Podcasts about Yale school

Welcome back to another episode of the #squarepizzapod. This week, Greg is in conversation with Brittany Young, Founder + CEO of B-360. One fun fact you will learn about Brittany and B-360 is the Mayor of Baltimore designated March 25th as "B-360" day to honor the five-year anniversary of their organization. The celebration includes a press conference and a proclamation from the Mayor. In this episode:B-360 history and overview Awards: Kelly Clarkson, Steve Harvey, Ne-Yo, Ted TalkFellowship experience at Camelback & Echoing GreenDiverse funding modelRide for Change campaignSuccess and challengesBio:Brittany is a retired engineer, educator, professor, and Baltimore native; she has programmed nuclear plants, developed medical devices, and planned satellite explorations, but finds the most satisfaction in her roles in education, problem-solving & service to her community. After the incarceration of her minor brother as an adult, she became empowered to create solutions to funnel talent which resulted in B-360. B-360 , is an organization that utilizes dirt bike culture to end the cycle of poverty, disrupt the prison pipeline, and build bridges in communities. Through STEM education, community engagement, workforce pipe-lining, and events the organization is changing the perception of engineers and dirt bike riders.She was the first Black woman Baltimore native to have a TED Talk, the First Black person ever to receive the prestigious Bessie Stringfield Award, and is currently creating the first ever campus for dirt bikes and education in the country. If you visit Union Station Market in DC, she is currently on a mural 3 blocks from the White House focusing on successful Black women entrepreneurs. Outside of being a history maker she has some of the following accolades and accomplishments: Yale School of Management Lecturer, Baltimore 40 under 40, Echoing Green Fellow, Baltimore's Woman to Watch, and transition team member to Mayor Brandon Scott. Her work has been featured in Johns Hopkins, CBS, Forbes, Teen Vogue, Afro-Punk, Broccoli City Fest, Toyota, Nike NBC Sports, and more!   Brittany is a champion for Black joy, Black women, and true systemic change and providing digits and skills access to people just like her. Brittany's life goals are to show people how smart they truly are and to unlock innate genius. When she is not advocating for change through B-360, you can also find her advocating for caregivers and supporting her brother who lives with down syndrome. Support the show

Dan Weiss, president of the Metropolitan Museum of Art, served as the judge of the 2021 Plein Air Easton art competition.  As we worked with Dan during the festival, we found him to be a passionate, kind, and easy-going man that was able to say incredibly intelligent things in a way that felt connecting when other wise people may sound exclusionary.  He joined us virtually from quarantine to share the story of how he became such a uniquely qualified candidate for his role at the Met and express his love for Plein Air painting. A scholar of art history and a seasoned leader of complex institutions, Dan Weiss was previously President and Professor of Art History of Haverford College and, from 2005 to 2013 of Lafayette College. He holds an MBA from Yale and a PhD from Johns Hopkins University in western medieval and Byzantine art, where he joined the art history faculty and in six years rose to full professor and then chair of the department. Three years later, he became the James B. Knapp Dean of Johns Hopkins's Krieger School of Arts and Sciences. He holds a BA in Art History and Psychology from The George Washington University.  The author of six books and numerous articles, Weiss has published and lectured widely on a variety of topics, including the art of the Middle Ages and the Crusades, higher education, museums, and American culture. His most recent books include In That Time: Michael O'Donnell and the Tragic Era of Vietnam (2019), and Remaking College: Innovation and the Liberal Arts (2013). Earlier in his career, Weiss spent four years as a management consultant at Booz, Allen & Hamilton in New York. The recipient of fellowships from Harvard University, the Andrew W. Mellon Foundation, and the National Endowment for the Humanities, Weiss received the Business and Society Award from the Yale School of Management, the Van Courtlandt Elliott Award from the Medieval Academy of America for scholarship in medieval studies, the Distinguished Alumni Award from George Washington University, and he was inducted into the Society of Scholars at Johns Hopkins in 2018. Follow The MET: Official Site Facebook Instagram Twitter YouTube Follow Plein Air Easton: Official Site Facebook Instagram YouTube To inquire about being a guest or sponsoring the Plein Air Easton Podcast, send us an email at info@pleinaireaston.com. This episode is sponsored by JFM Enterprises, providing distinctive ready-made and custom frames & mouldings to the trade since 1974. Music in this episode was generously provided by Blue Dot Sessions & Scott Gratton.

Ep.113 features Chris Watts, an interdisciplinary artist working primarily in painting and installation. Within his work, he seeks to revise, interrogate, and re-examine social and personal narratives. This re-examination is not to simply supplement a new narrative, but to create a project of disruption. Watts attended graduate studies at Yale School of Art, New Haven, CT, after attending the College of Arts and Architecture, University of North Carolina, Charlotte, NC, and the Academy of Fine Arts and Design, Wroclaw, PL. The artist has held various artist residencies, among them the Marek Maria Pienkowski Foundation, Chelm, PL; McColl Center for Art + Innovation, Charlotte, NC; the Art & Law Fellowship Program, at Cornell University Art Architecture Planning, New York, NY; and the Lower Manhattan Cultural Council Workspace Program, New York, NY. His work has been exhibited in national and international institutions and exhibitions. Watts lives and works in New York, NY, and North Carolina, NC, US. Watts is a featured artist in the documentary film, The Art of Making It, directed by Kelcey Edwards, and from the Emmy-nominated producer Debi Wisch (The Price of Everything). The film had its world premiere at the 2021 Hamptons International Film Festival and won an Audience choice award at 2022 SXSW Film Festival. Welancora Gallery https://www.welancoragallery.com/artists/34-chris-watts/overview/ Galerie Lelong https://www.galerielelong.com/exhibitions/open-doors-june-edmonds-carl-e-hazlewood-helen-evans-ramsaran-chris-watts The Art of Making It https://www.ifccenter.com/films/the-art-of-making-it/ Bode https://www.bode-projects.com/artists/42-chris-watts/overview/ Monica King projects https://monicakingprojects.com/artists/45-chris-watts/biography/ QC Exclusive https://qcexclusive.com/fine-arts/chris-watts-redefines-southern-art/ LinkedIn https://www.linkedin.com/in/chris-watts-510236a9/

About Eleanor: Eleanor Beaton is the founder of SafiMedia, an education & coaching company for women entrepreneurs. SafiMedia is committed to advancing global gender equity one woman-owned business at a time. Together with her colleagues, Eleanor is on a mission to double the number of women entrepreneurs who scale past $1M in revenue by 2030.Eleanor hosts the Power + Presence + Position podcast, a top-ranked podcast for female founders with over 1.5 million downloads to date. The former chair of the Visiting Women's Executive Exchange Program at the Yale School of Management, Eleanor has been featured in publications including The Globe & Mail, The Atlantic, CBC, Chatelaine, and more.Connect with EleanorWebsiteSafi Media WebsiteEleanor's InstagramSafi Media InstagramLinkedInFacebookFavorite Quotes“As women, we need to have these conversations and stop taking the bake sale approach: bake the cookies and sell them. No. How about we start really creating assets and thinking about an ecosystem of growth rather than putting it all on our own back and growing through our labor?”“The key to a sustainable business is packaged standardized offerings. So a business will start with a lot of bespoke services. And I think that's really a powerful way (to start) and you can always have a portion of your business be bespoke. But if you truly wanna scale, you're going to need to start standardizing through group programs, courses, or standardized services.”“We're living through this epidemic of overwhelm. There can certainly be a huge amount of ease and flow. But the reality is there are parts of a business that are hard. And sometimes you just have to choose your hard.”In This Episode You'll Learn:What's holding female entrepreneurs back from meeting their revenue goals and milestonesHow to build an ecosystem that supports your business minus the overwhelmScaling through standardized vs. bespoke servicesThe ability to “choose your hard” in the times there's lack of ease and flowAvoiding the trap of comparisonitis with everyone else's Instagram highlightsLove the show? Then why don't you:Leave us a review on Apple Podcasts.Subscribe to the show.Tag us on Instagram @go.to.gal or Jaclyn @jaclyn_mellone and let us know what you think or what and who you'd want to hear on the show!Want to become a Gal Pal? Head on over to this link to Become a Go-To Gal Podcast Insider

What IS happiness, really? And what's the difference between biting into a bar of chocolate and a much more sustained contentment that often eludes us? Ph.D. psychologist Emma Seppälä has studied happiness for much of her career. She's a best-selling author who also teaches business leaders at the Yale School of Management. Turns out, achieving career success and wealth doesn't lead to that contentment. If you're searching for mental well-being, Emma says: Start with your body, specifically, your breathing. She explains how anyone, from a stressed out manager to a soldier in a warzone, can use breathing techniques to gain focus and ingenuity. Emma also deconstructs many myths about what makes us happy, and how focusing our minds on others leads to long-term emotional resilience.

Howie and Harlan are joined by Yale epidemiologist and MacArthur ‘genius' Gregg Gonsalves to discuss his non-traditional route to improving responses to global public health challenges. Links: Eric Topol on COVID reinfections Harlan's Twitter thread on insurance debt “Health Savings Accounts No Longer Promote Consumer Cost-Consciousness” Sherry Glied in Health Affairs The Best Little Boy in the World Learn more about the MBA for Executives program at the Yale School of Management.

