30 Burst results for "Makita"

"makita" Discussed on Life Things with Maquita Donyel

Life Things with Maquita Donyel

03:49 min | 10 months ago

"makita" Discussed on Life Things with Maquita Donyel

"I bet you and your dreams nags just it. Just does yeah. Yeah it gets louder and louder and like it was getting it. It was making me even more and more and more uncomfortable. I mean still is actively like so much that i'm like what is going on like it's really it's really not that yeah And things are happening. That are telling me like you can't be right. Yeah that's like this is supposed to be make a real hot until you understand girl or are you just buying gall that's true. That's true infer like i. Don't i wanna speak just life into those that are choosing to burn that like truly destined for something else and for more and once this life is over like your spirit Your spirit your spirit is infinite and soul the choices and decisions that you make here on earth they will carry out into your spiritual life here. Who des so this is bernie choosing burner here like what does that mean. What does that mean. Physical self has gone choosing to to bir- infinitely. Is that worth it. I don't know who grow you had defunding for here. We're here to operate in his purpose and we're also here to learn. Whatever that we're supposed to learn here on earth and our human experience. If you're not doing that something's maggie that he's delete that then would you here for as we need to figure out what that is and like you said like that's so to speak spirit has infinite so it's here after work on and so what does that mean for like our descendants. You know what i mean like. We're here to learn something behalf on and some sort of way. Yeah i mean. I truly feel like ancestors that did everything they were fulfilled to and the ones that didn't that are pushing me to not make the same mistakes. Yeah yeah i feel like my. I think it might look something like that you know. Yeah i totally agree now me either on that note when we well is that brings us to the end of our episode. I am so glad to have you all here with me. Because when is real and witnessed authentic and we get happy which put out there and it's rooted in your purpose. It's bound to connect with those needs. Connect with it. And i'm grateful for the opportunity to create and connect with you as life. Things makita danielle of polish pistol. You can follow me on social media at makita don yell or that's on instagram fee schedule gets cetera. You can follow future blockposts and check off the old block post on polish pistol dot com and se on the next episode saluted zoom.

bernie maggie makita danielle
"makita" Discussed on Discover Music Channel (Discover Music Channel)

Discover Music Channel (Discover Music Channel)

03:46 min | 1 year ago

"makita" Discussed on Discover Music Channel (Discover Music Channel)

"Ring up baby back up now to get things out. How can you go now. bring back up. Nice and slow his body. So big majority is anchor laying. Makita me he can make a. My.

Makita
Allyship Fundamentals - Mike Moskowitz

Judaism Unbound

02:29 min | 1 year ago

Allyship Fundamentals - Mike Moskowitz

"Moskowitz welcome to judaism unbounded so great to have you. He's still for so. I'd love to start with a question that i'm sure you've been asked a million times. But basically how did an ultra orthodox rabbi come to be the scholar and residence for trans and queer studies at a progressive judaism synagogue that is actually the largest lgbt synagogue in the world. And i think what are the first so how did that happen. Rabbi hyman and i met in the back of a police wagon where we both got arrested for civil disobedience over daca. It was in dc about three and a half years ago and in the back of this police wagon. We are all in handcuffs. And there's five melded a vying folks on one side makita a metal partition in the middle of this police. Dan and then five defying rabat's on the other side and rabbi climate says you know bunch of to share toronto share and it's a captive audience role in hand and i just read an article in gender and clothing and so i share these thoughts with her and through the course of the afternoon where we were massive warehouse in also separated by gender. She a little bit of my story. How is a rabbi in harlem at columbia and was now working at a deli lakewood new jersey. I've taken off the day to get arrested. And she got together and created this position for me. Because i wasn't able to find a job in the radio world anymore because of the positions taken very publicly Those positions for me came about As it does most people as a function of proximity someone in my family transitions at a student. Congregation who had transitioned really wasn't kind of authority and also works representation within the rabbinate to create a sacred space for people to be who they are without having to choose between a gender identity and religious identity. In so i kind of started the occupying that space void and cdc showed up as as my ally to give me the platform in the agency to able to do that. It's been a fantastic relationship. That's i think has been surprisingly simple. It actually lacks the complexity of what i think. Most people would assume would be awkwardness of being in both of those spaces. Because i think. Cbs team particular frames. Judaism as being in relationship with tradition. And god it really allows for the commonality of individuality where we're all struggling were journeying. Were also exploring And that way were all equal

Rabbi Hyman Daca Moskowitz Rabat DC Harlem DAN Lakewood Toronto Columbia New Jersey CDC CBS
Oh Mikita! What Are You Doing?

The Breakdown Poker Podcast

02:14 min | 1 year ago

Oh Mikita! What Are You Doing?

"Talking about this tournament and this he s six remain in this five scoop going to be a tough damn field. Okay got makita badza. Cousy in the hand yeah. His opponent in the hand is dubbing. He's got ten million in live earnings two million in online. He's not even close to the most accomplished player in the hand. He's got is the eighty ninth. Most moneyed live tournament player of all time. Not even close not even close all right. Six forty five k. So you're only nine xing. You're buying their. I guess it was not that big of a field Versus one hundred and seventy seven k. Whoa wake me up before you go go all right george. Thirty six to care the blinds. Makita hausky the joker. He's in the small bundy. His agent of chaos. He's got five point five million so almost one hundred bakes cool and raises to one hundred sixty k. With two eights eight of diamonds. Eight of clubs. Cool fine sure matthias. Bigger in the big blind as two point two million so not doing his well. Just thirtyish blinds calls with queen jack of spades in the big binder. I'm cool with that. Yeah it seems like. He's got too many chips to shove and not enough chips to raise for like because he has a good hand right. Yeah and this is play super well in position against a raise especially against the super wideness of this race. It seems great yeah pots. Three hundred and sixty five k. The flop is six of diamonds. Ten of clubs. Four of spades pretty mandatory. Continue for beds cow. Ski area goes pretty small. Pretty standard stuff. You're eighty-seven k into three sixty five all right. So is this just an auto float for bigger with to back doors. Two overs and yeah. I think absolutely competent opponent. Is there an argument for raising. Oh that's a cool question. If we feel like bazakov's he doesn't have a lot of ups on the turn. I'm a little bit more interested in raising right now. Yeah but if he's gonna check fold fairmount once we've called once which. I think i would guess he's got a fair amount of those. I would think so. Yeah then i just calling in position. We don't have to put a lot of chips in play here and we get to see a card super cheap.

Cousy Matthias George Bazakov
"makita" Discussed on KPRC 950 AM

KPRC 950 AM

01:57 min | 1 year ago

"makita" Discussed on KPRC 950 AM

"She she flung one of them to the ground, and then he kicked her in the head so she could divert her full attention. To the pink pantsuit, girl and go stab her up against the car. Well, folks tell you, it only starts at home. E think this is a good example of how it does. Um, yeah. If you're a young parent out there my advice to you would be if your daughter is about to stab someone deal with that before you go kick someone in the head. Actually, if she's about to stab Kenny Kenny has made it very clear that if he is about to be stabbed, he would like us or the police or anybody else. Who stopped him? Yeah, I'm just gonna put that out there. Now. If anyone wants to know do I want you to shoot my stabber? The answer's Yes, There's someone's about to stab me with a knife and you're a law abiding citizen with a handgun. Shoot them. I will testify that you were saving my life because it sounds like you were in this hypothetical scenario. And still, we haven't heard from the pink pantsuit girl or her mom and dad who should be pretty happy with the police. Okay? We actually have heard from her. We have an update on that, would you? I didn't hear that. Okay, so that girl is now moved to a different home. She has had to go into hiding because she was also in the same foster home as Makita Makita. Whatever name is so many people are making death threats against her that she's had to go into hiding. They really want her dead people that are critics of the police. Black lives matter. Activists they can't have nothing to do with this black girl figured out who she wasps. Published her personal information online, Doc Doc stocks getting Doc's right. That's called Doc Sing, and then as a result of that she's had an overwhelmingly high number of people reach out and say they're going to kill her, one person said. They were on their way to her to kill her. She's had to go into hiding, and she says she's now getting counseling to try to deal with all of this. Oh, so black lives matter, but not some black one..

Kenny Kenny one person one Makita Makita Doc Sing Doc
How to Generate Loyal and Committed Clients with Cristy Nickel

Healthcare Business Secrets

02:13 min | 1 year ago

How to Generate Loyal and Committed Clients with Cristy Nickel

"The working with christy nikko. Christie is the president and ceo of code rid author of the code revolution number. Two will ranked boxes. Currently retired and celebrity tristesse a warning from china in elite level. Athletes is also the author of four books. I'm really excited to have her on the show. She's an evid makita salesperson and has got a kick ass business which we're gonna talk about today's episode. Welcome to the show. Kristy yes and the mohawk. Let's not forget the mohawk. Oh my god. I got a different color for change it constantly. My poor husband walks around the corner. He goes and he goes. Oh as you. And i'm like why do you think it's red now. So yes thank you for that awesome introduction. Only some some background on you. What do you do. Who do you help. And how'd you get into the space. The elevator pitch is. I created a nutrition program that enables people to lose ten percent of their body weight every month without shakes pills diet foods or exercise. So that's kind of the some of the code red lifestyle but it kind of started back when i was. I was raised in northern idaho which is in the pacific northwest and i was raised very poor. My dad was a cop and our local minister was a very small town and my mom worked for minimum wage and we just had no money but we raised on a farm and so we were very poor growing up and when it was time for me to move out of the house and go to college. Nobody in my family helped me. That was zero help. I was working. I bought my first horse at ten years old making monthly payments to my neighbor to buy this horse so i started waiting tables and i was just waiting tables and bartending trying to put myself through nursing school and i was approached by a boxing coach after he watched me in in a local boxing class. And he said how long you been. Boxing and i said forty four minutes. And he said you have a propensity for this. And i was like pow whatever and he goes. Do you wanna fight. And i thought fight. Are you kidding me like real fight. I've never even been in a fight. Never been hit. He said you could earn money. Well that's all. I needed to hear because i was so poor so i literally started fighting for my dinner. I started fighting for five hundred bucks a five. This legit federally licensed sanctioned boxing matches you know six ounce gloves Twelve rounds three minute rounds and little. Did i know. I was really good at boxing

Christy Nikko Christie Kristy Boxing China Pacific Northwest Idaho
"makita" Discussed on The Marketing Rescue Podcast

The Marketing Rescue Podcast

03:45 min | 1 year ago

"makita" Discussed on The Marketing Rescue Podcast

"To do just engaging with the customer through transparent lanes versus hiding behind the algorithm makita stated a great quotes trying to tweak the algorithm trying to have the perfect amount of hashtags trying to have the correct meta data. Trying to have these are all things that market is hide behind because they lack the authenticity of the brand connection between the customer and the brand man unite talk about this all the time we constantly see market is optimized dog rhythms and market is hiding behind the technology and forgetting where they come from having a meaningful connection between the brand and yes using technology to facilitate that connection but not creating connection through optimizing technology. Yeah absolutely. I love what you said about paying attention. That marketers need to pay attention to what's going on in these communities like that's such a critical important concept that is difficult to really understand. There's this book that i've been reading with my kids at night called the city of ember. It's a book series geared towards like third graders third to fourth grade kind of thing and sperry the details of the premise of the book. But in that book there's a character who is trying to save his community and test to escape from this area and his dad tells him look for things that no one else is seeing. Look for the things that people aren't willing to spend the time to look for and that's where you'll find what you need to find. And of course that's how he discovers the secret that allows him to escape the situation and save the city in this book and it makes me think of this story and i wish i could remember who it was but i had read an article. That was talking about this concept and how there was this young advertising creative and she would when she first got into the industry you know she did what we all do in advertising which is work. Really hard to meet our deadlines and police our clients and so she worked these really long hours and she'd work over the weekends trying to get that deck..

makita
Dr. Mark Hoffman, Research Associate Professor at the University of Missouri, Kansas City - burst 01

Scientific Sense

44:57 min | 1 year ago

Dr. Mark Hoffman, Research Associate Professor at the University of Missouri, Kansas City - burst 01

