotz: Faster growth, the ability to negotiate better terms because you're delivering better product and service generally means higher profit margins.   0:51:34.2 Travis Timmons: Yes.   0:51:34.6 Andrew Stotz: Fast growth with higher profit margins generally means you're generating more cash and you're no longer in cash crisis all the time and you have resources to decide, okay, now we want to expand or we want to invest or whatever.   0:51:50.9 Travis Timmons: Right.   0:51:51.4 Andrew Stotz: Is that...   0:51:51.9 Travis Timmons: Yeah, the cash crunch was real those first 10 years. So yeah, to your point, when you get to the other side of that and process is a big part of that so you're having a whole counting process, but yeah, you get to that size. But yeah, the intrinsic piece, one of the reasons I talk about Deming as much as I can. I've got two sons that are in college. My hope is there's more companies in the world today than there were 10 years ago that know about Deming, because that means there's a higher likelihood that my boys will work at a Deming company. And just seeing what a lot of companies do to people, we as owners have a big responsibility, I feel, we have a big responsibility to have a positive impact on our employees. And you're, as an owner, are responsible for that, in my opinion. And if you get it right, man, is it fun to look in the mirror or sit down with a team member or their spouse and be proud of, be proud of what you built. That's at the end of the day, the intrinsic motivation.   0:52:57.9 Travis Timmons: If you can be proud of what your product is and proud of the impact you're having on your team to where you're not sucking the life out of them, but actually intrinsically motivating them. There's not much else you can accomplish in business that was worth more than that, in my opinion.   0:53:18.5 Andrew Stotz: Yeah, wonderful. That's a great way to end it. What's the likelihood that our children are going to be working in a Deming company? Well, that's the whole reason why we are here talking about it. So, Travis, I want to say on behalf of everyone at the Deming Institute, I want to thank you for this discussion and of course, for listeners out there and viewers, remember to go to deming.org to continue your journey. This is your host, Andrew Stotz. I'll leave you with one of my favorite quotes from Dr. Deming, and I believe it's probably one of Travis's too people are entitled to joy in work.   0:53:56.0 Travis Timmons: Love it. Love it. Thank you, Andrew.   0:53:58.0 Andrew Stotz: Yep.

Dr. Hope Rugo and Dr. Vivek Subbiah discuss innovative trial designs to enable robust studies for smaller patient populations, as well as the promise of precision medicine, novel therapeutic approaches, and global partnerships to advance rare cancer research and improve patient outcomes. TRANSCRIPT  Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center [in Los Angeles]. The field of rare cancer research is rapidly transforming thanks to progress in clinical trials and treatment strategies, as well as improvements in precision medicine and next-generation sequencing that enable biomarker identification. According to the National Cancer Institute, rare cancers occur in fewer than 150 cases per million each year, but collectively, they represent a significant portion of all cancer diagnoses. And we struggle with the appropriate treatment for these rare cancers in clinical practice. Today, I am delighted to be joined by Dr. Vivek Subbiah, a medical oncologist and the chief of early-phase drug development at the Sarah Cannon Research Institute in Nashville, Tennessee. Dr. Subbiah is the lead author of a paper in the ASCO Educational Book titled "Designing Clinical Trials for Patients with Rare Cancers: Connecting the Zebras," a great title for this topic. He will be telling us about innovative trial designs to enable robust studies for small patient populations, the promise of precision medicine, and novel therapeutic approaches to improve outcomes, and how we can leverage AI now to enroll more patients with rare cancers in clinical trials. Our full disclosures are available in the transcript of this episode.  Dr. Subbiah, it is great to have you on the podcast today. Thanks so much for being here. Dr. Vivek Subbiah: Thank you so much, Dr. Rugo, and it is an honor and pleasure being here. And thank you for doing this podcast for rare cancers. Dr. Hope Rugo: Absolutely. We are excited to talk to you. And congratulations on this fantastic paper. It is such a great resource for our community to better understand what is new in the field of rare cancer research. Of course, rare cancers are complex and multifaceted diseases. And this is a huge challenge for clinical oncologists. You know, our clinics, of course, cannot be designed as we are being very uni-cancer focused to just be for one cancer that is very rare. So, oncologists have to be a jack of all trades in this area. Your paper notes that there are approximately 200 distinct types of rare and ultra-rare cancers. And, by definition, all pediatric cancers are rare cancers. Of course, clinical trials are essential for developing new treatment strategies and improving patient outcomes, and in your paper, you highlight some unique challenges in conducting trials in this rare cancer space. Can you tell us about the challenges and how really innovative trial designs, I think a key issue, are being tailored to the specific needs of patients with rare cancer and, importantly, for these trials? Dr. Vivek Subbiah: Rare cancers present a perfect storm of challenges. First, the patient populations are very small, which makes it really hard to recruit enough participants for traditional type trials. Second, these patients are often geographically dispersed across multiple cities, across multiple states, across multiple countries, across multiple zip codes. So, logistics become complicated. Third, there is often limited awareness among clinicians, which delays referrals and diagnosis. Add to that regulatory hurdles, funding constraints, and you can see why rare cancer trials are so tough to execute. To overcome these barriers, we are seeing some really creative novel trial designs. And there are four different types of trial designs that are helping with enrolling patients with rare cancers. The first one is the basket trial. So let us talk about what basket studies are. Basket studies group patients based on shared genetic biomarkers or shared genetic mutations rather than tumor type. So instead of running separate 20 to 30 to 40 trials, you can study one therapy across multiple cancers. The second type of trial is the umbrella trial. The umbrella trials flip that concept of basket studies. They focus on one cancer type but test multiple targeted therapies within it. The third category of innovative trials are the platform studies. Platform trials are another exciting innovation. They allow new treatment arms to be added or removed as the data matures and as the data evolves, making trials more adaptive and efficient. The final category are decentralized tools in traditional trials, which are helping patients participate closer to where they are so that they can sleep in their own bed, which is, I think, a game changer for accessibility.  These designs maximize efficiency and feasibility for rare cancer research and rare cancer clinical trials. Dr. Hope Rugo: I love the idea of the platform trials that are decentralized. And I know that there is a trial being worked on with ARPA-H (Advanced Research Projects Agency for Health) funding in triple-negative breast cancer as well as in lung cancer, I think, and others with this idea of a platform trial. But it is challenged, I think, by precision medicine and next-generation sequencing where some patients do not have targetable markers, or there isn't a drug to target the marker. I think those are almost the same thing. We have really seen that these precision medicine ideas and NGS have moved the needle in helping to identify genetic alterations. This helps us to be more personalized. It actually helps with platform studies to customize trial enrollment. And we hope that this will result in better outcomes. It also allows us, I think, to study drugs even in the early stage setting more effectively. How can these advances be best applied to the future of rare cancers, as well as the challenges of not finding a marker or not having a drug? Dr. Vivek Subbiah: Thank you so much for that question. I think precision medicine and next-gen sequencing, or NGS, are truly the backbone of modern precision oncology. They have transformed how we think about cancer treatment. Instead of treating based on where the tumor originated or where the tumor started, we now look at the genetic blueprint of cancer. The NGS or next-gen sequencing allows us to sequence millions of DNA fragments quickly. Twenty, 30 years ago, they said we cannot sequence a human genome. Then it took almost a decade to sequence the first human genome. Right now, we have academic centers and commercial sequencing companies that are really democratizing NGS across all sites, not just in academic centers, across all the community sites, so that NGS is now accessible. This means that we can identify these actionable alterations like picking needles in haystacks, like NTRK fusions, RET fusions, or BRAF V600E alterations, high tumor mutational burden. This might occur across not one tumor type, across several different tumor types. So for rare cancers, this is critical because some of these mutations often define the best treatment option. Here is why this matters. Personalized therapy, right? Instead of a one-size-fits-all approach, we can tailor treatment to the patient's unique molecular profile. For trial enrollment, this can definitely help because patients can join biomarker-driven trials even if their cancer type is rare or ultra-rare. NGS technology has also helped us in designing rational studies. Many times monotherapy does not work in these cancers. So we are thinking about rational combination strategies. So NGS technology is helping us. Looking ahead, I see NGS becoming routine in clinical practice, not just at major niche academic centers, but everywhere. We will see more tumor-agnostic approvals, more molecular tumor boards guiding treatment decisions in real time. And I think we are seeing an expanded biomarker setup. Previously, we used to have only a few drugs and a handful of mutations. Now with homologous recombination defects, BRCA1/2 mutation, and expanding the HRD and also immunohistochemistry, we are expanding the biomarker portfolio. So again, I personally believe that the future is precision. What I mean by precision is delivering the right drug to the right patient at the right time. And for rare cancers, this isn't just progress. It is survival. And it is maybe the only way that they can have access to these cutting-edge precision medicines. Dr. Hope Rugo: That is so important. You mentioned an important area we will get to in a moment, the tumor-agnostic therapies. But as part of talking about that, do you think that the trials should also include just standard therapies? You know, who do you give an ADC to and when with these rare cancers? Because some of them do not have biomarkers to target and it is so disappointing for patients and providers where you are trying to screen a patient for a trial or a platform trial where you have one arm with this mutation, one arm with that, and they do not qualify because they only have a p53 loss, you know? They just do not have the marker that helps them. But we see this in breast cancer all the time. And it is tough because we don't have good information on the sequencing. So I wonder, you know, just because for some of these rare cancers it is not even clear what to use when with standard treatments. And then that kind of gets into this idea of the tumor-agnostic therapies that you mentioned. There are a lot of new treatments that are being evaluated. We have seen approval of some treatments in the last few years that are tumor-agnostic and based on a biomarker. Is that the best approach as we go forward for rare cancers? And what new treatment options are most exciting to you right now? Dr. Vivek Subbiah: Tumor-agnostic therapies, really close to my heart, are real breakthrough therapies and represent a major paradigm shift in oncology. Traditionally, for the broad listeners here, we are used to thinking about designing clinical trials and therapy like where the cancer originated, breast cancer, kidney cancer, prostate cancer, lung cancer. A tumor-agnostic therapy flips that model. Instead of focusing on the organ, they target the specific genetic alteration or biomarker that drives cancer growth regardless of where the tumor started, regardless of the location of the tumor, regardless of the zip code of the tumor. So why is this so important for rare cancers? Because many rare cancers share molecular features with more common cancers. For instance, NTRK fusion might occur in pediatric sarcoma, a salivary gland tumor, or a thyroid cancer. Historically, each of these would require separate trials, which is nearly impossible, unfeasible to conduct in these ultra-rare cancers like salivary gland cancer or pediatric sarcomas. Tumor-agnostic therapies allow us to treat all those cancers with the same targeted drug if they share that biomarker. Again, we are in 2025. The first tissue-agnostic approval, the historic precedent, was in fact an immunotherapy. Pembrolizumab was approved in 2017, May 2017, as the first immunotherapy to be approved in a tumor-agnostic way for a genomic biomarker, for MSI-High and dMMR cancers. Then came the NTRK inhibitors. So today we have not one, not two, but three different NTRK inhibitors: larotrectinib, entrectinib, and repotrectinib, which show response rates of nearly more than 60 to 75% across a handful of dozens and dozens of cancer types. Then, of course, we have RET inhibitors like selpercatinib, which is approved tissue-agnostic, and pralsetinib, which also shows tissue-agnostic activity across multiple cancers. And more recently, combination therapy with a BRAF and MEK combination, dabrafenib and trametinib, received tumor-agnostic approval for all BRAF V600E tumors with the exception of colorectal cancer. And even recently, you mentioned about antibody drug conjugates. Again, I think we live in an era of antibody drug conjugates. And Enhertu, trastuzumab deruxtecan, which was used first in breast cancer, now it is approved in a histology-agnostic manner for all HER2-positive tumors defined by immunohistochemistry 3+. So again, beyond NGS, now immunohistochemistry for HER2 is also becoming a biomarker. So again, for the broad listeners here, in addition to comprehensive NGS that may allow patients to find treatment options for these rare cancers for NTRK, RET, and BRAF, immunohistochemistry for HER2 positivity is also emerging as a biomarker given that we have a new FDA approval for this. So I would say personally that these therapies are game changers because they open doors for patients who previously had no options. Instead of waiting for years for a trial in their specific cancer type, they can access a treatment based on their molecular profile. I think it is precision medicine at its finest and best. Looking ahead, the third question you asked me is what is exciting going on? I think we will see more of these approvals. My hope is that today, I think we have nine to ten approvals. My hope is that within the next 25 to 50 years, we will have at least 50 to 100 drugs approved in this space based on a biomarker, not based on a location of the tumor type. Drug targeting rare alterations like FGFR2 fusions, FGFR amplifications, ALK fusions, and even complex signatures like high tumor mutational burden. I think we will be seeing hopefully more and more drugs approved. And as sequencing becomes routine, we will identify more patients for these therapies. I think for rare cancers, this is not just innovative approach. This is essential for them to access these novel precision medicines. Dr. Hope Rugo: Yeah, that is such a good point. I do think it is critical. Interestingly in breast cancer, it hasn't been, you know, there is always like two patients in these tumor-agnostic trials, or if that. You know, I think I have seen one NTRK fusion ever. I think that highlights the importance for rare cancers. And you know, I am hoping that that will translate into some new directions for some of our rarer and impossible-to-treat subtypes of breast cancer. It is this kind of research that is really going to make a difference. But what about those people who do not have biomarkers? What if you do not fit into that? Do you think there is a possibility of trying to do treatments for rare cancers in some prospective way that would help with that? You know, it is really a huge challenge. Dr. Vivek Subbiah: Absolutely. I think, you know, you're right, usually many of these rare cancers are driven by specific biomarkers. And again, some of the pediatric salivary gland tumors or pediatric sarcomas like fibrosarcomas, they are pathognomonic with NTRK fusions. And again, given that we have a tumor-agnostic approval, now these patients have access to these therapies. And I do not think that we would have had a trial just for pediatric fibrosarcomas with NTRK fusions. So that is one way. Another way is SWOG, right? The SWOG DART [1609] had this combination dual checkpoint, it was called the DART study dual combination chemotherapy with ipi/nivo. Now here the rare cancer subtype itself becomes a biomarker and they showed activity across multiple rare cancer subtypes. They didn't require a biomarker. As long as it was a rare or ultra-rare cancer, these patients were enrolled into the SWOG DART trial and multiple arms have read out. Angiosarcoma, Kaposi sarcoma, even gestational trophoblastic disease. Again, they have shown responses in these ultra-rare, rare cancers. Sometimes they might be seeing one or two cases a whole year. And I think this SWOG effort, this cooperative group effort, really highlighted the need for such studies without biomarkers as well. Dr. Hope Rugo: That is such a fantastic example of how to try and treat patients in a collaborative way. And in the paper, you also emphasize the need for collaborative research efforts, you know, uniting resource expertise across different ways of doing research. So cooperative groups, advocacy organizations that can really help advance rare cancer research, improve access to new therapies, and I think importantly influence policy changes. I think this already happened with the agnostic approvals. Could you tell us more about that? How can we move forward with this most effectively? Dr. Vivek Subbiah: Personally, I believe that collaboration is absolutely critical and essential for rare cancer research. No single institution, no single individual, or no single state or entity can tackle these challenges alone. The patient populations are small and dispersed. So pooling resources is the only way to run these meaningful trials. Again, it is not like singing, it is like putting a huge, huge, I would say, an opera piece together. It is not a solo, vocal therapy, but rather putting a huge opera piece like Turandot. You know, you mentioned cooperative groups. Cooperative groups, as I mentioned earlier, the SWOG DART program, the ASCO [TAPUR study]. ASCO is doing a phenomenal work of the TAPUR study. Again, this ASCO TAPUR program has enrolled so many patients with rare cancers who otherwise would not have treatment options. NCI-MATCH, the global effort, right? NCI-MATCH and the ComboMATCH are great examples. They bring together hundreds of sites, thousands of clinicians to run large-scale trials that would be impossible for any individual center or institution. These trials have already changed practice. For instance, the DART demonstrated the power of immunotherapy in rare cancers and influenced NCCN guidelines. One of the arms of the NCI-MATCH study from the BRAF V600E arm contributed towards the BRAF V600E tissue-agnostic approval. So, the BRAF V600E tissue-agnostic approval was by a pooled analysis of several studies. The ROAR study, the Rare Oncology Agnostic Research study, the NCI-MATCH dataset of tumor-agnostic cohort, and another pediatric trial, and also evidence from literature and evidence of case reports. And all this pooled analysis contributed to the tissue-agnostic approval of BRAF V600E across multiple rare cancers. There are several patient advocacy organizations which are the real unsung heroes here. Groups like, for instance, we mentioned in the paper, Target Cancer Foundation, don't just raise awareness for rare cancer research, they actively connect patients to trials providing financial, emotional support, and even run their own studies like the TRACK trial. They also influence policy to make access easier. On a global scale, initiatives like DRUP in the Netherlands, the ROME study in Italy, the PCM4EU in Europe are expanding precision medicine across these borders. These collaborations accelerate research, improve trial enrollment, and ensure patients everywhere can have access to these cutting-edge therapies. Again, it is truly a team effort, right? It is a multi-stakeholder approach. Researchers, clinicians, investigators, industry, regulators, academia, patients, patient advocates, and their caregivers all working together. And it takes a village. Dr. Hope Rugo: Absolutely. I mean, what a nice response to that. And I think really exciting and it is great to see your passion about this as well. But it helps all of us, I think, getting discouraged in treating these cancers to understand what is happening moving forward. And I think it is also a fabulous opportunity for our junior colleagues as they rise up in academics to be involved in these international collaborative efforts which are further expanding. One of the things that comes up for clinical trials for patients, and I think it is highlighted with rare cancers because, as you mentioned, people are all over the place, you know, they are so rare. They are all far away. Our patients are always saying to us, "Should I go here for a phase 1 trial?" Can you talk a little bit about how we can overcome these financial and geographic burdens for the patients? You talked about having trials locally, but it is a big financial and just social burden for patients. Dr. Vivek Subbiah: Great point. Financial cost is a major barrier in rare cancer clinical trials. It is a major barrier not just in rare cancer clinical trials, but in clinical trials in general. The economics of rare cancer research are one of the toughest challenges we face. Developing a new drug is already expensive, often billions of dollars. On an average, it takes 2 billion dollars or 2.8 billion dollars according to some data from drug discovery to approval. For rare cancers, the market is tiny, which means the pharmaceutical companies have really little financial incentive to invest. That is why initiatives like the Orphan Drug Act were created to provide tax credits, grants, and market exclusivity to encourage development for rare diseases. Clinical trials themselves are expensive because the small patient populations mean longer recruitment times and higher per-patient costs. Geographic dispersion, as you mentioned, for the patients adds travel, coordination. That is why we need to think out of the box about decentralized trial infrastructure so that we can mitigate some of these expenses. Complex trial designs like basket or platform trials sometimes require sophisticated data systems and regulatory oversight. That is a challenge. And I think some of the pragmatic studies like ASCO TAPUR have overcome those challenges. Advanced technologies like next-gen sequencing and molecular profiling also add significant upfront cost to this. Funding is also limited because rare cancers receive less attention compared to common cancers. Public funding and cooperative group trials help a lot, but I think they cannot cover everything. Patient advocacy organizations sometimes step in to bridge these gaps, but sustainable financing remains a huge challenge. So, the bottom line is without financial incentives and collaborating funding models, many promising therapies for rare cancers would never make it to patients. That is why we need system-wide policy changes, global partnerships, and innovative, effective, seamless trial designs which are so critical so that they can help reduce the cost and make research feasible so that we can deliver the right drug to the right patient at the right time. Dr. Hope Rugo: There is a lot of excitement about the future integration of AI in screening. Just at the San Antonio Breast Cancer meetings, we have a number of different presentations about AI to find markers, even like HER2, and using AI where you would screen and then match patients to clinical trials. Do you have any guidance for the rare cancer community on how to leverage this technology in order to optimize patient enrollment and, I think, identification of the best treatment matches? Dr. Vivek Subbiah: I think artificial intelligence, AI, is a game-changer in the making. Right now, clinical trial is clunky. Matching patients to trial is often manual, time consuming, laborious. You need a lot of personnel to do that. AI can automate this process by analyzing genomic data, medical records, and trial eligibility criteria to find the best matches quickly, accurately, and effectively. For the community, the key is to invest in data standardization and interoperability because AI needs clean, structured data to work effectively. Dr. Hope Rugo: Thank you so much, Dr. Subbiah, for sharing these fantastic insights with us on the podcast today and for your excellent article. Dr. Vivek Subbiah: Thank you so much. Dr. Hope Rugo: We thank you, our listeners, for joining us today. You will find a link to Dr. Subbiah's Educational Book article in the transcript of this episode. And please join us again next month on By the Book for more insightful views on key issues and innovations that are shaping modern oncology.  Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:        Dr. Hope Rugo   @hoperugo   Dr. Vivek Subbiah @VivekSubbiah Follow ASCO on social media:        ASCO on X  ASCO on Bluesky       ASCO on Facebook        ASCO on LinkedIn        Disclosures:       Dr. Hope Rugo:    Honoraria: Mylan/Viatris, Chugai Pharma   Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer   Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx   Dr. Vivek Subbiah: Consulting/Advisory Role: Loxo/Lilly, Illumina, AADI, Foundation Medicine, Relay Therapeutics, Pfizer, Roche, Bayer, Incyte, Novartis, Pheon Therapeutics, Abbvie Research Funding (Inst.): Novartis, GlaxoSmithKline, NanoCarrier, Northwest Biotherapeutics, Genentech/Roche, Berg Pharma, Bayer, Incyte, Fujifilm, PharmaMar, D3 Oncology Solutions, Pfizer, Amgen, Abbvie, Mutlivir, Blueprint Medicines, Loxo, Vegenics, Takeda, Alfasigma, Agensys, Idera, Boston Biomedical, Inhibrx, Exelixis, Amgen, Turningpoint Therapeutics, Relay Therapeutics Other Relationship: Medscape, Clinical Care Options

