35 Burst results for "kuwait"

Frances ANSII warns of a longrunning Sandworm campaign

The CyberWire

06:04 min | 2 weeks ago

Frances ANSII warns of a longrunning Sandworm campaign

"French authorities specifically the information security agency. Ansi said yesterday that they determined a russian threat. Actor has been active against french targets from two thousand seventeen to twenty twenty ansi. Didn't flatly say which group was responsible but it did note. According to reuters that similar tactics techniques and procedures had been seen in use by sand worm also known as voodoo bear and operation belonging to russia's gru military intelligence service and see has also made a detailed technical report available. The attackers dropped back doors as web shells in their targets. The operation appears to have been another software supply chain attack with the attackers working their way in through century on products used for it monitoring and see didn't say how many victims there had been but the agency indicated that most of them were it service firms especially web hosting providers the similarity in targeting in approach to the so laura gate campaign in the us is obvious. Centurions customer profile is similar to that of solar wins the paris based firm lists more than six hundred customers worldwide including local and regional government agencies. There's no informed official conjecture about the goals of the campaign that exploited century on yet but wired quotes industry. Expert says observing that. Sandra has a track record of disruption and destruction and hasn't confined itself to simple data theft century on hadn't as of this morning posted any statement about the incident to its website wired says century on emailed it to say that it was too soon to say whether the campaign represented an ongoing threat or whether it had been stopped by the patches and upgrades century on regularly issues. Voodoo bear of them as fancy. Bears daughter is known for going after industrial control systems especially those associated with power generation and distribution. It's most well known. Tool is the black energy malware kit. The threat actor is widely believed to have been responsible for both two thousand eight distributed denial of service attacks against georgia and twenty fifteen action against a portion of ukraine's power grid to return to salora gate the investigation and mop-up of the very large and presumably very damaging cyber espionage campaign against us targets continues. Cbs sixty minutes this weekend. Featured the solar winds compromise and highlighted both the scope of the attack and the effort that went into conducting it microsoft president. Brad smith said quote. I think from a software engineering perspective. It's probably fair to say that this is the largest and most sophisticated attack. The world has ever seen quote. He added that microsoft believed at least a thousand engineers were involved in mounting the attack. How microsoft arrived at that figure is unclear. And while it's probably better to read a thousand as a lot and not as a rigorously supportable quantification of the human capital. Russian intelligence applied to the task. It is in any case. Allot a member of south. Korea's parliamentary intelligence committee told reuters that he'd been briefed on an attempt by north korean operators to breach pfizer and steal information on the company's covid nineteen vaccine development. Hey take king said that. The republic of north korea's national intelligence service briefed him on the attempted espionage and that the apparent motive was financial. Pyongyang is looking more to its criminal. Revenue stream not to public health in the dprk last week bloomberg renewed its reporting on an alleged chinese hardware back door allegedly found on super micro products. The report was greeted with more skepticism than such reports usually are since the earliest versions of the story published. Initially in two thousand eighteen generally went unconfirmed by organizations that would have been in a position to confirm them super micro issued a statement about the bloomberg story which says in part quote bloomberg story is a mismatch of disparate. An inaccurate allegations that date back many years. It draws far-fetched conclusions that once again. Don't withstand scrutiny. In fact the national security agency told bloomberg again last month that it stands by its two thousand eighteen comments and the agency said a bloomberg's new claims that it cannot confirm that this incident or the subsequent response actions described ever occurred despite bloomberg's allegations about supposed cyber or national security investigations that date back more than ten years super micro has never been contacted by the us government or by any of our partners or customers about these alleged investigations and quote to round out the familiar four of bad girl. Nation-states researchers at security firm anomaly report a static kitten citing. the threat. Group believed to be run by. Tehran has been targeting government agencies in the united arab emirates. Fishing them with the goal of installing screen connect remote access tools and the systems used by. Its emirati targets. The fish bait is usually an israeli themed geopolitical loor the emails masquerade is communications from kuwait's foreign ministry and the fish hook itself is similar to those used previously in operation quicksand. There's not much new to report about the oldsmar. Florida water utility sabotage attempt local authorities in oldsmar have grown increasingly tight lipped about the attack on the town's water system with the pinellas county sheriff discouraging any municipal officials from discussing what is as they say and ongoing investigation. Detectives are on the case they say. And the sheriff wants the public to understand that it was never in any danger.