"Welcome to the site of accents podcast. Where we explore emerging ideas from signs, policy economics, and technology. My name is Gill eappen. We talk with woods leading academics and experts about the recent research or generally of topical interest. Scientific senses at unstructured conversation with no agenda or preparation. Be Color a wide variety of domains red new discoveries are made. and New Technologies are developed on a daily basis. The most interested in how new Ideas Affect Society? And, help educate the world how to pursue rewarding and enjoyable life rooted in signs logic at inflammation. V seek knowledge without boundaries or constraints and provide unaided content of conversations bit researchers and leaders who low what they do. A companion blog to this podcast can be found at scientific sense dot com. And displayed guest is available on over a dozen platforms and directly at scientific sense. Dot? Net. If you have suggestions for topics, guests at other ideas. Please send up to info at scientific sense dot com. And I can be reached at Gil at eappen Dot Info. Mike yesterday's Dr Mark Hoffman, who is a research associate professor in the University of Minnesota Against City. He is also chief research inflammation officer in the children's Mussa hospital in Kansas City. Kiss research interests include health data delayed indication sharing initialisation Boca Mark. Thank you for inviting me. Absolutely. So I start with one of your papers Kato you need the use by our system implementation in defy date data resource from hundred known athlete off my seasons. So Michio inflicted. Data aggregated for marketable sources provide an important resource for my medical research including digital feel typing. On. Like. Todd beat to from a single organization. Guitar data introduces a number of analysis challengers. So. So you've worked with some augmentation log and in almost all cases be used. Data coming from that single macy's listen primary care behavioral. Or specialty hospitals and I always wondered you know wouldn't be nice. Get a data set. That sort of abrogates data from the radio on-ice. Asians but a lot of different challenges around that. So you wanted to talk a bit about that. I'd be happy to the resource that we've worked with. Is primarily a called health fax data resource. It's been in operation for almost twenty years. And the the the model is that organizations who are. Using these Turner Electronic. Health. Record. Enter into an agreement was turner they agreed to provide data rights to sern are. The identifies the date of affords aggregated into this resource. And certner provides data mapping, which is really critical to this type of work. It also the aggregate the data. And for the past probably six years. Then, they provide the full data set to especially academic contributors who want to do research with that resource. And I've been on both sides of that equation Lead that group during my career there, and then now I have the opportunity to really focus research on that type of data. So before we get into the details smog so e Itar Systems. So this is. Essentially patient records. So he gets dated like demographics out family history, surgical history hats, medications, lab solves it could have physician nodes no snow. So it's it's a combination of a variety of different types of data, right? A couple of things on the examples you gave it includes demographics. Discreet Laboratory results Medication orders. Many vitals so If access the blood pressure and pulse data. It does not include text notes because those can't be. Automatically identified consistently. So. We don't have access currently to TEX notes. Out of an abundance of caution. That his Hobby Stephen, physician writes something down they could use names they could use inflammation that could then point back to their. Patients Makita Perspective been the data's aggregated, the primary issue shoe that date has completely the identified, right? Correct. So. So yeah. So the data that we receive there's eighteen identifiers. Hip requires be removed from data. And those include obvious things like name address email addresses are another example One of the. Things. That is also part of the benefit of working with this particular resource. The. Dates of clinical service are not allowed to be provided under hip. White is done with this resource that allows us to still have a longitudinal view is. For any given patient in the data set the dates are shifted by A. Consistent. Pattern that for any given patient it can be. One two three four five weeks forward or one, two, three, four or five weeks backward. But that preserves things like day of the week effect. So for example, you see -nificant increase in emergency department encounters over weekends and you don't WanNa lose. Visibility to that. but it also allows us to receive. Very, granular early time stamped events in so. We can gain visibility into the time that a blood specimen was collected, and then the time that the result was reported back. And so we're able to do very detailed analyses with this type of resource. Right right and I don't know the audience our market is fragmented. Tau himself e Amorebieta providers out there. and so two issues. One is sort of. Standardization as to how these databases are designed and structured and others even that standardization that the actual collection of the data. In itself is not standardized played. So vk CAV vk potentially lot inability coming from different systems. Correct and that's part of what the paper that you mentioned Evaluates so. Often, night you out in the field in conferences you hear. Comparisons kind of lumping all organizations using one. Vendor lumping all using another together but as you get closer to it, you quickly learn that. It's not even clear. It's within those. Vendor markets. There's variation from organization to organization in how they use the e Hr and so. Because the identities of the. Contributing organizations are blinded to those of us who work with the data. We have to be creative about how we. Infer those implementation details, and so with this paper, we describe a couple of methods that We think move things forward towards that goal. Yes. So I'm not really familiar with that. So you mentioned a couple of things here. One is the the merge network. So this initiative including electric medical records and genomics network and pc off net the national patient, centered clinical research network support. Decentralized analyses that goes disparate systems by distributing standardized quotas to site. So this is a situation where you have multiple systems sort of. Communicating with each other and this net folks at allowing to sort of quickly them In some standardized fashion. So In this type of technology, there's janitorial core models. One is the. Federated or distributed model, the other is a centralized data aggregation. So there are examples including those that are mentioned in the paper where. Queries are pushed to the organization and. They need to do significant work upfront to ensure that there are standardizing their terminologies the same way. And once they do that upfront work than they're able to perform the types of queries that are distributed through those. Federated Networks. With. Okay. So that just one click on so that the police have standardized. So all on the at Josh site, then they have like some sort of a plan slater from from Stan Day squatty do all the data structure. And in many cases, they work through an intermediate technology. that would be. In general, consider it like a data warehouse. And so the queries are running against the production electric. Health record. That has all kinds of implications on patient care where you don't want to slow down performance. By using these intermediaries They can receive queries and then Follow that mapping has occurred. Than, they're able to to run those distributed queries. Okay. And the other model is You know. You say the g through the medical quality, improvement consortium and sooner to the health facts initiative. So this says in Sodas case, for example, in swags. This is essentially picking up data from the right deals, clients and Dan standardizing and centralizing data in a single database is that that is correct. One benefit of that model is that Organizations who for example, may not be academic and don't have the. Resources to do that data mapping themselves by handing out over that task over to the vendor you get a broader diversity of the types of organizations so you can have. A safety net hospitals you can have. Critical access rural hospitals, and other venues of care that are probably under represented in some of those. More academically driven models. And clearly the focus on healthcare about I would imagine applications in pharmaceutical out indeed to right I. Don't know if it s use and bad direction there has been some were performed with these data resources to. Characterize different aspects of medications, and so it does have utility in value. In a variety of. Analytical contexts. I was thinking about you know a lot of randomized clinical trials going on into Kuwait context and One of the issues of dispatch seem development toils that are going on that one could argue the population there are not really well to percents. it may be number by Auditees, men, people that deputy existing conditions. and. So he will serve at my come out of facedly trial. granted might work for the population. Tried it minority have sufficient? more largely. So I wanted this type of well I guess we don't really have an ID there right. So clearly, you don't know who these people are but they could be some clustering type analysis that might be interesting weight from It's very useful for Health Services Research and for outcomes research for you know what I characterize digital phenotype being. they can then guide. More, more formal research. you know you can use this type of resource to. Make sure. You're asking a useful question and make sure that there's likely to be. Enough patients who qualify for given study. Maybe you're working on a clinical trial in your casting your net to narrow you can. Determine that with this type of data resource. And is the eight tiff date who has access to it typically. So for this data resource on, it's through the vendor so. You need to have some level of footprint with them. which is the case with our organization. They're definitely a broadening their strategies. So they're. Gaining access into health systems that aren't exclusively using their electronic health records so. It's exciting to be a part of that that process. and to again work with them to. Analyze the data. I think. To the example you gave a formal randomized trials. In key part of what were growing our research to focus on is because this is real world data. You learn what's happening in practice whether or not it's well aligned with guidelines or formal protocols. And doing that there's many opportunities for near-term interventions that can improve health outcomes simply by. Identifying where providers may be deviating more from. Best Practices in than taking steps through training and education to kind of get them back towards those best practices. This data is a fresh on a daily basis. It's not. It's because it's so large and bulky? Typically we've received it on a quarterly basis in since it's retrospective analysis that's not been a major barrier. But. mechanistically, on onto soon aside is data getting sort of picked up from this system that it's harvested every day and then it's aggregated bundled and distributed on A. On a different timescale. Okay okay. So. From again, going to the, it's our system designed issue and implementation You say many HR systems comprised of more news at specific clinical processes or unit such as Pharmacy Laboratory or surgery talked about that. But then then people implement them this of fashion right they they implement modules by that can be a factor or sometimes they may want. One vendor for their primary electronic health record, but another vendor for their laboratory system. and so that's where you don't see a hundred percent usage of every module and every organization. And detailed number of different you know sort of noise creating issues in data one. This is icy speech over from ICT denied ten. and I don't know history of this but this was supposed to be speech with sometime in twenty fifteen. That's correct. So there is A. You know. There's a date in October of Twenty fifteen where most organizations were expected to have completed that transition. When I see with researchers who aren't as familiar with the you know the whole policy landscape around `electronic health records that? you can imagine researchers who assumed that all data before that date in October is is nine and all data after that date would be icy the ten. While we demonstrate in this paper, is that that transition was not Nearly, that clean and it was a much more, you know there are some organizations who just It the bullet and completed in twenty fourteen, and there are other organizations that were still lagging. In. Two Thousand Sixteen. Potentially because they weren't as exposed to those incentives in other things that you know stipulated the transition so. Part of why were demonstrating with that particular part of that work was that. you know these transitions aren't always abrupt. Yeah and and and so that is one issue and then you know a lot of consistency inconsistency issues fade. So we see that in in single systems and one of the items note here as you know if you think about the disposition code for death. you could have a right your race supercenter, right? It's a death expire expedite at home hospice, and so on. if this is a problem for a single system, but then many think about aggregating data from multiple sources this this problem sort of increased exponentially. Absolutely. So one of the challenges with documenting and and finding where you know if a patient has A deceased that. There's just multiple places to put that documentation in the clinical record. The Location in the record that. We have found to be the most consistent is what's called discharge disposition. By as we show in that analysis, that field is not always used document that and so if you're doing outcomes research and one of your key. Outcome metrics is death. And there are organizations that. Aren't documenting death in a place that successful. You should filter those out of your analysis before moving forward. And so part of what we wanted to promote is the realization that. That's the type of consideration that needs to be made The four. Publishing. Your data about an outcome metrics like death that. You're not. If you're never gonNA see that outcome it doesn't mean that people are. Dying in that particular facility, it just means it's not documented in the place that successful. Right. Yeah. So you know you on your expedience. Unique Position Mark because you you look at it from the from the vendor's perspective you're in an academic setting you're also in practice in a hospital. What's your sense of these things improving the on a track of getting getting this more standardize or it's camping in the other direction I think in general there is improvement I think The. Over the past eleven years through various federal mandates, including meaningful use and so forth. Those of all incentive organizations to utilize. Standard terminologies more consistently than was the case beforehand. I think there's still plenty of room for improvement and You know it's it's a journey, not a destination, but I think things have improved substantially. I was wondering there could be some applications of artificial intelligence here to In a clearly TATECO systems and you'd like the most them pity human resource intensive Yvonne to get it completely right. So one question would be you know, could be actually used a Dick needs to get it maybe ninety nine percent white. And that the human deal with exceptions I definitely think that that's an exciting direction that You want those a algorithms to be trained with good data, and that's a big part of what's motivated us to. Put this focus on data quality and Understanding these strange nuances that are underpinning that date has so that. As we move towards a in machine learning and so forth. We have a high level of confidence in the data that's training those algorithms. Right. Yeah. I think that a huge opportunity here because it's not quite as broad as NFL, not natural language processing it is somewhat constrained. that is a good part of it. The back part of it is that is highly technical. and so. you know some of the techniques you know you can have a fault tolerance in certain dimensions such as you know, misspellings lack of gambling and things like that. But as you have Heidi technical data, you cannot apply those principles because he could have misspelling the system may not be able to. Get, sometimes, and that's where you know I think. It's totally feasible to use. Resources to you know when you're dealing with. Tens of millions of patients and billions of detailed records. Using a I'd even identify those patterns of either. Inconsistent data or missing data it's also very powerful just to. kind of flag in identified. Areas that need to be focused on to lead to a better analysis. Greg Wait Be Hefty. Use that information somehow did is a belt of information that you know and so it just filtering into decision processes that the are really losing it. So hopefully getting improving in that dimension I've jumping to another paper bittersweet interesting. So it's entitled rates and predictors of using opioids in the Emergency Department Katrina Treat Mike Dean in Young Otto's and so so this is sort of a machine learning exercise you have gone through to locate you know coup is getting prescribed. OPIOIDS water the conditions for the Democrat not Nestle demographics but different different maybe age and things like that gender. and and then ask the question desert has some effect on addiction. In the long term rights. So that project To great example of team science though. We. Assembled a team of subject matter experts in neurology pain management. And Data Science and. The neurologist and pain management experts. Identified an intriguing question that we decided to pursue with data. In their question was. Based on anecdotal observation and so we thought it'd be interesting to see how well the data supported that. Observation is that. for youth and young adults Treated or admitted into the emergency. Department. With a migraine headache that. All too often they were treated with an opioid. And so we Use the same day to resource that we were discussing earlier. To explore that. Question. And using data from a hundred and eighty distinct emergency departments. We found that on average twenty, three percent of those youth and young adults were treated with. An opioid medication while they were in the emergency department. In general, it should be almost zero percent in general. There's really Better medications to us, four people presenting with a migraine. and. So this fits into obviously the OPIOID crisis it. it demonstrates the. Scenario describing that. You know using real world data. You can identify patterns of clinical behavior that. Don't match guideline. And the good news is that the? correctable and so through. Training and communication there's great opportunity to. To, manage this. Really. Striking. So fifteen thousand or so inevitably the encounters. And nearly a quarter of this encounters you say involved inoculate. and these are not just Misha and Congress right. It is not filtered down to migraine encounters. Okay. Okay. So these fifteen thousand just might in encounters might vein being repeating disease So once you. If you make a statement and. This or not Easter conditioning issue here. So you get your pain, you go to an emergency department and you get treated with an opioid you get quick tactical relief. From pain. auditing condition expect that in the next episode. So you can say we didn't pursue that particular question, but that is Definitely key part of. Managing the OPIOID crisis is that drug seeking behavior and so Part of our goal was to quantify that and use this as an opportunity to educate providers that. You really shouldn't be treating migraines with an opioid in there are better alternatives and. So we we felt that this was an important contribution to that national dialogue, but we didn't specifically pursue the question of whether the patients we analyzed. Within. Encounter show up Subsequently. With the same symptoms. Right right. Yeah you it develop into period when problematic patterns of drug use comedy. FEST MERGE THE PREVALENCE RATE OF OPIOID misuse estimated to be two to four percent and debts in each goofy just young adult drew from overdoses are rising. and. You say that literally prescribe IOS has been slumping loose future opioid misuse by thirty three percent. Betas Mehta say really huge number. I think just validates the importance of this of this work. Interesting mark. I don't know you exploded on data. Last the question if you look at the aggregate data, it'd be flying opioid. Misuse. what percentage of the total number. Actually started from. You know some sort of medical encounter has mike or some sort of. related encounter that could be completed otherwise was three a bit opioid. in that encounter documented resulted in that misuse. So what so If you look at the active misuse problem that we have today. do you have a sense of what percentage of that goal is actually started I? Think the exciting thing about this type of research is for everyone questioned that you pursue you have. You have ten new that you can pursue. We haven't. Delved into that specific area, but it's It's very ripe for further analysis and A considerable part of where I end my colleagues and our time as. We do this type of work to get an initial analysis published. And then You know in my leadership role I just WANNA. support people like my colleagues on this paper Mark Connelly Jennifer Bickel. in in using data to. Support their research into identify those follow. I mean, he tests policy implications. So it's sweet important work. and. If you find it direct relationship here than you have to ask you know from from a medical perspective what is right intervention? maybe is not just added of care just best practice but clearly should be the bay You know things should be looked at you say you're American Academy of Neurology has included avoidance of using opioid to treat gain one of stop top flight choosing wisely recommendations. For high-value duck in this gives Really evidence to to support that. The other thing that's really intriguing is this level of variation from site to site in. Some Sun facilities are very much aligned with the guidelines. Others are at the you know well, above twenty three percent. And that gives an opportunity for a really precision. conversations about you know, where does our organization stand on that spectrum? Yeah that's a that's an interesting avenue to right. So you know one could ask he says some sort of push sliced Intervention if we can fly goal of patients who who had gone an opioid sexually don't have an addiction problem. that as you know Anna, the kofoed does. if you can fly those type of patterns than you can think about. A customized within electronic health record systems. There's. The ability to provide decisions poor. There's certainly phenomena called pop up fatigue were physicians. You know they don't like having so many pop up windows but at the same time. It's Within the capability of an e e Hr to do that if then logic if patient has. migraine medication order equals opioid. encourage the provider to pause and reconsider that. Right, right and so this is supervised machine learning type analysis where so you have. you have number features that comes directly from each else. So each sex race ethnicity. insurance type. Encounter prostate suggest duration. time of the year and so on. and you have labeled data in this case I guess you have able tater because you would know if op- inscribed on trade. Okay and so are the two questions here. One is to ask the question given a new patient and those features. you could assign a probability that that patient will be prescribed will. Definitely. Impress the data from that predictive Minds. Right and then can you so that data definitely tell you if the patient is going to progress into some sort of an addiction issue. So. Earn Predicting Substance Abuse. So. Yeah. Yeah. Yeah. There's additional diagnosis codes that document. whether a patient has a history of substance abuse disorder. and. So it would be feasible to. Identify the with those diagnosis codes in than really look at their prior history. Of What other conditions were they treated for? What medications were they give in? to develop that model. One of the things in this case that helped with this study is that just in general, it's not advised get. So there are other things that are much more of a gray area. Or whether opioid is as useful, but in this case. The really not. Considered. To be helpful for migraines compared to other options and so that help us have a fairly clear cut scenario to do this work. Yeah. This this won't be the data like you say once you do something like this, you have been other things you could. You could stop asking. So unquestioned that that been to my mind as you know, how did they hugged the actually prescribing opioids? Is it the patient asking for it all so? Off that was another scoping thing with this project is focused on what happens within the emergency. Room. So it's it's. Really, medication order in administration that happens. In that emergency room setting. Whether or not the patient. was. Requesting that you know if they came in and said, this has worked for me before. Can I have it again? we don't have visibility to that. Right. Right. And so from a practical perspective So the the analysis that you did slightly ended up with the Family Clyde power we think it is. Compelling. Pretty compelling. So as as a new patient gets into e D either high. and what I mean by that probably is if there is a history of substance abuse property. the physician has really think twice about. The use of may be the well, and in this case, even without that history. Just because it's not considered to be an effective treatment. You know encouraging them to pause in that decision making. In this particular case is as effective as wall. Right. So looking forward. In if you think about both of these issues, one is the data quality data aggregation data standardized recent problem in the the right of Utah Systems have did that the talked about? And then if we can get to a level that we can look at cross a large data set. Beacon, ask. More. US specific questions, treatment. Optimum treatment type questions. subpoenaed. US The mark big think B be hunting. Certainly, the volume and variety of data that we're able to work with will be even greater I, think the. Opportunity To. Look, holistically at how upstream data capture. Effects Downstream data. Analysis. example I frequently give is if we have a Aggregate Data said we identify. Ten patients whose way in that data such shows up as being. Something that's completely infeasible. let's say they're documented is being. Fifty year old person who weighs two pounds. Clearly air. What's important is? Creating the process to communicate that back upstream. Because that clinical decision. Support. Many drug dosing things are evaluated using weight based logic and so. That same logic that's Evaluating the appropriateness of dosage. It's going to be running against an incorrect value in that may or may not always be visible. So I really am intrigued with that holistic opportunity. In it I am I remain just we have three or four additional papers coming out. About other examples where Provider behaviors not aligned with Best Practices and I'm just excited about you know when you compare that to how long it takes to develop a new drug or how long it takes to. To a really long term research. This research has the opportunity for a pretty quick turnaround on an effective intervention. A really that. Other so much that right. Providers. been taught in a no, but they're. Not always using that in practice and so to help them. Identify, those topics in just modifying behaviors is. In the scheme of things, it's a very straightforward way to improve. So. You know the entire spectrum from essentially getting the data. Right or cleaner like you know Missa mischaracterized or miss input data like wait or something like that. To to get. Better diagnosis better treatment modalities. policies there and from a femme perspective clearly inflammation therefore clinical trials. I was even thinking about drug interaction type. Inflammation. I haven't been involved in the former de for awhile but. Typically, this type of data doesn't get back into automatic processes that fast but I think that is all I know there's strong interest in Pharma in. Working with this type of data there a again looking at real world behavior. This is an excellent resource for off label medication use at. you know where Pharma's Always interested in repurposing existing medications the. Regulatory Processes, much more straightforward for that because the safety is already been. Evaluated and so. The. Significant Opportunity With this, there's also just exciting. Patterns of you know. What are those unrecognised correlations? That's where the machine learning opportunities are really exciting where. You know we're not always asking the right question. And the data can show us what we should be. Yeah exactly. So if the machine a sort of red flags something or create hypotheses. that Cubans have missed sometimes, those types of things are extremely powerful. because maybe that sometimes it's countering tutor. and so we all look at data with an Incan bias. The beauty of machines that at least on the surface began deploy Michigan. This volume of data. Techniques like machine deep learning can recognize those subtle but consistent associations. Wait quite. Excellent. Idea this has been great mark Thanks so much time with me. I enjoyed it very much. Thank you. But