It isn't as normal, or rather heard of, to make idols or to worship other gods. We don't live in a society where everyone goes to a pagan temple once a week to make their sacrifice and worship Baal. Don't get me wrong, some people do still worship pagan gods, but nowadays we have made all kinds of new idols. In today's message, Pastor Mark will teach that anything can be an idol. Traditionally, you may think an idol is just a physical object or person that someone idolizes, but anything can be idolized…Your phone, your job, and even your family. Anything that you value more or put above God is an idol.

In today's episode, Gina discusses the brain and contemporary thought concerning the plastic and changeable nature of the brain. The ability of individuals to exploit the brain's adaptability with their own minds and guidance is highlighted. Specific steps to change your brain and reduce your anxiety are included.Please visit our Sponsor Page to find all the links and codes for our awesome sponsors!https://www.theanxietycoachespodcast.com/sponsors/ Thank you for supporting The Anxiety Coaches Podcast. FREE MUST-HAVE RESOURCE FOR Calming Your Anxious Mind10-Minute Body-Scan Meditation for Anxiety Anxiety Coaches Podcast Group Coaching linkACPGroupCoaching.comTo learn more, go to:Website https://www.theanxietycoachespodcast.comJoin our Group Coaching Full or Mini Membership ProgramLearn more about our One-on-One Coaching What is anxiety? Find even more peace and calm with our Supercast premium access membership:For $5 a month, all episodes are ad-free! https://anxietycoaches.supercast.com/Here's what's included for $5/month:❤ New Ad-Free episodes every Sunday and Wednesday❤ Access to the entire Ad-free back-catalog with over 600 episodes❤ Premium meditations recorded with you in mind❤ And more fun surprises along the way!All this in your favorite podcast app!Chapters0:26 Embracing the Changeable Brain3:38 The Power of Mindfulness6:20 Understanding Anxiety and Hope8:11 The Role of Repetition in Change9:45 Practical Steps for Transformation12:57 Taking Responsibility for ChangeSummaryIn this episode of the Anxiety Coaches Podcast, I dive into the fascinating concept of the changeable brain, exploring the implications of neuroplasticity and its profound effects on our mental health. Traditionally, many of us were led to believe that our brains reach a fixed state in adulthood, but recent scientific breakthroughs reveal an exciting reality: our brains are not hardwired and, instead, possess remarkable adaptability and the capacity to change throughout our lives. This understanding offers a sense of hope, empowering us to take charge of our mental wellness.I emphasize the importance of retraining our brains to navigate away from anxiety. To break free from the anxiety cycle, we must forge new neuropathways while simultaneously dismantling the old ones that tether us to fear. This process is not merely an academic exercise; it happens organically as our brains utilize the remnants of old pathways to build new connections. Thus, whether we consciously train our brains or not, change is inevitable, making it essential for us to guide that change purposefully.Mindfulness emerges as a cornerstone in this journey, enabling us to cultivate awareness and intentionality in our daily lives. I discuss the impactful role that mindfulness plays in breaking free from automatic responses, compelling us to engage more fully with our thoughts and experiences. By becoming vigilant about our mental habits, we create space for healthier, more peaceful thoughts to flourish. I draw an analogy of a rider managing a horse; just as the rider must train the horse to move in the desired direction, we must learn to direct our thoughts consciously to foster the change we seek.#anxiety, #neuroplasticity, #mentalhealth, #mindfulness, #anxietyrecovery, #brainhealth, #stressrelief, #wellness, #selfcare, #personalgrowth, #healing, #mindset, #calm, #podcast, #mentalwellness, #ginaryan, #anxietycoachespodcast, #brainplasticity, #overcominganxiety, #meditation, #intentionality, #selfhealing, #neuroscience, #mentalhealthmatters, #innerpeace, #journaling, #anxietysupport, #healthyliving, #positivity, #growthmindsetSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Success isn't accidental; it follows principles that most people prefer to ignore.In this episode, I show you how to focus on the things that really matter: the timeless principles that will make your success inevitable.Traditionally around this time, we produce an episode focused on the outlook for the year ahead but, heading into 2026, we decided to do something a little different.I'm going to focus on the success principles that will make a genuine difference. Your job is to distil the one or two that are most important to you, and work out how to embrace them in the coming year. There's some work in this for you… it's not just a casual listen. But I know you're up for it! It will make ALL the difference to your mindset as you head into another year.————————FREE QUIZ: I've developed a 3-question quiz that'll give you a free personalised podcast playlist tailored to where you are right now in your leadership career!Click here to take the 30-second quiz now to get your on-the-go playlist————————You can connect with me at:Website: https://www.yourceomentor.comFacebook: https://www.facebook.com/yourceomentorInstagram: https://www.instagram.com/yourceomentorLinkedin: https://www.linkedin.com/in/martin-moore-075b001/Youtube: https://www.youtube.com/@YourCEOMentor————————Our mission here at Your CEO Mentor is to improve the quality of leaders, globally.

A meditation preached on January 31, 2025, last day of the year, at Lyncroft centre. Traditionally, in the old Mass, after the priest had given the blessing, before returning to the sacristy, he would read the prologue of John's Gospel about the preexistence of the Word, from all eternity that had now become flesh. This Gospel was a way to seal the Mass with the mystery of the incarnation, reminding the faithful of what they had received. Our faith is an encounter with the incarnate Logos, not merely an ethical system of good ideas. The apostles were energized by this truth at Pentecost. Now we too feel this same sense of mission as we embark on 2026.Music: O Come O Come Emmanuel. On X from Catholic Arena.Thumbnail: Icon of the enthroned Virgin and Child with saints George, Theodore and angels, 6th century, Saint Catherine's Monastery, Mount Sinai.St. Catherine's Monastery, Sinai, Egypt)