Laura Gate Bloomberg Reuters GRU Microsoft Ansi Parliamentary Intelligence Com Republic Of North Korea National Intelligence Service Actor Brad Smith Russia Sandra Paris Ukraine United States CBS Allot Georgia Dprk
Bill Bruford (Yes/King Crimson) 1980 Interview

The Tapes Archive

08:47 min | Last month

Bill Bruford (Yes/King Crimson) 1980 Interview

"In this episode. We have one of prog rock's greatest drummers bill at the time of this interview in nineteen eighty. Broussard was thirty one years old and on tour with solo band supporting his album. Gradually going tornado in the interview buford talks about why he left. Yes how robert fricke try to cancel the king crimson. Nineteen seventy four central park concert and the advantage of making a name for himself and banned by yes genesis and king crimson as always we have music critic mark allen at the helm conducting the interview. One last thing before we get to the interview the tapes archive. Podcast is a proud member of cyrus media a global community connecting passionate fans with podcast and experiences about artists and topics loves. Thanks for tuning in. And now it's time to open the vault over. No i'm not gonna player stations here and i'll give you rush especially in that not many commercials. Well the recent that lies these senior can add vocals eventually note. I don't know that wouldn't think by. Anthony singapore quite probable. There's nobody bill. Prince discounts finals. I it's just that this particular album. Not on kuwait's america would voice and something this hotline dance especially yes and on such a huge level. You made your holiday every two years now here you are. i just. You're staying with less than had to move with yet more. Yes that's not the only ask you how. How does as eddie feel about the. Because you're obviously made a name for yourself willy. Mason soldiers is that america beside more for music and the whole thing is a viable proposition. She's really good. It doesn't so listen. I'm going to be stable kind of and who who doesn't doesn't mind. I like to be able to play madison back on. Not that i ever have to and And trump's although there's not a whole level of problems occur pasta two three thousand seats by now we can just play music or problems. Did you have that are raised now. A group of flannel. It's magic pilot very easily that level. It's incredibly uninspired. It's amazingly easy to find some to seventy thousand blackout faces. Eight any pressure tool because the sounds inside. North and the whole shemozzle would sucha an isolated insulated kind of fair so much no reaction no visible reaction from anybody to your play like in a club. You can see people reacting in those places. None of that happens to. It's an extraordinary ritual. It's an amazing amazing feeding of power. But it was a strategic. Bit of works really got me to america to keep interest in on wants to in future thing this. I've had this time. And american gotten how planners do places north america generally in american about me and on you always make a good to substance feels. Good gets me and say you need some sort of strategic planning for thing like that genesis suitable time. You've got new playing it. Got my face around. It wasn't the best musical world. Then it wasn't gonna be paid for by a five month job which was fine. I could stay. Probably but i had other plans so i think we used each other way. German ankles return for it. Because i was having or without america trying very hard to exist by five synthesizers to buy a hop hannah's to buy another tunes. It's europe is a very strong place to and we could pass numerical together for the good work here more or less decided book. America's favorite and no sheppard's son to healthy strict with north vessel for any given output the musical direction. You're likely to gain the speech. Must people. you'll disseminate music. Quickest efficiently probably followed by canada. I wasn't sure that he would be person. You would like to talk to as many as i liked to. I actually. I am doing this as a promotion exercise. There's no doubt about. I need you know with mike to rice about what it is. Because i'm interested in. It really wants to get it across that. It would be lovely day. It's an insane people kind of associate. What communist play. There was no constant need to keep talking about see we have tried to compete with. Americans are americans be comforting to six weeks which seemed like forever but an american band will six months about thinking. It's an order to compete a tool to be in the same race as all must make use of here in college is coming in at smaller the low level where you stopped club. We're not we're not on the bottom is out. I mean the clubs club sold out and that's great. That's not actually at the starting gate and a lights to up. Cities is the american system. Sex could sound systems by much. And sometimes you can to the radio same time so food good system and there's no other way to do it. I mean next level of this hour talking about what the next rung. Up hewlett america. You have to be seen to keep climbing runs. And she else kills loose successful in the country. And i'm sitting. We'll be able to come back short and hopefully find some colleges and smoke. Fix that will. That will be good year to something like that and then we'll worry about what happens. Then what would you want to tell people about your music. It's not death you serious one out about the guggenheim museum. It's not it's the instrumental music. This must be either jazz or classical something like work about some h. Difficult music. And i see that tool. We have supply interesting music fry or or accessible particularly. I think we when we play. We play in such ways to invite people in this environment. Rob repel oppress them and defy. Likes which is not at you. Some refunds out. But i don't like a lot to recession music. Most standardized breath cheating quick tudor or the need to survive really. It's an era fear round action especially because in the bottom. That's right if there there's definitely a climate of whereas the sword go full next. It's partly to good specific management company that we're announces gun because well there's potential that may not be too modest talked about the groups that you played in about people. I band savoy grounding. Savoy was my best friend and that was pretty awful three days and that was that was good that i came up with my first guitar hero. Gibson's she was guitar by then. I looked around a bit and came close. Yes and that was good basketball break. Excellent be very well and I've had enough about six hours. Somebody because i didn't want to spend a lot one time insisted on the last one that can agents. I love sweating. Giving trump generally and i was thinking how am i would support each other and a plane can crimson. Then he sees you superior way. And so i said well that sounds great and off. You went five mercantilist. Some last show ever played in central far out you that that was an emotional night was in when i talked to him about that. He said that was the closest that i'm to being great. Since the first and like you said that the last king clinton in the i can principle the best. It was extremely good easy. You might like no one further anecdotes about that story. Which is the chinese absolute damnedest to cancel events about some sounds which inaudible kind of buzz to hear any sound system and said it was impossible for us to play and he was cut gerald and bullied threatened in two thousand people and he was just about dragged on student and now he will no doubt hail it is being here on the strongest span of did. He's a man of fiction on many levels and not least of which is that. That's enough the mandate about that greg. We really pavlik and blue myself. One of those great night's you believe you're strong as you are. I really enjoy that.