In this episode, Sujani sits down with Denise Chow, a 1st year MPH student studying at the Yale School of Public Health. Denise was accepted into all five MSPH/MPH programs she applied to and in this episode, she speaks about her application process and gives some great advice for others considering pursuing a graduate degree.You'll LearnHow Denise came upon the field of public health and experiences led to her knowing it was the right field for her What influenced Denise's decision in pursuing an MPH vs. an MSPH and why she decided to enter the graduate degree right after completing her undergradWhat considerations prospective students should make when deciding which schools and programs to apply toDenise's decision making process and how she ultimately made the choice to study at Yale amongst the other schools she was accepted intoTips from Denise on how to strengthen applications for graduate schoolHow having a solid support network is important through your education and career path, especially as a first generation student with unique barriers during the application processHow to go about building this support networkAdvice from Denise for others who may be considering higher educationToday's GuestDenise Chow is a 1st-year MPH student at the Yale School of Public Health. She recently graduated from University of California, Berkeley, studying Public Health and Education. Her research interests include mental health and well-being, qualitative and community-based participatory research, social and interpersonal relationships, and early childhood development among children, refugees, and displaced populations.ResourcesConnect with Denise on LinkedIn Other PH SPOT resources:Share ideas for the podcast: Fill out this formNever heard of a podcast before? Read this guide we put together to help you get set up.Be notified when new episodes come out, and receive hand-picked public health opportunities every week by joining the PH SPOT community.Contribute to the public health career blog: www.phspot.ca/contributeUpcoming course on infographics: phspot.ca/infographicsLearn more about PH Spot's 6-week training programSupport the show

Dr. Anjani Mahabashya completed her medical training in India, then emigrated to the U.S. After participating in several elective experiences, she entered the McLaren Flint Internal Medicine Residency Program in Flint, Michigan. She then began her career as a hospitalist. Her career was suddenly interrupted as the result of a disabling injury in 2020. This jeopardized her long-term plans and she had to develop a radical new career trajectory. She obtained additional health care management training at the Yale School of Management and became certified by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP). During our conversation, Anjani describes how she overcame the challenges she faced, why she likes working as a hospital-based utilization management physician advisor, and the one step that made all the difference in her successful transition. You will find links and a transcript of the episode at nonclinicalphysicians.com/overcome-adversity/  =============== You can support this podcast by making a small monthly or annual donation. To learn more, go to nonclinicalphysicians.com/donate You can now join the most comprehensive Community for all clinicians looking for a nontraditional career at NewScr!pt. Get an updated edition of the FREE GUIDE to 10 Nonclinical Careers at nonclinicalphysicians.com/freeguide. Get a list of 70 nontraditional jobs at nonclinicalphysicians.com/70jobs. Check out a FREE WEBINAR called Best Options for an Interesting and Secure Nonclinical Job at nonclinicalphysicians.com/freewebinar1

Dr. Louann Brizendine completed her degree in neurobiology at UC Berkeley, graduated from Yale School of Medicine and did her internship and residency at Harvard Medical School. In this episode we talk about her new book The Upgrade: How the Female Brain Gets Stronger and Better in Midlife and Beyond. She also wrote the New York Times best seller The Female Brain and its follow-up, The Male Brain, which continues to be read around the world.This episode is filled with so much great information, enjoy and please review the podcast on Apple Podcasts!Watch the interview YouTubeDr. Louann BrizendineThe Upgrade bookDr. Brizendine on InstagramFacebookTwitterThe Female BrainThe Male BrainThe Women's Health InitiativeI Feel Bad About My NeckSupport the show

Indian immigrant Indra Nooyi led PepsiCo as chairman and CEO for more than a decade, making her one of the most powerful women in corporate America. Nooyi is also on the board of Amazon, a Dean's Advisory Council member at MIT's School of Engineering, and advisor on economic development to Gov. Ned Lamont. When the pandemic hit, she led the reopening committee with Dr. Albert Ko, who is the Raj and Indra Nooyi Professor of Public Health at the Yale School of Public Health. This hour on Where We Live, Nooyi joins us to talk about her new book My Life in Full: Work, Family, and Our Future. We learn how paid leave impacted her early career after the birth of her children, and after a horrific car crash. Paid leave also allowed her to care for both her parents – her father had cancer, and her mother became paralyzed from the neck down. It's one of the reasons she now urges companies to provide the benefit of paid leave for workers today. GUEST: Indra Nooyi: Former Chairman and CEO, PepsiCo. Author of My Life in Full: Work, Family, and Our Future Cat Pastor contributed to this show which originally aired April 20. Support the show: http://wnpr.org/donate See omnystudio.com/listener for privacy information.

In this episode, we welcome Dr. Jason Falvey, PT, PhD, DPT who speaks on his experiences and thought process in formulating his research. Join us for a discussion on topics such as tenure, grants, and more! Biography: Jason Falvey is a PhD trained clinician-scientist who studies post-acute and long-term care for older adults. He has been a physical therapist for 10 years, working mostly in the home health care setting,  and also holds a board certification in geriatric physical therapy. Jason completed his PhD at the University of Colorado, Anschutz Medical Campus and is currently a post-doctoral fellow in the Yale School of Medicine, Division of Geriatrics.  He has authored or co-authored 24 peer-reviewed publications in top ranking rehabilitation, geriatric, and orthopedic journals, and has been an invited speaker at multiple national conferences.  His primary research focus is evaluating the utilization and impact of post-acute rehabilitation on functional recovery, community reintegration, and symptom burden for older adults recovering from disabling hospitalizations or major surgery. Jason's research additionally extends to assessment of how social and environmental factors influence successful aging in place for vulnerable older adult populations in home and community settings. 

Join us in this episode with our Special Guest Dr. Amber Childs, assistant professor at Yale School of Medicine. In this episode, we will chat about Dr. Childs academic journey, and how she contributes to increasing DEI in academia. To send in questions for our next episode, email theempowerlab@gmail.com Dr. Amber Childs Twitter | Yale Measurement Based Care Collaborative Twitter | The EMPOWER Lab Twitter & Instagram

In this episode, CII General Counsel Jeff Mahoney interviews Jeffrey A. Sonnenfeld, the Founder & President of the Yale Chief Executive Leadership Institute and the Senior Associate Dean of the Yale School of Management, and  Steven Tian, Director of Research of the  Yale Chief Executive Leadership Institute. Sonnenfeld and Tian are co-authors of a recent paper entitled "It Pays For Companies To Leave Russia."

Eric chats with Michael Kraus, Associate Professor of Organizational Behavior at the Yale School of Management. Michael's lab studies what behaviors and emotions maintain and perpetuate economic and social inequality in society. Michael's research has appeared in Psychological Review, Perspectives on Psychological Science, and Journal of Personality and Social Psychology.In this episode, Michael talks about his recent work on how much US-Americans overestimate how equal their country is. For example, why are some people motivated to deny the vast wealth inequality between Whites and African Americans? Michael then shares how he has successfully intervened to make people's estimates somewhat more accurate. Finally, Eric asks Michael about advice for young researchers and how he comes up with interesting research ideas. If that is not exciting enough, Michael even performs a power analysis live on the podcast! But not of the statistical kind…Paper: https://www.pnas.org/doi/10.1073/pnas.2108875118 

On June 13, the US Food and Drug Administration (FDA) approved oral baricitinib (Olumiant) tablets for the treatment of severe alopecia areata in adults, which marked the first approval of a systemic treatment for the disorder. The approval has excited patients and providers alike who struggled for decades to treat severe cases of this autoimmune disorder. For this episode of DocTalk, several key opinion leaders in the dermatology field sound off on the implications of this decision, as well as the versatility of Janus kinase (JAK) inhibitors, and how this approval will aid providers in redefining alopecia areata as an autoimmune disorder rather than simply a cosmetic condition, which will help more patients receive proper care. Joining us on the podcast and in written form are the following dermatologists: Brett King, MD, PhD, Yale School of Medicine, New Haven Lisa Arkin, MD, member of the Society for Pediatric Dermatology, University of Wisconsin School of Medicine & Public Health / American Family Children's Hospital. Karan Lal, DO, MS, FAAD, Schweiger Dermatology Group and member of The Society for Pediatric Dermatology Brittany Craiglow, MD, Yale School of Medicine, New Haven

 On June 13, the US Food and Drug Administration (FDA) approved oral baricitinib (Olumiant) tablets for the treatment of severe alopecia areata in adults, which marked the first approval of a systemic treatment for the disorder. The approval has excited patients and providers alike who struggled for decades to treat severe cases of this autoimmune disorder. For this episode of DocTalk, several key opinion leaders in the dermatology field sound off on the implications of this decision, as well as the versatility of Janus kinase (JAK) inhibitors, and how this approval will aid providers in redefining alopecia areata as an autoimmune disorder rather than simply a cosmetic condition, which will help more patients receive proper care. Joining us on the podcast, and in written form, are the following dermatologists: ·      Brett King, MD, PhD, Yale School of Medicine, New Haven ·      Lisa Arkin, MD, member of the Society for Pediatric Dermatology, University of Wisconsin School of Medicine & Public Health / American Family Children's Hospital. ·      Karan Lal, DO, MS, FAAD, Schweiger Dermatology Group and member of The Society for Pediatric Dermatology  ·      Brittany Craiglow, MD, Yale School of Medicine, New Haven