In this special end-of-year episode of Behind the Genes, host Sharon Jones is joined by Dr Rich Scott, Chief Executive Officer of Genomics England, to reflect on the past year at Genomics England, and to look ahead to what the future holds.  Together, they revisit standout conversations from across the year, exploring how genomics is increasingly embedded in national health strategy, from the NHS 10-Year Health Plan to the government's ambitions for the UK life sciences sector. Rich reflects on the real-world impact of research, including thousands of diagnoses returned to the NHS, progress in cancer and rare condition research, and the growing momentum of the Generation Study, which is exploring whether whole genome sequencing could be offered routinely at birth.  This episode offers a thoughtful reflection on how partnership, innovation, and public trust are shaping the future of genomic healthcare in the UK and why the years ahead promise to be even more exciting.  Below are the links to the podcasts mentioned in this episode, in order of appearance:  How are families and hospitals bringing the Generation Study to life? How can cross-sector collaborations drive responsible use of AI for genomic innovation? How can we enable ethical and inclusive research to thrive? How can parental insights transform care for rare genetic conditions? How can we unlock the potential of large-scale health datasets? Can patient collaboration shape the future of therapies for rare conditions? https://www.genomicsengland.co.uk/podcasts/what-can-we-learn-from-the-generation-study “There is this view set out there where as many as half of all health interactions by 2035 could be informed by genomics or other similar advanced analytics, and we think that is a really ambitious challenge, but also a really exciting one.”  You can download the transcript, or read it below. Sharon: Hello, and welcome to Behind the Genes.   Rich: This is about improving health outcomes, but it's also part of a broader benefit to the country because the UK is recognised already as a great place from a genomics perspective. We think playing our role in that won't just bring the health benefits, it also will secure the country's position as the best place in the world to discover, prove, and where proven roll out benefit from genomic innovations and we think it's so exciting to be part of that team effort.  Sharon: I'm Sharon Jones, and today I'll be joined by Rich Scott, Chief Executive Officer at Genomics England for this end of year special. We'll be reflecting on some of the conversations from this year's episodes, and Rich will be sharing his insights and thoughts for the year ahead. If you enjoyed this episode, we'd love your support, so please subscribe, rate, and share on your favourite podcast app. So, let's get started.  Thanks for joining me today, Rich. How are you?  Rich: Great, it's really good to be here.   Sharon: It's been a really exciting year for Genomics England. Can you tell us a bit about what's going on?  Rich: Yeah, it's been a really busy year, and we'll dive into a few bits of the components we've been working on really hard. One really big theme for us is it's been really fantastic to see genomics at the heart of the government's thinking. As we'll hear later, genomics is at the centre of the new NHS 10-year health plan, and the government's life sciences sector plan is really ambitious in terms of thinking about how genomics could play a role in routine everyday support of healthcare for many people across the population in the future and it shows a real continued commitment to support the building of the right infrastructure, generating the right evidence to inform that, and to do that in dialogue with the public and patients, and it's great to see us as a key part of that.  It's also been a really great year as we've been getting on with the various programmes that we've got, so our continued support of the NHS and our work with researchers accessing the National Genomic Research Library. It's so wonderful to see the continued stream of diagnoses and actionable findings going back to the NHS. It's been a really exciting year in terms of research, publications. In cancer, some really exciting publications on, for example, breast cancer and clinical trials. Really good partnership work with some industry partners, really supporting their work. For me, one of the figures we are always really pleased to see go up with time is the number of diagnoses that we can return thanks to research that's ongoing in the research library, so now we've just passed 5,000 diagnostic discoveries having gone back to the NHS, it really helps explain for me how working both with clinical care and with research and linking them really comes to life and why it's so vital.   And then, with our programmes, it's been great to see the Generation Study making good progress. So, working with people across the country, more than 25,000 families now recruited to the study, and we're beginning to hear about their experiences, including some of the families who've received findings from the programme. It's really nice to see and hear from Freddie's family, who talked to the press a bit about the finding that they received. Freddie was at increased risk of a rare eye cancer, and really pleasingly, it was possible to detect that early through the screening that was put in place. Again, it really brings to life why we're doing this, to make a difference and improve health outcomes.  Sharon: That's an incredible 12 months. Diving into that Generation Study piece and for listeners who don't know what that is, it's a research study in partnership with the NHS that aims to sequence the genomes of 100,000 newborn babies. On an episode from earlier in the year, we had mum, Rachel Peck, join the conversation, whose baby Amber is enrolled on a study. Let's year from Rachel now.  Rachel: From the parents' point of view, I guess that's the hardest thing to consent for in terms of you having to make a decision on behalf of your unborn child. But I think why we thought that was worthwhile was that could potentially benefit Amber personally herself or if not, there's the potential it could benefit other children.  Sharon: Consent has been such a big area of focus for us, Rich, and Rachel touches on that complexity, you know, making a decision on behalf of her unborn child. Can you talk a bit about our approach to consent in the Generation Study and what's evolving in that model?  Rich: Yeah. It's been for the whole study, really, starting out asking a really big question here, what we're aiming to do is generate evidence on whether and if so, how whole genome sequencing should be offered routinely at birth, and that's responding to a really ill need that we know that each year thousands of babies are born in the UK with treatable rare conditions. We will also need to see if whole genome sequencing can make a difference for those families, but we realise to do that, as with all screening, that involves testing more people than are going to benefit from it directly themselves. So, you have to approach it really sensitively. There's lots of complicated questions, lots of nuance in the study overall. One of them is thinking really carefully about that consent process so that families can understand the choices, they can understand the benefits and risks. This is still a research study. We're looking to understand whether we should offer this routinely. It's not part of routine care at this point. The evidence will help decision-makers, policymakers in the future decide that.  At the beginning of the programme, we spent a lot of time talking to families, talking to health professionals who understand the sorts of decisions that people are making at that time of life, but also are experts in helping think about how you balance that communication. That involved, as I say, a lot of conversations. We learnt a lot, lots of it practical stuff, about the stage of pregnancy that people are at when we first talk to them about the study, so that people aren't hurried and make this decision. What we've learnt in the study, right from the outset, is talking to people from midway through the pregnancy so that they really have time to engage in it and think about their choice. So, it's an important part of getting the study design right so that we run the study right. It's also a really crucial element of the evidence that will generate from the study so that we can understand if this is something that's adopted, how should we communicate about it to families. What would they want to know? What's the right level of information and how do we make that accessible in a way that is meaningful to people from different backgrounds, with different levels of interest, different accessibility in terms of digital and reading and so on. There's a lot that we've learnt along the way and there's a lot that we're still learning. And as I say, important things that we'll present as evidence later on.  Sharon: Thank you. It's fascinating there are so many moving parts and a lot to consider when you're building the design of a programme like this or study like this.  Earlier in the year you had a great conversation with Karim Beguir about the developments of AI in genomics. Let's revisit that moment.  Karim: We live in an extraordinary time. I want to emphasise the potential of scientific discovery in the next two or three years. AI is going to move, let's say, digital style technologies like coding and math towards more like science and biology. In particular, genomics is going to be a fascinating area in terms of potential.  Sharon: So, Karim talks about AI moving from maths and coding into biology. Why is genomics such a natural area for AI?  Rich: It's really fascinating. I think it links a lot to how we think about genomics and how you get the most value in terms of health benefit and sort of the progress that we can see could come through genomics more generally. So, your genome, which is your DNA code, written in 3 billion little letters across each one of us, one copied from mum, one copied from dad, even just our genomic code of one person is a large amount of data. That is just part of the story because we're not just interested in DNA for DNA's sake, this is about thinking about health and how we can improve health outcomes. So, it's also thinking about the other sorts of information that needs to link to genomic data to make a difference. Whether that's just to provide routine healthcare with today's knowledge, or whether it's about continuing to learn and discover.  As I mentioned at the beginning, I think a really important part of this whole picture is we've learnt a lot in the last 20/30/40 plus years about genomics. It's incredible how much progress has been made, and we're really just scratching the surface. Take rare disease and the progress that's been made there, it's wonderful how many more families we're able to help today. We know that many thousands of families we still can't find a diagnosis for when we know that there is one there for many of them. That theme of ongoing learning is at the centre of all of our work, and that will continue as we look about broader uses of genomics in other settings beyond rare conditions and cancer. It's also that ongoing learning, but also the amount of, at the moment, manual steps that are required in some of the processes that we need to, for example, find a diagnosis for someone or to make sure the tools that we use are the most up to date, the most up to date with the medical literature, for example. AI is a tool that we're, as the whole of the society, we're beginning to see how it can play a role. We see it as important today for some of the just really practical things. I mentioned it, staying up to date with the medical literature, making sure that we and our systems are aware of all of the knowledge that's coming in from around the world. It's got real potential there.  I think the biggest bottom line here is that it's got the potential to be a really important tool in terms of our ongoing learning and improvement. I'm a doctor by background, the human intelligence alone is fantastic, it's moved us a long way, but we know it also has tremendous blind spots. AI has the potential to complement us there. I guess another thing to really call out here, AI isn't a panacea, it's not suddenly going to answer all of the questions. And, just like human intelligence, it will have its own biases, have its own strong points, and less strong points.  One of the things we're really committed to is working with people like Karim, and many others, to understand where AI could make a difference, to test it, to generate evidence on how well it works and an understanding in all sorts of ways about how that might play out. And, make sure that as AI becomes a tool, that we in genomics, but also in other areas, we understand its strong points and where we need to be more careful and cautious with it. That's a really important part of what we're going to be doing in the coming years here, is making sure that we can maximise the impact of it, but also be confident, so that we can explain to people whose data we might use it on how we're doing it and what it's bringing.  Sharon: Thanks Rich. It's definitely a fast-moving conversation of which we really want to be part of. One of the things that's come up again and again this year is participation and co-production. Let's hear quote that really captures that.  Bobbie: In an earlier conversation with Paul, which you might find surprising that it's stuck with me so much, he used the word ‘extractive'. He said that he'd been involved in research before and looking back on it, he had felt at times it could be a little bit extractive. You come in, you ask questions, you take the data away and analyse it, and it might only be by chance that the participants ever know what became of things next. One of the real principles of this project was always going to be co-production and true collaboration with our participants.  Sharon: That was Professor Bobbie Farsides talking about moving away from extractive research towards true co-production. How are we making that shift in practice here at Genomics England?  Rich: It's a great question. It's one of the areas where I think we've learnt most as an organisation over the years about how really engaging from the beginning with potential participants in programmes, participants who join our programmes, people who are involved in delivering our programmes and healthcare is so important at the beginning. I mentioned earlier the work to think about the consent process for the Generation Study, and that's one of the areas where I think from our first programme, 100,000 Genomes Project, we learnt a lot about how to do that well, some of the pitfalls, some of the bits that are most challenging. And really, right from the start of our programmes, making sure that people who will potentially benefit from the programmes, potentially join them, can be part of that engagement process, and really part of the design and the shaping of the research questions, the parameters around research, but also the materials and how people will engage with them. And that's one of the key capabilities we have internally as an organisation, so we work with partners externally, but also it's a really key part of the team that we have at Genomics England.  Sharon: So, whilst Bobbie talked about moving away from research that can feel one-sided and towards true collaboration, in another episode, Lindsay, a parent of a child with a rare condition, reflected on what that change really means for families and how it's empowering to see their voices and experiences shaping future treatments.  Lindsay: Historically, there's been a significant absence of a patient voice in rare disease research and development. And knowing that that's changing, I think that's really empowering for families. To know that professionals and industry are actually listening to our stories and our needs and really trying to understand, that offers much greater impact on the care and treatments of patients in the future.  Sharon: So, what role do you see participants as partners in shaping the next phase of Genomics England's work?  Rich: So, as you probably detected from my last answer, we see it as absolutely vital. One of the really exciting things here at Genomics England, we've had a participant panel from very early in our life as an organisation. That's one really important route to us at the heart of our organisation, part of our governance, making sure that participants representing all sorts of parts of our programme, but rare conditions being a really large focus for us. And I think, what's so striking as someone with a medical and a research background can see how I think historically medics and researchers have sometimes not known, sort of maybe been a bit scared about knowing how to involve participants from the outset. Often, because they're worried that they might ask the wrong questions in the wrong way, they just don't have the tools.   One of the things I often say now to people we work with is one of the most empowering and positive experiences we have at Genomics England is the power of our participants helping to, right from the beginning, shape what the questions are that we should be asking. Realise some of the challenges that you can't possibly, if you're not in their shoes, understand are the most important to really shape how we prioritise our work internally, the problems that we need to solve first, how we think about some of the practical impacts on people's lives that, again, without hearing from their voice you just wouldn't know. And again, to help our researchers, people accessing data in the National Genomic Research Library, helping them make sure that they involve participants in their work and the confidence and tools to do that.  Sharon: That's great, thank you. Another big theme this year has been collaboration across the NHS, academia, and industry. Dr Raghib Ali puts this really well.  Raghib: There are areas where academia and the NHS are very strong, and there are areas where industry is very strong, and why working together, as we saw, you know, very good examples during the pandemic with the vaccine and diagnostic tests, etc., a collaboration between the NHS, academia, and industry leads to much more rapid and wider benefits for our patients and, hopefully, in the future for the population as a whole in terms of early detection and prevention of disease.  Sharon: So, how does collaboration fit into the 10-year health plan and what's next for 2026 in that space, Rich?  Rich: I think one of the most enjoyable parts of my role at Genomics England and our role as an organisation is the fact that we see ourselves very much as part of a, sort of team across the UK and in fact internationally in terms of delivering on the potential we see for genomics. So, we have a vision as an organisation, which has been the same the last 5 or so years, which is a world where everyone can benefit from genomic healthcare. In fact, that vision is now shared by the NHS from a genomics perspective, and really demonstrably, the 2 parts of the system absolutely pointing in the same direction. And when we've been thinking, looking forward with that 10-year lens on it, what we always like to do, and I think it's a real privilege to be able to do, because we're here in the UK, because we have a National Health Service, because there's been that long-term commitment from government on genomics and really taking a long-term investment view there, and because of so many other parts of the ecosystem, other experts who access data in the National Genomic Research Library, research organisations like Our Future Health, UK Biobank, all teaming together, and the expertise that's there in genomics more broadly. So we've, if you like, worked back from what the UK could do as whole, and in the 10-year health plan, as I said earlier, genomics is at the heart of that.  There's a double helix on the front cover and, in fact, on the watermark on almost every page. And, there's this view set out there where as many as half of all health interactions by 2035 could be informed by genomics or other similar advanced analytics. And we think that that's a really ambitious challenge. We see a really important role for us, as Genomics England, in contributing to that, but it's very much a team effort. Our role is around where we have the biggest capabilities, so around building and running digital infrastructure at a national scale for healthcare delivery and for research, to building evidence to inform future policies, so running programmes like the Generation Study to inform future policy. And really, as part of that, that evidence piece, being driven by engagement, ethics, and work on equity, to really make sure that evidence that future policy can be built on is informed by a fully rounded view. We think if we do that right that we could as a country with others, the NHS, research organisations, many others could live up to that ambition that's set out there in the 10-year plan.   And the 10-year plan is really clear, and government is really clear that this is about improving health outcomes. But it's also part of a broader benefit to the country because the UK is recognised already as a great place from a genomics perspective. We think playing our role in that won't just bring the health benefits, it also will secure the country's position as the best place in the world to discover, prove and where proven role out benefit from genomic innovations. And we think it's so exciting to be part of that team effort.  Sharon: So, Genomics England's refreshed mission and direction of travel is really setting out how we move from research to routine care, and how we embed genomics across the health system. Carlo Rinaldi captured the idea perfectly, imagining a future where diagnosis and hope arrive hand in hand.  Carlo: My dream is that in five to ten years' time an individual with a rare disease is identified in the clinic, perhaps even before symptoms have manifested. At that exact time the day of the diagnosis becomes also a day of hope, in a way, where immediately the researcher, the genetic labs, flags that specific variant, that specific mutation. We know exactly which is the best genetic therapy to go after.   Sharon: And Rich, what are your thoughts on that?  Rich: I think Carlo captures it really well. And for us, I think a really big theme is for that potential for genomics to make a difference, a continued and in fact increased difference for people with rare conditions and cancer, areas where it's already making a difference, but also with the potential to make a much broader impact for people across the population. The real theme is embedding genomics into routine care, making it something that you don't need to know that you're seeing an expert in genomics to benefit from it, really make sure that those benefits can be felt as just part of routine care. It's not something separate where we recognise that the best healthcare is healthcare that's supported by all sorts of inputs, with genomics being a key part of that, and that we can continue to learn as we do that. So that with people's consent, with their understanding of how their data is being used, we know that if we don't have the best answer for them today, we give the best answer we can today, and we can continue to learn, and they can benefit from that in the future.   I'm a rare disease doctor by background, and one of the really most enjoyable parts of my job is seeing that come to practice. In the last year or so I've had a number of families where I've been seeing the family for years, and a researcher accessing data in the National Genomic Research library has found an answer that we've not been able to find for maybe their child's whole life, and then finally we're able to feed it back. Seeing that come to life is just so wonderful, and I think gives us a bit of a blueprint for how things could work more generally.  Sharon: That's great. I mean, what a feeling for those families who do get those answers. As we look ahead to 2026 and beyond, the conversation is starting to include prevention, using genomics not just to diagnose conditions but to predict and treat and even prevent them. Alice Tuff-Lacey summarised this nicely in an episode about Generation Study.  Alice: This is quite an exciting shift in how we use whole genome sequencing, because what we're talking about is using it in a much more preventative way. Traditionally where we've been using it is diagnostically where we know someone's sick and they've got symptoms of rare condition, and we're looking to see what they might have. What we're actually talking about is screening babies from birth using their genome to see if they're at risk of a particular condition. And what this means is this raises quite a lot of complex ethical, operational, and scientific and clinical questions.  Sharon: Rich, when you think about 2026, what's your biggest hope for where we'll be this time next year?  Rich: I think it's a really exciting time. As you can tell from how we've been speaking, I'm really excited about the direction of travel and how over the next 5 and 10 years we can really make a transformational shift because of how well placed we are in the UK from a genomics perspective. Where we are with today's knowledge, where we could be because of the continued government and NHS commitment to genomics being at the heart of this, if we build the right infrastructure, if we generate the right evidence to inform what's adopted, I think we're in a really exciting place.  From a 2026 perspective, I think what we're really committed to is continuing to do the work, the day-by-day-by-day work that is to build that incrementally. So, a really big focus for us is continuing to support the NHS and making sure researchers can access data, so that flow of answers for families can continue and grow, accelerate, to continue delivering the Generation Study because it's a really important part of that wider jigsaw to generate the evidence that can inform future policy on whether this is something that's adopted and offered routinely to every child when they're born.  I think a really important time now that the government's provided the opportunity for us as a team, as a UK genomics and life sciences ecosystem, is to really put in place some of the next steps, the building blocks that can take us towards that 10-year vision. So for us also, a really important part of the year is beginning the design process for an adult population genomics programme, where we're looking at what evidence it's important that we can provide that's complementary to different work around by others in the ecosystem that needs to be there if we're going to think about that potential broader use of genomics.  Sharon: That's great. It sounds like another exciting year ahead. So, we're going to wrap up there. Thank you to Rich Scott for sharing your reflections on the key milestones this year, and for your thoughts on the year ahead. Thanks, Rich.  Rich: Thanks very much for having me.  Sharon: If you enjoyed today's episode, we'd love your support, so please subscribe, share, and rate us on wherever you listen to your podcasts. I've been your host, Sharon Jones. This podcast was produced by Deanna Barac and edited by Bill Griffin at Ventoux Digital. Thank you for listening. 