Policy Technology Economics Science Gill Eappen Mike Yesterday Dr Mark Hoffman Children's Mussa Hospital Turner Electronic Certner Migraine Inflammation Federated Networks Stan Day Squatty Michio Kato University Of Minnesota Makita GIL Federated Kansas City
Dr. Mark Hoffman, Research Associate Professor at the University of Missouri, Kansas City - burst 01

Scientific Sense

44:57 min | 1 year ago

Dr. Mark Hoffman, Research Associate Professor at the University of Missouri, Kansas City - burst 01

"Welcome to the site of accents podcast. Where we explore emerging ideas from signs, policy economics, and technology. My name is Gill eappen. We talk with woods leading academics and experts about the recent research or generally of topical interest. Scientific senses at unstructured conversation with no agenda or preparation. Be Color a wide variety of domains red new discoveries are made. and New Technologies are developed on a daily basis. The most interested in how new Ideas Affect Society? And, help educate the world how to pursue rewarding and enjoyable life rooted in signs logic at inflammation. V seek knowledge without boundaries or constraints and provide unaided content of conversations bit researchers and leaders who low what they do. A companion blog to this podcast can be found at scientific sense dot com. And displayed guest is available on over a dozen platforms and directly at scientific sense. Dot? Net. If you have suggestions for topics, guests at other ideas. Please send up to info at scientific sense dot com. And I can be reached at Gil at eappen Dot Info. Mike yesterday's Dr Mark Hoffman, who is a research associate professor in the University of Minnesota Against City. He is also chief research inflammation officer in the children's Mussa hospital in Kansas City. Kiss research interests include health data delayed indication sharing initialisation Boca Mark. Thank you for inviting me. Absolutely. So I start with one of your papers Kato you need the use by our system implementation in defy date data resource from hundred known athlete off my seasons. So Michio inflicted. Data aggregated for marketable sources provide an important resource for my medical research including digital feel typing. On. Like. Todd beat to from a single organization. Guitar data introduces a number of analysis challengers. So. So you've worked with some augmentation log and in almost all cases be used. Data coming from that single macy's listen primary care behavioral. Or specialty hospitals and I always wondered you know wouldn't be nice. Get a data set. That sort of abrogates data from the radio on-ice. Asians but a lot of different challenges around that. So you wanted to talk a bit about that. I'd be happy to the resource that we've worked with. Is primarily a called health fax data resource. It's been in operation for almost twenty years. And the the the model is that organizations who are. Using these Turner Electronic. Health. Record. Enter into an agreement was turner they agreed to provide data rights to sern are. The identifies the date of affords aggregated into this resource. And certner provides data mapping, which is really critical to this type of work. It also the aggregate the data. And for the past probably six years. Then, they provide the full data set to especially academic contributors who want to do research with that resource. And I've been on both sides of that equation Lead that group during my career there, and then now I have the opportunity to really focus research on that type of data. So before we get into the details smog so e Itar Systems. So this is. Essentially patient records. So he gets dated like demographics out family history, surgical history hats, medications, lab solves it could have physician nodes no snow. So it's it's a combination of a variety of different types of data, right? A couple of things on the examples you gave it includes demographics. Discreet Laboratory results Medication orders. Many vitals so If access the blood pressure and pulse data. It does not include text notes because those can't be. Automatically identified consistently. So. We don't have access currently to TEX notes. Out of an abundance of caution. That his Hobby Stephen, physician writes something down they could use names they could use inflammation that could then point back to their. Patients Makita Perspective been the data's aggregated, the primary issue shoe that date has completely the identified, right? Correct. So. So yeah. So the data that we receive there's eighteen identifiers. Hip requires be removed from data. And those include obvious things like name address email addresses are another example One of the. Things. That is also part of the benefit of working with this particular resource. The. Dates of clinical service are not allowed to be provided under hip. White is done with this resource that allows us to still have a longitudinal view is. For any given patient in the data set the dates are shifted by A. Consistent. Pattern that for any given patient it can be. One two three four five weeks forward or one, two, three, four or five weeks backward. But that preserves things like day of the week effect. So for example, you see -nificant increase in emergency department encounters over weekends and you don't WanNa lose. Visibility to that. but it also allows us to receive. Very, granular early time stamped events in so. We can gain visibility into the time that a blood specimen was collected, and then the time that the result was reported back. And so we're able to do very detailed analyses with this type of resource. Right right and I don't know the audience our market is fragmented. Tau himself e Amorebieta providers out there. and so two issues. One is sort of. Standardization as to how these databases are designed and structured and others even that standardization that the actual collection of the data. In itself is not standardized played. So vk CAV vk potentially lot inability coming from different systems. Correct and that's part of what the paper that you mentioned Evaluates so. Often, night you out in the field in conferences you hear. Comparisons kind of lumping all organizations using one. Vendor lumping all using another together but as you get closer to it, you quickly learn that. It's not even clear. It's within those. Vendor markets. There's variation from organization to organization in how they use the e Hr and so. Because the identities of the. Contributing organizations are blinded to those of us who work with the data. We have to be creative about how we. Infer those implementation details, and so with this paper, we describe a couple of methods that We think move things forward towards that goal. Yes. So I'm not really familiar with that. So you mentioned a couple of things here. One is the the merge network. So this initiative including electric medical records and genomics network and pc off net the national patient, centered clinical research network support. Decentralized analyses that goes disparate systems by distributing standardized quotas to site. So this is a situation where you have multiple systems sort of. Communicating with each other and this net folks at allowing to sort of quickly them In some standardized fashion. So In this type of technology, there's janitorial core models. One is the. Federated or distributed model, the other is a centralized data aggregation. So there are examples including those that are mentioned in the paper where. Queries are pushed to the organization and. They need to do significant work upfront to ensure that there are standardizing their terminologies the same way. And once they do that upfront work than they're able to perform the types of queries that are distributed through those. Federated Networks. With. Okay. So that just one click on so that the police have standardized. So all on the at Josh site, then they have like some sort of a plan slater from from Stan Day squatty do all the data structure. And in many cases, they work through an intermediate technology. that would be. In general, consider it like a data warehouse. And so the queries are running against the production electric. Health record. That has all kinds of implications on patient care where you don't want to slow down performance. By using these intermediaries They can receive queries and then Follow that mapping has occurred. Than, they're able to to run those distributed queries. Okay. And the other model is You know. You say the g through the medical quality, improvement consortium and sooner to the health facts initiative. So this says in Sodas case, for example, in swags. This is essentially picking up data from the right deals, clients and Dan standardizing and centralizing data in a single database is that that is correct. One benefit of that model is that Organizations who for example, may not be academic and don't have the. Resources to do that data mapping themselves by handing out over that task over to the vendor you get a broader diversity of the types of organizations so you can have. A safety net hospitals you can have. Critical access rural hospitals, and other venues of care that are probably under represented in some of those. More academically driven models. And clearly the focus on healthcare about I would imagine applications in pharmaceutical out indeed to right I. Don't know if it s use and bad direction there has been some were performed with these data resources to. Characterize different aspects of medications, and so it does have utility in value. In a variety of. Analytical contexts. I was thinking about you know a lot of randomized clinical trials going on into Kuwait context and One of the issues of dispatch seem development toils that are going on that one could argue the population there are not really well to percents. it may be number by Auditees, men, people that deputy existing conditions. and. So he will serve at my come out of facedly trial. granted might work for the population. Tried it minority have sufficient? more largely. So I wanted this type of well I guess we don't really have an ID there right. So clearly, you don't know who these people are but they could be some clustering type analysis that might be interesting weight from It's very useful for Health Services Research and for outcomes research for you know what I characterize digital phenotype being. they can then guide. More, more formal research. you know you can use this type of resource to. Make sure. You're asking a useful question and make sure that there's likely to be. Enough patients who qualify for given study. Maybe you're working on a clinical trial in your casting your net to narrow you can. Determine that with this type of data resource. And is the eight tiff date who has access to it typically. So for this data resource on, it's through the vendor so. You need to have some level of footprint with them. which is the case with our organization. They're definitely a broadening their strategies. So they're. Gaining access into health systems that aren't exclusively using their electronic health records so. It's exciting to be a part of that that process. and to again work with them to. Analyze the data. I think. To the example you gave a formal randomized trials. In key part of what were growing our research to focus on is because this is real world data. You learn what's happening in practice whether or not it's well aligned with guidelines or formal protocols. And doing that there's many opportunities for near-term interventions that can improve health outcomes simply by. Identifying where providers may be deviating more from. Best Practices in than taking steps through training and education to kind of get them back towards those best practices. This data is a fresh on a daily basis. It's not. It's because it's so large and bulky? Typically we've received it on a quarterly basis in since it's retrospective analysis that's not been a major barrier. But. mechanistically, on onto soon aside is data getting sort of picked up from this system that it's harvested every day and then it's aggregated bundled and distributed on A. On a different timescale. Okay okay. So. From again, going to the, it's our system designed issue and implementation You say many HR systems comprised of more news at specific clinical processes or unit such as Pharmacy Laboratory or surgery talked about that. But then then people implement them this of fashion right they they implement modules by that can be a factor or sometimes they may want. One vendor for their primary electronic health record, but another vendor for their laboratory system. and so that's where you don't see a hundred percent usage of every module and every organization. And detailed number of different you know sort of noise creating issues in data one. This is icy speech over from ICT denied ten. and I don't know history of this but this was supposed to be speech with sometime in twenty fifteen. That's correct. So there is A. You know. There's a date in October of Twenty fifteen where most organizations were expected to have completed that transition. When I see with researchers who aren't as familiar with the you know the whole policy landscape around `electronic health records that? you can imagine researchers who assumed that all data before that date in October is is nine and all data after that date would be icy the ten. While we demonstrate in this paper, is that that transition was not Nearly, that clean and it was a much more, you know there are some organizations who just It the bullet and completed in twenty fourteen, and there are other organizations that were still lagging. In. Two Thousand Sixteen. Potentially because they weren't as exposed to those incentives in other things that you know stipulated the transition so. Part of why were demonstrating with that particular part of that work was that. you know these transitions aren't always abrupt. Yeah and and and so that is one issue and then you know a lot of consistency inconsistency issues fade. So we see that in in single systems and one of the items note here as you know if you think about the disposition code for death. you could have a right your race supercenter, right? It's a death expire expedite at home hospice, and so on. if this is a problem for a single system, but then many think about aggregating data from multiple sources this this problem sort of increased exponentially. Absolutely. So one of the challenges with documenting and and finding where you know if a patient has A deceased that. There's just multiple places to put that documentation in the clinical record. The Location in the record that. We have found to be the most consistent is what's called discharge disposition. By as we show in that analysis, that field is not always used document that and so if you're doing outcomes research and one of your key. Outcome metrics is death. And there are organizations that. Aren't documenting death in a place that successful. You should filter those out of your analysis before moving forward. And so part of what we wanted to promote is the realization that. That's the type of consideration that needs to be made The four. Publishing. Your data about an outcome metrics like death that. You're not. If you're never gonNA see that outcome it doesn't mean that people are. Dying in that particular facility, it just means it's not documented in the place that successful. Right. Yeah. So you know you on your expedience. Unique Position Mark because you you look at it from the from the vendor's perspective you're in an academic setting you're also in practice in a hospital. What's your sense of these things improving the on a track of getting getting this more standardize or it's camping in the other direction I think in general there is improvement I think The. Over the past eleven years through various federal mandates, including meaningful use and so forth. Those of all incentive organizations to utilize. Standard terminologies more consistently than was the case beforehand. I think there's still plenty of room for improvement and You know it's it's a journey, not a destination, but I think things have improved substantially. I was wondering there could be some applications of artificial intelligence here to In a clearly TATECO systems and you'd like the most them pity human resource intensive Yvonne to get it completely right. So one question would be you know, could be actually used a Dick needs to get it maybe ninety nine percent white. And that the human deal with exceptions I definitely think that that's an exciting direction that You want those a algorithms to be trained with good data, and that's a big part of what's motivated us to. Put this focus on data quality and Understanding these strange nuances that are underpinning that date has so that. As we move towards a in machine learning and so forth. We have a high level of confidence in the data that's training those algorithms. Right. Yeah. I think that a huge opportunity here because it's not quite as broad as NFL, not natural language processing it is somewhat constrained. that is a good part of it. The back part of it is that is highly technical. and so. you know some of the techniques you know you can have a fault tolerance in certain dimensions such as you know, misspellings lack of gambling and things like that. But as you have Heidi technical data, you cannot apply those principles because he could have misspelling the system may not be able to. Get, sometimes, and that's where you know I think. It's totally feasible to use. Resources