America Robert Fricke Cyrus Media Anthony Singapore Mark Allen Broussard King Crimson Buford Willy Kuwait Eddie Mason Prince Madison Rob Repel Sheppard North America Hannah Hewlett Guggenheim Museum
Video released in police killing of Black man holding phone

AP News Radio

01:04 min | 2 months ago

Video released in police killing of Black man holding phone

"Police body camera footage of a black man being fatally shot by a Columbus Ohio police officer has been released Columbus Ohio police officer Adam Kuwait did not activate his body camera before fatal shooting early Tuesday morning a six second clip of that shooting was captured by an automatic look back feature there was no audio the clip shows Andre hill a forty seven year old black man walking out of the garage cell phone in his hand seconds later he shot after that Kuwait turns on the camera you know got a medic common hill lay groaning on the garage floor no officer coming to his aid Columbus mayor Andrew Ginther wants Corey fired more detailed on two directors not turning on the body worn camera in failing to offer the after the shooting the state bureau of investigation is open the case the U. S. attorney's office in Columbus will review for possible federal civil rights violations once the state completes its investigation I'm timid wire

Columbus Ohio Police Adam Kuwait Andre Hill Columbus Andrew Ginther Ohio Kuwait Bureau Of Investigation Corey U. S. Attorney's Office
"kuwait" Discussed on Zero Blog Thirty

Zero Blog Thirty

04:57 min | 3 months ago

"kuwait" Discussed on Zero Blog Thirty

"Not all of us. I guess some people aren't allowed to have this is from the read it page. Somebody's read those. Who's read those. Somebody posted this a thirty dollar bundle of pork sells for two hundred dollars off post so intel completes their investigation. No more pork is going to be sold. So if you live on base and you love your bacon in the morning at base housing which entitled mad brandon walker. Pse brandon walker not being able to eat his pound of bacon every day. But i mean if you know that you can walk into the commissary. I you can five separate pork products and then sell them for like two hundred bucks off post. You'd be crazy not to come on pork. Nco at the commissary has got. Hey bitch that's your seventh pack pork today right. Who's to of a mac. Yeah who's keeping track of houses buying how much pork and whatever but just a wild. That's one of the things that ncis. You never think this interesting though. Just how different people think. Someone's willing to do that five packets of pork every day just to make a few hundred bucks and then some people probably want to go on a different scale and with the entire shipment and start figuring that out it would never occur to me to do this on a daily basis. That's just too much work for not enough return but that's good. You can get though you pay thirty five and you can throw it into two hundred. That's a good return on investment. Yes that is a good. Roi but is at worth my time every day. Unless it's just like. I'm walking out the door and and being handed the hundred hours right on the spot but i have to imagine. There's a little bit more to get in this money for your five pork products each day but people were also commenting remember being deployed to other countries and like the kuwaiti police asking special And special forces asking for alcohol and porn and what else like anything you could smuggle off the base that that was illicit to them with a hot ticket item so one of them who will bring in those like prohibited items still like uae kuwait. Even though you can go on vacation. They're dangerous like dj esco. One of the best future songs is a as a product of that because dj esco was in uae like from dubai like he was just walking through a hotel there and somebody found that he had like just residue of marijuana in his bag ended up spending forty nights in a uae. Jail terrible joke. Don't mess around. That's for damn sure so. Watch out for that illegal pork match money. I can make fucking guessing. Taylor hand over there though. Yeah really blow their socks off against the first eight fucking the very first kuwait wa wa is going to go and soon and that'll be a huge shadow..