//The Wire//2300Z December 29, 2025////ROUTINE////BLUF: PRESIDENT TRUMP QUIETLY CONFIRMS LAND-BASED STRIKES HAVE BEGUN IN VENEZUELA. CHINA LAUNCHES LARGE-SCALE MILITARY EXERCISES NEAR TAIWAN.// -----BEGIN TEARLINE----- -International Events-Far East: This morning China kicked off their large-scale yearly military exercise in the waters surrounding Taiwan. This year's exercise has been titled "Justice Mission 2025" and focuses on combined arms warfare techniques that will be necessary for the invasion of Taiwan. In the graphics and AI-generated content provided on the exercises by China, the focus for the drills is openly to deter a Taiwanese bid for independence.Analyst Comment: As usual, all eyes are on the drills this year to assess whether or not China will be capable of taking Taiwan when the time comes. Traditionally, China never announces their military drills ahead of time. In this case, approximately one hour elapsed between the official announcement of the drills, and the first aircraft detected on Taiwanese radar. Somewhat interestingly this year, China has leaned into camouflage as a concept. Ironically, China directly stole the idea of "urban camouflage" from Taiwan, which has taken the form of Chinese units camouflaging ICBM launchers to appear to be construction cranes...a tactic Taiwan has been using for many years. Due to the nature of the expected urban combat of Taipei, Taiwan has had to come up with unique ways for military equipment to survive as long as possible in the event that war kicks off. Turns out, China has also replicated much of this urban camouflage doctrine, which indirectly confirms that China is expecting missiles to be landing within their homeland as well.-----END TEARLINE-----Analyst Comments: This afternoon, President Trump received Prime Minister Netanyahu at his Mar-a-Lago residence to conduct talks on the Middle East and other various topics. While this visit was quite standard (as these visits have become fairly regular over the past year), several very important items of note took place during the reception.As Prime Minister Netanyahu was welcomed, a brief press conference was called as is common for dignitary visits. As journalists were present asking questions, the topic of conversation turned to Venezuela. During this off-the-cuff press briefing, President Trump casually stated that the United States had conducted at least one land-based strike within Venezuela. President Trump stated that an "implementation area" (sic) was struck, which he described as being a dock area where boats were being loaded with drugs.This leaves more questions than answers, and when pressed by journalists about this rather important conflict, President Trump stated that he did not want to comment on the matter any further. As this short 30 second clip is all we have to go on, there's not much that can be discerned at present, however it's almost certain that ground strikes have already quietly started throughout the region.Throughout this short presser, various other topics came up as well. President Trump reiterated the commitment to continue strikes in Iran, which is not surprising but still notable as it confirms that this conflict is certainly far from over. President Trump also confirmed that he took an unscheduled call from President Putin regarding an event that occurred this morning. In Moscow, the Kremlin reported a Ukrainian drone strike being conducted at an undisclosed location which targeted one of Putin's personal residences. Ukraine has denied this attack outright, and has stated that the whole affair has been fabricated from the ground up.During this morning's ad hoc press briefing in Florida, President Trump stated that the phone call had taken place, and that the US stopped the sale of Tomahawks to Ukraine for this reason (presumably to prevent them from using these munition

The CopDoc Podcast - Season 9 - Episode 165There's a consistent problem in American law enforcement that rarely makes headlines but shapes everything: what we do with people when they get promoted to lieutenant. Traditionally, they get a rank, a schedule, sometimes a handshake, and they're told to run the night shift. Nobody teaches them they've fundamentally changed jobs. They still think like a sergeant, which makes sense. They were excellent sergeants. So they become, as researcher Steve Morreale puts it, "a super-sergeant, not a lieutenant."Sacramento Police Chief Kathy Lester identifies this gap as one of the most important leverage points for changing police culture. It's not the strategy. It's not the programs. It's the person standing between upper management and line-level officers. That's where culture actually shifts or stalls.When Lester got promoted to lieutenant, the model was basic: "Congratulations. You're going to graveyard. You've got a brand new set of patrol teams. Nobody has more than three or four years experience. Here are the keys to the city. Try not to break it." She had one lifeline: she could call the previous lieutenant for emergency numbers if something went sideways. That was the leadership development program.Now as chief, Lester has completely reimagined lieutenant development. She has roughly twenty lieutenants at the Sacramento Police Department. She doesn't just develop captains and deputy chiefs. She spends significant time with lieutenants because they talk to sergeants every single day, and sergeants have the most influence over how officers behave.Here's what she does differently: lieutenants ride with her for a week at a time. They go to every event. They attend city council meetings, press conferences, community meetings. They see behind the curtain of what executive leadership actually manages. They understand why decisions get made the way they do. They become ambassadors who can explain departmental direction to their sergeants and officers.The first year, people wondered if this transparency was authentic. Four years in, lieutenants bring real problems to leadership expecting real solutions. They've seen that the chief actually listens and acts. That changes everything about how they lead underneath them.Lester is also clear that this isn't about being soft. When people are elevated to captain, she looks for who will be a future chief. She's assessing leadership capacity, not popularity. The distinction matters. She's developing people who understand the department's direction, can navigate difficult situations, and model professional behavior. Some of that comes from state-required training. More of it comes from internal programs built by leaders who are passionate about seeing people succeed in this profession.The lieutenant development gap exists in most departments. It creates a vacuum where middle managers either become loyal implementers of whatever came before, or they try to be mini-chiefs without the authority or context. Lester solved it by making lieutenants visible partners in leadership. They see the actual job. They understand the constraints. They build relationships with senior leaders. And they take that back to their sergeants and officers. That's how culture changes, not through mandates from above, but through lieutenants who genuinely understand the "why" and can arHey there! Send us a message. Who else should we be talking to? What topics are important? Use FanMail to connect! Let us know!Contact us: copdoc.podcast@gmail.com Website: www.copdocpodcast.comIf you'd like to arrange for facilitated training, or consulting, or talk about steps you might take to improve your leadership and help in your quest for promotion, contact Steve at stephen.morreale@gmail.com

Noisy Doors, Leaky Roofs, and the Mark of the Beast Last week's newsletter was written to be very simple. This week...not simple. We're tying together our lessons on the Salt Covenant, The Scarlet Harlot, and the basic menorah pattern of Workbook One. So no, it's not simple, but it's not too difficult, either! Try printing it off and studying it over two Shabbats, referencing the suggested videos or workbooks as you go.   ***   So what do noisy doors, leaky roofs, and the mark of the beast have in common?    Excellent question! I'm glad you asked.   In order to see the connection, we have to know a little something about each of them. If you want a refresher on the Beast, consider signing up for the Creation Gospel Workbook Four class coming up with Kisha Gallagher (scroll down for info) or watching the Scarlet Harlot series on YouTube. You can also refresh your memory on the meaning of the mezuzah with our "More Than" YouTube videos. We'll cover a few basics here to tie it together.   “Behold, I stand at the door and knock; if anyone hears My voice and opens the door, I will come in to him and will dine with him, and he with Me…”   Yeshua standing at the door knocking is a huge hint, especially on the heels of John's sobering prophecies of the mark of the beast in Revelation. If we can't see the link to the world commercial system as “Babylon” in Revelation, we're not trying very hard. Revelation begins with memos to the seven assemblies emphasizing their need to “overcome” the tribulations John is about to describe,   • “Behold, I stand at the door and knock; if anyone hears My voice and opens the door, I will come in to him and will dine with him, and he with Me. He who overcomes, I will grant to him to sit down with Me on My throne, as I also overcame and sat down with My Father on His throne. He who has an ear, let him hear what the Spirit says to the churches.” (Re 3:14-21)   We can conclude that how to overcome is described in Revelation, but we can also conclude that an ignorance of the Torah will make our understanding only partial. Revelation is written as an incredibly intricate re-telling of the Torah portions. Without an understanding of those Torah portions, it will be difficult to be identified as one of those who overcome when they “keep the testimony of Yeshua and the commandments of God.”   If Yeshua knocks on the door of one of these potential overcomers, he knocks on a door that is marked by a mezuzah, which contains summaries of the commandments. To pull in the themes of our Salt Covenant study over the last several weeks, a mezuzah is a sign that those inside the house know to be salty within, tenderly and joyfully salting their commandment-keeping. Because they are pliable to the work of the Ruach HaKodesh within the house, they are ready to meet the challenges of the Beast outside the house.   The mezuzah is their reminder that they've committed their coming and going, especially their work and business dealings, to preserving their covenant with the Father with salt, for savory salt is our faith, the tenderness we have toward His Word. It is our desire to draw close to Him through our sacrifices, not begrudgingly or to be admired by others, but to give glory to the Father. Yeshua reminds us that he also wants to draw near to our salty selves, so he stands at the door and knocks.   Just imagine that the mezuzah on your door was Yeshua standing there each day inquiring if he may accompany you in your coming and going.   Because he is. The custom is to touch one's fingers to the mezuzah and kiss the fingers. It demonstrates affection and tenderness toward the Shma and other scriptures in the mezuzah, which remind us in our coming and going Who the only Source of wealth is. The name Shaddai is inscribed on mezuzot, which is the name describing His attribute of nourishment and supply.   By touching the mezuzah, we also are reminded like the Israelites in Deuteronomy Eight: “Otherwise, you may say in your heart, ‘My power and the strength of my hand made me this wealth.' But you shall remember the LORD your God, for it is He who is giving you power to make wealth, that He may confirm His covenant which He swore to your fathers...”   The mezuzah on the door marks the boundary between what happens when we go into the world and how we are inside our homes. If we are at war inside our homes, then how will we war against the principalities and powers outside our homes? The shin on the tefillin reminds the person Who opens the Heavenly windows to drip down zuzim, or coins, transactions, in our lives. Zuz is found in the word mezuzah, but the letter shin is found on both the mezuzah and the prayer tefillin.   Because they are worn in prayer, it helps one to adjust those trade prayers according to Yeshua's model…daily bread…forgiveness…holiness…His will and glory on earth…protection from temptation to sin. Ever notice how many famous actors, musicians, and sports stars end up unhappy, addicted, disconnected from the real world, and just plain weird? We are not spiritually wired to receive the glory of Heaven, only to reflect the glory of Heaven outward with salt. Of course they get weird and depressed!   Our labor and business dealings outside the home must be salted and lit from within first. We must extend ourselves from within, or it will eventually be evident to the world that we did not exert ourselves according to our wealth of salvation and light.nIt is thought that the marks of tzaraat (leprosy) that appeared in a home were a result of greed and stinginess. When the priests removed everything inside to the outside to quarantine and scrape the stones, everyone would see the wealth concealed inside, especially if they'd pretended not to have enough to help the needy brother. The “best third” is where the mezuzah is placed on a door, the upper third, like an upper room. The mezuzah marks the right hand frame of the door about 2/3 of the way up: “Mezuzah guards the Covenant, and so observing the mitzvah of mezuzah leads a person to truth and faith, the faith which is absolutely necessary when conducting business.”    “And I will bring the third part through the fire, Refine them as silver is refined, And test them as gold is tested. They will call on My name, And I will answer them; I will say, ‘They are My people,' And they will say, ‘The LORD is my God.'” (Zec 13:9)   Yeshua invokes this prophecy in Zechariah when he warns the Laodiceans in Revelation Three that he is standing at the door knocking: “Because you say, “I am rich, and have become wealthy, and have need of nothing,” and you do not know that you are wretched and miserable and poor and blind and naked, I advise you to buy from Me gold refined by fire so that you may become rich…”   This is where we see another connection to the mezuzah. Zechariah prophesies of the “third part.” This is thought to be the remnant that will come through the tribulation refined by fire instead of destroyed by it. They have not succumbed to the Beast's commercial activity, buying and selling excessively or on Shabbat (see CG Workbook Four or Workbook Two). Traditionally, the mezuzah is affixed at a pointing on the right side of the door 2/3 of the way up the door. To relate the thirds, the mezuzah is like the principle of the “upper room” we've studied over the last several weeks.    Ancient Israelite houses typically had two levels, a ground level where beasts were stabled and practical household work such as cooking and weaving took place, but the family quarters were on the second floor. An extra upper room had to be built either on the second floor or atop the family quarters, making it an upper third. More simply, an upper room was where the family made space for visitors, a space that wasn't there, yet they created the space through hospitality.   Those upper rooms in Scripture were places associated with hospitality toward the righteous visitor as well as resurrection from the dead, like the stories of Elijah, Elisha, Dorcas, and Eutychus. A mezuzah reminds us not to neglect making those spaces of hospitality for the righteous visitor, who represents hospitality toward Yeshua and the Living Word. Yeshua's noisy knocking on the door is a daily reminder that when we make an “upper room” of hospitality, then we are actually tapping into the Garden of Eden. The resurrections in the upper rooms of Scripture show us this.    On the mezuzah is either the Name Shaddai, or it is in the shorthand of the first Hebrew letter shin. Not so coincidentally, the tefillin that are placed on an Israelite male's forehead and arm are also marked with a shin (see above). The mezuzah and tefillin remind each day:   • Hear, O Israel! The LORD our God, the LORD is one! And you shall love the LORD your God with all your heart and with all your soul and with all your might. And these words, which I am commanding you today, shall be on your heart; and you shall teach them diligently to your sons and shall talk of them when you sit in your house and when you walk by the way and when you lie down and when you rise up. And you shall bind them as a sign on your hand and they shall be as frontals on your forehead. And you shall write them on the doorposts of your house and on your gates. (Dt 6:4-9)    Deuteronomy 8:11-19 reminds Israel not to be deceived when they become comfortable and prosperous in the Land, for their wealth will deceive them into thinking they earned it with their own hand. Remember the gumballs?   The tefillin on the hand and arm are a reminder that it is YHVH alone who gives the power to acquire wealth. Likewise, the mezuzah is marked with a shin for Shaddai, the One who provides sustenance, nourishment to Israel. Strangely, the shin is made of three Hebrew letters vav joined at the bottom. The gematria value of vav is six. 666.    Whaaaaat? Yes, it's the mark of the beast. But that's not the whole story. The mezuzah and tefillin are NOT the mark of the beast. The mark of the beast is when you get very close to being a salt covenant household or person, yet you have something lacking. Salt. Your daily work is not to acquire the wealth of the Kingdom to the glory of the Father, which can only be done through the power of the Ruach HaKodesh moving through the Word in you. The mark of the beast is when our daily work is to acquire the object of desire for our own sake. We can hear the disingenuous, unsalty believer when he says, “If God will just let me win the lottery, I'll build orphanages and feed the poor all over the world.”   And he probably will. But he will do it only in order to feed his own desires first. He's not really seeking first the Kingdom of God and His righteousness. He's pursuing his own kingdom, offering God a deal that the Kingdom of Heaven will benefit from the scraps. Such a person will not give commensurately with his newfound wealth, for he is stingy at heart. Unsavory salt. Tepid. Lukewarm. Blechhhh!   The secret of the 666 is that it is only the letter of the Torah without the Ruach. The shin is like a menorah when the backlight of the Ruach shines through it (again, see Workbooks 2 & 4). Remember last week's lesson on the gumball machine? It was what you couldn't see that had to occur before what you could see. The Ruach precedes the letter of the Torah. Together, with the spiritual backlight through the literal three vavs, it yields seven, the seven- branched menorah. One tefillin has three vavs, but its mate has four! 3 + 4 = 7. Compare to the above: To be unsalty is 666. To be salty is to shine the seven spirits of Adonai described in Isaiah and Revelation:     •  wisdom   •  understanding   •  counsel   •  Spirit of Adonai   •  power   •  knowledge   •  reverence    Yeshua, the Living Word, is the doorkeeper of the overcoming household. We never want to reduce him to someone there to reward us with wealth. The word mezuzah comes from a Hebrew word meaning movement, going back and forth. The historical zuz was a coin, about a day's sustenance for one adult:   • Weight: About 4.26 grams (0.137 troy ounces) of silver. • Value: Historically equivalent to a day's wage or a portion of food/clothing, (e.g., 200 zuz was a year's support).  • Modern value would be about $20.   "Give us today our daily bread." Not the lottery.   Not so coincidentally, a mezuzah means more than movement. It is rooted as well in the movement of a beast: What starts out as a beautiful creation of spirit (upper room), soul and body (lower rooms), can degenerate into the mark of the beast. Instead of letting the Ruach drip into our lower rooms of work and family, the upper room is sealed off because of our stinginess and greed. Esau and Jacob had very different motives in asking for blessings. We can become unsavory, relentless hunters like Esau, the Red One, nicknamed Edom because he was red and hairy all over like a beast, a man of the field who loved hunting. We don't want to become marked by the Red One, never satisfied, even on Shabbat.   “…and he provides that no one will be able to buy or to sell except the one who has the mark, either the name of the beast or the number of his name.” (Re 13:17)   Nehemiah's struggles with those returning to rebuild Jerusalem and the Temple, especially in their continued buying and selling on Shabbat, are the reference point. He eventually had to order the gates of Jerusalem shut and locked to prevent the vendors from coming in with their goods. How glorious will it be when the gates no longer need to be shut, for no one will even entertain the idea of disobeying the King of King's command to rest and be with Him in Jerusalem on Shabbat.   Knock, knock.   In short, the mark of the beast is on one who buys and sells on Shabbat. Because there is no trust in Adonai to provide the many things we crave, we continue to work on His holy day. Someone who believes in God may have salt, but it is not savory. One who believes in God enough to do what He says is savory salt. Salt allows us to draw near the upper room of the Garden. I'm sure Yeshua is having wonderful conversations with the righteous souls of those who just didn't understand Shabbat, but they were faithful in what they knew. They are learning while they wait, not rebelling.   Ezekiel describes what went wrong in the “upper room” of the Garden of Eden, a hospitable place for those who want to draw near to the voice of Elohim, but a place from which rebels are purged. The “trader” was cast out of the heavenly fiery stones and tossed into the lower realms of strange, profane fire, that is, fire used by those estranged from the upper room fires of the Ruach above:   You were in Eden, the garden of God; Every precious stone was your covering: The sardius, topaz, and diamond, beryl, onyx, and jasper, Sapphire, turquoise, and emerald with gold. The workmanship of your timbrels and pipes Was prepared for you on the day you were created. You were the anointed cherub who covers; I established you; You were on the holy mountain of God; You walked back and forth in the midst of fiery stones. You were perfect in your ways from the day you were created, Till iniquity was found in you. By the abundance of your trading You became filled with violence within, and you sinned; Therefore I cast you as a profane thing out of the mountain of God; And I destroyed you, O covering cherub, from the midst of the fiery stones. (Eze 28:13-16; 18)   Ezekiel 28 drops a hint to where we should be vigilant: “By the abundance of your trading [H7404 rekula] you became filled with violence within, and you sinned...”   ????? rawkal' [H7402] to travel for trading   Our trade is part of work for our living, yet, the abundance is the danger zone. If our inner fire craves more wealth than we are willing to give back to Heaven commensurately, our going back and forth, zuzing about, to trade our time and effort for goods, power, and esteem becomes idolatry. In Hebrew, moving back and forth is zuz [zuz is also a coin], the root of mezuzah. The mezuzah marks the door where we travel back and forth each day to obtain our portion of wealth.   When our pursuit of wages and wealth pushes the testimony of Yeshua and the commandments of God beneath our feet instead of allowing them to drip daily from the upper room of the resurrection Ruach that raised Messiah from the dead, we sin. Our house's upper room should be designed to drip to lower floors of daily living, or we become unsavory salt.   We trade our precious lives, our time, our effort, to accumulate an abundance of things, not necessarily money, but what money will purchase: entertainment, security, comfort, esteem, power, knowledge, appeasement, etc. These things deceive us into believing they will bring joy and peace, but we know it's a lie because they never do. They are simply offered to the strange, consuming fire of the soul, but are not refinement of the spirit, which is everlasting peace and joy. It brings savory salt, light, and contentment from within.    The ancient investment advice is:   • Invest 1/3 of your income in tangible property such as real estate, durable goods, secure long-term investments  • Invest 1/3 in your daily labor, your paycheck, investments that provide a faster return, a little riskier, easily liquidated • Invest 1/3 above the mezuzah in the Kingdom of Heaven by lending to the poor, giving to needy, investing time in spiritual causes along with Torah study, prayer, service, discussing Scripture with others, etc. Even kindness is an investment!   We should not become “stingy” with Heavenly principles in the world of work, which would reflect a home's lower rooms sealed off from the upper room. The upper room should drip the testimony of Yeshua and the noisy commandments of God through the power of the resurrection Ruach. It leaks into the lower rooms of family and work!   The leaky roof is what we need to carry into the world of work and business as well as our relationships. An outwardly successful business producing wealth that can only be spent before the resurrection of the dead is not successful at all.    Preparation in the home under the disciplines of the Ruach HaKodesh will be evident in the place of business, not as a pile of 666 cash, but as peace in drawing near the Father, salt. The physical work is simply a means of building the Kingdom instead of demanding that the Father bless our work to build our own kingdoms of security, esteem, attention, comfort, intellectual stimulation, etc. Whether we have little or many zuzim, all we need to remember is that we must give commensurately with the wealth the Father drips down upon us.    If we can be responsible even with earthly money, which has no righteousness within itself, then we can be responsible with Heavenly riches.   If we can't be trusted to give commensurately with our wealth when there is no Temple service, and much freedom is granted in when and how much we give, then how can the Father trust us with His riches when the Temple on “the mountain of God” descends? The Temple services and the Land of Israel are places of extreme exactness in managing work and wealth.   Manage earthly zuzim faithfully, and we will inherit the Heavenly riches to manage.    One of my favorite movies is about a Quaker family, from the book Friendly Persuasion. One of the funniest lines is, “Friend, thee's got a squeaky door upstairs.”    Friend, thee's got a squeaky door downstairs, too. Yeshua is knocking, reminding, inquiring, requesting if we will open to his voice. It is the same voice of Elohim that walked and talked in the Garden, an upper room.   When we open our doors to him, we release the water of the Word from our upper rooms and let it fill our homes, workplaces, and relationships. If we move about, may we zuz for the glory of the Father.    Please SUBSCRIBE to our newsletter to get new teachings.