to you know when you're dealing with. Tens of millions of patients and billions of detailed records. Using a I'd even identify those patterns of either. Inconsistent data or missing data it's also very powerful just to. kind of flag in identified. Areas that need to be focused on to lead to a better analysis. Greg Wait Be Hefty. Use that information somehow did is a belt of information that you know and so it just filtering into decision processes that the are really losing it. So hopefully getting improving in that dimension I've jumping to another paper bittersweet interesting. So it's entitled rates and predictors of using opioids in the Emergency Department Katrina Treat Mike Dean in Young Otto's and so so this is sort of a machine learning exercise you have gone through to locate you know coup is getting prescribed. OPIOIDS water the conditions for the Democrat not Nestle demographics but different different maybe age and things like that gender. and and then ask the question desert has some effect on addiction. In the long term rights. So that project To great example of team science though. We. Assembled a team of subject matter experts in neurology pain management. And Data Science and. The neurologist and pain management experts. Identified an intriguing question that we decided to pursue with data. In their question was. Based on anecdotal observation and so we thought it'd be interesting to see how well the data supported that. Observation is that. for youth and young adults Treated or admitted into the emergency. Department. With a migraine headache that. All too often they were treated with an opioid. And so we Use the same day to resource that we were discussing earlier. To explore that. Question. And using data from a hundred and eighty distinct emergency departments. We found that on average twenty, three percent of those youth and young adults were treated with. An opioid medication while they were in the emergency department. In general, it should be almost zero percent in general. There's really Better medications to us, four people presenting with a migraine. and. So this fits into obviously the OPIOID crisis it. it demonstrates the. Scenario describing that. You know using real world data. You can identify patterns of clinical behavior that. Don't match guideline. And the good news is that the? correctable and so through. Training and communication there's great opportunity to. To, manage this. Really. Striking. So fifteen thousand or so inevitably the encounters. And nearly a quarter of this encounters you say involved inoculate. and these are not just Misha and Congress right. It is not filtered down to migraine encounters. Okay. Okay. So these fifteen thousand just might in encounters might vein being repeating disease So once you. If you make a statement and. This or not Easter conditioning issue here. So you get your pain, you go to an emergency department and you get treated with an opioid you get quick tactical relief. From pain. auditing condition expect that in the next episode. So you can say we didn't pursue that particular question, but that is Definitely key part of. Managing the OPIOID crisis is that drug seeking behavior and so Part of our goal was to quantify that and use this as an opportunity to educate providers that. You really shouldn't be treating migraines with an opioid in there are better alternatives and. So we we felt that this was an important contribution to that national dialogue, but we didn't specifically pursue the question of whether the patients we analyzed. Within. Encounter show up Subsequently. With the same symptoms. Right right. Yeah you it develop into period when problematic patterns of drug use comedy. FEST MERGE THE PREVALENCE RATE OF OPIOID misuse estimated to be two to four percent and debts in each goofy just young adult drew from overdoses are rising. and. You say that literally prescribe IOS has been slumping loose future opioid misuse by thirty three percent. Betas Mehta say really huge number. I think just validates the importance of this of this work. Interesting mark. I don't know you exploded on data. Last the question if you look at the aggregate data, it'd be flying opioid. Misuse. what percentage of the total number. Actually started from. You know some sort of medical encounter has mike or some sort of. related encounter that could be completed otherwise was three a bit opioid. in that encounter documented resulted in that misuse. So what so If you look at the active misuse problem that we have today. do you have a sense of what percentage of that goal is actually started I? Think the exciting thing about this type of research is for everyone questioned that you pursue you have. You have ten new that you can pursue. We haven't. Delved into that specific area, but it's It's very ripe for further analysis and A considerable part of where I end my colleagues and our time as. We do this type of work to get an initial analysis published. And then You know in my leadership role I just WANNA. support people like my colleagues on this paper Mark Connelly Jennifer Bickel. in in using data to. Support their research into identify those follow. I mean, he tests policy implications. So it's sweet important work. and. If you find it direct relationship here than you have to ask you know from from a medical perspective what is right intervention? maybe is not just added of care just best practice but clearly should be the bay You know things should be looked at you say you're American Academy of Neurology has included avoidance of using opioid to treat gain one of stop top flight choosing wisely recommendations. For high-value duck in this gives Really evidence to to support that. The other thing that's really intriguing is this level of variation from site to site in. Some Sun facilities are very much aligned with the guidelines. Others are at the you know well, above twenty three percent. And that gives an opportunity for a really precision. conversations about you know, where does our organization stand on that spectrum? Yeah that's a that's an interesting avenue to right. So you know one could ask he says some sort of push sliced Intervention if we can fly goal of patients who who had gone an opioid sexually don't have an addiction problem. that as you know Anna, the kofoed does. if you can fly those type of patterns than you can think about. A customized within electronic health record systems. There's. The ability to provide decisions poor. There's certainly phenomena called pop up fatigue were physicians. You know they don't like having so many pop up windows but at the same time. It's Within the capability of an e e Hr to do that if then logic if patient has. migraine medication order equals opioid. encourage the provider to pause and reconsider that. Right, right and so this is supervised machine learning type analysis where so you have. you have number features that comes directly from each else. So each sex race ethnicity. insurance type. Encounter prostate suggest duration. time of the year and so on. and you have labeled data in this case I guess you have able tater because you would know if op- inscribed on trade. Okay and so are the two questions here. One is to ask the question given a new patient and those features. you could assign a probability that that patient will be prescribed will. Definitely. Impress the data from that predictive Minds. Right and then can you so that data definitely tell you if the patient is going to progress into some sort of an addiction issue. So. Earn Predicting Substance Abuse. So. Yeah. Yeah. Yeah. There's additional diagnosis codes that document. whether a patient has a history of substance abuse disorder. and. So it would be feasible to. Identify the with those diagnosis codes in than really look at their prior history. Of What other conditions were they treated for? What medications were they give in? to develop that model. One of the things in this case that helped with this study is that just in general, it's not advised get. So there are other things that are much more of a gray area. Or whether opioid is as useful, but in this case. The really not. Considered. To be helpful for migraines compared to other options and so that help us have a fairly clear cut scenario to do this work. Yeah. This this won't be the data like you say once you do something like this, you have been other things you could. You could stop asking. So unquestioned that that been to my mind as you know, how did they hugged the actually prescribing opioids? Is it the patient asking for it all so? Off that was another scoping thing with this project is focused on what happens within the emergency. Room. So it's it's. Really, medication order in administration that happens. In that emergency room setting. Whether or not the patient. was. Requesting that you know if they came in and said, this has worked for me before. Can I have it again? we don't have visibility to that. Right. Right. And so from a practical perspective So the the analysis that you did slightly ended up with the Family Clyde power we think it is. Compelling. Pretty compelling. So as as a new patient gets into e D either high. and what I mean by that probably is if there is a history of substance abuse property. the physician has really think twice about. The use of may be the well, and in this case, even without that history. Just because it's not considered to be an effective treatment. You know encouraging them to pause in that decision making. In this particular case is as effective as wall. Right. So looking forward. In if you think about both of these issues, one is the data quality data aggregation data standardized recent problem in the the right of Utah Systems have did that the talked about? And then if we can get to a level that we can look at cross a large data set. Beacon, ask. More. US specific questions, treatment. Optimum treatment type questions. subpoenaed. US The mark big think B be hunting. Certainly, the volume and variety of data that we're able to work with will be even greater I, think the. Opportunity To. Look, holistically at how upstream data capture. Effects Downstream data. Analysis. example I frequently give is if we have a Aggregate Data said we identify. Ten patients whose way in that data such shows up as being. Something that's completely infeasible. let's say they're documented is being. Fifty year old person who weighs two pounds. Clearly air. What's important is? Creating the process to communicate that back upstream. Because that clinical decision. Support. Many drug dosing things are evaluated using weight based logic and so. That same logic that's Evaluating the appropriateness of dosage. It's going to be running against an incorrect value in that may or may not always be visible. So I really am intrigued with that holistic opportunity. In it I am I remain just we have three or four additional papers coming out. About other examples where Provider behaviors not aligned with Best Practices and I'm just excited about you know when you compare that to how long it takes to develop a new drug or how long it takes to. To a really long term research. This research has the opportunity for a pretty quick turnaround on an effective intervention. A really that. Other so much that right. Providers. been taught in a no, but they're. Not always using that in practice and so to help them. Identify, those topics in just modifying behaviors is. In the scheme of things, it's a very straightforward way to improve. So. You know the entire spectrum from essentially getting the data. Right or cleaner like you know Missa mischaracterized or miss input data like wait or something like that. To to get. Better diagnosis better treatment modalities. policies there and from a femme perspective clearly inflammation therefore clinical trials. I was even thinking about drug interaction type. Inflammation. I haven't been involved in the former de for awhile but. Typically, this type of data doesn't get back into automatic processes that fast but I think that is all I know there's strong interest in Pharma in. Working with this type of data there a again looking at real world behavior. This is an excellent resource for off label medication use at. you know where Pharma's Always interested in repurposing existing medications the. Regulatory Processes, much more straightforward for that because the safety is already been. Evaluated and so. The. Significant Opportunity With this, there's also just exciting. Patterns of you know. What are those unrecognised correlations? That's where the machine learning opportunities are really exciting where. You know we're not always asking the right question. And the data can show us what we should be. Yeah exactly. So if the machine a sort of red flags something or create hypotheses. that Cubans have missed sometimes, those types of things are extremely powerful. because maybe that sometimes it's countering tutor. and so we all look at data with an Incan bias. The beauty of machines that at least on the surface began deploy Michigan. This volume of data. Techniques like machine deep learning can recognize those subtle but consistent associations. Wait quite. Excellent. Idea this has been great mark Thanks so much time with me. I enjoyed it very much. Thank you. But

Policy Technology Economics Science Gill Eappen Mike Yesterday Dr Mark Hoffman Children's Mussa Hospital Turner Electronic Certner Migraine Inflammation Federated Networks Stan Day Squatty Michio Kato University Of Minnesota Makita GIL Federated Kansas City
Museum Workers Must Decide Whether To Return To Work Amid Pandemic

NPR's Business Story of the Day

04:00 min | 1 year ago

Museum Workers Must Decide Whether To Return To Work Amid Pandemic

"Back, in the spring New York City with the epicenter of the coronavirus outbreak. But recently, case numbers there have stayed low and New Yorkers are trying to get back to a life that's as normal as possible during a pandemic the big museums the met the Whitney in the Guggenheim have started reopening. Some people are thrilled but some museum workers are not hear Sally herships on the sidewalk outside the Museum of Modern Art. A slender man is smugly holding the world's tiniest Chihuahua Torres climb out of taxis gazing. At their phones with directions and digital tickets, they're wearing interesting glasses and have not haircuts but everyone is masked. Harry Allen is visiting from upstate New York and he's nervous. This is his first big outing since the pandemic began just seeing goes, but for employees on the inside, it's a bit more complicated some of the turmoil from the pandemic has crept into the museum. Lay says for her the problems began in early. March at the time it was her job to help museum visitors learn about workshops and activities. But coronavirus virus cases were starting to spike and she didn't feel safe at work. They gave us hand sanitizer and it was I could have gloves you ought. She was a contract worker paid around twenty one dollars an hour but her hours were capped at thirty per week. So she didn't get benefits like health insurance. What if she got sick spoke to nearly a dozen contract workers likely who said the problems began long before the pandemic it's called the fissured workplace where you end up having to take multiple jobs in order to support yourself and everything is so contracted and then you don't get any safety net from your employer laces. There's another problem too at Moma diverse workers both contract and paid staff or at the bottom of the pyramid in terms of pay and. Power all the front facing staff, the security, the restaurant workers, customer service, and educators are all very diverse, and then I would then go to the cafeteria where all the staff eight and then like everyone else would be why Lisa's us that meant when financial problems from the pandemic it diverse workers were more likely to be affected in March. The museum laid off eighty four people in an email. The museum said quote we did not have to furlough or layoff a single employee of the museum unquote that means all of those laid off were contract workers like lay the museum said it paid those laid off through March. Or heard from full time employees who are afraid to speak out publicly for fear of losing their jobs they say, they feel under intense pressure to return to the museum when they can do their job safely at home. But moma has told almost all staff they need to be at the museum. Here's museum director Glenn, lowry explaining his thinking during an online staff meeting. We must show solidarity with each other that our place of work is the museum, and while some of US might be able to argue, we never need to be museum to still do our work that's not equity. opposite. A spokesperson from the museum said, it's taking every precaution and workers are only required to be onsite part time but the workers I've heard from say the logic doesn't make sense. For example, the Metropolitan Museum of art is only allowing certain staff to work in person Makita flowers worked with visitor engagement at Moma but as a contractor, she was also laid off in March. She says, lowry is out of touch with workers like her with his multi-million dollar salary. He's the highest paid museum director. In the country I had a chance to speak to Glen I would just feel like. Roll like look at your family look at what you call the family. How are we doing now? Where are we as for on lay she has a new shop working with the city to help other Southeast Asians navigate resources during the pandemic