On Episode 17 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the June 2022 issue of Stroke: “Vitamin D Enhances Hematoma Clearance and Neurologic Recovery in Intracerebral Hemorrhage” and “Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns.” She also interviews Dr. Bruce Campbell on his article “Role of Intravenous Thrombolytics Prior to Endovascular Thrombectomy.” Dr. Negar Asdaghi:         Let's start with some questions. 1) Is vitamin D that golden key to recovery from intracerebral hemorrhage? 2) Endovascular therapies seem to have prevailed where thrombolytics have failed. In the era of fast and furious thrombectomy, what is the role of pre-thrombectomy thrombolysis? 3) And finally, 20 years of clinical research has failed to demonstrate the superiority of anticoagulation over antiplatelet therapies for treatment of patients in sinus rhythm with low left ventricular ejection fraction, and yet, our practice patterns have not changed. Why do we remain resolute in prescribing anticoagulation despite the lack of evidence? We're back here to tackle the toughest questions with our Stroke Alert Podcast because this is the latest in Stroke. Stay with us. Dr. Negar Asdaghi:         Welcome back to another extremely motivating Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. The June 2022 issue of Stroke contains a number of interesting articles. As part of our Advances in Stroke, we have two articles, one on the topic of cost-effectiveness of stroke care to inform health policy and the second on the current state and the future of emerging stroke therapies. As part of our Original Contributions category, we have an interesting study by Dr. [Ben] Assayag and colleagues from the Department of Neurology at Tel Aviv Sourasky Medical Center, where we learned that just over 10% of patients with TIA and stroke developed post-traumatic stress disorder, or PTSD. Higher presenting stroke severity, preexisting white matter disease, and having anxious coping styles are risk factors for development of post-stroke PTSD. Dr. Negar Asdaghi:         In another Original Contribution, by Dr. Daehoon Kim and colleagues from Yonsei University College of Medicine in Seoul, South Korea, we read with interest on the topic of whether or not we should be anticoagulating frail patients with atrial fibrillation. In this large population-based cohort, which included patients with atrial fibrillation older than 65 years of age with frailty as defined by a score of equal or greater than five on Hospital Frailty Risk Score, we learned that despite their frailty, patients with atrial fibrillation still significantly benefit from oral anticoagulation therapy. In this study, those treated with anticoagulation had lower net adverse clinical events as compared to those untreated. We also learned that direct oral anticoagulants provided lower incidence of stroke, bleeding, and mortality over Coumadin. This paper really provided practical information on treatment of frail patients with atrial fibrillation. So, I encourage you to review these papers in addition to listening to our podcast today. Later in the podcast, I have the great pleasure of interviewing Dr. Bruce Campbell from University of Melbourne in Australia on an especially timely topic, that is the role of intravenous thrombolytics prior to endovascular therapy. Dr. Campbell is a leading authority on the topic, and his interview does not disappoint. But first, with these two articles. Dr. Negar Asdaghi:         In the setting of intracerebral hemorrhage, or ICH, aside from the primary brain insult that occurs at the time of hemorrhage, secondary brain injuries continue for days and sometimes to months mostly due to the pathological response of the brain to byproducts of hematoma lysis or RBC degradation products. Today, the majority of spontaneous ICH cases are not surgically evacuated, so we rely on the body's own ability to clear blood for hematoma clearance, and obviously the faster the clearance, the better the outcome. Erythrophagocytosis by monocyte-derived macrophages contributes to hematoma clearance and ultimately to the functional recovery from ICH. So, it's conceivable that therapeutic approaches to enhance the endogenous erythrophagocytosis can potentially improve ICH outcomes. Vitamin D has been known to have variety of functions within the central nervous system, and it turns out that it may also be one such therapeutic option to improve the much needed erythrophagocytosis in intracerebral hemorrhage. Dr. Negar Asdaghi:         In the current issue of the journal, in the study titled "Vitamin D Enhances Hematoma Clearance and Neurologic Recovery in Intracerebral Hemorrhage," a group of researchers led by Dr. Jiaxin Liu from the Department of Surgery at Queen Mary Hospital at the University of Hong Kong studied the effects of oral vitamin D administered two hours after the induction of hematoma in a rodent model of ICH using direct collagenase injection into the striatum of the mouse. Eighty-nine young mice and 78 middle-aged mice were included in the study and randomly divided into three groups. Group one were sham-operated mice; group two, ICH mice treated with vehicle, which was corn oil; and group three, vitamin D-treated ICH mice. In the third group, 1000 international unit per kg of vitamin D diluted in corn oil was administered orally using a pipette two hours after the induction of ICH to mice, and then daily afterwards. And here are their top three findings of this study. Dr. Negar Asdaghi:         Number one, vitamin D-treated mice did better than vehicle on two neurobehavioral tests that were completed in the study. On the cylinder test, treatment with vitamin D significantly alleviated the asymmetric usage of four limbs at day seven, and vitamin D elongated the duration that the mice could run on the accelerated rod at day 10 on the rotarod test. Dr. Negar Asdaghi:         Number two, in terms of hematoma resolution and perihematoma edema, it's an issue that we deal with, with ICH, they used MRI imaging for edema measurement on T2-weighted images, and then sacrificed the mice and used digital quantification of hematoma volume with fresh brain specimens. And they found that treatment with vitamin D significantly alleviated both the ICH-associated brain swelling on MR and resulted in significant reduction in hematoma volume on the fresh brain specimens when compared with the vehicle-treated group at day three and day five. Dr. Negar Asdaghi:         And finally, their third main finding is in terms of erythrophagocytosis. So, the pathway that is mediated by the monocyte-derived macrophages is an endogenous pathway, that is, PPAR-γ (which stands for peroxisome proliferator-activated receptor γ) and its downstream scavenger receptor CD36 mediated. This pathway is essential for directing the endogenous erythrophagocytosis. Using flow cytometry, they found that vitamin D-treated mice had more mature macrophages expressing the scavenger receptor CD36, which was not expressed by the undifferentiated monocytes. Dr. Negar Asdaghi:         Western blot analysis confirmed that vitamin D treatment increased the tissue levels of CD36 and the upstream PPAR-γ levels in the brain at day five after collagenase model. Locally, vitamin D-enriched phagocytes that were positive for PPAR-γ and CD36 in the perihematoma regions. So, in summary, vitamin D increased the number of mature macrophages rather than undifferentiated monocytes in the perihematoma region and accelerated the differentiation of reparative macrophages from bone marrow-derived monocytes. So, bottom line is that in vitamin D, we have a simple, accessible, and well-tolerated agent to improve both the ICH outcomes and enhance hematoma resolution, but this we all observed in rodents. So, we stay tuned with interest to find out whether the same success will be seen in humans treated with vitamin D after intracerebral hemorrhage. Dr. Negar Asdaghi:         Patients with depressed left ventricular ejection fraction, or low EF, are at risk of development of ischemic stroke even if they remain in sinus rhythm. The optimal antithrombotic treatment for these patients is still unknown. Over the past two decades, we have a number of randomized trials studying the efficacy of oral anticoagulation, predominantly Coumadin, over aspirin therapy in prevention of all forms of stroke, that is ischemic and hemorrhagic, and death in patients with a low EF in sinus rhythm. Dr. Negar Asdaghi:         The meta-analysis of WASH, HELAS, WATCH, and WARCEF trials showed that treatment of low ejection fraction patients in sinus rhythm with Coumadin does reduce the subsequent risk of stroke, but it comes at the cost of a higher major bleeding risk in this population. The COMMANDER HF clinical trial published in New England Journal of Medicine in October 2018 studied whether low-dose rivaroxaban at 2.5 milligram BID was superior to placebo in patients with recent worsening of chronic heart failure, reduced ejection fraction, coronary artery disease, but no atrial fibrillation, and very similar to its prior counterparts, it did not show that rivaroxaban was associated with a lower rate of combined death, myocardial infarction, or stroke as compared to placebo. But very similar to prior studies, it also showed that rivaroxaban-treated patients had a lower risk of subsequent ischemic stroke. This poses a conundrum for stroke neurologists treating patients with this condition, especially after they present with an embolic-appearing stroke. So, the question is, how often do we encounter this situation, and what do we do in routine practice? We know that when there is equipoise, there's practice variation. Dr. Negar Asdaghi: In the current issue of the journal, in the study titled "Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm," Dr. Richa Sharma from the Department of Neurology at Yale School of Medicine and colleagues examined the prevalence of heart failure with sinus rhythm among hospitalized patients with acute ischemic stroke and the physician's practice patterns with regard to the choice of antithrombotics in this population. Dr. Negar Asdaghi:         So, let's look at their study. The study was comprised of five separate study cohorts of hospitalized acute ischemic stroke patients in the Greater Cincinnati Northern Kentucky Stroke Study for the year 2005, 2010, and 2015, and then four additional academic hospital-based cohorts in the United States during different timeframes. These were the Massachusetts General Hospital from 2002 to 2016, Rhode Island Hospital from 2016 to 2018, Yale-New Haven Hospital 2015 to 2017, and Cornell Acute Stroke Academic Registry from 2011 to 2018. All of these cohorts combined contributed to the 19,155 total number of patients in this study, which included over 14,000 patients that had documented left ventricular ejection fraction. Amongst those, 1,426 had a depressed EF and were included in this study. The investigator obviously excluded those with documented atrial fibrillation and flutter. And so the sample size for this analysis was 805 patients. And here are their main results. Dr. Negar Asdaghi:         The overall prevalence of this condition, that is low ejection fraction and sinus rhythm, among hospitalized acute ischemic stroke patients was 5%. It varied slightly between the different cohorts in this study from 4 to 6%. In terms of the antithrombotic treatment patterns, this information was available in close to 500 patients in the cohort. Overall, 59% of patients were discharged on an antiplatelet treatment alone, and 41% on anticoagulation. But these percentages significantly varied between the different institutions and was as low as 22% in one of the cohorts and as high as 45% in another cohort. Dr. Negar Asdaghi:         So, what were the factors that were associated with the use of anticoagulation at discharge? They found that the absolute percentage of left ventricular ejection fraction and the presenting NIH Stroke Scales were associated with anticoagulation use. That is, the lower the percentage of EF and the higher the presenting NIH Stroke Scale, the more likely physicians were to discharge the patients on an anticoagulation in univariate analysis, but in multivariate analysis, only the study site and presenting NIH Stroke Scale over eight were independently associated with anticoagulation use. Dr. Negar Asdaghi:         Now, interestingly, 2002 to 2018, which was their overall study period, was a time during which some of the largest and neutral randomized trials on the topic of anticoagulation versus antiplatelet were published, including the WATCH and the WARCEF trial. But the authors found no temporal variation in anticoagulation practice patterns before and after the publication of the results of these trials. So, it appears that we didn't change our minds. So, overall, we have some important takeaway messages from this study. We learned that 5% of hospitalized acute ischemic stroke patients have low left ventricular ejection fraction and remain in sinus rhythm without atrial fibrillation. Today, over 40% of patients with this condition are anticoagulated at discharge despite the results of the randomized trials, but the practice is widely variable among different institutions, and a higher presenting NIH Stroke Scale is a significant predictor of anticoagulation use at discharge in this population. Dr. Negar Asdaghi:         Almost 20 years after the approval of intravenous thrombolysis for treatment of patients with acute ischemic stroke, endovascular therapy was approved for treatment of select ischemic stroke patients with a large vessel occlusion. The two treatments are, therefore, entangled, as one was the standard of care while the second one was being tested. Therefore, all endovascularly treated patients enrolled in randomized trials would've received intravenous thrombolysis if eligible. Now, with the overwhelming success of endovascular therapy in achieving reperfusion in areas where IV thrombolysis has drastically failed, there're still critical questions regarding the added value of IV thrombolysis to endovascularly treated patients. The critical question remains as to whether eligible ischemic stroke patients who have immediate access to endovascular thrombectomy should receive prior IV thrombolysis, or should we skip the thrombolysis step altogether and just move to the angio suite as fast as possible. And there are, of course, arguments for and against each approach. Dr. Negar Asdaghi:         In this issue of the journal, in an invited topical review titled "The Role of Intravenous Thrombolytics Prior to Endovascular Thrombectomy," we learn about these arguments as the authors go through a comprehensive review of the current literature on this issue. I'm joined today by the first author of this review, Dr. Bruce Campbell, to discuss this paper. Dr. Campbell absolutely needs no introduction to our Stroke listeners. He's a professor of neurology and head of neurology and stroke at Royal Melbourne Hospital, University of Melbourne, in Australia. He's a pioneer in the field of acute stroke therapies and acute neuroimaging. He has served as the lead investigator of multiple landmark randomized trials, including EXTEND-IA and EXTEND-IA TNK, and holds multiple leadership roles. He's the clinical director of the Stroke Foundation and co-chairs the Australian Stroke Guidelines Working Party and the coordinator of the National Brain School Training Program for Neurologists in Training. And, of course, last but not least, he's my friend. So, I'm delighted to welcome him to our podcast today. Top of the morning to you, Bruce, 6:00 a.m. in Melbourne. That's quite some dedication. Thank you for being here. Dr. Bruce Campbell:       It's great to be with you. Thanks for the invitation. Dr. Negar Asdaghi:         Congrats on the paper, really exciting topic. So, let's just start with this question as part of a case. We have a patient with an M1 occlusion, a large clinical syndrome presenting two hours out from their symptom onset, and we are at a hospital where the angio suite is ready. What are some of the benefits of basically spending time in giving IV thrombolytics first rather than quickly going to the angio suite? Dr. Bruce Campbell:       I think a key element of this case is that the patient has presented directly to a hospital with immediate access to thrombectomy. Thrombolytic used in drip-and-ship transfer patients really isn't controversial, and the recent randomized trials excluded them. So, the debate's all about this context of bridging thrombolytics in patients presenting directly to a comprehensive stroke center. And you mentioned spending time giving lytics, but in fact, if you do things in parallel, that shouldn't be the