The first book of the New Testament of the Bible and one of the three synoptic Gospels. Matthew tells how Israel's messiah (Christ), Jesus, comes to his people (the Jews) but is rejected by them and how, after his resurrection, he sends the disciples to the gentiles instead. Matthew wishes to emphasize that the Jewish tradition should not be lost in a church that was increasingly becoming gentile. The gospel reflects the struggles and conflicts between the evangelist's community and the other Jews, particularly with its sharp criticism of the scribes and Pharisees with the position that through their rejection of Christ, the Kingdom of Heaven has been taken away from them and given instead to the church. The gospel is anonymous. Traditionally attributed to the Apostle Matthew, the predominant scholarly view is that it was written in the last quarter of the first century by an anonymous Jew familiar with technical legal aspects of scripture. Most scholars think Matthew used the Gospel of Mark and the hypothetical sayings Gospel Q (which consists of the material Matthew shares in common with Luke) and is the product of the second generation of the Christian movement, though it draws on the memory of the first generation of the disciples of Jesus. E169. Gospel of Matthew available at https://amzn.to/3LEeP8F ENJOY Ad-Free content, Bonus episodes, and Extra materials when joining our growing community on https://patreon.com/markvinet SUPPORT this channel by purchasing any product on Amazon using this FREE entry LINK https://amzn.to/3POlrUD (Amazon gives us credit at NO extra charge to you). Mark Vinet's HISTORY OF NORTH AMERICA podcast: www.parthenonpodcast.com/history-of-north-america Mark's TIMELINE Video channel: https://youtube.com/c/TIMELINE_MarkVinet Website: https://markvinet.com/podcast Facebook: https://www.facebook.com/mark.vinet.9 Twitter: https://twitter.com/HistoricalJesu Instagram: https://www.instagram.com/denarynovels Mark's books: https://amzn.to/3k8qrGM Audio credits: Breaking in the Habit videocast with Fr. Casey (Episode: Matthew is Unsettling (24jan2025); and, Priest Answers Questions About the Bible (oct2024). Audio excerpts reproduced under the Fair Use (Fair Dealings) Legal Doctrine for purposes such as criticism, comment, teaching, education, scholarship, research and news reporting. See omnystudio.com/listener for privacy information.

Friends of the Rosary,Today, Sunday, December 28, the Fourth Day within the Octave of Christmas, is the Feast of the Holy Family, an invitation to every Christian family to live in harmony and in prayer, which are the pledges of joy and union.At the end of the past century, Pope Leo XIII promoted this feast to present the Holy Family of Jesus, Mary, and Joseph as the model of all Christian families.Although they were the holiest family that ever lived, or ever will live, on earth, as they were God's closest friends, they had more than their share of this world's troubles. Today's Gospel from Matthew 2:13-15; 19-23 tells us of some of these earthly woes and sufferings.They had just settled in Bethlehem, and the Baby Jesus was only a few months old when, to avoid his murder at the hands of Herod, they had to flee from Bethlehem and become displaced persons in a foreign and pagan land.This story is a message of encouragement and consolation for every one of us. If the Holy Family suffered such trials and hardships, we should be ready to bear the trials that God sends us for our own eternal welfare.The devotion to the Holy Family was born in Bethlehem, together with the Baby Jesus. The shepherds went to adore the Child and, at the same time, to honor His family. Later, in a similar way, the three wise men came from the East to adore and give honor to the newborn King with gifts of gold, frankincense, and myrrh that His family would safeguard.Christ Himself showed His devotion to His mother and foster father by submitting Himself, with infinite humility, to the duty of filial obedience towards them.Today's celebration demonstrates Christ's humility and obedience regarding the fourth commandment, whilst also highlighting the loving care that His parents exercised in keeping Him.Let us imitate the Holy Family in our Christian families, and our families will be a prefiguration of the heavenly family. We say a prayer dedicating your family to the Holy Family. Also, we pray for all families to uphold the sanctity of the marriage bond, today under attack.Traditionally, the Feast of the Holy Innocents is celebrated on December 28th. Still, since that falls on a Sunday this year, many Western churches, like those in the Archdiocese of NY, observe it on Monday, December 29, 2025, to commemorate the baby boys killed by King Herod, honoring them as the first martyrs for Christ.Ave MariaCome, Holy Spirit, come!To Jesus through Mary!Here I am, Lord; I come to do your will.Please give us the grace to respond with joy!+ Mikel Amigot w/ María Blanca | RosaryNetwork.com, New YorkNew Upgrade! Enhance your faith with the new Holy Rosary University app:Apple iOS | New! Android Google Play• December 28, 2025, Today's Rosary on YouTube | Daily broadcast at 7:30 pm ET

Jacks joins us this week to break down the final two episodes of the Hallmark Channel Christmas show, Twelve Dates 'Til Christmas.ABOUT: TWELVE DATES 'TIL CHRISTMAS (EPISODE 5 & EPISODE 6)Episode 5: Kate has difficult decisions to make, and turns to Delilah for help. Despite Laura's commitment not to meddle, she wants to make things right for Callum and Kate.Episode 6: As the twelfth date draws near, Kate is feeling confident in her choices. But when new information comes to light, she can no longer deny her true feelings.AIR DATE & NETWORK FOR: TWELVE DATES 'TIL CHRISTMAS (EPISODE 5 & EPISODE 6)December 19, 2025 | Hallmark Mystery ChannelCAST & CREW OF: TWELVE DATES 'TIL CHRISTMAS (EPISODE 5 & EPISODE 6)Mae Whitman as KateJulian Morris as CallumJane Seymour as EvelynNathaniel Parker as MacBRAN'S TWELVE DATES 'TIL CHRISTMAS (EPISODE 5 & EPISODE 6) SYNOPSISKate is on a train, replaying the kiss in her head — and Cal is doing the exact same thing when Oliver shows up. Oliver wants to clear the air after Dates & Mates, reassuring Cal that telling the truth was the right thing to do… a comment that clearly hits deeper than intended.On the train, Kate's mom sits down across from her and gently asks what's going on. Kate admits she kissed Cal. Her mom offers unexpected advice: find a third man — perspective is everything. Kate takes the advice and goes on a date with Charlie, an American.But things get complicated fast when Kate bumps into Richard, who's out on yet another date. Awkward all around.Kate later confronts Cal for running away after the kiss and leaving her alone to process everything. Wanting to make things right, Laura and Cal work with the event organizer to set up a special do-over for Date 11. Unfortunately, Richard beats Cal to the punch, sending a car to pick Kate up and whisk her away for a carefully planned romantic night.Meanwhile, Delilah continues aggressively pursuing Mac. Determined to clear things up, Mac goes to Evelyn to confess his feelings — and they kiss. He's ecstatic… until he heads to the bathroom, gives himself a pep talk, and suddenly believes he's having a heart attack.Back on Richard's date, Kate is making out with him when Cal calls — three times. She finally answers and rushes to the hospital, where she learns her dad hasn't had a heart attack after all, but a panic attack. When she returns home, she discovers her mom has moved out.Soon after, Kate learns her mom bought a nearby house. Her mom apologizes for not being present, tells Kate she's too talented to be working for someone else, and asks her to decorate the new house. She promises she's ready to change and will be there whenever Kate is ready.Kate goes to tell Cal — but he's clearly upset. He explains that he planned the do-over date. Kate insists she didn't know. They argue, and Cal leaves, telling her he doesn't know what she wants but hopes she finds it. Kate quietly replies, “Maybe I already have.” Laura tries to convince Kate to fight for Cal, but Kate believes Richard is the right choice.Evelyn comes to check on Mac, and the two of them end up kissing again.While out with Richard, Kate learns he's been heavily flirting with other women throughout the dating experiment. When she confronts him, he explains they were both allowed to date — but in the end, he chose her. As they slow dance, Richard admits he chose her because it made for a good story. That's the final straw. Kate wishes him a Merry Christmas and walks away.Kate finds her dad, breaks down in his arms, and cries. He tells her he now understands his panic attacks and knows how to manage them. He reassures her that he has Evelyn — Kate doesn't need to worry about him anymore. She can focus on herself.Kate reconnects with her mom, grateful that she'll finally be around, and the family spends Christmas together.Later, Kate meets Laura. Traditionally, she'd spend Christmas night with Laura and Cal — but Cal doesn't show. Kate gives Laura a gift she had taken from Cal's place: a framed picture of a drawing Kate made years ago.Realizing what she truly wants, Kate runs to Cal. She tells him she wants him. Cal steps outside, turns on the lights, and they share a big, emotional kiss.Christmas is finally complete — together. Watch the show on Youtube - www.deckthehallmark.com/youtubeInterested in advertising on the show? Email bran@deckthehallmark.com Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Traditionally, since 2019, we share the account of Henry Williamson of his experience of the Christmas Truce in the First World War. It concludes with a prayer that, we, divided and broken politically, can come together as the combatants did on the western front in 1914. Today, Lloyd reflects on that story and how we no longer see that same star rising. Armed Lutheran Radio is a listener-supported podcast. If you value the information and entertainment we provide, consider supporting the show by joining our membership site, The Reformation Gun Club! http://gunclub.armedlutheran.us Links of Interest Episode 388 – They Saw the Same Star Rising – https://www.armedlutheran.us/388-2/ Prayer of the Week Lord, we implore You to keep Your household the Church in continual godliness, that through Your protection she may be free from all adversities and devoutly given to serve You in good works; through Jesus Christ, Your Son, our Lord who lives and reigns with You and the Holy Ghost, ever one God, world without end. Amen. Get in Touch Visit our Feedback Page - http://www.armedlutheran.us/feedback Please tell your friends about us, leave an iTunes review, and like us on Facebook Join our Facebook group - http://www.armedlutheran.us/facebook Subscribe to us and follow us on Youtube - http://www.armedlutheran.us/youtube Check Out More at our Website- http://www.armedlutheran.us Use these Links to Support Armed Lutheran Radio If you value the information and entertainment we provide, consider supporting the show by joining our membership site, or shopping at your favorite online stores using the links below. Check out the other Great Armed Lutheran Books - http://www.ArmedLutheran.us/Books Shop at Amazon* - http://www.armedlutheran.us/amazon Armed Citizens Legal Defense Network - https://www.armedcitizensnetwork.org Disclaimer The links above which are indicated with an asterisk (*) are affiliate links, which means that if you choose to make a purchase, I will earn a commission. This commission comes at no additional cost to you. Please understand that I have experience with all of these items, and I recommend them because they are helpful and useful, not because of the small commissions I make if you decide to buy something. Please do not spend any money on these products unless you feel you need them or that they will help you. New Original Music by Reformer Keep Shooting, Keep Praying, We'll Talk to you Next time!

Dr. Asher Eghbali, Co-Founder of Fuerte, has developed a platform to address the significant communication challenges between healthcare providers and pharmaceutical industry representatives. The goal is to streamline this relationship by replacing inefficient scheduling methods, and eliminate miscommunication and missed meetings to reduce frustrations and wasted time. The app is designed to combine professional networking with social media elements, including user profiles and notifications, to help build stronger, long-lasting professional relationships that benefit everyone involved. Asher explains, "Within the life science companies and pharmaceutical reps, as we know, they're working very hard to commercialize medications and new drugs, new therapies that come out there that they want to get into patients' hands. But sometimes they have a very hard time scheduling and putting in time to go to the doctor's office. Traditionally, they conduct a lunch-and-learn session or a coffee consult, where they come on-site to a doctor's office or a hospital setting."   "Right now, to schedule that appointment, it's being done where the medical assistant or the office manager is writing down that individual's name on some kind of paper calendar, at most, maybe some kind of Google sheet, or a Google Meet account that they have within the office section. And that's the way that they're scheduling it. Healthcare reps are sometimes cold walking in, sometimes they're cold calling. They're putting in a lot of effort. They're working very hard to figure out how to get in and educate providers and their staff on new advancements." "What Fuerte hopes to do with a streamlined communication platform is make it very easy for the providers to find the reps and the reps to find providers to keep in touch with each other, to search each other by disease state, by therapeutic drug, by medical advancement, and to have a shared calendar system that they can keep in constant communication and contact." fuerteapp.com Listen to the podcast here  

Dr. Asher Eghbali, Co-Founder of Fuerte, has developed a platform to address the significant communication challenges between healthcare providers and pharmaceutical industry representatives. The goal is to streamline this relationship by replacing inefficient scheduling methods, and eliminate miscommunication and missed meetings to reduce frustrations and wasted time. The app is designed to combine professional networking with social media elements, including user profiles and notifications, to help build stronger, long-lasting professional relationships that benefit everyone involved. Asher explains, "Within the life science companies and pharmaceutical reps, as we know, they're working very hard to commercialize medications and new drugs, new therapies that come out there that they want to get into patients' hands. But sometimes they have a very hard time scheduling and putting in time to go to the doctor's office. Traditionally, they conduct a lunch-and-learn session or a coffee consult, where they come on-site to a doctor's office or a hospital setting."   "Right now, to schedule that appointment, it's being done where the medical assistant or the office manager is writing down that individual's name on some kind of paper calendar, at most, maybe some kind of Google sheet, or a Google Meet account that they have within the office section. And that's the way that they're scheduling it. Healthcare reps are sometimes cold walking in, sometimes they're cold calling. They're putting in a lot of effort. They're working very hard to figure out how to get in and educate providers and their staff on new advancements." "What Fuerte hopes to do with a streamlined communication platform is make it very easy for the providers to find the reps and the reps to find providers to keep in touch with each other, to search each other by disease state, by therapeutic drug, by medical advancement, and to have a shared calendar system that they can keep in constant communication and contact." fuerteapp.com Download the transcript here

On the third Sunday of Advent, we light the pink—or rose-colored—candle. Traditionally called the Shepherds’ Candle, it represents joy. But just like Hope and Love in the earlier weeks of Advent, Joy also has many counterfeits. One of the most common substitutes is happiness. What’s the difference? Happiness is a state of well-being or contentment; it’s a pleasurable or satisfying experience. Joy, however, is a source or cause of great happiness—it is rooted in something (or Someone) that produces lasting delight. Here’s the question: Do you want an experience that fades… or a connection to the source that endures? Trying to find joy in the trappings and traditions of Christmas is like opening a beautifully wrapped present labeled “Joy Inside”—only to discover the box is empty. Our traditions don’t contain joy; they point to it. If we want the empty spaces in our hearts truly filled, we must look not merely at Christmas, but through Christmas—to the One in whom indestructible, unspeakable joy is found.