Museum Of Modern Art United States Metropolitan Museum Of Art New York City Moma Sally Herships Chihuahua Torres Whitney New York Harry Allen Director Lowry Glen Lisa Makita Glenn
"makita" Discussed on WIBC 93.1FM

WIBC 93.1FM

02:43 min | 1 year ago

"makita" Discussed on WIBC 93.1FM

"Voters have an opportunity to learn more about each candidate. Now the negative stuff comes with it as well. And that's unfortunate, But some of that negative stuff is really information dense. So until voted no on this or voted yes on that, So the negative stuff should not be written off as just a. You know a waste of time that it can be very good stuff. I think we are probably looking at a pretty hot rate there. I think that it's probably still a Republican leaning district in general, not necessarily in this race. But things are shifting. And this may be the raid that helped us figure out how much the shift is actually happening. Of course, we also have redistricting coming up, so that will probably change everything. Come next year. Think is a pretty safe bet on that front. Yeah, quite a question for you, my friend. Before we let you go here one talk a little bit about the attorney general's race. Curtis L lost. The convention challenge to Todd Makita Assad, Regina versus Jonathan Western Camp. The West can people were planning to run against criticism, but they've kind of adopted China change your strategy a little bit. Where do you see that going? Or is it just gonna be one of those? Well, whatever the national races go, That's how the race is going to go. There's reason to think that's what's going to happen. But we need to remember that wine samples actually raised a pretty good amount of money and can afford to campaign and he can afford to campaign in a state where there is basically one really hot congressional race where we're not likely to be a lot of presidential campaign advertising and may not be a lot of gubernatorial advertising so normally, while the price of the campaign would get driven up by lots of competitive races We're not having that here. So so the money that one that will have could be enough, Teo keep that race very hotly Contested also winds, Apple gets to put Okita in the position of defending or running away from decisions that Hill made, and we both know there's plenty of things that Hill did that were very popular with Republican voters and something that we're not popular with Republican voters. If wind papel can drive a divide in the Republican Party, he may be able to pick up enough votes. Pull that off. Alright, We'll disagree. Get FYI folks we're going to. We're pulling right now out in the field for any politics. And so when the question we're asking about the governor's race, presidential races and the attorney general race and so, Andy, I'll be I'll be. I'll be hitting you up to get your reaction was to get our results in. Ah, probably Tuesday, wins it next week, my friend Not like my birthday when they send those poll results to me in the present. I'm looking forward to it. All right, Andy Down like down Center for Indiana politics, but universe one way. And you, my friend. Thank you very much with us. Have a good labor day. We'll talk to you soon. Thank you, too. You listen to 93 W faces.

Todd Makita Assad Republican Party attorney Andy Down Hill Jonathan Western Camp Curtis L China Teo Indiana Okita Apple Regina
"makita" Discussed on Alas Tres

Alas Tres

01:52 min | 2 years ago

"makita" Discussed on Alas Tres

"Also Makita Hall on one hundred. Beat them lasagna. Into SAKE SEAN. At school is our Luna Savvy. Principal beginning benign o'clock on so many in the audience Komo La- subtle our on weekends from them that I'm them or not getting enough. I in the minimum under study one hundred ninety of Shawna ob gyn undermined. The bus would keep on. Keep on. They've been able to that. I'm going to hold a mobile of going down in the means subway. Nappy BOGGY REPEATED. Nothing by you and someone. Dorey guy in hung up against some better and develop me. I may must molasses Puerta. Almost topic.

Makita Hall Komo La Principal
"makita" Discussed on Life Things with Maquita Donyel

Life Things with Maquita Donyel

08:06 min | 2 years ago

"makita" Discussed on Life Things with Maquita Donyel

"Because another thing that I learned was how much we do not have all the answers and how much we have. No idea what's going to happen like I I heard got boy. Sixty is before actually saw like the. I heard him tell me to do something. It was six days later when I was actually presented with the opportunity to do so In a way that I couldn't have land. I couldn't even have come up with if I wanted to. In fact when I heard him I like hit up one of my home. Girls Look like so. This is what our guys you. That's crazy right like that. That must just be me right E Yeah So. That was less than a week. I learned how much can really happen within a week. Also this past summer I lost a childhood friend He was young early. Thirty S We love him very much in a week. He was fine and gone. So it's just something that we didn't we didn't think me and one of my best friends Who was married to this person? We didn't think we didn't even though I mean it was just so like what like we? Just it's hard to plan towards a we couldn't again. We couldn't have even thought that up that we would be dealing with that this summer And the list goes on and on and on truly it does but I think the important message here is It's essential to relinquish the pretend control that you think you have because you don't actually have it and At any minute your life can change in. So you have to put your your faith in something that's actually Never changing and that being God because everything else honey moves and shakes. Yeah and don't assume with that being said don't assume that you know what's going to happen tomorrow next week next month. And I realize a lot of instances that's easier said than done but I. I'm really saying that resign. Tv idea that you know what's going to happen tomorrow. 'cause you don't So that's that's one of the other things that I resigned to you. And lastly I resigned to allowing anyone or anything and that did not promote the positive things that God placed inside of me and the strength that God placed inside of me. resigned to putting other people's needs above my own when really it should be give give the best conversations that. I have like with micro friends. It's like at the end of it. You feel you feel like wow like I offered some good stuff and they gave me some good style like you just end up leaving lake almost on a type of high. It's like give gift saying. And that's how the relationship should be one should feel depleted or weakened. And we have we go you know ebbs and flows rain. Yeah but really really truly. That's what I resigned to. And that's probably more of a more of a fall winter thing. Yeah I'd say so that's why I'm like I'm still resided like it. Didn't even stop them. And maybe it won't stop ever I don't know but yeah resigned to Allowing other people to put their their needs over mine And putting in allowing myself to be in relationships where I was made. Smaller shrunken in order to fit within their their comfort the comfort of their own reality. You know a lot of times. They're in a situation where they don't want to change and they're fearful they're fearful of changing and so When your place there than your strengths are also weakened because they don't have the strength to feed themselves let alone their other relationships and so you know and that's no hard feelings at all. It's one more thing that I resigned to. I resigned to allow a beer endow to control my my moves my stubs my decisions by lack thereof a lot of times. I was I was in positions where I would procrastinate order you know I was. I call it self doubt procrastination. And that's not what I'm experiencing in this moment and today but it's it's all very much related and sometimes we can allow the fear and doubt that we have in the abilities that God gave us long before we even discovered that they were there to that and that meant giving up things that seemed acceptable to others. But we're truly not acceptable to the person that I was put on this earth to be a lot of times. We allow fear doubt to become so prominent in our lives that that's all that we see. We completely blocks our view of the talent and abilities and the white and the strength. He instilled in us. 'cause he didn't give us fear that's that's not from guy you know that's not from God and so when we allow fear in doubt to completely just block and I'm speaking from a place of listen. I did this today right like sometimes we can allow. You're in doubt to block us so much that we just start moving and making decisions based on that in that is not. That's not a way that I want to live in. I completely resigned to that so I don't know if this episodes anything like anyone predicted but I am more than happy to answer some questions And then discuss them on the next episode. Which likely you know. We'll have nothing to do with this but again. I can't see what's going to happen tomorrow. Let Alone X. Men you know and I'm dropping episode every month with the occasional surprise episode. Maybe but no promises. The promise is once a month. I'm in the air. Is You and me once a month. You got me all to yourself. They make sure that you subscribe so that you were notified when new episode drops. I am not dropping it on every Monday at two PM. Now he's gotta hit. That subscribe by ends that you know what a new episode has draft so you don't miss it because listen timing is everything and the day that it drops is going to be a purposeful day and I need you to get on that purposeful day. You're all right. I am wishing you all of beautiful day. I'm wishing you four hearts and hearts around you in light around you and inside of you that brings you to a place that you could have never imagined before and I look forward to share with you guys on the next land. Maybe maybe you'll have a guest on the next line. Maybe I'll do that. It'll be had. He knows not already recording. Ah Okay Okay I really. This is life things with Makita Danielle of Polish pistol. You can follow me on social media at Makita dining yell or that's on Instagram. Feast full gets CETERA. You can follow future blockposts and check out the blog post on Polish pissed told DOT COM and se on the next episode saluted assume..

Makita DOT
Porpoises On The Brink Of Extinction Face Daunting Odds For Survival

Environment: NPR

05:20 min | 2 years ago

Porpoises On The Brink Of Extinction Face Daunting Odds For Survival

"Marine Mammal is on the verge of extinction in Mexico's Gulf of California. Conservationists have been trying to save the the Keita Porpoise for years but that work has been complicated by the nets and even drug cartels from Arizona public media in Tucson area Brosius reports seafood restaurants. Colorful mosaics line. The Boardwalk in downtown San Felipe pay fishing is a mainstay of the small northern Mexico. Town love I keep. The restaurant is just a couple blocks over a framed photo of the little porpoise that could be. The town's mascot hangs in the office of Ramon Franco the as head of a local fishermen cooperative representing about five hundred and seventy families is sending. Well it though this earth announced that animal as you must know only lives here in this area and it's ours belongs to us. Mexicans for decades of akitas population has been declining as fishermen inadvertently catch them while pursuing fish and shrimp but dea says many local fishermen treasure the animal when it rises above the water with its characteristic. Black rimmed is he says That causes those do those. It's as if it was smiling with you. So real fishermen don't WanNa harm them. It's the opposite in the last few decades. Mexico has established of Akita Refuge and backed research into the species but lately the number of Akita has plummeted around just a dozen or less as poaching for another endangered fish called. The Toba has ramped up. Fishermen use large Gill Nets to trap the toe to Wada. Which also killed Akita in two thousand fifteen Mexico's then president banned Gill Nets in the Vicki habitat increased enforcement against poaching and started paying fishermen not to work so the species could recover. This little sanitizer came to an agreement that we would leave the sea so that the federal government clean up the illegal boats but Diaz says enforcement was insufficient. Problem got worse. He says he's filed numerous complaints with the government to no avail then a year ago. The payments fishermen stopped those. Odi The liberal Emma. So now we have a serious problem. Because we don't have a fishing practice that is permitted. And we also don't have any compensation. Last September Diaz announced his fisherman had no option but to return to the sea to support their families. He says two thousand eighteen. Us Ban Mexican seafood caught with Gillnets has only made life harder for legal fishermen. Mexico missed an opportunity to be a world leader in shifting a fishery over from Gillnets to alternative gear. Barbara Taylor is marine conservation biologist with the US government who studied the Makita for thirty years. She says the Gillnet Ban wasn't very effective. Because some fishermen hurting financially were tempted into the illegal Totowa Trade F- Iquitos and Gill Nets are completely incompatible. And the fishermen needed to be able to make a living and so developing alternative fishing methods. Were really the only way for Bikita. Survive Louise Mendosa is working on it in his centrally bay office. He pulls a large thin strand net from a milk crate. Wait to the bottom. He's a member of pesca obeys. Say A small nonprofit group of fishermen working with the Mexican government to test alternative driftnets like this one called suit. Peta for this war with the current only with but Mendoza says using these nets can be nearly impossible because of the sheer number of illegal gill nets under the waves. He says even though it's cheaper it will be hard to convince fishermen to use it. They've become very effective. The Gill Nets and with this kind of equipment. You have to get money. The Keita Researcher Barbara Taylor says Mexico needs to support legal fishing if alternative nets prove less profitable and crackdown on poaching. Akitas prime habitat. She still has hope for the species but there are fewer of Akiba every year though. Two of poaching is rampant because the fishes swim bladder is highly prized in China. As a medicinal food. Because there's a little money is more money than drugs. I mean we're talking about twenty thousand dollars twenty five dollars for one soon blind. Jp Geoffroy leads the Conservation Group Sea Shepherd's Makita protection efforts. He says that money has attracted international drug cartels and during high season there can be dozens of boats fishing illegally inside the Vicki to refuge for the last five years sea shepherd has been working with some local fishermen to collect Gill Nets. Trying give the species a fighting chance to recover important. Centrally Bay Crew Members. Use a hook to move huge bags of fishing gear. They've pulled from the ocean. All these boxes contain all Guinea. Gotten it that way we move from riveted by Kedah not all local support sea shepherd's work recently suspected poachers fired shots at a sea. Shepherd vessel in the Makita refuge despite that tension. Geoffroy says they support local fishermen who just want to do their job. We are just trying to work with them and explain to them to. At least respect the small rectangle release the critical area. Geoffroy says if they can just protect the remaining Makita the species can recover but for now observers. Say there's little evidence that current efforts to stop poaching will be enough for NPR news. I'm Arianna Brosius.