brandon walker ncis intel kuwaiti police uae kuwait uae dubai Taylor kuwait
"kuwait" Discussed on Zero Blog Thirty

Zero Blog Thirty

03:41 min | 3 months ago

"kuwait" Discussed on Zero Blog Thirty

"Pork products and a majority muslim country. An army official explained to the military times that us citizens who are on american basis in that country can purchase five pork products per day from the army and navy exchange services but they are strictly forbidden from transporting them on or off post and reselling them. I have the quote. Says i can confirm special agents from the us army criminal. Investigative command are investigating allegations of abuse. And the illegal resale of pork products at. Ap's in kuwait said chris. Gay who cid's chief of public affairs in a statement emailed to the military times quote due to the ongoing investigation. No further information will be released about this pork or the investigative process behind it. It was not immediately clear whether the eighth officials have been asked to remove for products from their shelves in kuwait and the ap's operates nine in kuwait. According to its west a website and deployed servicemembers are eligible and permitted to shop there the arab times an english-language kuwait news organization has reported past arrests of foreign citizens for importing pork including four philippine nationals. In two thousand six who were caught in possession of thirty five kilograms. Kate off the top of your head. How many pounds. That's two pounds. Two pounds forbidden porges reportedly a hot commodity in the black market and kuwait because it plays a central role in the native cuisine. I there's all kinds of stuff that happens that you're not supposed to sell. We would get for instance in japan if you go to the cash sales on any marine base and you go get a six pack of budweiser. It's basically at the us cost. You're going to pay for a six pack over there. Now if you go out in town in japan and you get a twelve pack of budweiser them for costs. You fifty sixty bucks because the import taxes are so high so we weren't allowed to bring budweiser off because there are so many people that would get caught selling it to the japanese locals and you get in trouble for that taught now well. I'm sorry i've just picturing this story. This dude chris chris. Gay coming into to staff chaffetz. This office drops a big big stack of papers on your desk all right chaps. We got a big one for you coming straight from the top pork swertz. Imagine it with colonel jessop. That's what you brought me here pork. Products pork rolls educated man. But i don't know whether this private is actually out here slinging pounds of bacon part of such a lucrative hustle. I'm pork products are huge in filipino cooking. And there's over almost two hundred sixty thousand filipino expats living in jordan and sixty thousand. Yes so sorry. Numbers numbers but but so i look like people on base. There's like some sort of connected they're buying the pork and then they're selling it. I don't know necessarily to filipino. People base or anything. But that's what i was reading the reddit comments and people were saying that. That was probably one of the more likely things there. S bullshit throw that entire thing on the philippine fucking community. We all like poor. I know that. But i'm just saying that the people who have been stationed blaming read it. I'm not personally faulting uk. I just don't know if you can put all of this on that one community there because we all like pork..

kuwait Ap army porges us army chris chris chaffetz navy japan philippine colonel jessop chris us Kate jordan reddit uk
"kuwait" Discussed on Zero Blog Thirty