Well, here we are. The UX Strategy and Leadership course has wrapped up, and I am officially putting down my digital pen until January 8th.I know. Try not to weep.

Traditionally, being a spokesperson meant you were the person fronted for interviews with media. This is still the case, but the definition has broadened as the media channels have broadened. How do you become a credible voice for your business when communicating across channels? In this Quick Hit, you'll hear Peter Murphy Lewis, the Founder & CEO of Strategic Pete. Catch the full episode here

Please hit Subscribe and tell Somone about the show. Click here to go to our Facebook page. https://www.facebook.com/222paranormal Click here to see Jens Book. https://a.co/d/0CFyrFm Click here to see Joe's Book. https://a.co/d/583VdkN Click here to save on Clothing and home goods.   In this week's episode of the 222 Paranormal Podcast, we dive deep into the mysterious and powerful world of the mojo hand — one of the most iconic tools in Hoodoo and American folk magic. You've heard it in blues music, seen it referenced in Southern folklore, and maybe even spotted one tucked away in an old attic or antique store. But what exactly is a mojo hand? And why do so many people believe it has the ability to change someone's luck, protect against harm, or alter the course of a person's life? We explore the origins of mojo hands, tracing them back to the spiritual blends of African, Native American, and European traditions. Traditionally made from red flannel and containing a carefully selected collection of roots, herbs, stones, coins, personal items, or written petitions, a mojo hand is believed to be more than an object — it is treated as a living spiritual tool that must be fed, respected, and kept hidden from others. Once touched or opened by someone else, the mojo's power is said to fade… or even turn against the owner. This episode takes listeners into the heart of blues culture, where musicians like Muddy Waters and Lightnin' Hopkins famously sang about keeping their "mojo working." We explore why so many blues legends depended on these magical charm bags and how the tradition shaped parts of Southern music and identity. We also share compelling stories from folklore and modern encounters, including the unnerving tale of a gambler whose luck skyrockets — until someone touches his mojo hand and his life unravels in days. You'll hear accounts from listeners who've found mojo bags tucked behind walls or under floorboards, along with chilling experiences that followed. We also uncover darker uses of mojo hands such as hot foot spells, hexing bags, and graveyard-consecrated charms meant to bind, confuse, or torment. Throughout the episode, we break down different types of mojo hands — love hands, money hands, protection hands, and more — and discuss how rootworkers historically crafted each one with intention and spiritual purpose. We also examine why mojo hands are still widely used today, how genuine rootworkers create them, and why mass-produced versions are considered both disrespectful and powerless. As we close, we reflect on the deeper meaning behind these charm bags: the belief in personal empowerment, the connection to ancestors and heritage, and the mysterious blend of psychology, intention, and spiritual energy that continues to draw people toward folk magic. If you've ever found or used a mojo hand — or have your own experiences with magical objects — we invite you to share your stories with us. This is one episode where the supernatural meets culture, music, and mystery… so keep your mojo working and stay spooky!   Welcome to the 222 Paranormal Podcast, your gateway to the captivating world of the supernatural. Immerse yourself in our expertly crafted episodes, where we delve deep into a wide range of paranormal phenomena, including ghostly hauntings, cryptid sightings, and unexplained mysteries that defy logic. Each episode is meticulously researched and features engaging discussions with leading experts, seasoned ghost hunters, and renowned paranormal investigators. We cover the latest advancements in ghost hunting technology, offer practical tips for both amateur and experienced investigators, and review essential equipment for your paranormal adventures. Our podcast also explores the rich history of haunted locations, sharing true stories and firsthand accounts that will send chills down your spine. Whether you're a die-hard fan of the paranormal or just curious about the unknown, our content is designed to entertain, inform, and ignite your imagination. Stay tuned as we uncover secrets from the most haunted places around the world and analyze the most intriguing supernatural events. We also provide in-depth interviews with notable figures in the field and explore theories that challenge conventional understanding of reality. By subscribing to our Paranormal Podcast, you'll stay updated with the latest episodes, allowing you to join a community of like-minded individuals who share your fascination with the unexplained. Don't miss out on our exclusive content and special features, which bring you closer to the mysteries that lie beyond our everyday experiences. Dive into the world of the unknown with our Paranormal Podcast and experience the thrill of discovering what lies just beyond the veil of reality.

JCO Editorial Fellow Peter Li and author Dr. Jahanzaib Khwaja discuss the  ASH 2025 Simultaneous Publication article, "A New Validated Staging System for AL Amyloidosis With Stage lllC Defining Ultra-Poor Risk: AL International Staging System." TRANSCRIPT The disclosures for guests on this podcast can be found in the show notes. Dr. Peter Li: Welcome to this episode of JCO Article Insights. I am Dr. Peter Li, JCO's Editorial Fellow, and today, I am joined by Dr. Jahanzaib Khwaja on a new validated staging system on AL amyloidosis with stage lllC defining ultra-poor risk, AL International Staging System. This is a simultaneous publication that will be presented at this year's ASH Conference.  At the time of this recording, our guest has disclosures that will be linked in the transcript.  So, Dr. Khwaja, let's start off first: What would you say is the significance of your study? Dr. Jahanzaib Khwaja: Thank you very much. This is an important study in that, in the current treatment era, we have really improved outcomes of patients with systemic AL amyloidosis. Traditionally, the staging systems that have been employed, which are the Mayo 2012 and the European modification 2016, have been founded in eras where there were historic treatment protocols. So the significance of this new staging system is looking at outcomes of patients in the modern treatment era. That is patients who are treated with daratumumab-based treatments in the first line. And this is kind of the largest study which is externally validating a new prognostic model in the current treatment era with modern outcomes. Dr. Peter Li: Can you tell our listeners what is different about your new staging system? Dr. Jahanzaib Khwaja: The traditional staging systems, the Mayo 2012 and the European modification of 2016, looked at outcomes of patients with systemic AL amyloidosis with historic treatment protocols. And we know that they looked at outcomes according to an NT-proBNP and troponin, and in the Mayo 2012, they looked at it with the addition of the dFLC, which is the difference in the involved and uninvolved free light chain. Over the years, we have seen that outcomes have improved, and over decades, actually, outcomes are much better when we compare them to the previous decade. If we look at current treatment approaches, those traditional staging systems inadequately determine the poorest prognostic risk. So they are unable to tell us those who are going to perform poorly. Our current new validated staging system looks at the traditional NT-proBNP and troponin but uses the addition of the longitudinal strain. This is an echocardiographic parameter, and it is used widely in treatment centers who treat amyloidosis. This really identifies those ultra-high risk patients, and these are the patients who will perform poorly in current treatment protocols. And why is that important? Well, we need a robust staging system in the current treatment era which can stratify patients who will do well but also stratify those patients who do not do well. Because that is important for counseling patients, for risk stratification, for treatment approaches, and in the future, for designing clinical trials. Dr. Peter Li: And that is referring to the longitudinal strain greater than  -9% and NT-proBNP greater than 8,500 and then the high-sensitivity troponins greater than 50, which will define the new staging system. Can you talk more about how you picked these cutoffs and also what that alludes to in terms of the outcomes that you have discovered in this age of daratumumab-based therapy? Dr. Jahanzaib Khwaja: Yeah, that is a really excellent question because we have aimed to build upon traditional staging systems. So clinicians have used these traditional models for many, many years, and they have robustly underpinned our stratification of patients and how we counsel patients. So we didn't want to change some of these well-established thresholds, but we wanted to test them in the current treatment era. So the NT-proBNP of 8,500 and the high-sensitivity troponin of 50 were the traditionally used thresholds. And they actually stand the test of time. But we found that longitudinal strain additionally and independently predicts outcome independent of these other biomarkers. It is independent actually as a continuous variable, so you can cut this at a number of different stratification points and find independence. But we wanted to determine and discriminate those with the poorest outcomes. So we validated a longitudinal strain threshold of greater than  -9% by deriving this from a dataset of patients with the traditionally highest risk. Those are with European stage lllB. And looked at the optimal threshold with time-dependent ROC analysis. So we did this in our derivation cohort and then validated this externally in our external validation cohort amongst a number of centers in Europe, in the US, and in the UK. And it is important to note because longitudinal strain is an echocardiographic parameter, and traditionally the limitations are considered to be inter-vendor and inter-operator variability and intra-operator variability, and there are challenges with reproducibility of some of these measurements. So that is often cited as a limitation. But we found, when we have externally validated this across different centers using different platforms, actually the threshold of -9% is independently predictive of poorer outcomes independent of the traditional NT-proBNP and troponin thresholds, and it is robustly predictive of poorest outcomes. We know that those with stage lllC have a median overall survival of 4 to 7 months in the modern treatment era. And if we sub-stratify these by patients treated with daratumumab, outcomes have improved, but still, even if we look at daratumumab-treated patients, one-year overall survival is still only around 50 percent. So these are a poor risk group in the modern treatment era. Dr. Peter Li: Which kind of makes sense in a way because this kind of predicts whether they have amyloid-related cardiomyopathy. So I think this all tracks with our listeners. But given the poor outcomes even with daratumumab-based therapies, do you think this new staging system would change practice, if at all? Dr. Jahanzaib Khwaja: Yeah, I think that is a really good point because I think it comes to the question of why we use a staging system. What are its applications? I think one of the key things we think about in the clinic is how do we counsel patients when we first talk to them about their diagnosis. So there is a lot of information, but predominantly people want to know, what is my outlook going to look like? And as I say, in the bortezomib treatment era, 2010 to 2020, we used to say you have stage lllB, you have very poor outcomes, median survival maybe around six months. We have shown here that actually those with lllB have much better outcomes definitely over 12 months, up to 24 months in those with daratumumab-based therapies. So we need to counsel them in a different way. We then also need to say, "Well, who are the ultra-high risk?" So we said those with the longitudinal strain of greater than -9% with the traditional NT-proBNP and troponin cutoffs. And those patients will have poor outcomes. We need to talk about palliation. We need to talk about alternate treatment approaches. And then importantly for the community is about treatment and clinical trial design. So again, traditionally the traditional high-risk group lllB used to be considered an exclusion for all major trials. So these were excluded in the ANDROMEDA study, which led to the approval of daratumumab-based therapy, and multiple other trials. And we show here that actually patients with lllB should not be excluded from these studies because they do have good outcomes. And I think we make the important point that those with lllC, who do have poor outcomes, they need a different treatment approach, and we need to think about stratifying these patients differently. So perhaps the next modality of treatment will be the anti-fibril antibodies or a mode of treatment which can clear antibodies or clear the amyloid fibrils from the organs and reduce the organ toxicity early on. We know that those with lllC have poor outcomes particularly within the first year, and organ dysfunction really predominates here. So a different treatment approach is required, and we need to design trials specifically for these patients which look beyond anti-plasma cell clone therapy but also look at clearing the amyloid fibrils and improving organ function as this is predominantly the cause of death in these patients. Dr. Peter Li: That's an excellent point right there.  Do you foresee any limitations to this new staging system, or can you comment on is there potentially a better way to refine this staging criteria in the future? Dr. Jahanzaib Khwaja: Yeah, I think that is a really excellent point to consider, that staging systems always need refining across treatment eras. So we have looked at the bortezomib era, and then we have validated this in the daratumumab-based era. We know that amongst different countries access to treatment varies. We know that there are a number of factors which determine your health-related outcomes. That's access to healthcare, speed of diagnosis, access to tertiary diagnostics, ability to biopsy, and then supportive care. And I think our staging system highlights the importance of organ dysfunction predominantly causing death early on. And I think that as treatments improve this should be refined. So the expectation I think is, as we have better anti-plasma cell directed therapies, and as we hopefully develop anti-fibril antibodies and anti-fibril clearance drugs, that we will need to revalidate new models to effectively prognosticate in this treatment era. And I also think that as we become a bit more sophisticated with our approaches, we know that this can be refined in the future looking at other prognostic factors with regards to healthcare outcomes. I would say one of the strengths, however, of this model is that it builds on the traditional model, and it's quite simple to use. You just have the NT-proBNP and the troponin, and then longitudinal strain, which is used quite frequently in amyloid centers, and an echocardiogram is used in essentially all patients for diagnosis. So I think it will certainly be quite practical. But certainly I think, as you say, as treatment approaches change over time, and as we have further options in the future, we will need to refine prognostication. Dr. Peter Li: For the listeners out there, let's say someone comes in our clinic and we diagnose them with stage lllC amyloidosis. Can you comment on what clinical trials are out there that potentially they can refer their patients to? You mentioned anti-fibril therapy, which I think would be the way of the future. Can you kind of comment what you know at this current stage and point listeners in the right direction? Dr. Jahanzaib Khwaja: This is the challenge in amyloidosis. We don't have specific trials that are looking at those with the highest risk. And at present, even the ISA International Guidelines talk about risk according to the old treatment approaches and discuss attenuating our current chemotherapy approaches. And I think that for clinicians out there who identify those at the highest risk, it is really important to have a multidisciplinary approach, to consider palliation and palliative services early, and really work with your fellow cardiologists and renal physicians and neurologists to enable the best supportive care you have in order to deliver this anti-plasma cell directed therapy. We know that actually you only need for most patients small amounts of doses of chemotherapy to get good clonal responses, and we have seen that even in the bortezomib era that actually they have good CR rates and more impressive CR rates with daratumumab. But because of the organ dysfunction, it can be really challenging to deliver these doses. And supportive care is going to be really important particularly for these challenging patients. The future will be designing clinical trials that are appropriate for these patients. At present, we currently don't have available options, but I think the more we gather this data, the more we work collaboratively as a community, we will be able to mobilize our resources and get the best outcomes for these patients.  Dr. Peter Li: First build the field of dreams and then hopefully more therapies will arrive in the future. Thank you so much, Dr. Khwaja, for speaking about the JCO article, "A New Validated Staging System for AL Amyloidosis With Stage lllC Defining Ultra-Poor Risk: AL International Staging System," and for all your valuable input today. Dr. Jahanzaib Khwaja: Thank you very much. Dr. Peter Li: Make sure to check out the presentation at this year's ASH Conference taking place from December 6 to December 9. Thank you for listening to JCO Article Insights. Please come back for more interviews and article summaries and be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit asco.org/podcast. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

James: True Successor and Leadership of Jerusalem Movement — James Tabor — Tabor argues that James, Jesus's biological brother, functioned as the authentic successor to the Jesus movement leadership, not Peter as traditionally claimed. Tabor cites non-canonical textual sources and the Acts of the Apostles demonstrating that Jamespresided over the Jerusalem Council, making determinations regarding Jewish law observance by Christian converts. Tabor emphasizes the profound familial bond between the brothers and documents Mary's presence with Jesus and James at the crucifixion scene, indicating James maintained centrality to Jesus's personal and theological circle. 1698

What if the only letter in the New Testament addressed to a woman has been hiding in plain sight? As one of the shortest texts in the New Testament, Second John is often overlooked and dismissed as a condensed version of First John. Traditionally, its opening line has been read as addressed "to an elect lady"–a phrase understood metaphorically as the Church personified as a woman. This interpretation has dominated Greek editions of the New Testament for over 150 years, reinforcing the view that the letter was not directed to an individual but to a community.  In this episode, associate dean of research in Religious Education, Lincoln Blumell, discusses his recently published scholarship that challenges this long-standing assumption. Drawing on evidence from papyri, manuscripts, and other sources, Dr. Blumell argues that the text should instead be rendered "to the lady Eclecte," identifying a named woman as the recipient. This reinterpretation not only clarifies the meaning of the letter but also makes Second John the only text in the New Testament canon addressed directly to a woman, reshaping its significance and offering new insight into the role of women in the New Testament Church. Publications: Lady Eclecte: The Lost Woman of the New Testament (Fortress Press, 2025) Didymus the Blind's Commentary of Psalms 26:10–29 and 36:1–13 (Brepols Publishers, 2019) New Testament History, Culture, and Society: A Background to the Texts of the New Testament (Religious Studies Center, 2019) "'Is Jesus's Yoke Easy"? Reconsidering the Translation in Matthew 11:30" (BYU Studies, forthcoming) "A Ptolemaic Petition from a 'Judeo-Egyptian' (Ἰουδαιοαιγύπτιος)," with Kerry Hull, in Journal of Jewish Studies, 75.2 (2024) "The Text of the New Testament," in The King James Bible and the Restoration (Religious Studies Center, 2011) "The Greek Texts of the New Testament," Y Religion Podcast, Episode 20 (2020) Website: https://lincolnhblumell.com/ Click here to learn more about Lincoln Blumell