case. It shouldn't delay thrombectomy if you go and give thrombolysis. Dr. Bruce Campbell:       So, the general principle is that getting the artery open faster by any means is better, and IV thrombolytic certainly has the potential to open the artery before thrombectomy in a proportion of patients, perhaps not that many, but it may also facilitate the thrombectomy. So, in the randomized trials, reperfusion after the thrombectomy was significantly better when patients had had bridging thrombolytic despite a low rate of pre-endovascular reperfusion. Other reasons for giving the lytics are the potential safety net it provides if the thrombectomy procedure is unexpectedly delayed or fails to get the artery open, and there's also this potential for lytics to dissolve distal embolic fragments and perhaps improve microvascular reperfusion. Dr. Negar Asdaghi:         So, great. So, let me summarize for our listeners what you mentioned. First off, so these are arguments in favor of giving lytics. As you mentioned, we're not really wasting time. These processes occur in parallel, so it's not like we're wasting time in giving a therapy that is potentially not as efficacious as thrombectomy is. And number two, we have improved the possibility of early reperfusion, perhaps, with the lytics. And if there are some fragments or distal clots that thrombectomy wouldn't have reached, then the lytics would. And then also there is also the chance that the thrombectomy might have failed in difficult access, and so on and so forth, and at least the patient has some chance of revascularization with the lytics. So, if these are the arguments for giving lytics, what are the arguments against giving lytics in this scenario? Dr. Bruce Campbell:       The main argument is the potential to reduce both the intracerebral and systemic hemorrhagic complications. There's also potential cost saving by skipping thrombolytics. That's probably more relevant in low-resource settings, particularly when relatives may have to pay for the thrombolytic before treatment is initiated, and that can be burdensome and also potentially delay the thrombectomy. There's a theoretical concern about thrombus fragmentation with lytics and potential migration of the clot out of reach of the thrombectomy or to new territories. But final reperfusion, as I mentioned, was, on average, better with the patient having a lytic on board in the randomized trials. Dr. Negar Asdaghi:         Perfect. And I want to highlight this issue of thrombus fragmentation because I think our readers will read more and more about this idea of, as you mentioned, fragmentation will potentially make an accessible clot for thrombectomy inaccessible. But I see that later in our questions, we're going to address that as part of the findings of randomized trials as well. So, these are some of the arguments for and against. And before we go to the randomized trials, I'd like to get an overview of what we knew as part of observational studies and non-randomized studies prior to more recent randomized trials on this topic. Dr. Bruce Campbell:       There've been a couple of nice systematic reviews and meta-analyses of the observational data, and notably in most of these studies, the direct thrombectomy patients had contraindications to lytics, and that introduces confounding factors that are difficult to adjust for. For what that's worth, the functional independence, mortality outcomes were better in the bridging patients. Hemorrhage rates weren't always higher with the lytic, and one study by Jonathan Coutinho in JAMA Neurology for the SWIFT and STAR studies showed the opposite despite them having really careful adjustment for all the confounders they could think of. And the meta-analysis by Eva Mistry in Stroke did not detect a difference in symptomatic ICH between the direct and bridging strategies. One thing that should be less affected by the patient characteristics would be the technical efficacy outcomes, and it was interesting that in the observational data, the patients who'd had bridging lytic had higher mTICI 2b-3 rates and also fewer device passes. Dr. Negar Asdaghi:         Okay. And now we do have further information with all of these new randomized trials. So, why don't we start with some of the earlier studies, the three, SKIP, DEVT, and DIRECT-MT, and start with those studies first before we move to some more recent European trials. Dr. Bruce Campbell:       SKIP was performed in Japan, and it used the lower 0.6 milligram per kilogram dose of alteplase that's standard there, and DEVT and DIRECT-MT were performed in China. All three of them showed numerically similar functional outcomes with slight trends favoring direct thrombectomy. SKIP had a smaller sample size and did not meet its non-inferiority criteria, and the other two trials did meet their specified non-inferiority margin, but it could be argued those margins were overly generous. If you think about non-inferiority trials, we generally try to set a margin for non-inferiority such as lower 95% confidence interval for the trial intervention would sacrifice up to 50% of the reference treatment effect. And it's difficult to estimate the effect of alteplase in this specific population. But if you think of the Emberson meta-analysis of alteplase, overall zero to three hours alteplase versus placebo has a 10% effect size and mRS 0-1, three to four and a half hours of 5% effect size. And we regard that as clinically important. So, half of 5%, 2.5%, is a lot tighter margin than any of the direct randomized trials employed. Dr. Negar Asdaghi:         So, Bruce, let me recap what you just mentioned. Two out of the three earlier trials seem to suggest that perhaps skipping IV therapy is the way to go rather than bridging as these two trials met the non-inferiority criteria if we believe that non-inferiority margins you mentioned. And now we have a couple of more trials, more recent trials. Can you tell us about these trials please? Dr. Bruce Campbell:       MR CLEAN-NO IV in a European population did not demonstrate non-inferiority, and the point estimate slightly favored bridging. Interestingly, in that trial, the symptomatic intracerebral hemorrhage risk, which was one of the main drivers for trying this strategy, was 5.9% in the direct and 5.3 in the bridging group. So, there's no hint of benefit from dropping the lytic on that metric. SWIFT-DIRECT was more selective in only enrolling internal carotid and M1 occlusions, which had a lower chance of early recanalization with lytic. But the protocol also specified giving the full dose of lytic. In the other trials, it seems the alteplase infusion was often stopped once the patient was in the angio suite, so the full dose may not have been delivered. And despite very low pre-endovascular recanalization in that selected group in SWIFT-DIRECT, the end of procedure reperfusion was significantly better in the bridging group, which is a consistent finding across the trials and suggests that the lytic may improve the thrombectomy outcome. Dr. Bruce Campbell:       DIRECT-SAFE, the final of those trials, was interesting in that the patients were enrolled roughly 50:50 from Australia, New Zealand, versus Asia. And in contrast to the original three randomized trials in Asian patients, DIRECT-SAFE found a significant benefit of bridging lytic in Asian patients. So, it'd be very interesting to see the results of the IRIS individual patient data meta-analysis, but we may not find a difference in Asian versus Caucasian patients despite those initial trials and despite substantial differences in the prevalence of intracranial atherosclerosis, which has often been proposed as something that would increase the risk of having bridging thrombolytic on board. Dr. Bruce Campbell:       The original study level estimate of symptomatic hemorrhage had a borderline significant 1.8% absolute reduction in the direct group. Whether those data were not all core lab adjudicated and the final analysis may show a smaller difference than that. Notably, given that trend with symptomatic intracerebral hemorrhage, mortality did not differ significantly, and, in fact, the trend favored bridging patients. So, the symptomatic hemorrhage slight trend into increase did not translate into any hint of increased mortality. Dr. Negar Asdaghi:         So, Bruce, a lot of information, and I need a recap for me. So, let me try to recap some of the things you said, and please jump in. So, so far, the newer data really basically don't show us any convincing evidence that skipping is the way to go, and direct endovascular we really don't have data in favor of going directly to the angio suite. And the jury is still out regarding an increase in the symptomatic intracerebral hemorrhage rate amongst those that actually are pre-treated with IV therapy. Is that correct? Dr. Bruce Campbell:       That's correct. So, none of the three recent trials met their non-inferiority margins. And again, we had this issue of relatively generous non-inferiority margins, and the symptomatic hemorrhage, it would make sense that there's a small difference, but it's not really been borne out in the data to be statistically significant at this stage. And again, this individual patient data meta-analysis is keenly awaited to get the most accurate estimate on that. Dr. Negar Asdaghi:         So, while we wait that, I'm going to digress a little bit and ask you a question that's not addressed in the paper that you have in this issue of the journal, and that's the CHOICE trial. So, by now, we have the results of CHOICE trial. Do you mind first give us a brief overview of what CHOICE was and how you feel that the results of CHOICE would affect this field of direct versus bridging in general? Dr. Bruce Campbell:       CHOICE is a very interesting study in that it tested giving the intra-arterial lytic at the end of a thrombectomy procedure that had achieved an mTICI 2b or better, which is what we traditionally regarded as angiographic success. The idea was to improve microvascular flow, and that may be the case. The trial was terminated early due to logistic reasons and showed a very large effect size that requires replication. The subgroup analyses are interesting in that the benefits seem to mostly accrue in patients who'd not already had intravenous lytic. Dr. Bruce Campbell:       So, perhaps giving the IV lytic before thrombectomy can still benefit patients after the thrombectomy, as well as achieving early recanalization in a proportion of patients and perhaps facilitating the thrombectomy. The other issue to address with the DIRECT trials is that with the exception of a few patients in DIRECT-SAFE, the comparator was alteplase and not tenecteplase. And we have data from EXTEND-IA TNK that tenecteplase bridging is not just non-inferior, but superior to alteplase bridging. There's an ongoing Brazilian trial of exactly that, tenecteplase versus the direct approach, which will be very interesting. Dr. Negar Asdaghi:         So, great, Bruce. I just want to repeat this segment again for our listeners. So, CHOICE is a very interesting study, looked at giving intraarterial alteplase to patients after endovascular therapy was completed and after they'd already achieved the complete and successful revascularization, and the trial was terminated early because of logistic reasons. So, we have to keep in mind, this was a smaller study, early termination, but the effect size was pretty large in favor of giving lytics. Dr. Negar Asdaghi:         So, what you mentioned is interesting, and I think that it's really worth paying attention to, that the majority of the benefits seem to have occurred from intraarterial thrombolytics in patients that have not been given intravenous lytics prior to endovascular therapy. So, in other words, you need some sort of lytics either before or after the endovascular thrombectomy to achieve that ultimate improved outcome. So, moving forward now from the randomized trials that we have on bridging versus direct thrombectomy, you have mentioned in the paper some interesting subgroups that may benefit or not benefit as much from bridging versus direct thrombectomy. Do you want to elaborate a little more about those subgroup analyses? Dr. Bruce Campbell:       The idea of precision selection or individualized treatment is being talked about a lot given there didn't seem to be much overall difference between strategies in the randomized trials, but it's important to note that the randomized trial actually disadvantages the bridging group by delaying lytic until the patient was firstly confirmed eligible for thrombectomy and then consented and randomized. Putting that aside, if we could identify a subgroup who clearly benefit from skipping lytic and, importantly, identify them without delaying lytic for those who likely benefit, that's clearly attractive. Dr. Bruce Campbell:       Currently, I'd say we have not identified that kind of subgroup, and the planned IRIS individual patient data meta-analysis will be critical for that. Patients with a large ischemic core are one potential group where there's a high risk of bleeding hypothesized. To date, there is no definitive data to indicate the risk is lower with the direct approach. Patients who need stents certainly may benefit from not having a lytic on board because they often need adjuvant antithrombotics that could increase the bleeding risk. But the question there is whether we can confidently identify those patients before the procedure, and I think that's unclear at this stage. Patients with really large clot burdens and proximal occlusions have sometimes been said not to benefit from IV lytic based on the low rates of pre-endovascular reperfusion, but the randomized trials really hinted other benefits like this potential facilitative thrombectomy. So, that hypothesis may be insecure as well. Dr. Negar Asdaghi:         And how about age? Have you come across and has there been any signal towards an impact or interaction between age and benefit from pre-endovascular thrombectomy and thrombolytics? Dr. Bruce Campbell:       It's an interesting question because age has not generally been a treatment effect modifier in previous stroke studies with thrombolytics and thrombectomy, and the individual direct thrombectomy trials that have reported subgroups haven't shown any convincing heterogeneity by age. There's certainly no indication that older patients are at risk from bridging in what I've seen so far. Dr. Negar Asdaghi:         So, this question comes up in clinical practice all the time, that a person's older, perhaps more atrophy, more vascular risk factors and white matter disease, and they're more prone, so to speak, of having a symptomatic intracerebral hemorrhage. So, what you're saying is, from the data we have, there's really no signal in favor of withholding pre-thrombectomy lytics in this population. So, it's important to know this. Bruce, what should be our final takeaway message from this study? Dr. Bruce Campbell:       I tend to agree with the recent European Stroke Organization and ESMINT guideline that for now, patients should receive lytic as early as possible and in parallel with the decision to perform thrombectomy such that neither treatment delays the other. I think if we can identify a subgroup that benefits from direct thrombectomy, and that's confirmed in the individual patient data and meta-analysis, and we can identify them without disadvantaging the majority of patients, and also that the ongoing improvements in IV lytic strategies don't render the existing trial data obsolete, then we may, in future, skip lytic for some patients, but we are not there yet. Dr. Negar Asdaghi:         So, that's amazing, Bruce. We look forward to reviewing the paper and individual data meta-analysis and interviewing you, hopefully at a better hour your time, on that. Thank you very much for joining us on the podcast today. Dr. Bruce Campbell:       Thanks again for the invitation. It's been great talking to you. Dr. Negar Asdaghi:         Thank you. Dr. Negar Asdaghi:         And this concludes our podcast for the June 2022 issue of Stroke. Please be sure to check out this month's table of contents for the full list of publications, including three very interesting images that are presented as part of a new article type, Stroke Images, and a special report in Comments and Opinions section on "Bias in Stroke Evaluation: Rethinking the Cookie Theft Picture." June is the month of Pride, and in spirit of equality, we hope to do our part to reduce all biases in stroke processes of care, diagnosis, and outcomes as we continue to stay alert with Stroke Alert. Dr. Negar Asdaghi:         This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit AHAjournals.org.