Zero Blog Thirty

04:08 min | 3 months ago

"kuwait" Discussed on Zero Blog Thirty

"It's especially sensitive nuclear enterprise. We cover that story of several months ago indeed. Dozens of sailors assigned to the nuclear reactor department aboard the uss. Ronald reagan aircraft carrier. Were punished in connection with lsd. Ring aboard the vessel. You know ronald reagan rolling over in his grave big drug goofy guy zip. Nancy fuming at all no terrible and last year fourteen airmen responsible for protecting the pentagon's nuclear missiles. Missile silos were disciplined for dropping acid between shifts. I don't know how long the break between shifts were. But i should be able to do that. Nuclear security and like the areas that they're at south dakota montana. Get outta town if you can drop a little. Lsd what's this whole thing even been about plus the military needs. I would be interested to see because there is a shit ton of trial. Prescribe like trial basis of lsd. And and how. It affects veterans brains for ptsd. I would like to see how widespread was l. as the oxygen and if it was super widespread in suicide numbers decrease and so should they start putting a couple of scores of lsd. In murray's. that's all say. Hey spitballing here. Just thinking out loud. We're not suggesting we should start rampant drug use but yeah that's general needs to call me. I have some idea. Said there was at least one marine corps officer who made the argument that at least in terms of microdosing. It might be worth checking out for like intel. People in intel lake may unlock and things in your mind. lets you see some new lakes. Oh yeah but anyway. That's where i would darpa. Does darpa bride. Just gives their people some lsd. Some shrooms. just be like come up with the real weird weapon. They're like okay. No hear me out. We're gonna control people's minds. Yeah okay and you're going to communicate on the battlefield without talking again out there I lose as i've taken acid before. I've done like mushrooms. Acid all that stuff but like but i took the first dose and it was. I was like after my divorce and it was having a weird time..

Ronald reagan ronald reagan pentagon Nancy south dakota montana ptsd intel murray marine corps darpa 's
Angry Trump promises rally in battleground state of Georgia

AP News Radio

00:53 sec | 3 months ago

Angry Trump promises rally in battleground state of Georgia

"Despite dozens of legal and procedural set backs president trump continues to challenge the results of the presidential election president trump spoke to reporters at the White House after thanksgiving conversation with U. S. military members overseas hours Kuwait doing trump renewed claims of fraud and crooked local officials in battleground states led to his election defeat that's going to be a very hard thing to concede because we know there was massive fraud he says he's going to Georgia on December fifth for a rally to boost to Republican candidates facing run off elections that will determine control of the Senate maybe I'll go twice and it's very important we win those races trump told reporters he will leave the White House if the electoral college votes in Joe Biden by the December deadline certainly I will and you know that but I think that there will be a lot of things happening between now on the twentieth trump wouldn't say what his plans were for the inauguration I'll be honest I know the answer but I just don't want to say it yet Jennifer king Washington

President Trump White House Kuwait Georgia Senate Joe Biden Jennifer King Washington
A Quest to Extend Life through Early Disease Detection

The Bio Report

08:09 min | 3 months ago

A Quest to Extend Life through Early Disease Detection

"Joe thanks for joining us here. We're gonna talk about quenching. Its effort to use technology to detect disease at its earliest stages. And it's audacious goal of extending life by ten years within a decade a i. I'd like to start with the u. Quenching grew out of a a lab that iran uc berkeley You have a masters in economics and a master's in psychology. Your career began in the advertising industry. With w p p and omnicompetent. How did you find yourself working with artificial intelligence and next generation sequencing to transform medicine. Well in a way. It's the circus is closing. So when i was born. I was born into a household of scientists and my mom and my dad bio scientists microbiology Next plank bene- germany and my whole life. All the way up to nineteen was busy just biosciences. I heard it every every day. Counted always intriguing. Not intriguing enough to make me study medicine. Which goes of the wanted me to but i found other things also interesting is typically economics in psychology and so for the first nineteen years busy got the not just a crash caused very intensive course off mike about d by chemistry and so i was very familiar with a whole field then decided you know the other things too in the world that i wanted to explore the advertising and marketing angles more random because i was moving on the strategic side of things and from there i found actually even though i loved you know thinking about innovation and growth. Which was my my main objective. At these elijah marketing firms. I felt more drawn to a financial side of things in it's via transition more into kind of strategic planning and finance. These are very large organizations of it by their doing marketing. Also have wbz's in two thousand employees. It's not a small firm and from there you know i did some strategic acquisition things for them and they had gotten in touch with startups a lot and i decided i wanted to actually switch sides and doing do something much more. Entrepreneurial did this worldwide in the us young then the entertainment circuit beck abbas busy looking at different industries from more from an investment perspective and you know biotechnology became more and more important Starting two thousand fourteen fifteen because some sequencing confidence of sequencing innovation and a and cloud systems reach a critical mass that enabled you know something. That's amazing new age of precision medicine. And you know. I was looking had multiple industries but that really caught my eye and brought back these memories from my first nineteen years and i felt very comfortable jumping a little deeper in looking at different technologies and then by a series of coincidences led to the point where i realize now we are truly at this complete in point in medicine and biotech and then all these things came together right my my bio bake around my financial background in my date of bakery digital bitten finance and Ended was as perfect confluence of really liking biology and details of sequencing on the chemistry left side But also the combination with complex cloud systems artificial intelligence and of course business model innovation. Which was a part of my career. These ten years of graduating college Yeah there's all comes together in this would be the future of medicine. He was gone gene. And our ambitions goto extent you the human life span by ten years within the next ten years and dad's executive technology stack. You need to do that. You need biochemistry. Sequencing cloud systems ai in a deep understanding of business model innovation. The company as i mentioned has rather ambitious goals for transforming medicine. What's wrong with the practice of medicine today. It must be ironic. Miss you asking there. But i can. I can outline that. The biggest there are two things that are really wrong about what's happening today. And these two things resulted in you know. Hundreds of thousands of american lives being lost every year. Like talking about covid. This is a much much. Bigger problem in kuwait. Just has guesses so two things wrong. Unim- on the medically process sites that the feet of medicine still fundamentally follows. The idea that medicine is about treating disease treating symptomatic disease and when you get how people die today. What are the biggest causes of death. It's cancer it's cardiovascular it's diabetes and metabolic diseases in its new problems. All of these are chronic diseases. And all of these diseases cannot be dealt with on a symptomatic basis. You cannot wait until you have alzheimer's and then try to do something about it. You cannot wait until you have late. Stage metastatic cancer. It's just too late so the first problem is ed. Medicine is reactive and symptoms driven when it needs to be proactive and prevention driven and ought to get their many things. Have to fundamentally change Need to be data driven the level of precision foreside statistical understanding to be a higher by by many many many magnitudes. That's problem number one. And the problem too is the business model of health care And i'm in the middle of this right now because we also started doing cooler testing and god reimbursement and things like that.