Advent is more than a countdown to Christmas—it’s a season of spiritual preparation, reflection, and anticipation for the coming of Jesus. Isaiah 9:6 reminds us of the promise of a Savior, calling Him Wonderful Counselor, Mighty God, Everlasting Father, and Prince of Peace. By intentionally preparing our hearts and homes, we can embrace the joy, hope, and light of Christ, creating meaningful family traditions that honor His arrival and cultivate a posture of worship. Highlights Advent is derived from the Latin word for “coming” and lasts four weeks, focusing on Christ’s first and second comings. Attend special Advent services to reflect, pray, and celebrate the birth of Jesus. Use an Advent calendar to daily engage with Scripture, small treats, or family moments that highlight Christ’s arrival. Light an Advent wreath weekly to symbolize expectation, reflection, and Christ as the light of the world (John 8:12). Create visual reminders like Advent chains or prepare a manger to help children and families anticipate Christ’s birth. Share the story of Jesus with others each week, following the example of the shepherds in Luke 2:17-18. Advent encourages both personal reflection and communal celebration, fostering gratitude, faith, and joyful expectation. Gift Inspiration: Crosswalk's Holiday Gift Guide Looking for a meaningful way to celebrate the season? Check out our Holiday Gift Guide—from beautifully illustrated Bibles and devotionals to novels, greeting cards, and picture books, there’s something for everyone on your list. Wrap up stories for loved ones, tuck a book into your own nightstand, and join us in celebrating the wonder of giving this Christmas! Full Transcript Below: Preparing Our Hearts and Homes for Advent By Lynette Kittle Bible Reading: “For to us a child is born, to us a son is given, and the government will be on His shoulders. And He will be called Wonderful Counselor, Mighty God, Everlasting Father, Prince of Peace—Isaiah 9:6 Preparing a home for the arrival of a new baby is a busy time, full of choosing clothes, bedding, accessories, and more. It’s an exciting time of getting everything ready and waiting for the day to come. It’s a time when families and friends come together to help prepare and celebrate the coming birth. As well, during the Advent season, we can remember, prepare, and celebrate anew the coming of Jesus as a newborn baby into our world. Some Christians may ask, what is Advent? Even though I grew up as a pastor’s daughter, we didn’t really emphasize Advent; it was something celebrated in more liturgical churches like Catholic, Anglican, and Lutheran, so we didn’t really learn or practice the observance growing up. The word Advent is derived from the Latin word “coming” and is a time of anticipation, prayer, spiritual reflection, and preparation for the birth of Jesus on Christmas Day. Advent traditionally starts four weeks before Christmas, beginning on the Sunday closest to November 30 and ending on Christmas Eve. Yet, it’s a beautiful time of preparation, lasting four weeks, leading up to the celebration of Jesus’ first coming at Christmas in the birth of our Messiah, and also the anticipation of His second coming and return to earth, yet to occur. 6 Meaningful Ways to Prepare for and Celebrate Advent The following are six traditional ways to prepare our hearts to celebrate Advent. Attend special Advent services. Some churches and denominations offer Advent services leading up to Christmas, where attendees join together to prepare their hearts for Christ’s birth with Scripture reading, an Advent message, songs, and prayers. Follow an Advent Calendar. Leading up to Christmas day, as a family, go through an Advent calendar, which offers 24 or 25 doors to open, each holding a small surprise, toy, candy, or Bible verse inside to help us focus on, prepare, and celebrate each day of Advent. Opening each door helps to teach us about Christ’s coming, along with creating warm family moments and memories to last for years to come. Light an Advent Wreath. An Advent wreath is traditionally made out of evergreens, but can come in various forms, such as wooden or plastic, holding four candles to represent the four weeks leading up to Advent, lighting one candle each Sunday. Traditionally, because purple represents royalty, the candles are usually three purple and one pink candle. Lighting the wreath offers a time for expectation and reflection, where we can look forward to Christ’s coming and rejoice because Jesus is the light of the world. As John 8:12 records, “When Jesus spoke again to the people, He said, ‘I am the light of the world. Whoever follows Me will never walk in darkness, but will have the light of life.’” Create an Advent chain. As a visual countdown to Advent, young children may especially enjoy making an Advent chain, linking together colorful pieces of paper to represent each day leading up to Advent. Every day, remove a link until Christmas Day. Prepare a manger. Some families construct a small manger to represent preparing a place for the coming Christ, lining it each day with pieces of straw in preparation. As Luke 2:7 reminds us, “And she gave birth to her firstborn, a son. She wrapped Him in cloths and placed Him in a manger, because there was no guest room available for them.” Share Jesus. Each week of Advent, tell someone about celebrating it and what it means to all of us. Like the shepherds told others about Jesus’ birth in Luke 2:17-18, tell those we know about His coming. “When they had seen Him, they spread the word concerning what had been told them about this child, and all who heard it were amazed at what the shepherds said to them.” Intersecting Faith & Life: If you grew up Christian, but unaware of celebrating Advent, take some time to prayerfully consider if you and your family would like to participate this coming year in one or more of the traditions. Further Reading: 4 Advent Traditions to Carry on with Your Family Discover more Christian podcasts at lifeaudio.com and inquire about advertising opportunities at lifeaudio.com/contact-us.

A new week means new questions! Hope you have fun with these!Hinge, pivot, ball and socket are three types of what skeletal structure?In Canada, what province is the capital city located?Stanisław II August ruled from 1764 to 1795 and was the last king of which country, the fifth largest EU country?What element has the highest melting point?In 1926 Gertrude Ederle swam what in 14 1/2 hours, breaking the men's record by 2 hours, and the inspiration for the Daisy Ridley film "Young Woman and the Sea"?Which Aristophanes comedy shares its name with a 1963 natural horror film directed by Alfred Hitchcock?What was the first horror film to be nominated for Best Picture?The word "Alphabet" comes from the first two letters of what language?In operation since 1930, London's Great West Aerodrome later became the site of what?Traditionally, what color are the community chest cards in a game in Monopoly?In "The Office" what does Michael Scott eat at lunch to make him fall asleep?What is the best selling album of the 21st century thus far?In 2010, Jonathan Franzen was the first American novelist to appear on the cover of TIME since what legendary and prolific American writer?MusicHot Swing, Fast Talkin, Bass Walker, Dances and Dames, Ambush by Kevin MacLeod (incompetech.com)Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/Don't forget to follow us on social media:Patreon – patreon.com/quizbang – Please consider supporting us on Patreon. Check out our fun extras for patrons and help us keep this podcast going. We appreciate any level of support!Website – quizbangpod.com Check out our website, it will have all the links for social media that you need and while you're there, why not go to the contact us page and submit a question!Facebook – @quizbangpodcast – we post episode links and silly lego pictures to go with our trivia questions. Enjoy the silly picture and give your best guess, we will respond to your answer the next day to give everyone a chance to guess.Instagram – Quiz Quiz Bang Bang (quizquizbangbang), we post silly lego pictures to go with our trivia questions. Enjoy the silly picture and give your best guess, we will respond to your answer the next day to give everyone a chance to guess.Twitter – @quizbangpod We want to start a fun community for our fellow trivia lovers. If you hear/think of a fun or challenging trivia question, post it to our twitter feed and we will repost it so everyone can take a stab it. Come for the trivia – stay for the trivia.Ko-Fi – ko-fi.com/quizbangpod – Keep that sweet caffeine running through our body with a Ko-Fi, power us through a late night of fact checking and editing!

Lando Norris' first proper chance to clinch the Drivers' Championship of the 2025 Formula 1 season. Will he clinch it on his first attempt, or will the title battle go down to the wire in Abu Dhabi? In Las Vegas, Norris was frazzled by Max Verstappen on the front row. Will this trend continue in Qatar? And btw, have we all resigned to the fate that Oscar Piastri won't be crowned F1 World Champion in 2025? Qatar will be the final "Sprint and Grand Prix" format of the F1 2025 season. Traditionally, Red Bull Racing has struggled to get their car in optimal working range when there is just one FP1 session. Given their plank woes, will McLaren suffer similar fate i.e. require more "track time" to find the accurate ride height to race with? How aggressive will McLaren go, or will they be conservative given Norris' 24-points lead at the top of the table? The battle for P6 in the Constructors' Championship is another one to watch. A lot of money is at stake and we expect teams and drivers to throw everything at it.

Soul Food: Nourishment for the Spirit In the sermon titled “Soul Food,” delivered on November 23, 2025, the idea of soul food is explored in a spiritual context. Traditionally, soul food refers to the rich, flavorful cuisine developed by African Americans in the antebellum South, symbolizing resilience and cultural heritage. In this sermon, the focus shifts to the spiritual nourishment needed for a fulfilling life in Christ. The Two Food Groups of the Soul Pastor Chris teaches that there are two main types of “soul food”: junk food and health food. Junk Food: Complaining. Just as physical junk food harms the body, complaining harms spiritual vitality. It blinds us to God's blessings and opportunities, making us less sensitive to His presence and the needs of others. Health Food: Thanksgiving. Gratitude strengthens the soul. When we give thanks, our souls become more vibrant and alive to God's love and purpose. Thanksgiving is a recurring theme throughout the New Testament, showing its importance for spiritual health. Biblical Foundations The sermon draws on several passages to highlight the importance of thanksgiving: Colossians 3:15–17: Paul urges believers to let the message of Christ dwell richly among them and to teach and admonish one another with wisdom through songs and gratitude. James 1:17: Every good and perfect gift comes from above, reminding us of God's grace and constancy. 2 Corinthians 4:15: Paul explains that his hardships serve others and lead to an overflow of thanksgiving to God. 2 Corinthians 9:11: Generosity that flows from gratitude results in thanksgiving to God. Romans 1:21: Refusing to glorify God or give thanks leads to futile thinking and darkened hearts, showing the destructive nature of ingratitude. 1 Thessalonians 5:16–18: Paul calls believers to rejoice always, pray continually, and give thanks in all circumstances—because this is God's will. Cultivating a Thankful Heart To develop a taste for the “health food” of thanksgiving, Pastor Chris suggests: Change Your Mind: Focus your thinking on God's goodness and grace. Recognize Him as the source of all good things. Change Your Diet: Practice intentional thanksgiving. The Jewish tradition of offering benedictions, or blessings, is highlighted as a way to foster gratitude. Conclusion Thanksgiving is not just a polite gesture but a spiritual discipline that aligns us with God's will and enriches our souls. It moves us to live out our faith with joy and purpose, reflecting the light of Christ in a world often overshadowed by complaint and ingratitude. The sermon closes with an invitation to place faith in Jesus, recognizing Him as the ultimate source of life and gratitude. By embracing thanksgiving, believers nourish their souls and live more abundantly in God's grace.

Are you in control of your emotional reactions? Each and every person has dormant abilities locked away in their genetic codes. Traditionally, scientists believed it would take generations to activate a new evolutionary ability, but we now know that epigenetics can expedite the process. Today on Conscious Fertility, Dr. Cassandra Vieten elaborates on the mind-body connection and how you can influence your genetic code with your environment and habits. You cannot control the world, but you can control your reaction to it. Dr. Vieten is the executive director of the John W. Brick Foundation and the author of Mindful Motherhood. Her groundbreaking research into mind-body medicine is changing how we understand our human potential. Dr. Vieten teaches you practical steps you can take today to change your outlook, so you can rewire your brain and become spiritually competent. You can develop entirely new thought patterns with the help of mindfulness training. Dr. Vieten explains how mothers can unlock their latent potential for inner peace and how that skill transfers to their children. You cannot eliminate life's obstacles, but you can bolster your ability to deal with stress by communing with nature and making time for yourself. Join us to explore how you can access your hidden potential with epigenetics and mindfulness training. Key Takeaways: Unlocking your dormant potential The mind-body connection Epigenetics and gene expression Emotional freedom technique Virtual reality for mental health Being at peace with the present Controlling your reactions Developing new response patterns Self-compassion practices Mindful motherhood Lowering resistance Practicing detachment About Dr.Cassandra Vieten Dr. Cassandra Vieten is Executive Director of the John W. Brick Foundation. She is also a Scholar-in-Residence at the Arthur C. Clarke Center for Human Imagination at the University of California, San Diego. She is a Senior Fellow at the Institute of Noetic Sciences, where she worked for 18 years in successive roles as Scientist, Director of Research, CEO, and President from 2013-2019. She is a clinical psychologist, mind-body medicine researcher, and author of numerous articles in scientific journals. Where to Find Cassandra Vietten: Website: Cassandravieten.comMental Health Global Summit Center for Mindfulness Instagram: https://www.instagram.com/cassandra.vieten/Facebook: https://www.facebook.com/cassandravieten

#top .av-special-heading.av-gs9o3p-eb26fedf851de4b641602a8b5bcca505{ padding-bottom:10px; } body .av-special-heading.av-gs9o3p-eb26fedf851de4b641602a8b5bcca505 .av-special-heading-tag .heading-char{ font-size:25px; } .av-special-heading.av-gs9o3p-eb26fedf851de4b641602a8b5bcca505 .av-subheading{ font-size:15px; } Through My Bible Yr 02 – November 22Song of Songs 1:1 – 2:7 LISTEN HERE Through My Bible – November 22 Song of Songs 1:1 – 2:7 (EHV) https://wels2.blob.core.windows.net/tmb-ehv/02-1122db.mp3 See series: Through My Bible Title Song of Songs 1 1 The Song of Songs, which is Solomon's. Anticipation—Take Me Away The Woman 2 Let him kiss me with the kisses of his mouth. Experiencing your love is better than wine. 3 Your perfumes are fragrant. Your name is perfume poured out. [1] That is why the virgins love you! 4 Carry me away with you—let us run. Let the king bring me into his chambers. Best Wishes to the Man The Friends We rejoice and are happy because of you. We celebrate your expressions of love more than we celebrate wine. How right the virgins [2] are to love you! My Own Vineyard The Woman 5 Dark am I, but lovely, O daughters of Jerusalem, dark like the tents of Kedar, like the tent curtains of Solomon. 6 Do not stare at me because I am dark     because the sun gazed at me. My mother's sons were angry with me. They made me take care of the vineyards. I could not take care of my own vineyard. Escape to the Country The Woman 7 You whom my soul loves, tell me where you pasture your flock, where you rest your sheep at noon. Why should I be like a veiled woman beside the flocks of your companions? A Reply to the Woman 8 If you do not know, most beautiful of women, go out and follow the tracks of the flock and graze your young goats     by the dwellings of the shepherds. Most Beautiful of Women The Man 9 My darling, I compare you to a mare among the chariots of Pharaoh. 10 Your cheeks are adorned with earrings, your neck with strings of jewels. 11 We will make for you gold earrings decorated with silver. The Woman 12 While the king was at his couch, my nard [3] gave off its fragrance. 13 My lover is to me a sachet of myrrh,     spending the night between my breasts. 14 My lover is to me a cluster of henna blossoms from the vineyards of En Gedi. Our House The Man 15 How beautiful you are, my darling! How beautiful! Your eyes are doves. The Woman 16 How beautiful you are, my lover. How delightful! Yes, our bed is fresh. 17 The beams of our house are cedar. Our rafters are fir. The Woman Song of Songs 2 1 I am a wildflower [4] of Sharon, [5] a lily of the valleys. The Man 2 Like a lily among thorns, so is my darling among the girls. He Embraces Me The Woman 3 Like an apple tree among the trees of the forest, so is my lover among the boys. I desire to sit in his shade. His fruit is sweet to my taste. 4 He has brought me to the reception hall, [6] and his banner over me is love. [7] 5 Strengthen me with raisin cakes. Refresh me with apples, for I am weak from love. 6 His left arm is under my head, and his right arm embraces me. 7 Daughters of Jerusalem, you must swear to me by the gazelles, or by the does of the field, that you will not arouse or awaken love     until it so desires. Footnotes Song of Songs 1:3 The meaning of the Hebrew term oil of Turuq is uncertain. The ancient versions support the meaning oil which is poured out. Song of Songs 1:4 The noun virgins is supplied from verse 3 to make it clear that the man is being addressed. Song of Songs 1:12 Nard, myrrh, and henna are expensive fragrances and cosmetics. Song of Songs 2:1 Traditionally translated rose, but more likely a crocus, daffodil, or lotus. Song of Songs 2:1 Sharon is a region on the coast of Israel. Song of Songs 2:4 Literally house of wine, an expression that speaks of drink more than food Song of Songs 2:4 The meaning of the line is uncertain. #top .hr.hr-invisible.av-aocsdx-89cb4ca21532423cf697fc393b6fcee0{ height:10px; } The Holy Bible, Evangelical Heritage Version®, EHV®, © 2019 Wartburg Project, Inc. All rights reserved. #top .hr.hr-invisible.av-4vzadh-3f04b370105df1fd314a2a9d83e55b26{ height:50px; } Share this entryShare on FacebookShare on LinkedInShare by MailLink to FlickrLink to InstagramLink to Vimeo