Harlan interviews Howie about his life as a doctor and teacher, including how a radiologist without a PhD got to teach economics at Yale, why he engages in the daily battles that come with speaking out on Twitter, and the extraordinary return on investment from time spent mentoring young people. Links: Arnold Schwarzenegger on deaths attributable to pollution “Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit” “Climate Change, Fossil-Fuel Pollution, and Children's Health“ Merriam-Webster on the origin of the word “doctor” Learn more about the MBA for Executives program at the Yale School of Management.  

Welcome to Strategy Skills episode 251, an episode with a leading Yale expert and serial entrepreneur, Barry Nalebuff. Get Barry's book here: https://amzn.to/3OiNiJs For thirty years, Barry has taught negotiation, innovation, strategy, and game theory at Yale School of Management, which led him to develop a new approach toward negotiation. This approach is vastly different from how most people think about negotiation, which usually involves having the best tactic to out-smart the other party and get the best deal.  This podcast explains the concept of the negotiation pie, which is the additional value created through an agreement to work together. It exhibits fairness and identifies what's really at stake in any negotiation. We share examples that showcase negotiation principles and a different mindset about creating value that benefits both parties involved – more importantly, understanding the views of each party as if they are solving problems rather than making the most out of the negotiation. Barry is the co-author of seven books and an online course. Thinking Strategically and The Art of Strategy are two crossover books on game theory with more than 400,000 copies in print. Co-opetition looks beyond zero-sum games to emphasize the potential for cooperating while competing. Why Not? offers a framework for problem-solving and ingenuity. Lifecycle Investing provides a new strategy for retirement investing. Mission in a Bottle tells the story of Honest Tea. His most recent book is Split the Pie, which is based on his negotiation course at SOM. An online version of the negotiation course is available for free on Coursera. It has 400,000 active learners and is the second-highest rating on the Coursera platform. In 1998, Barry—together with his former student Seth Goldman—co-founded Honest Tea. In 2011, the company was purchased by Coca-Cola. His second venture, Kombrewcha, is a slightly alcoholic version of kombucha. The company was acquired in 2016 by AB-Inbev. He is currently working to build Real Made Foods.  He works with many entrepreneurial firms. He serves on the board of Q Drinks (started by his former student Jordan Silbert), Calicraft Beer, and AGP Glass. Alongside startups, he has extensive experience consulting with multinational firms. He advised the NBA in their prior negotiations with the National Basketball Players Association and served on the board of Nationwide Insurance. A graduate of MIT, a Rhodes Scholar, and a Junior Fellow at Harvard's Society of Fellows, Nalebuff earned his doctorate at Oxford University. Get Barry's book here: Split the Pie: A Radical New Way to Negotiate. Barry Nalebuff: https://amzn.to/3OiNiJs Enjoying our podcast? Get access to sample advanced training episodes here: www.firmsconsulting.com/promo