Gill Nets Mexico Nets Jp Geoffroy Makita Barbara Taylor Diaz Keita Porpoise Akita United States Ramon Franco San Felipe Arianna Brosius Conservation Group Sea Shepher NPR Tucson Bikita California Brosius
Police Raid Offices of Alexei Navalny

PRI's The World

04:17 min | 2 years ago

Police Raid Offices of Alexei Navalny

"This week police also rated the office of Moscow's most well-known opposition figure Alexei Navalny and his team on top of that one of Navan as close allies was forcibly conscripted into the Army Nikita. Cooler Chekhov knows that man from Navales Group the Anti Corruption Foundation Makita joined us from Berlin. They cannot taking forcefully to the army is just. There is no such legal way to do that. So in and this is why this is so unusual because it's just something not within the law and it's like so cynically taken to the place where there is no communication and there is no civil as as we know there is no civil transport of civil service to displace journalists won't be able to get there so lawyers won't be able to get unless they got the seats in the military the plane so this is a relatively new tactic. By the Kremlin what what concerns you most about it well because it's actually prison sentence for one year for the person because was he would be in the accident he won't be able to leave and it's and at the same time he has the military he has. Medical conditions prevented him from serving in the army. And so it's something extraordinary brain. It's something like like like arrest or detention Nikita. Help US understand. What exactly is the goal of love? FBI The Anti Corruption Foundation of his organization. What is the work you do? We are making the news with publish them. And we informed the General Russian from public on the on what is actually happening and how the corruption works in the highest level of the Russian government. This is just the basic idea at the same time since Aleksei Alexander Valentine's the pollution and he's like main platform is the Fighting corruption we we like we support his main political. restful and as I said earlier. You're in Berlin. Nick you're actually wanted In Russia by the F. Espy the domestic security forces out. Why are you willing to take these risks continuing to do this? Work on behalf of Putin's opposition. It was almost like seven or six six years ago when I at one point thought that time and not going to be anymore in the corporate environment. And I'm GonNa do something for my country and sideshow to sewer Kwalik State. So it was watching Alexei navalny crack jokes with his colleagues and make light of the raid while it was happening. I'm sure you haven't lost your sense of Russian humor humor but I mean how are you able to do that end in Berlin. Do you still see the humor in all this well If you are in Berlin it's easy to see Jolson that because you don't have that risks that your computer will be stolen by the police officers you get used to it. I think of our employees were at least interrogated or detained one Johnson. Some of them spent several months in in in in this shot detentions still nothing funny about detention so what. We're looking at Here at the end of 2019 is the Kremlin staging a number of schemes to silence the opposition in Russia. What's next for F-? PK The anti corruption foundation or are you looking more at twenty twenty one when there are parliamentary elections in Russia so we have implemented smart votes tactic or smart vote system in this year earrings summer and it was successful with say here. Are The candidates that time notes anyhow links to the United Russia. The pro-government So we expect that we go to use the same tactic. I'm this SMUT. Vote System in two thousand twenty one in the State Duma elections however it depends ends on the activities and the steps of the government because we if that they are trying to implement the new restrictions and Internet's attempting to implement them because they would like to block some particular contents or some particular videos in Youtube for example some particular website like the smart. Whoa let's see what they will do? So our tactic may change Makita Kulikov in Berlin. He works on the Investigations Unit at the Anti Corruption Foundation. A group group led by prominent opposition leader in Moscow Alexei Navalny Nikita. Thank you very

Berlin Anti Corruption Foundation Alexei Navalny Russia Moscow Alexei Navalny Nikita Kremlin United States Aleksei Alexander Valentine Navan Navales Group Chekhov Makita FBI United Russia Putin Kwalik State F. Espy Youtube
"makita" Discussed on 77WABC Radio

77WABC Radio

10:05 min | 3 years ago

"makita" Discussed on 77WABC Radio

"Between eight hundred and one thousand units per day and then depending on the underlying cause we hear our tree. as you just tuning in by the way with that we're talking with doctor help on pronouncing right magenta is that correct and the camera Gita Makita McHale who's attending physician in the division of endocrinology diabetes metabolism and the associate director of the bone mineral research center at NYU I went up and also part of the exciting new N. Y. U. school of medicine here so that's one of and I really appreciate you coming on and talking to us about this and it seems extraordinarily prevalent in something that for the most part you're saying people don't know that they may have this there's a lot of risk factors yeah and you know you need this I guess the only way to diagnose it besides god forbid you get a fracture and you didn't realize you know your risk is to get this game is that right. this is key this is really key and it's covered by insurance is not does it involve a big deal the Texas scanners and X. ray it's like an X. ray technician and we have at our own Texas can access and I were born I'm in a research center and and when you went to yes what a diet do you think the diet plays a role do you when you were in when you're faced with a new patient than you do go over their dieted yeah make other things that they could add to their diet that may. source of calcium is there a product we always inquired about how much the eighty they consume some people have like food intolerance they don't eat on too much daily so the main source of calcium is daily so if they can have their calcium intake from their diet we encourage that so we tell them to take each serving of dairy is about three hundred milligrams of calcium so if they could have three or four servings of dairy and date that would be great so I servings of Danny would be an ounce of cheese or a glass of milk corner on a Cup of yogurt these are examples of the daily serving so we encourage taking their catch him from the diet but if someone can not eat dairy or have like those in because then we advised cast him as a supplement about a thousand to twelve hundred milligrams CD okay that's interesting because you know that dairy is been controversial especially for our our men was with prostate diseases and and a you know per dairy can cause inflammation and there's been studies to show that the more dairy you taking your diet may actually exacerbate prostate cancer but he you're saying so it's a kind of like well maybe there's a balance because you need some there and it's running about men that are men and women that are vegetarians I mean how are they getting there you know and again some people can have half of the amount is or supply from diets and half of it from from customer so maybe five hundred milligram is a calcium supplement calcium carbonate accountants to treat and one or two servings of deity from your side so they can use both you and what about actual of medications because I've gone online it looks like there's a whole host of medications that also can be used but then there's of course unlike any other medication the side effects I think that the medication that we use again it and he said if the patient has hypogonadism we treat with testosterone replacement but the first line of treatment in for us to proceed in man is that class of medication called this fascinates and these medications work by suppressing the osteoclast activity or they are they suppress borders auction and again we have long term data and studies showing that the the split fascinates are very effective in improving bone density in men and also decreasing factors just people and another keeper fracture crack of stick in a population of men like for example be since who are on androgen deprivation therapy the first line of treatment is not this fascinates actually it is a medication called them the sum up which is on it's a humanized monoclonal antibodies that suppresses bone resorption suppresses those two plans function and it's actually the first line of treatment in men and who are receiving androgen deprivation therapy yes I mean I use it quite a bit in my office for men that have prostate cancer on hormone therapy if you mention in the diseases in the bone because the bones get weaker right and so this is the notion map which is an injection it had data twice a year in traction at the other name put it is probably under the commercial name and it's a twice a year in Jackson the P. **** injection because again men who loss of bone density can be detected. you know as soon as six months after starting androgen deprivation therapy and it can happen in twenty percent of men within five years of the season yes it's recommended to actually all men before starting AT P. to have a baseline measurement of the bone density and they should be monitored and they should be treated with denosumab and also monitored the by Texas can a V. one or two years to see what what's happening with their phones and hopefully there is an improvement on the treatment but it's been this is the first line of treatment for androgen deprivation therapy but for the rest of our patients with he produces this fascinates it's the first line of treatment is decent cannot tolerate this function eight or if this country indicated there is an and medication called petty peptide it's actually a bone forming medication it's given as a daily injection for two years daily as you do it at home yourself right and given by the media well this is extremely important from nation and Amin for men and women of course in improving and I you know you're so you get the Texas canyon you you have a low T. score I as soon why don't assume anything but a I wonder if you take the medication or maybe just why diet changing your diet calcium supplementation vitamin D. supplementation. exercise perhaps maybe try getting exercise week during exercise and stop uncle hold on scene another entity patients who are on glucocorticoids the same thing they have on a high risk of developing bone loss and a few bruises so again this fascinated the recommended for a man who will be starting glucocorticoid treated and can you you you say you can't cure it to but perhaps me can you T. score get better over time yeah it does get better. it does get better with the end result of medication like this fascinates and to move from up it's it's improved at this find more at the hip with the bone formation Asians like teddy peptide it's it's it's improved more than a great improvement in bone density but that's recommended for patients with severe osteoporosis and fracture and definitely we have long term data with this function eight that it will again it's fifty eight twin prevents others Cuba and another keeper fractures ordered to fascinate there is the weekly alendronate the order should remain and then if patient cannot take oral discuss any since the intravenous forms electronic accidents given at the once a year intravenous infusion the Kelly leaders have a minute left as one if you could maybe give that some information about yourself and your practice it in where you went if if if you're interested in you been listening to the show and want more information from doctor makayla or make an appointment how how would people do that yes so we again we have a well established and the crane practice and in where you went through and we had AT bone mineral research center we have I would Texas can our own Texas can machine we have our technician and we get her for referrals from all over my from PC peas and other physicians peace and will usually send their information to us and their Texas can report and we look at that and then we schedule an appointment for them to come in for a for that evaluation and treatment through this again and you have the one location on Long Islanders are multiple sites one one a one manual Boulevard in Mineola on the second floor okay and it was their phone number there you can hide. five one six six six three three five one one. five one six six six three three five one one three five one one. thank you so much I really appreciate you coming on the show this morning it was terrific information doctor McAllen. obviously in a very important topic for many of our men that are listening have a wonderful day down. thank you we really appreciate that terrific information well that's the end of the show everyone I want to wish you all a wonderful rest of the weekend have a great day off to my yoga class and exercise trying to keep the bones healthy vitamin D. calcium and well again another reason to stop smoking and drinking excessive alcohol I'll see you next week we got a great show for you then tune in every Sunday on WABC radio in New York this is doctor Aaron Katz WABC New York.

two years twenty percent five years six months milk
Dave Bautista, Keita And Makita discussed on The Frame