Traditionally, parenthood has been seen as a career disruption-especially for mothers. But what if becoming a parent could be one of the greatest leadership incubators of all? The Parenthood Advantage: Building Corporate Cultures That Value Working Parents (Dg Press, 2025) challenges the outdated narrative that working parents are a burden to manage and instead shows how they're an untapped asset that forward-thinking companies can't afford to overlook. Drawing on compelling research, candid interviews, and real-world examples, authors Mason Donovan and Mark Kaplan reveal how the skills honed through parenthood-resilience, crisis management, empathy, prioritization, and negotiation-are the very qualities that modern workplaces need. The book offers practical strategies for leaders and organizations to transform parental leave, return-to-work support, and everyday culture into true competitive advantages. Whether you're an HR leader seeking to attract and retain top talent, a manager aiming to better support your team, or a working parent ready to reframe your value at work, The Parenthood Advantage will inspire you to see what's possible when we stop sidelining parents and start recognizing them as a powerful source of growth, innovation, and leadership. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

  Fertility Docs Uncensored is hosted by Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center. Today, they had a special Guest: Phillip Romanski, Associate Research Director of US Fertility. He is also an Assistant Professor and Associate Program Director of the reproductive endocrinology fellowship at Mount Sinai. In this episode, the docs explore how research shapes the future of fertility care. As Associate Research Director for US Fertility, Dr. Romanski shares how the organization leverages its extensive national data to support studies that directly influence patient outcomes. With eight to nine active clinical studies, patients can visit the US Fertility website to learn about current opportunities to participate, helping advance science, even if the immediate benefits are for future patients. Dr. Romanski highlights a recent study examining development in embryos that initially appeared to have abnormal fertilization. Surprisingly, many of these embryos progressed to the blastocyst stage, and a significant number were genetically normal. This information may help increase the number of viable embryos for future transfer. He also discusses a recent study with unexpected results: a comparison of fertilization outcomes between ICSI and conventional insemination with frozen sperm. Traditionally, eggs are fertilized with ICSI when using frozen sperm. By dividing eggs from individual patients and comparing ICSI with conventional insemination, the team found no difference in fertilization outcomes. This finding could reduce unnecessary embryo manipulation, minimize risk, and decrease costs for patients. This episode takes a fascinating look at how research today is improving the fertility treatments of tomorrow. This podcast was sponsored by US Fertility. 

Traditionally, CRE decisions have relied on fragmented data from multiple sources—lease management, occupancy analytics, HR, and financial reports.

In this podcast, Delilah S. Dawson talks about House of Idyll, writing comics, how to get traditionally published, and much more. About Delilah S. Dawson Delilah S. Dawson is the New York Times bestselling writer of Star Wars: Phasma, Galaxy's Edge: Black Spire, Inquisitor: Rise of the Red Blade, The Secrets of Long Snoot, The … Continue reading

Not the sequel to the game from 1H1D #83.Traditionally game selection is left to the Xbox Game Pass "Surprise Me" button, but this First Person Action RPG developed by Obsidian Entertainment was actually chosen by Matt aka Stormaggedon, who was previously a guest on the show for episode 225! There was a possibility that Matt would be our first repeat guest, but alas, it was not our stars. Tom and Chris were left to tackle this review solo, or at least as solo as a duo can be. Chris has played a bit of the original but Tom is going in completely blind, so what will each of their final thoughts be on this sequel? Will it be worth the hour they each invested? More important to you, is it worthy of your precious time? Those answers won't be found here in this blurb, but you can certainly discover them by exploring this stellar review. Let's hope the humor in the game lands better than these terrible puns.What do you think? Let us know!Hit us up on Twitter at https://twitter.com/tc1h1dOr on Threads at https://www.threads.net/@tc1h1dDrop us an email at tc.1h1d(at)outlook[dot]comFollow us on Goodpods @1h1dCheck out our fancy site: https://quitthebuild.com/1h1dWatch the video: https://bit.ly/1H1DYTThanks for taking this ride with us :-)

For Episode #188 of the PricePlow Podcast, we welcome Edwin Gonzalez, Functional Health Sales Manager at Health Tech Bio Actives (HTBA), alongside Michael Alfaro from Master Foods Lab. This episode marks a milestone collaboration: putting cutting-edge vitamin B12 science into functional foods that consumers can actually feel working. Edwin introduces MecobalActive, HTBA's ultra-pure, optimized methylcobalamin ingredient that's redefining what B12 supplementation can do. Traditionally, the industry positioned B12 as a deficiency vitamin for tired, anemic, or sluggish individuals. HTBA is changing that narrative completely. New clinical research demonstrates that just three days of MecobalActive supplementation significantly improved both physical power output and cognitive reaction time in healthy, well-trained athletes without B12 deficiency. This isn't about correcting what's broken, it's about optimizing what already works. The conversation explores HTBA's nearly 50-year European heritage, their unique position as the only EU manufacturer of all active B12 forms, and the proprietary green chemistry process that yields MecobalActive's exceptional purity and stability. Michael walks through the technical challenges of incorporating functional ingredients into Skinny Bite cakes (showcased at SupplySide Global 2025), revealing the complex interplay between formulation science, manufacturing constraints, and innovative problem-solving. From raspberry-colored B12 filling to protected cake layers to the partnership model driving functional food innovation, this episode delivers both scientific depth and practical application insights. https://blog.priceplow.com/podcast/vitamin-b12-htba-mecobalactive-188 Video: Redefining B12 with HTBA's Edwin Gonzalez and Master Foods Lab's Michael Alfaro https://www.youtube.com/watch?v=KGqZm9Q5bkw Detailed Show Notes: MecobalActive B12 Takeover (0:00) – Welcome Back: A Dive Into Functional Foods (2:00) – Redefining B12: From Deficiency to Performance Enhancement (4:45) – Creating Functional Foods: The Clear Can Problem (7:15) – The Formulation Challenge: Making Actives Work in Real Food (11:00) – HTBA's European Heritage and Manufacturing Excellence (14:30) – Green Chemistry: Manufacturing B12 Without Toxic Reagents (16:45) – Light Sensitivity and Creative Product Applications (19:00) – Redefining B12 Like Creatine Was Redefined (22:00) – The Clinical Study: Triple-Blind Crossover in Healthy Athletes (26:45) – The Results: 4% Power, 6% Fatigue Resistance, 5% Cognition (31:00) – Structure/Function Claims and Market Applications (35:45) – Color-Driven Innovation and Future Applications (37:00) – The Chocolate Coating: Formulation Within Constraints (39:00) – Manufacturing Mastery: Solving the Protein Cake Challenge (41:00) – The Partnership Model: When Ingredient Suppliers Become Collaborators (42:00) – The Pressure Cooker: Building Brands in Real Time (44:00) – Closing and Where to Find Edwin, HTBA, and Michael Where to Find HTBA, MecobalActive, and Master Foods Lab HTBA and MecobalActive: MecobalActive: Healt... Read more on the PricePlow Blog

Lift a glass to the story of sake—from Japanese homebrew to global phenomenon. Sake, Japan's iconic rice-based alcoholic drink, has been central to Japanese culture for over 1,300 years. Traditionally made with rice, water, and koji mold, it was consumed in early brewpubs and was vital to samurai rituals and festivals. Sake's story includes homebrewers like clan matriarchs, ancient princes, and modern political activists who defied laws to keep homebrewing alive. Temples refined sake-making techniques, laying the foundation for a thriving industry that became a major economic force for shoguns and the modern state. Kanpai is the first history of sake in English, exploring its evolution from homebrew to flavored varieties, and its cultural significance and global rise—including its growing popularity and production in North America and Europe. The book also shows how sake has shaped Japanese food, society, and traditions.Eric C. Rath is professor of premodern Japanese history at the University of Kansas. He is the author of Food and Fantasy in Early Modern Japan.Buy the book from Wellington Square Bookshop - ​https://wellingtonsquarebooks.com/book/9781836391159

Traditionally, a college degree has been seen as a ticket to a secure future.But not today. Thanks to soaring tuition costs and weighty student loans, many people are questioning the value of college. A 2025 Pew Research poll found that only one in four U.S. adults says it's “extremely or very important to have a four-year college degree” to get a well-paying job. And many young Americans — including Black, Latino and Indigenous students — contend they can build solid careers without seeking further education. In a 2025 survey by New America, a majority of young Americans agreed “there are lots of well-paying, stable jobs that people can find with only a high school diploma or GED.”So is college still worth it — especially when it comes to low-income or first-generation students? Is college still worth it? MPR News' North Star Journey Live project teamed up with Sahan Journal Community Conversations in October to host a panel discussing the pros and cons of higher education. They also discussed other burgeoning post-secondary options, like trade schools, apprenticeships and becoming an entrepreneur. Guests: Frida Torres Macal is the founder of That Social Invite, an independent social media marketer focused on helping women-owned businesses and professionals grow.Marquan Harper is a sophomore at the University of St. Thomas, where he is double majoring in Digital Media Arts and Marketing Management. He's also the founder of Ador Hospitality, a Midwest-based hospitality group dedicated to enhancing the nightlife experience for young adults aged 18-24. Jalayah Johnson is enrolled at the Finishing Trades Institute of the Upper Midwest as a second-year glazer apprentice for the Empire House.Ali Osman is a high school counselor at South High School in Minneapolis. Jessica Yang is the senior implementation manager at the Get Ready GEAR UP Minnesota program administered through the Minnesota Office of Higher Education.Subscribe to the MPR News with Angela Davis podcast on: Apple Podcasts, Spotify or RSS. 

So, who's really making all the money at RTÉ? Traditionally, it's been the on-air talent leading the earnings table. This year, however, there's been a shake-up: the executives/suits are now outpacing the stars on the payscale. But with Newstalk snapping up big-name presenters, could RTÉ's pay cuts signal the start of a slide? And as fresh revelations emerge about unorthodox payments, is another storm brewing over the national broadcaster's headquarters? ­ This podcast has been amended on 31 October 2025 to remove the incorrect statement that the 725m three-year Government funding plan for RTE is in addition to TV license fee revenueSee omnystudio.com/listener for privacy information.

New York City is on the cusp of an election in which what once looked impossible has begun to seem inevitable. Zohran Mamdani, a democratic socialist member of the New York state Assembly, is heavily favored to beat Andrew Cuomo, New York's onetime Democratic governor and a former icon of the party establishment, in a race for mayor that has become among the most-watched in the nation.Cuomo and Mamdani articulate two vastly different visions for New York City — and where the Democratic Party is going overall. This week on The Intercept Briefing, Akela Lacy speaks to people hoping to see each of those two visions fulfilled.“Traditionally, we've thought about politics as left, right, and center,” says Alyssa Cass, a Democratic strategist who has worked on local and national campaigns. “Zohran offered a message that was less about ideology and more about disrupting a failed status quo that is working for almost no one.”Cass, who worked on Andrew Yang's mayoral campaign in 2021, isn't working for Mamdani but says his candidacy indicates “that Democrats can win when we have ideas.”In the view of Jim Walden, a former mayoral candidate who is now backing Cuomo, those ideas are “dangerous and radical policies.” He says Mamdani's popularity is an indication that “there's going to be a flirtation with socialism and maybe some populist push” among Democrats. But “ultimately,” Walden says, “the party will come back closer to the center.”Chi Ossé, a City Council member who endorsed Mamdani, sees Mamdani's success as evidence of the opposite. “We could have gone back to or continued this trend of electing centrist, moderate Democrats,” Ossé says. Instead, he thinks that New Yorkers want “someone who ran as a loud and proud democratic socialist who has always fought on the left.”While New York City is preparing for a general election, Republican candidate Curtis Sliwa is unlikely to win — turning the race almost into a second Democratic primary. “The party is now confronted with a choice,” said Lacy, “between a nominee who has become the new face of generational change in politics and a former governor fighting for his political comeback. The results could reveal where the party's headed in next year's midterms and beyond.”Listen to the full conversation of The Intercept Briefing on Apple Podcasts, Spotify, or wherever you listen.You can support our work at theintercept.com/join. Your donation, no matter the amount, makes a real difference. Hosted on Acast. See acast.com/privacy for more information.

Modern Primary Care Diagnostic Sequences; Why the Future of Care Hinges on Faster, Smarter Diagnostics. Traditionally, and still in many practices today, some of the most important parts of a primary care visit happen after the patient leaves the exam room. Diagnosis is often delayed, follow-up decisions are disconnected from the visit itself, and early opportunities for intervention can be missed. The diagnostic sequence may be the least celebrated yet the most essential part of a primary care visit. Whether it's a healthy 25 year old seeking reassurance or a 45 year old at risk for diabetes, the pattern is the same: see the doctor, get the labs, wait for results, then discuss what it all means. This four step routine isn't just tradition, it's the structure payers recognize, the basis on which health system workflows are built, and the process clinicians rely on to deliver care.

Catch up with ALLISON INTERVIEWS Host, Allison Kugel: Follow Me on Instagram: https://www.instagram.com/theallisonkugel/ My Allison Interviews Blog: allisoninterviews.com Buy My Book: Journaling Fame: A memoir of a life unhinged and on the record  Support My Interviews @ Buy Me a Coffee: buymeacoffee.com/allisoninterviews In the latest installment of the Allison Interviews Podcast, journalist and host Allison Kugel talks with New York Times bestselling author Jeff Pearlman, about writing Only God Can Judge Me: The Many Lives of Tupac Shakur (on sale 10/21, Mariner Books), the most complete Tupac Shakur biography ever penned, featuring 650+ interviews. The book features in-depth interviews with Tupac's sister Set Shakur, late Outlawz member Yaki Kadafi's mother Yaasmyn Fula, Digital Underground's Money B, Tupac's aunt Gloria and her son Kenny Lesane, former Tupac managers Leila Steinberg and Atron Gregory, Juice director Ernest Dickerson, former classmates, love interests and close friends from the Baltimore School for the Arts, former roommates from the projects and former classmates in Marin City, the surprising woman who gave Tupac his first and middle name, actress Lela Rochon, Gang Related director Jim Kouf and hundreds of others. The book also features never before heard quotes from Tupac's former fiancée Kidada Jones. Traditionally a sports figure biographer, Pearlman's previous book include: Showtime (adopted for the screen with HBO's Winning Time series), The Last Folk Hero, Three-Ring Circus, Football for a Buck, Gunslinger, Sweetness, The Rocket That Fell to Earth, Boys Will Be Boys, Love Me Hate Me and The Bad Guys Won. Jeff Pearlman's Links https://jeffpearlman.com/ https://www.instagram.com/jeff_pearlman/ https://www.harpercollins.com/products/only-god-can-judge-me-jeff-pearlman?variant=43756802310178 _____________________________________________________________________________ Subscribe to the audio podcast of Allison Interviews on Apple Podcasts and Spotify, and subscribe to the video podcast on YouTube. :-) Learn more about your ad choices. Visit megaphone.fm/adchoices

Traditionally the most “high-profile” session of the weekend, the Sunday Morning Session gets Radio Free Mormon's full treatment. From prophetic posturing to carefully crafted soundbites, RFM highlights what's said on the big stage—and what's quietly avoided. If you want the conference decoded, this is the session to watch.

Traditionally the most “high-profile” session of the weekend, the Sunday Morning Session gets Radio Free Mormon's full treatment. From prophetic posturing to carefully crafted soundbites, RFM highlights what's said on the big stage—and what's quietly avoided. If you want the conference decoded, this is the session to watch. The post GenCon Post Mortem: Sunday Morning: RFM: 421 appeared first on Mormon Discussions Podcasts - Full Lineup.