Subscribe on Patreon and hear this week's full patron-exclusive episode here: www.patreon.com/posts/67732744 Beatrice speaks with Gregg Gonsalves about the recent monkeypox outbreaks in multiple countries, how global public health and healthcare priorities have left us in a politically vulnerable position to respond to outbreaks, and his work with ACT UP and Treatment Action Group. Gregg Gonsalves is the codirector of the Global Health Justice Partnership and an associate professor of epidemiology at the Yale School of Public Health. Read Gregg's piece, "Monkeypox Is Not a Gay Disease" here: https://www.thenation.com/article/society/monkeypox-hiv-lgbt-pride/ Pre-orders are now live for Bea and Artie's book, Health Communism, out October 18th from Verso Books. Pre-order Health Communism here: bit.ly/3Af2YaJ Runtime 1:10:45, 13 June 2022

I respect her as the dean of the Yale School of Architecture, admire her as a practicing architect, but flipped for her when she said, “There are two versions of the story, and both of them are true.” Not contradiction, nuance. The joys of complexity. Presented with the Center for Architecture.  Music: Hubby Jenkins.

Influence Is Your Superpower: The Science of Winning Hearts, Sparking Change, and Making Good Things Happen by Zoe Chance About The Book: “The new rules of persuasion for a better world.” —Charles Duhigg, author of the bestsellers The Power of Habit and Smarter Faster Better Rediscover the superpower that makes good things happen, from the professor behind Yale School of Management's most popular class. You were born influential. But then you were taught to suppress that power, to follow the rules, to wait your turn, to not make waves. Award-winning Yale professor Zoe Chance will show you how to rediscover the superpower that brings great ideas to life. Influence doesn't work the way you think because you don't think the way you think. Move past common misconceptions—such as the idea that asking for more will make people dislike you—and understand why your go-to negotiation strategies are probably making you less influential. Discover the one thing that influences behavior more than anything else. Learn to cultivate charisma, negotiate comfortably and creatively, and spot manipulators before it's too late. You'll meet alligators, skydivers, a mind reader in a gorilla costume, Jennifer Lawrence, Genghis Khan, and the man who saved the world by saying no. Influence Is Your Superpower will teach you how to transform your life, your organization, and perhaps even the course of history. It's an ethical approach to influence that will make life better for everyone, starting with you. About The Author: Zoe Chance teaches, researches, writes about, and talks about the psychology of influence all the freaking time because it's the secret to happiness, success, and saving the world. Her influence course is the most popular elective at Yale School of Management, and that course sparked the idea for this book. Her research has been published in places like Proceedings Of The National Academy Of Sciences and Harvard Business Review, and she has appeared on stages, on TV, and in media outlets around the world including The New York Times, the BBC, CNN, and The Economist. Google used Zoe's behavioral economics framework to design its food policies. Before coming to Yale, she earned a doctorate in marketing from Harvard, worked in sales jobs like door-to-door sales and telemarketing, and managed a 200 million dollar segment of the Barbie brand at Mattel. She is donating half the profits from this book to help solve the climate crisis. And, interesting fact – she once had a starring role in an obscure karate movie so boring that both her parents fell asleep watching it! Click here for this episode's website page with the links mentioned during the interview... https://www.salesartillery.com/marketing-book-podcast/influence-superpower-zoe-chance

Howie and Harlan are joined by Dr. Seth Trueger of Northwestern University, who was diagnosed with a rare autoimmune disorder in 2020. They discuss his experience navigating the healthcare system as a patient and what he's learned about the challenges facing people with complex medical issues. Links: 2022 Medicare Trustees Report  “A Cancer Trial's Unexpected Result: Remission in Every Patient” “PD-1 Blockade in Mismatch Repair–Deficient, Locally Advanced Rectal Cancer” Seth Trueger: “The Best Bad News” “Public Finance Balance of Smoking in the Czech Republic” Learn more about the MBA for Executives program at the Yale School of Management

It's Out! There is no one in Hawai‘i who knows more about the music scene, and the artists themselves than Jon Woodhouse.” - Pat Simmons, The Doobie Brothers. “We've all been waiting for this book.” “At last a written document that honors the music that has taken place on this island represented with grace and passion.” - Mick Fleetwood, Fleetwood Mac. “Jon, who I've known as a friend here for so many years always had great insight into not only the local talent, but more than often a full knowledge of all the incredibly varied world stage acts that have graced these islands.” “Jon's love and deep understanding of music, the variety of people who make it, and the island of Maui are why this book is completely unique.” - Ben Verdery, Professor of Guitar, Yale School of Music. Compiling more than 80 interviews conducted over four decades, Music Legends on Maui presents intriguing profiles of many icons, from Willie Nelson, Prince, and Paul Simon, to B.B. King, Herbie Hancock, and Joan Baez, with unique insights into their creative and spiritual paths. Here are innovative trailblazers, prophets, revolutionaries, and influential artists who have shaped the course of music into the 21st century, many referencing how the Hawaiian islands impacted them https://www.amazon.com/Music-Legends-Maui-Conversations-Hawaiian-ebook/dp/B0B2V1BVVJ/ref=sr_1_1?crid=2AFDRUCZREO20&keywords=jon+woodhouse+music+legends+on+maui&qid=1654653054&sprefix=jon+woodhouse+music+legends+on+maui%2Caps%2C156&sr=8-1

Jessi Gold, MD, MS, is an Assistant Professor and the Director of Wellness, Engagement, and Outreach in the Department of Psychiatry at Washington University School of Medicine in Saint Louis. She is a nationally recognized expert on healthcare worker mental health and burnout (particularly during the pandemic), college mental health, using social media and media for mental health advocacy, and the overlap between pop culture and mental health, including celebrity self-disclosure. Dr. Gold is a graduate of the University of Pennsylvania with a B.A. and M.S in Anthropology, the Yale School of Medicine, and completed her residency training in Adult Psychiatry at Stanford University where she served as chief resident. Dr. Gold also writes for the popular press and has been featured in, among others, The New York Times, The Atlantic, The Washington Post, TIME, Forbes, In Style, and Self. Dr. Gold is actively working on a book about healthcare worker mental health and burnout during the pandemic for Simon Element and is a member of the Expert Advisory Council for the ViacomCBS Mental Health Storytelling Initiative and Co-author of the Mental Health Media Guide. https://www.drjessigold.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

Eleanor Beaton learned at an early age that money is power from her mother who told her, “Money is power, always make your own.”  Influenced by her mother's words,  Eleanor became a business owner but lost her ambition after her father died in 2014.  Doing the bare minimum and eventually  ceasing to run her business, Eleanor turned to journaling as an outlet to deal with her grief.  Through her journaling and self evaluation, she eventually decided to take the leap of starting Safi Media, an education and coaching company for women entrepreneurs with the mission of helping women unlock their leadership and entrepreneurial potential.  As an entrepreneur and an award winning journalist, Eleanor was personally asked by Canada's Minister of Finance, Chrystia Freeland, to give economic advice at the World Economic Recovery program in 2021.  Eleanor has given talks at Yale School of Management, the Professional  Business Women's Association of California, ACC foundation, Shio and many more.   Safi Media is committed to advancing global gender equity through women's entrepreneurship and is on a mission to double the number of women entrepreneurs who scale past 1 million dollars in revenue by 2030. What You Will Hear in This Episode:  Eleanor's personal story The effects of Eleanor witnessing her mother's power and disempowerment. Losing her father and the constellation of emotions and shift of family dynamic. The conflict of relief and guilt. Evaluating  expectations and true self. Journaling leading to Safi Media. Storytelling structure and dissent into the dark feminine. Processing grief individually and collectively. Practical support vs. emotional support. Willingness to be successful and scaling. The power of words Quotes “Even inside a marriage and a family that is very healthy in many ways, economic disempowerment can be incredibly painful.” “Money is power, always make your own.” “A part of how you define yourself is often in relation to other people.” “Dissent into the dark feminine: who we are and what we really want is so critical for women.”  “Grief and Loss and necessary endings provide a sort of creative fuel for so many of us.” Mentioned: EleanorBeaton.com Power, Presence, Position Podcast The Hero's Journey https://bonniemarcusleadership.com/ https://web.facebook.com/bonnie.marcus/  https://www.linkedin.com/in/bonniemarcus https://twitter.com/selfpromote https://www.instagram.com/self_promote_/ Gendered Ageism Survey Results Forbes article 5 Tips to own the superpower of your age IAMMusicGroup Purchase my book Not Done Yet on Amazon:  If you enjoyed this episode of Badass Women Podcast, then make sure to subscribe to the podcast and drop us a five-star review. 

Dr. Zoe Chance is a writer, teacher, and researcher obsessed with the topic of interpersonal influence. She earned her doctorate from Harvard and now teaches the most popular course at Yale School of Management, which is the basis for her international bestseller, INFLUENCE IS YOUR SUPERPOWER. Her framework for behavior change is the foundation for Google's global food policy, and before academia, she managed a $200 million segment of the Barbie brand at Mattel. Today, Zoe teaches smart, kind people to raise money for charity, get elected to political office, fund startups, start movements, save lives, find love, negotiate great deals and job offers, and even get along better with their kids. In other words, she helps people to use their superpower of influence as a force for good. See acast.com/privacy for privacy and opt-out information.