The Frame

16:28 min | 3 years ago

Dave Bautista, Keita And Makita discussed on The Frame

"They were coming out a week after Spiderman far from home and a week before lion king I mean could we have like one shot at it. You know that weekend doesn't go well for gone forever. That's not Camille Janis only problem. It is new movie stupor. He plays an uber driver who picks up a nightmare passenger. Who's got a gun? That's Today on the frame weekend. Plus for filmmaker Lewan diverse casting is key even if it surprises surprises movie goers type of American lead that we're used to but that's part of it you know people need to get used to these faces as being part of the faces of America re talk too long about her new movie the farewell and we'll say hello to the LUBEC sister's piano duo from Paris who wowed the crowd at the Hollywood bowl this week. It's the frame weekend from the Broadcast Center at K._P._C._C. John Horn stay with us. I'm John Horn and this is the frame weekend on this show we talked with creative people about how and why they do what they do and about how their art is shaped by the wider world a little later today. We're going to find out why Tuesday nights are taking off in downtown L. as little Tokyo but I this you know there's a sense that certain movies theatre movies and certain movies are not theater movies. I think comedy's our theater movies to Oh. Actor and screenwriter male Nanjiani hopes that audiences agree he's going for big laughs and his new dark comedy. It's called Stupor the film just open this weekend. It's an action packed buddy cop flick with with a twist Nanjiani stars as an uber driver and he picks up a total nightmare of a passenger and out of control policeman played by Dave Bautista. He's losing his eyesight and he's got a gun. AFTER JANIS 2017 seventeen breakout film the big sick he was looking for an entirely different kind of role for a follow up so when he came across the script for Stupor he thought he'd found one as long as he could help tweak the script a bit genuine motto of the L._A.. L._A.. Times was my co host for the frames recent summer movie special and Nanjiani was one of our guests we started out by asking him to explain the premise. That's driving the stupor storyline. An Uber driver gets kidnapped by a COP and forced go on an adventure to catch a murderous drug dealer and the cop can't see because he just got leasing just got Leszek. That's the thing I don't know why it's not in the trailers. The cop just got laid sick and so there's like over the course of the whole movie. He's got this chart that he's staring at waiting for it to get on blurry so I'm curious how this came about. Were you looking for something like this. After the big sick I sort of had a little bit of paralysis about what to do next ext so I decided that the only way I wouldn't put too much pressure on myself was to do something completely different that nobody could compare it to the big sick right and so I kind of was I want to do like a big studio action comedy type movie so then descript came in and I read it and I thought it was really fun and funny by was like if I want to do like an action comedy with guns and all this stuff there has to be a reason for it to exist like it conscious be that it's entertaining and so I actually talked to to Fox a bunch about it and was like hey. I think there's some like underlying themes in this movie that I think we should really bring up to the surface and if you guys are willing to do that then I think this could be a cool thing to do. We'd be able to talk about things you don't normally see in like a big action movie like this. That seems like such a guy movie toxic masculinity in men talking about their feeling exactly exactly I was like if we're doing a movie in twenty nineteen about out angry dudes with guns. We have to talk about that. I feel like we're obviously in a narrow where you know. Masculinity is under the microscope and we're really sort of figuring out. Most of the world's problems come from men who can't feel their feelings so it was like I think this is a great rate way to talk about that stuff in a movie. That's traditionally a very like man movie and for people who don't know what's tuber means what does to remain Camille so my character's name is Stu and Driving Uber so my boss calls Me Stupor to make doc fund me and it really gets under by skin cancel. It affects my rating icon trouble for stars lose this job. ooh Do right now that that you for this stupid you can stop calling me that he really loves you. I think that's it's a really fun too because we were like let's take all the male types and reconstructive so this guy is sort of the you know the petty tyrant type of guy and we do a scene where we deconstruct that where he's just like kind of lonely and feels bad and insecure about himself on you have a whole seen in a male strip club. Yes exactly Steve. How is the name of the guy that I talked to a bunch and it's funny? He's like Hillary Clinton Tattoo. She was up twelve points in August. We just wanted to take a a bunch of different types of men and sort of deconstruct. All of the stripper is talking about being honest with your feelings and you know not hiding. You need to tell her you feel a relationship cannot thrive without honest and you know he's been body shamed by his his boss for being like you know one percent body fat as opposed to point five right right. He looks great by the way I'll tell you I felt very inadequate in that locker room because it's like Ted of the most gorgeous hunks and then me like I notice I watched this movie a bunch of different audiences. My posture is so much worse in that scene than any other scene in the movie the match up of you and Dave Batista his persona has his outward appearance appearance like it it lends itself to a deeper deconstruction along those lines. That's what's interesting about him is that he looks like such a brute. You know he's so big and he's looks like a scary guy but he's the sweetest most sincere man have truly ever met he he is completely in touch with his emotions. In a way are characters in the movie are Kinda swapped. He's the one who's really comfortable being sincere and crying and really talking about his feelings whereas I was the one who was really cut off for myself for a long time and in the last four or five years I've been sort of trying to do the work of getting in touch with my feelings and feeling comfortable expressing something other than anger anger you know what is that about. I mean is that about things that you think you can do. Through acting where you can start understanding yourself better yeah I mean honestly was I started taking acting classes like a year before the big sick because I knew that had got to be able to access parts of myself that hadn't been able to access an taking acting classes. It's Kinda was like therapy. I realized that for years I didn't know how I was feeling why was angry about stuff and so in doing doing acting work for the big sick I realized like Oh. There's a lot of stuff going on inside me that I thought was not good to feel and so after the big continued doing that work on myself like I cry it almost every movie movie now and I went like fifteen years without crying at all. When this movie came along? I was like well. I think this could be an interesting way to talk about some of the things that I've had to deal with on my own when I was sort of talking to Fox about this. I don't want to take credit for this movie in any way. All that stuff was in there but I was like I see these characters as one needs to get angry and one needs to cry. So how do you do that and make what is a summer movie with like you know. I won't say car chases but there's some car action. There's a ton of violence. There's a lot of like what we would see in a big action movie. How do you make sure that that is responsible as well that you're not just kind of random? gunplay people are just getting mowed down because that's what you have to do a summer movie I mean. That's tricky right. That's tricky so it is a shooting movie. It is people with guns. It is it is car chases. Those things happen in movie and that's the language of this type of cinema but I but I was like my cocker should be anti doc. I was very adamant. I was like fire. Hold a gun in this movie. I don't want to feel cool or good about it. The only time I fire is once into the air when we went to do the poster shoot for the movie. The concept was both of us holding guns and I was like I'm not going to hold a gun. That's completely not what this character is so I'm honestly not trying to take a big stand against guns or anything. Obviously you see I think gun control is very important but you know Dave has a lot of guns and he's a very responsible gun owner and he's very comfortable around guns. I'm not comfortable around counts I wanted. I thought that that perspective should be in their drive. I'm sue how do you do can get you some bottled waters and Canadian chocolate. It was one of those things where I thought was getting five bars Amazon but I ended Koreatown no rea- town now hold on. I'm going to bang a UEY Hero Quick Doc. No don't got it. It's clear that uber was a willing participant in this movie I mean they are all over the film and yet they're these jokes about the driver like Oh my God he took the right turn. It's now four minutes two minutes. How much freedom did you have to actually make fun of ride? Sharing Services and Uber particular first of all did not pay us any money for those people think this is like an ATF ruber. I'd be like this is a terrible herbal admiral the driver get kidnapped. How is this a positive thing for Uber? They wanted to make sure that the APP was used correctly. That was there. They wanted to make sure that that technically everything we were doing in the movie would have happened that way in real life they weren't too concerned about US making fun of Uber like they were kind of cool with that but they wanted to make sure that it was an accurate portrayal Nanjiani co stars in Stupor with Dave Bautista. It's in theaters now. You're listening to the frame weekend. I'm John. Do you know what if Akita is no well. A lot of people don't and a lot of future generations won't because it's almost extinct the vikings are a casualty of fishing nets in the Sea of Cortes off Baja California. The Nets are there to capture another species of marine marine animal the Totowa by the Documentary Sea of shadows examines not only the rapid eradication of Akita but also the nearly intractable plight of local fishermen. We sat down with the film's director Richard Laud Connie at at the Sundance Film Festival where see shadows premiered and he started by telling us more about this small porpoise like mammal. The Makita is the smallest waylon earth. It looks like it's very cute. It looks like a cross between a pond the baron dolphin there's so few left after them so the first mammal that may go extinct in a decade when we started there were less than thirty left now. We believe there's less than fifteen left so they're really declining fast but DEV akitas just a symbol for a much bigger story which is that the drug cartels tells the Mexican cartels in a Chinese mafia based in Tijuana are attacking this habitat of the Makita because they're looking for something else that cocaine of the C- the Toba and they liked that so much because the swim bladder ladder of this fish can fetch up to one hundred thousand dollars in China so they discovered it as an alternative to the drug trade so this is why story so big and dangerous because they're attacking a notion that Jacques Cousteau called the aquarium of the world and they are destroying it just to get this swim ladder and nobody was looking like when we did the IRA game the elephant crisis was known and it was a big deal and you know everyone loves elephants. This one was a silent war that no one knew about but it was so deadly because tens and hundreds of thousands of animals being killed in slaughtered and I was five hour south of Los Angeles Richard when I think about the challenges in making this movie obviously the first one is the by Keita. They're very few they're hard to find and there's certainly hard to document and then you're working in an area where there are people who don't want you to document what's happening and they don't want you interfering in their business and those people are powerful and they have guns so what were the biggest challenges is for you in trying to document what was going on outside of San Filippo. The Beach Chattan starts with that. Do you need a lot of money to make a film like that because Justice Security that goes into keeping us all safe because every day that we spend there we were noticed more and more and we try to pretend to be like a natural history kind of film team just doing a film on wildlife right but they were wondering why are they on the sea shepherd ship which is fighting the cartels house and why are they so interested in what's going on here so yes. It became the most dangerous film I've ever done. I set that as well. When did the every game they started sending us more clear messages that they do know who we are and especially the really bad guy? <hes> Oscar Para started to <hes>. Let us know by sending us a messenger saying. Why don't you interview me but we were like Oh? We're not going to do that because he had actually just murdered soldier in some Philippa a few weeks back caught on videotape too caught on videotape and we thought it could be a trap. There's a moment in the film where you were filming. If I keep that is in distress and to watch what is happening to this Keita's your cameras are rolling and the marine biologists who are trying to care for it is unbelievably difficult to watch because this is an animal. That's not only almost extinct it is in some ways kind of anthropomorphic and it's a it's an animal that has almost kind of human qualities in its face. Can you talk about without revealing what happens in the scene what was like to film that sequence where you see this Keita who is struggling to stay alive you know it took five weeks of us being out there on fifteen boats with ninety scientists who we're the best in the world to try to find them. You know for us. It was this journey this rollercoaster ride of emotions of being with a scientists looking for this animal which they wanted to rescue they wanted to extract all of Akitas and put them into a safe zone so they can stay alive because the thousands of ghost nets were going into catch to our killing everything they're like walls of death but yeah being close to that Makita that after five weeks was caught was was incredible. It was the first time Akita was even filmed like we were the first film team ever ever to film this animal in its entirety that was like Oh my God but then also watching it struggle with captivity that was emotional like you cannot believe it was tears of joy I to actually sleep find one bring it to safety but then also watching how it was struggling it was <hes> big rollercoaster for US emotionally direct KITA. There's maybe a dozen of them left. What would you say to people who say what differences the Fakih to make to the world? You know <hes> we have a responsibility I think to care into not look away and this story is remarkable because it is a small story but it's a small story that you find over and over again across the world. I want everyone to start looking at this and say like this can't happen like I can't allow this. I'm angry. I want to inspire especially the young people like our our hero Jack Drawn to these twenty one and he's risking his life every day and he's out there facing poachers and he's I angry and he's not ready to accept so he's fighting and to show here is like that I think it is very inspiring and empowering for young people who I think do

Dave Bautista Keita Makita Camille Janis Male Nanjiani FOX John Horn Broadcast Center OH Hillary Clinton Lewan America United States Richard Laud Connie ATF Hollywood Paris Steve Philippa
"makita" Discussed on KDWN 720AM

KDWN 720AM

01:55 min | 3 years ago

"makita" Discussed on KDWN 720AM

"Battle ahead in twenty twenty yet unmasked at bookstores everywhere, or check out the free offer, and save twenty five dollars go online to unmask seven one dot com. That's unmasked seven one dot com. Or call eight. Eight hundred Newsmax and get your free copy of unmasked today. When it comes to their kids dads, don't have favorites when it comes to their tools. They do and the Home Depot has every one of them top brands like Makita, and to wall, exclusive brands like ryobi husky and Rijn even Milwaukee with an EMMY twelve twelve five kick. Now just one hundred ninety nine bucks. Today is the day for doing and for the best selection of favorite tools, only at the Home Depot. More safe more of about nineteenth law supplies last home. You know, the days are getting longer and the nights are getting shorter. But guys do you have what it takes to be on top of your game? At night, Katie WN's John Shaffer here. And, you know, I want you to get my friends at numale medical call take this number down seven zero two five zero five four four one four numale medical. You know, they are the leader in men's sexual health, and there's a reason they've been in business so long, you know, in fact, you're going to see results on your very first visitor that visit is free calling now the best decision you're going to make for your own sexual health, the medical. Experts over numale medical will create a tailored solution specific for you. It's not just some blue pill that's a waste of your time in money. So if you're struggling in the bedroom, just remember this, you're not alone is it can be caused by several health issues like diabetes. High blood pressure prostate issues, low testosterone medications, you know, even just normal aging. So join the foul of patients who are no longer suffering, because they had the courage to call numale medical at seven zero two five zero five four four one four that's seven zero two five zero five four four one four or check them out online at numale. Medical dot com. I'm Ken Davenport of quality hearing age, what do the Arabic Chinese Greek Hebrew, and Russian languages have.

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"makita" Discussed on Xtra Sports Radio 1300 AM

Xtra Sports Radio 1300 AM

02:16 min | 3 years ago

"makita" Discussed on Xtra Sports Radio 1300 AM

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"makita" Discussed on KCRW

KCRW

02:35 min | 3 years ago

"makita" Discussed on KCRW

"City, Missouri with her mom's best friend Angela Moorhead Makita. I just thought it'd be really cool to sit with one of her friends. Like, how often do you get to do that to sit with your parents, friends and just ask questions, and they don't get to jump in and say. I want to know more about my mom as a woman because I only knew her as mom the part that most children don't see from their parents is the vulnerability. I think for the both of us we became vaults for each other. We call them out. She's like, okay. I need a vault moment. There's a matter of fact, she helped me when I had my son. I remember calling her the day. I came home with Christopher. I sat in my couch, and I had all of these beautiful things from my baby shower, and I'm just bawling. As opposed to now. And she was so cool year. She's like you a hotel baby all that stuff in the living room is good a stay right there until you get yourself together. So that was the one thing about I Lina. She would never let me lose it. I got emotional when you're telling the story because losing my mom to brisket, sir. When I was entering my eighth month of pregnancy. And haven't changed cohurt not. Oh. Is still bothers. But at the same time, a harder say, don't you be no say, mama from my grandbaby? Oh, yeah. She's like I need my daughter to be strong. Yeah. And I'm I'm feeling that I'm feeling like her encouraging me say now, your the mother your women. And when my baby looks up to me, and I'm singing lullabies that she's saying to me I'll do a little running up like though with the most. Yep. I'm watching every seed that your mother sewed in life manifesto, you in your son in your marriage. And I remember when my mother had passed away she came to the funeral. She hugged me. She whispered in my ear as she say, you got this. You will not break down. You will walk in there and be the legacy that your mother left to the. So I say that to you. You will not lose it. You will not break down, and you will walk in the legacy that your mother left.

Angela Moorhead Makita Missouri Lina Christopher
"makita" Discussed on 850 WFTL

850 WFTL

01:34 min | 3 years ago

"makita" Discussed on 850 WFTL

"The country Makita days in super eight a great hotel by Wyndham is closer than you think. Find when you're UN book direct win motels dot com. That's eight fifty W F L traffic. Here's CBS twelve weather. It's going to be a beautiful day, plenty of sunshine couple of puffy clouds here and there high of eighty two tonight's low sixty five and then tomorrow, you may see some rain we get a thirty percent chance of its sixty six at the ballpark of the Palm Beach. Is sixty eight plantation. Finally, something fresh something different something just flat out good the Markley invent camp show this afternoon from one till free on news talk. Eight fifty W F T L islanders in the Caribbean. Like to say that if you don't like the weather, wait, ten minutes. Hi, I'm RIC Edelman, and that's great advice for the stock market to it's easy to get upset when the market falls. But what we have to remember is that this too shall pass. Let's easy to say. But sometimes it can feel hard to do. So in times like these. When stock prices are swinging wildly one day to the next making you worry that your financial future might be at risk. Here's the advice. You need don't feel that you have to go it alone. I invite you to talk with one of my experienced financial planners at Eshelman, Financial Engines, let's take a look at your investments and see if they're doing what you need and expect will either reassure you that you're doing you should be doing or we'll give you recommendations to help. You get the peace of mind you need. So you can well. Wait for the sun to shine. Once again, call us a triple eight plan RIC. That's triple eight plan RIC or visit us at RIC.

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"makita" Discussed on PRI's The World

PRI's The World

04:46 min | 3 years ago

"makita" Discussed on PRI's The World

"He told me, right. And so you. Don't want to be Mr. Makita you for better or for worse, Lorenzo would become Mr Vecchi data. Nobody knew really what keitel's. And so we started thinking to make the world know about Kita to educate the world about Becky Lorenzo, I needed an accurate census of the population. In fact, he needed to actually see of Akita alive. So in nineteen Ninety-seven he organized a team hired a boat and launched an expedition in the upper sea of Cortes after more than a week at sea on the last day of the expedition Lorenzo finally spotted the pendulum porpoise, and it was so exciting to see finally this anymore that I've seen the animal have the DNA photographs. But it wasn't the first really sold of Akiba come out of the water. They say how they didn't may bring so being full. The little face coming out of the wilder, and then Cranleigh little Bula with watching it after so many attempts to to see it. I mean, it was like their eighties. Listen testing. Confirming that the Bucky to wasn't fact alive and not a mystical ghost or elf Lorenzo and his team placed a system of underwater microphones hydrophones record, the clicks and high frequency sounds the Bucky does make enabling Lorenzo and to determine the population size, which in nineteen ninety seven was around six hundred animals. Lorenzo would also take these recordings to talks and classes to educate the public the question how those Kita zone, and it sounds like a for days. How does it? So like in I could see the students they didn't want to laugh, but I could see them, and I told her on it's okay. Just laugh it this is the actual sound at the back. Ethan. After years of monitoring these animals Lorenzo realized a horrifying trend. The animal was dying off and then alarming rate and win. You will the time since then that there was illegal fishing for twelve to buy is a type of endangered sea bass and its swim bladder has become a high ticket commodity and Chinese cuisine illegal poachers, use gillnets deficient Dhamma. But these nets also catch the Keith accidentally. And it's been devastating for the porpoise population. In two thousand twelve things got out of control that year, Lorenzo sense. The Bucky counted only thirty animals left on the planet. There was so much money in India. The Satbir was I was threatened the Mexican navy and police were deployed to prohibit poachers from casting any nets into the water. But this provoked the ire of criminals in Lorenzo became a target. So the first time I had a call this professor Rufus I said, yes. Well, you know in calling you from seeing Kartal the Sinoloa cartel is one of the most infamous and brutal drug cartels in Mexico, and they've been linked with Autonoma poaching, and I hung up, and I didn't think it was a threat at that point in time. But then last year, I was seen the meeting in a friend came to me and said, Lorenzo there's a video in the video criminals. Threatened to beat Lorenzo to a pulp if you were to return to the area, some Philippi where he studies the buck Eva and these weren't empty threats in the area where we were soldiers was killed the head of the police in San Felipe was shot. However for Lorenzo and his. Team despite the danger the urgency to see the animal from extinction was at its highest. Some of started discussing Jesus would wish would start considering seriously catching akitas and put them under human care. The plan was to use various boats spotters and US navy trained dolphins defined identify in corral Keita's into an ocean pen or they would be held in captivity. It was a desperate move to save the animal. No one had ever tried to capture Avakian before on November four two thousand seventeen the team manage to successfully capture one is the breaking sold on its first I may have Heff Amita from me. In ching. Every part of the animal, the is the teeth of the snow, and so they took it to the NHS. And everything looked like it was perfect Lorenzo told the environment minister, the good news. I like cold the minister told him, we have one it looks like we're doing okay, then I hung up turn..