Melissa Giles, Director of Portfolio Management with Americana Partners presents the Monthly Market Commentary as written by, David M Darst, Chief Investment Officer with Americana Partners.  Any charts/graphs referenced are available in print format and may be provided at your request. David is currently the Chief Investment Officer for Americana Partners. David served for 17 years as a Managing Director and Chief Investment Strategist of Morgan Stanley Wealth Management, with responsibility for Asset Allocation and Investment Strategy; was the founding President of the Morgan Stanley Investment Group; and was founding Chairman of the Morgan Stanley Wealth Management Asset Allocation Committee. After 2014, he served for several years as Senior Advisor to and a member of the Morgan Stanley Wealth Management Global Investment Committee. He joined Morgan Stanley in 1996 from Goldman Sachs, where he held Senior Management posts within the Equities Division and earlier, for six years as Resident Manager of their Private Bank in Zurich. David is the Author of twelve books: (i) The Complete Bond Book (McGraw-Hill); (ii) The Handbook of the Bond and Money Markets (McGraw-Hill); (iii) The Art of Asset Allocation, Second Edition (McGraw-Hill); (iv) Mastering the Art of Asset Allocation (McGraw-Hill); (v) Benjamin Graham on Investing (McGraw-Hill); (vi) The Little Book that Saves Your Assets (John Wiley & Sons), which was ranked on the bestseller lists of The New York Times and Business Week; (vii) Portfolio Investment Opportunities in China (John Wiley & Sons); and (x) Portfolio Investment Opportunities in Precious Metals (John Wiley & Sons). His works have been translated into Chinese, Japanese, Russian, German, Korean, Italian, Indonesian, Norwegian, Romanian, and Vietnamese. Seapoint Books published David's eleventh book in 2012 , Voyager 3, containing his creative writing, and in 2016, his twelfth book, Flim-Flam Flora, a children's book coauthored with his daughter. David appears as a frequent guest on CNBC, Bloomberg, FOX, PBS, and other television channels, and has contributed numerous articles to Barron's Euromoney, The Money Manager, Forbes.com, The Yale Economic Review, and other publications. He has broadcast and written extensively on asset allocation in the Morgan Stanley biweekly Investment Strategy and Asset Allocation Commentary and in the Firm's Wealth Management monthly publication, Asset Allocation and Investment Strategy Digest, the predecessors of which he launched in 1997. David attended Father Ryan High School in Nashville, Tennessee, graduated from Phillips Exeter Academy, was awarded a BA degree in Economics from Yale University, and earned his MBA from Harvard Business School. David serves on the Investment Committee of the Phi Beta Kappa Foundation and the Advisory Boards of the George Washington Institute for Religious Freedom and the Black Rock Arts Foundation. David has lectured extensively at Wharton, Columbia, INSEAD, and New York University Business Schools, and for nine years, David served as a visiting faculty member at Yale College, Yale School of Management, and Harvard Business School. In November 2011, David was inducted by Quinnipiac University in their Business Leaders Hall of Fame. David is a CFA Charterholder and a member of the New York Society of Security Analysts and the CFA Institute. Join Our Distribution List – For a full copy of our report. Americana Partners - https://www.americanapartners.com/contact/ Americana Partners Website - https://www.americanapartners.com/ Linked In - https://www.linkedin.com/company/americana-partners/ Spotify - https://open.spotify.com/show/3rX19ND89pwEob9efsFNNF iTunes - https://podcasts.apple.com/us/podcast/americana-partners/id1496186853 Google Podcasts - https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2FtZXJpY2FuYXBhcnRuZXJzL2ZlZWQueG1s?sa=X&ved=0CAYQrrcFahcKEwj4gZrR_OnwAhUAAAAAHQAAAAAQAg   Disclosures Americana Partners, LLC is registered as an investment adviser with the SEC. The firm only transacts business in states where it is properly registered, or is excluded or exempted from registration requirements. Registration as an investment adviser does not constitute an endorsement of the firm by securities regulators nor does it indicate that the adviser has attained a particular level of skill or ability. A copy of Americana Partners' current written disclosure brochure filed with the SEC which discusses among other things, Americana Partners' business practices, services and fees, is available through the SEC's website at: www.adviserinfo.sec.gov. The tax and legal information contained in this newsletter is general in nature. It should not be construed as legal or tax advice. Always consult an attorney or tax professional regarding your specific legal or tax situation. Foreign securities, foreign currencies, and securities issued by U.S. entities with substantial foreign operations can involve additional risks relating to political, economic, or regulatory conditions in foreign countries. These risks include fluctuations in foreign currencies; withholding or other taxes; trading, settlement, custodial, and other operational risks; and less stringent investor protection and disclosure standards in some foreign markets. All of these factors can make foreign investments, especially those in emerging markets, more volatile and potentially less liquid than U.S. investments. In addition, foreign markets can perform differently from the U.S. market. Investing involves certain risks, including possible loss of principal. You should understand and carefully consider a strategy's objectives, risks, fees, expenses and other information before investing. The views expressed in this commentary are subject to change and are not intended to be a recommendation or investment advice. Such views do not take into account the individual financial circumstances or objectives of any investor that receives them. The strategies described herein may not be suitable for all investors. There is no guarantee that the adviser will meet any of its investment objectives. All indices are unmanaged and are not available for direct investment. Indices do not incur costs including the payment of transaction costs, fees and other expenses. This information should not be considered a solicitation or an offer to provide any service in any jurisdiction where it would be unlawful to do so under the laws of that jurisdiction. Past performance is no guarantee of future results. It is not possible to invest directly in an index. Exposure to an asset class represented by an index is available through investable instruments based on that index. The S&P 500® Index is a widely recognized, unmanaged index of 500 common stocks which are generally representative of the U.S. stock market as a whole. The Nasdaq Composite® Index is the market capitalization-weighted index of over 2,500 common equities listed on the Nasdaq stock exchange. The types of securities in the index include American depositary receipts, common stocks, real estate investment trusts (REITs) and tracking stocks, as well as limited partnership interests. The EAFE® Index is a stock index offered by MSCI that covers non-U.S. and Canadian equity markets. It serves as a performance benchmark for the major international equity markets as represented by 21 major MSCI indices from Europe, Australasia, and the Middle East. The EAFE® Index is the oldest international stock index and is commonly called the MSCI EAFE Index. The Russell 2500® is a market-cap-weighted index that includes the smallest 2,500 companies covered in the broad-based Russell 3000 sphere of United States-based listed equities. All 2,500 of the companies included in the Index cover the small- and mid-cap market capitalizations. The Russell 1000® Growth Index is an unmanaged index that measures the performance of the large-cap growth segment of the U.S. equity universe. It includes those Russell 1000® Index companies with higher price-to-book ratios and higher forecasted growth values. The CBOE Volatility Index (VIX) is a measure of expected price fluctuations in the S&P 500 Index options over the next 30 days. The VIX is calculated in real time by the Chicago Board Options Exchange (CBOE). P/E or Price to Earnings ratio is indicates the dollar amount an investor can expect to invest in a company in order to receive one dollar of that company's earnings. The Consumer Confidence Survey® reflects prevailing business conditions and likely developments for the months ahead. The Manufacturing Business Outlook Survey is a monthly survey of manufacturers in the Third Federal Reserve District; Participants indicate the direction of change in overall business activity and in the various measures of activity at their plants: employment, working hours, new and unfilled orders, shipments, inventories, delivery times, prices paid, and prices received. The ISM manufacturing index, also known as the purchasing managers' index (PMI), is a monthly indicator of U.S. economic activity based on a survey of purchasing managers at more than 300 manufacturing firms. The Composite Index of Leading Indicators, otherwise known as the Leading Economic Index (LEI), is an index published monthly by The Conference Board. It is used to predict the direction of global economic movements in future months. A bond rating is a letter-based credit scoring scheme used to judge the quality and creditworthiness of a bond. The option adjusted spread (OAS) measures the difference in yield between a bond with an embedded option, such as an MBS or callables, with the yield on Treasuries. Mean reversion, in finance, suggests that various phenomena of interest such as asset prices and volatility of returns eventually revert to their long-term average levels. A meme stock is a security that has seen an increase in trading volume after going viral on social media or an online forum. This document may contain forward-looking statements relating to the objectives, opportunities, and the future performance of the U.S. market generally. Forward looking statements may be identified by the use of such words as; “believe,” “expect,”“anticipate,”“should,”“planned,”“estimated,”“potential”and other similar terms. Examples of forward-looking statements include, but are not limited to, estimates with respect to financial condition, results of operations, and success or lack of success of any particular investment strategy. All are subject to various factors, including, but not limited to general and local economic conditions, changing levels of competition within certain industries and markets, changes in interest rates, changes in legislation or regulation, and other economic, competitive, governmental, regulatory and technological factors affecting a portfolio' operations that could cause actual results to differ materially from projected results. Such statements are forward-looking in nature and involve a number of known and unknown risks, uncertainties and other factors, and accordingly, actual results may differ materially from those reflected or contemplated in such forward-looking statements. Prospective investors are cautioned not to place undue reliance on any forward looking statements or examples. This material is proprietary and may not be reproduced, transferred, modified or distributed in any form without prior written permission from Americana Partners. Americana Partners reserves the right, at any time and without notice, to amend, or cease publication of the information contained herein. Certain of the information contained herein has been obtained from third-party sources and has not been independently verified. It is made available on an "as is" basis without warranty. Any strategies or investment programs described in this presentation are provided for educational purposes only and are not necessarily indicative of securities offered for sale or private placement offerings available to any investor. The mention of any individual security should not be construed as a recommendation to buy or sell that security.

Melissa Giles, Director of Portfolio Management with Americana Partners presents the Monthly Market Commentary as written by, David M Darst, Chief Investment Officer with Americana Partners.  Any charts/graphs referenced are available in print format and may be provided at your request. David is currently the Chief Investment Officer for Americana Partners. David served for 17 years as a Managing Director and Chief Investment Strategist of Morgan Stanley Wealth Management, with responsibility for Asset Allocation and Investment Strategy; was the founding President of the Morgan Stanley Investment Group; and was founding Chairman of the Morgan Stanley Wealth Management Asset Allocation Committee. After 2014, he served for several years as Senior Advisor to and a member of the Morgan Stanley Wealth Management Global Investment Committee. He joined Morgan Stanley in 1996 from Goldman Sachs, where he held Senior Management posts within the Equities Division and earlier, for six years as Resident Manager of their Private Bank in Zurich. David is the Author of twelve books: (i) The Complete Bond Book (McGraw-Hill); (ii) The Handbook of the Bond and Money Markets (McGraw-Hill); (iii) The Art of Asset Allocation, Second Edition (McGraw-Hill); (iv) Mastering the Art of Asset Allocation (McGraw-Hill); (v) Benjamin Graham on Investing (McGraw-Hill); (vi) The Little Book that Saves Your Assets (John Wiley & Sons), which was ranked on the bestseller lists of The New York Times and Business Week; (vii) Portfolio Investment Opportunities in China (John Wiley & Sons); and (x) Portfolio Investment Opportunities in Precious Metals (John Wiley & Sons). His works have been translated into Chinese, Japanese, Russian, German, Korean, Italian, Indonesian, Norwegian, Romanian, and Vietnamese. Seapoint Books published David's eleventh book in 2012 , Voyager 3, containing his creative writing, and in 2016, his twelfth book, Flim-Flam Flora, a children's book coauthored with his daughter. David appears as a frequent guest on CNBC, Bloomberg, FOX, PBS, and other television channels, and has contributed numerous articles to Barron's Euromoney, The Money Manager, Forbes.com, The Yale Economic Review, and other publications. He has broadcast and written extensively on asset allocation in the Morgan Stanley biweekly Investment Strategy and Asset Allocation Commentary and in the Firm's Wealth Management monthly publication, Asset Allocation and Investment Strategy Digest, the predecessors of which he launched in 1997. David attended Father Ryan High School in Nashville, Tennessee, graduated from Phillips Exeter Academy, was awarded a BA degree in Economics from Yale University, and earned his MBA from Harvard Business School. David serves on the Investment Committee of the Phi Beta Kappa Foundation and the Advisory Boards of the George Washington Institute for Religious Freedom and the Black Rock Arts Foundation. David has lectured extensively at Wharton, Columbia, INSEAD, and New York University Business Schools, and for nine years, David served as a visiting faculty member at Yale College, Yale School of Management, and Harvard Business School. In November 2011, David was inducted by Quinnipiac University in their Business Leaders Hall of Fame. David is a CFA Charterholder and a member of the New York Society of Security Analysts and the CFA Institute. Join Our Distribution List – For a full copy of our report. Americana Partners - https://www.americanapartners.com/contact/ Americana Partners Website - https://www.americanapartners.com/ Linked In - https://www.linkedin.com/company/americana-partners/ Spotify - https://open.spotify.com/show/3rX19ND89pwEob9efsFNNF iTunes - https://podcasts.apple.com/us/podcast/americana-partners/id1496186853 Google Podcasts - https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkLnBvZGJlYW4uY29tL2FtZXJpY2FuYXBhcnRuZXJzL2ZlZWQueG1s?sa=X&ved=0CAYQrrcFahcKEwj4gZrR_OnwAhUAAAAAHQAAAAAQAg   Disclosures Americana Partners, LLC is registered as an investment adviser with the SEC. The firm only transacts business in states where it is properly registered, or is excluded or exempted from registration requirements. Registration as an investment adviser does not constitute an endorsement of the firm by securities regulators nor does it indicate that the adviser has attained a particular level of skill or ability. A copy of Americana Partners' current written disclosure brochure filed with the SEC which discusses among other things, Americana Partners' business practices, services and fees, is available through the SEC's website at: www.adviserinfo.sec.gov. The tax and legal information contained in this newsletter is general in nature. It should not be construed as legal or tax advice. Always consult an attorney or tax professional regarding your specific legal or tax situation. Foreign securities, foreign currencies, and securities issued by U.S. entities with substantial foreign operations can involve additional risks relating to political, economic, or regulatory conditions in foreign countries. These risks include fluctuations in foreign currencies; withholding or other taxes; trading, settlement, custodial, and other operational risks; and less stringent investor protection and disclosure standards in some foreign markets. All of these factors can make foreign investments, especially those in emerging markets, more volatile and potentially less liquid than U.S. investments. In addition, foreign markets can perform differently from the U.S. market. Investing involves certain risks, including possible loss of principal. You should understand and carefully consider a strategy's objectives, risks, fees, expenses and other information before investing. The views expressed in this commentary are subject to change and are not intended to be a recommendation or investment advice. Such views do not take into account the individual financial circumstances or objectives of any investor that receives them. The strategies described herein may not be suitable for all investors. There is no guarantee that the adviser will meet any of its investment objectives. All indices are unmanaged and are not available for direct investment. Indices do not incur costs including the payment of transaction costs, fees and other expenses. This information should not be considered a solicitation or an offer to provide any service in any jurisdiction where it would be unlawful to do so under the laws of that jurisdiction. Past performance is no guarantee of future results. It is not possible to invest directly in an index. Exposure to an asset class represented by an index is available through investable instruments based on that index. The S&P 500® Index is a widely recognized, unmanaged index of 500 common stocks which are generally representative of the U.S. stock market as a whole. The Nasdaq Composite® Index is the market capitalization-weighted index of over 2,500 common equities listed on the Nasdaq stock exchange. The types of securities in the index include American depositary receipts, common stocks, real estate investment trusts (REITs) and tracking stocks, as well as limited partnership interests. The EAFE® Index is a stock index offered by MSCI that covers non-U.S. and Canadian equity markets. It serves as a performance benchmark for the major international equity markets as represented by 21 major MSCI indices from Europe, Australasia, and the Middle East. The EAFE® Index is the oldest international stock index and is commonly called the MSCI EAFE Index. The Russell 2500® is a market-cap-weighted index that includes the smallest 2,500 companies covered in the broad-based Russell 3000 sphere of United States-based listed equities. All 2,500 of the companies included in the Index cover the small- and mid-cap market capitalizations. The Russell 1000® Growth Index is an unmanaged index that measures the performance of the large-cap growth segment of the U.S. equity universe. It includes those Russell 1000® Index companies with higher price-to-book ratios and higher forecasted growth values. The CBOE Volatility Index (VIX) is a measure of expected price fluctuations in the S&P 500 Index options over the next 30 days. The VIX is calculated in real time by the Chicago Board Options Exchange (CBOE). P/E or Price to Earnings ratio is indicates the dollar amount an investor can expect to invest in a company in order to receive one dollar of that company's earnings. The Consumer Confidence Survey® reflects prevailing business conditions and likely developments for the months ahead. The Manufacturing Business Outlook Survey is a monthly survey of manufacturers in the Third Federal Reserve District; Participants indicate the direction of change in overall business activity and in the various measures of activity at their plants: employment, working hours, new and unfilled orders, shipments, inventories, delivery times, prices paid, and prices received. The ISM manufacturing index, also known as the purchasing managers' index (PMI), is a monthly indicator of U.S. economic activity based on a survey of purchasing managers at more than 300 manufacturing firms. The Composite Index of Leading Indicators, otherwise known as the Leading Economic Index (LEI), is an index published monthly by The Conference Board. It is used to predict the direction of global economic movements in future months. A bond rating is a letter-based credit scoring scheme used to judge the quality and creditworthiness of a bond. The option adjusted spread (OAS) measures the difference in yield between a bond with an embedded option, such as an MBS or callables, with the yield on Treasuries. Mean reversion, in finance, suggests that various phenomena of interest such as asset prices and volatility of returns eventually revert to their long-term average levels. A meme stock is a security that has seen an increase in trading volume after going viral on social media or an online forum. This document may contain forward-looking statements relating to the objectives, opportunities, and the future performance of the U.S. market generally. Forward looking statements may be identified by the use of such words as; “believe,” “expect,”“anticipate,”“should,”“planned,”“estimated,”“potential”and other similar terms. Examples of forward-looking statements include, but are not limited to, estimates with respect to financial condition, results of operations, and success or lack of success of any particular investment strategy. All are subject to various factors, including, but not limited to general and local economic conditions, changing levels of competition within certain industries and markets, changes in interest rates, changes in legislation or regulation, and other economic, competitive, governmental, regulatory and technological factors affecting a portfolio' operations that could cause actual results to differ materially from projected results. Such statements are forward-looking in nature and involve a number of known and unknown risks, uncertainties and other factors, and accordingly, actual results may differ materially from those reflected or contemplated in such forward-looking statements. Prospective investors are cautioned not to place undue reliance on any forward looking statements or examples. This material is proprietary and may not be reproduced, transferred, modified or distributed in any form without prior written permission from Americana Partners. Americana Partners reserves the right, at any time and without notice, to amend, or cease publication of the information contained herein. Certain of the information contained herein has been obtained from third-party sources and has not been independently verified. It is made available on an "as is" basis without warranty. Any strategies or investment programs described in this presentation are provided for educational purposes only and are not necessarily indicative of securities offered for sale or private placement offerings available to any investor. The mention of any individual security should not be construed as a recommendation to buy or sell that security.