Becky Lorenzo Bucky keitel Mr. Makita Mexican navy Cranleigh India Mexico Avakian Ethan NHS Keith Heff Amita US professor San Felipe Rufus I Keita Eva
"makita" Discussed on ESPN Chicago 1000 - WMVP

ESPN Chicago 1000 - WMVP

01:30 min | 3 years ago

"makita" Discussed on ESPN Chicago 1000 - WMVP

"Makita get the best rate guaranteed when you book at l q dot com can LeBron still carry four cadavers out after this back. Geico, fifteen minutes could save you fifteen percent or more on car insurance. Visit Geico dot com if you're not making five to ten thousand dollars a month at your current job than maybe it's time to start flipping properties for quick cash. If you like the sound of that you are in luck over the last five years, the N R E N team of flippers has been perfecting the art of flipping properties for cash without the added risk of using your own money, your credit call now, and they'll send you a free copy of their audio CD the networks flipping formula on this CD. You'll see they're easy flipping hold str-. Strategies for locating evaluating and flipping a property for profit in your area. So start learning how you can access highly discounted properties and the right funding partners for that. Perfect flippant, hold call one eight hundred six one five zero nine zero one now to get your free flipping CD. Call eight hundred six one five zero nine zero one and we'll also throw in our free live training to our introductory class. Are flipping toolbox plus a free digital smartwatch. Just for tending. Call eight hundred six one five zero nine zero one that's eight hundred six one five zero nine zero one and get your free flipping CD today. Call now. Hey, Tom, somebody forgot to follow the chicken. So a Chili's for three for ten. Oh, graduate your sister on her report card. It's not great. But this time she didn't try to hide it from us. Oh, I remember tonight your dad's goatee intervention love you see.

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"makita" Discussed on Newsradio 970 WFLA

Newsradio 970 WFLA

01:32 min | 3 years ago

"makita" Discussed on Newsradio 970 WFLA

"Steven stamkos still together. Makita kucherov is going to be. So we'll see the stamkos kucherov. Wow. Based on pregame. Warmups? Matthew Joseph gets elevated up to play with Tyler Johnson, Yanni gore and the Lawrence Sarah Miller lines stays the same Ernie pot. Cattleman Reich Eoghan drives back in after being scratched the last couple of games. But the loss of brain point is we'll have to keep an eye on that one for sure the domino effect as you said demand. Get an opportunity to start tonight. He's been good when called upon he has been and then I would expect nothing else from him. He's been so solid. Whether it's one start in five games or twelve out of thirteen when Roger guys Alaska was down. He has done everything that this team has asked him to do. And that's give them a chance to win on nightly basis. It's been awhile since he's played but good opportunity for him to get in. And what should be a fun atmosphere at MSG Ryan Callahan back in the lineup. And that's going to be a lot of fun for him for a lot of reasons playing against his former team, but he's been out of the lineup for a couple of games. He has been we talked about that last night in the fact that John Cooper had mentioned how they want some of the younger players to be tested and get an opportunity in some of these more high profile. All games as you go down the stretch in against opponents that are fighting for playoff spots. You know, you wanna see what those guys are made of. But I think again as we discussed last night, I think Ryan Kelly can still be an important player. He's not the player. He was when he first acquired him in two thousand fourteen but he's still brings so much the ice in terms of his leadership and his willingness physicality and everything else. It's good to see him be back in the lineup tonight, especially with this game being a massive Square Garden. It's been a big part of the PK..

Ernie pot Ryan Kelly Reich Eoghan Steven stamkos Ryan Callahan Makita Tyler Johnson Alaska Matthew Joseph Square Garden John Cooper Lawrence Sarah Miller Yanni gore Roger
"makita" Discussed on KLBJ 590AM

KLBJ 590AM

04:11 min | 3 years ago

"makita" Discussed on KLBJ 590AM

"So you can think of how they're having to appropriate their resources. The defense budget proximity. That's how that's how much money they're spending. That's not a country. That's just concerned with defending itself. All right now. Let's jump ahead to Fatima. We all know in one thousand nine hundred seventeen there were three Vert revelations given to the young people. Who claimed that they saw the blessed? Virgin mary. And we'll we'll talk into some of the events that occurred there, you know, they they talk about the miracle of the sun came down before one hundred thousand witnesses say. Picture apparently taken of that. But let's tie that into Fatima in those three secrets the third of which were told the church has and there's been some kind of controversy over what it was some say, it was the shooting of the pope. I don't think it was that. Well, what's interesting about that? You see the book of revelations? Now leaves us off. We know that the. The really dramatic Paktika. That's going to take place in Asia. Does she says east of your frady's? And parenthetically. Let me mentioned what the were Armageddon actually need. All right. It's a Greek transliteration of two Hebrew, terms, har- Makita, armies, mountain and Makita was a place name in northern Israel. And because of the use of the term, the Guito people always thought Armageddon would be fought in northern Israel. But that's not what it meant at all what he meant. The town that looked like that's on a now because he doesn't say Z place called in Hebrew, Tom Armageddon. He said a place. That's a big distinction. This part of his vision is not explained to him. But he would've seen Makita and been familiar with it. And he thought I don't know where this is. But it looks like Makita and it's up on now. So. That's been one of the very unfortunate thing is people. Keep trying to shoehorn the battle of Armageddon into this little place called the valley of it sounds very small place. There was one very popular book awhile back, and they had to March two hundred million people into two Makita. Well, you couldn't get a hundred you couldn't get a five hundred thousand. No, you might not have gotten one hundred thousand people, and and you gotta have equipment. So nobody this book was bestseller list. I thought to myself didn't ever excuse me. Didn't that anyone ever pay attention to the size of the valley? Vesta? Very small place. But now on the planes of. Asia. That's a different story that can accommodate two hundred million people. Well, so Jonah fat most gives us that much and then lease Lisa's hanging. So we now come to nineteen seventeen and we get the rest of the puzzle. As to what happens with the kings of the east. Now, why is came seventeen so important? That was when. The modern totalitarian state came into existence. With.

Makita Tom Armageddon Armageddon Fatima Asia Israel Jonah Paktika Guito Lisa
"makita" Discussed on KTRH

KTRH

03:37 min | 3 years ago

"makita" Discussed on KTRH

"So you can think of how they're having to appropriate their resources. The defense budget approximately the size. That's how that's how much money they're spending. That's not a country. That's just concerned with defending itself. All right now. Let's jump ahead to Fatima. We all know in one thousand nine hundred seventeen there were three Vert revelations given to the young people who claim that they saw the blessed? Virgin mary. We'll we'll talk into some of the events that occurred there, you know, they talk about the miracle of the sun that came down before one hundred thousand witnesses there was a picture apparently taken of that. But let's tie that into Fatima in those three secrets the third of which were told the church has and there's been some kind of controversy over what it was some say, it was the shooting of the pope. I don't think it was that. Well, what's interesting about Fatima? You see the book of revelations? Now leaves us off. We know that the. The really dramatic climactic events are going to take place in Asia because she says east of your frady's. And parenthetically. Let me mentioned what the were Armageddon actually made. All right. It's a it's a Greek transliteration of Hebrew, terms, har- Makita harm means mountain and Makita was a place name in northern Israel. And because of the use of the term, the Guito people always thought Armageddon would be fought in northern Israel. But that's not what it meant at all. What he meant. How that looks like that's on a mouse because he doesn't say Z place. Hold in the Hebrew, Tom Armageddon. He said eight place, and that's a big distinction. This part of his vision is not explained to him. But he have seen like eight, oh and been familiar with it. And he thought I don't know where this is. But it looks like Makita, and it's so fun now. So. That's been one of the very unfortunate thing is people keep trying to shoo mourn. The battle of Armageddon into this little place called the valley of law. It's up very small place. There was one very popular book a while back and they had. We're going to March two hundred million people into two Megido. Well, you couldn't get one hundred you couldn't get a five hundred thousand. No, you might not have gotten one hundred thousand people exactly and you gotta have equipment. So nobody this book was bestseller list. I thought to myself didn't ever excuse me. Didn't that anyone ever pay attention to size of the valley? True. Very small place. But now on the planes. Of. East asia. That's a different story that can accommodate two hundred million people..

Fatima Tom Armageddon Armageddon Makita East asia Israel Asia Guito Megido
Hackers may be targeting your fax machine

Michael Berry

00:47 sec | 4 years ago

Hackers may be targeting your fax machine

"Holds up Tiger Woods to win the PGA championship and does Greg tells us the. Pair also shared a bit of golf history looks kept took on the best Leaderboard in major championship golf this year and beat the whole camp got out of a. Type for the league with. Adam Scott with a, buddy at fifteen and then sealed his PGA championship victory with another good at sixteen to go to clear it. Became just the, fifth player to win the US I've been and. The peachy I in the same year and did it by shooting a final round sixty six to finish. At sixteen under the two shots clear of a charging Tiger. Woods who claimed second after a stunning sixty four Adam sculpt finished third at the teen under grandma's Saint Louis There's now a, security warning about fax. Machines as the AP's Donahue reports that

Charlottesville Tiger Woods Ed Donahue Adam Scott United States Golf White House Hewlett Packard Ap Digital PGA Tiger Greg Julie Walker Makita Megan Crane Jimmy Walker Apple Virginia
Jennifer Garner and Ben Affleck's Divorce Case May Be Dismissed

Colleen and Bradley

01:52 min | 4 years ago

Jennifer Garner and Ben Affleck's Divorce Case May Be Dismissed

"Jennifer garner in Ben Affleck's, divorce proceedings, might be thrown out if they don't act fast so Apparently if you fail to take the appropriate steps. In your case the court may dismiss your case. For delaying, prosecution is what a document says that's what, the blast has on their divorce situation you know they were married for nearly ten, years before separating in two thousand fifteen and Ben. Affleck has moved on with a, Saturday Night? Live producer and they, do have an amicable relationship. You don't hear anything. About them do you Jennifer. Garner, has said we're definitely. A modern family we're, doing really well it has to be children I you have no choice, it has to be but if they don't actually take another. Step, forward in the actual divorce, then it's going to be thrown. Out and they die file again I feel like I've been I won't speak for you Elizabeth but I think I know that there was, a long time that we were holding. Out hope, that the fact, that, this divorce wasn't progressing I'm, still holding out help me too I think because I'm like. Okay Going to happen, yours know I mean he's. Dating someone else I think she's she's done with having, him as one of the children I think that. I think probably more maintenance than, the children? And let me just, let me just say to. All the men out. There all four of you. Who, are listening to mytalk. One zero seven one, right now and I'm speaking particularly I think to heterosexual men simply because, that's the ones that I'm married to if you become one. Of, the children if you become, more work than one of the. Children it is the least attractive thing that you do it for your wife the kiss of death it's usually if it's like if she's, thinking like things would be easier without. You that is a bad, sign And that is why bet, it was like with Ben Affleck now and you're adding in addiction issue, which makes it very. Challenging and that does I mean when you add an addiction it does make that, person much

Bill Murray Nicole Kidman Gretchen Carlson Ben Affleck Jennifer Garner Simon Peter Simon Peter Simon Minnesota Elizabeth Roger Ailes Makita Carly Simon Paul Simon Producer Massachusetts Martha Demi Levato Maria Chicago
FBI releases Carter Page's surveillance records

Guaranteeing Your Retirement with David Graham

00:56 sec | 4 years ago

FBI releases Carter Page's surveillance records

"News Radio I'm Karen. Makita the FBI releases heavily redacted at Pfizer records and former Trump campaign Carter page one thing that is clear in the unredacted sections though is the democrat funded Steele dossier played a significant role in the initial foreign intelligence surveillance application which was submitted in October two thousand sixteen the FBI stated. Quote it, believes page has been, the subject of targeted recruitment by the Russian government to undermined. And influence the outcome of the two, thousand sixteen presidential election in violation of criminal law FOX's Gary Tenny Texans are about to get, a break. From record-setting heat waves day again in Dallas one or two by Monday you're down to say ninety six ninety seven down across, parts of Austin as well so it does get. Better FOX meteorologist Rick reichmueller meanwhile more heavy rain in the forecast for much of New. England this coming week Fox News. We report you decide NewsRadio nine seventy.

FBI Fox News FOX Gary Tenny Makita Pfizer Russian Government Newsradio Steele Carter Rick Reichmueller England Dallas Austin
Basics of sports betting in New Jersey

The Sports Zone With Pete McCarthy

01:21 min | 4 years ago

Basics of sports betting in New Jersey

"And today new jersey officials are confirming the presence of clinging jellyfish and yet another of the state's waterways the state's department of environmental protection says mom clare state university researchers tested water from the makita river located in ocean county and ken confirm the clinging jellyfish are there in previous years monmouth county shrewsbury and manosque kwan rivers were found to have the invasive species as well native to the pacific ocean clinging jellyfish are difficult to spot and water but pack a powerful and painful sting they aren't usually seen on beaches are sandy areas but rather back bays and rivers where folks are encouraged to use waiters or boots so as to avoid being stung james flippin for seven ten w o r people in new jersey reacting today to governor murphy signing the sports betting bill feeling lucky regarding status officially the second state to legalize sports betting governor murphy signed the legislation yesterday but there will be no wagering before tomorrow when the new jersey racing commission holds a hearing to review regulations establishing sports betting at race tracks monmouth park expects to be ready to roll and take the i bet thursday morning sports betting is expected to bring in thirteen million in annual revenue with beck taxed at eight and a half percent alice stockton rozina seven ten wwl and the forecast is.

Makita River Ocean County KEN Manosque Kwan Rivers Governor Murphy Monmouth Park Clare State University Monmouth County James Flippin Beck Seven Ten W