Uc Berkeley Beck Abbas Iran Elijah JOE Germany Mike Symptomatic Disease AI United States Metastatic Cancer Kuwait Diabetes Alzheimer Cancer ED
COVID-19 Lockdown

Sample podcast and live TV

01:26 min | 4 months ago

COVID-19 Lockdown

"I completely have agreed with the good doctor who was who was saying before me I agreed with the first log down by was that because was absolutely important for us to know where we stand, who showed up our health infrastructure which was vitally important even here in today's debate. I said, I I was commenting only about lock Downs in the past few months not from the beginning. So in the beginning the lockdown was important and obviously if the country is in lockdown, it doesn't take an Einstein to figure out that the are not in fact ivity ratio is going to come down. So less people would be infected off. The fact is we would showed up our infrastructure and we have we really have we have thousands of hospitals now Health infrastructure is showed up the point with not continuing with the lockdown was because we did not implement. Antibody test and when the government was saying on May 16th that they'll be zero cases of Kuwait. They already were seven million cases right now. A third of India is already covid-19. Take off from stances does having a lockdown have any impact but no sound will come out of that. We move forward with play plan. We've got the log down moved forward. We are not going the UK way, at least hopefully you can which is preparing for a second lockdown and and sending people home at this point in time just ahead of the festival season of Christmas

Lock Downs Einstein Kuwait India UK
Dr. Mark Hoffman, Research Associate Professor at the University of Missouri, Kansas City - burst 01

Scientific Sense

44:57 min | 5 months 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

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 | 5 months 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

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
Air with Prof Paul Lewis and Jo Polson - Paul

1202 - The Human Factors Podcast

01:44 min | 5 months ago

Air with Prof Paul Lewis and Jo Polson - Paul

"But. Gas Well. That's Elsa Dame's tongue talk natural off is can come from desert in does problems of seatings sprayed on these? Important. Because was mark is stay on foam tiny tropical. He's dig- water form clouds. Rain, the natural water cycle they'll get back off. So pounding Hartlepool's. Is Important. But if Gets two hours. We're. All to. Blame. With. A concentration love for microphones. He measure partners solution. UN's that that's natural. That's how Boris the API sauce who increase maybe devils attend fifteen train macron's leader. That's when you have. Problems health issues cares. Alan's come Kuwait. So that's January. Average. Levels of Pugsley too high as well as other gasses well. Oxide Soapbox. Unease time, come from. Combustion. So we tend to use going from cars. Lorries. In reality it's combustion anyway could be forest being birds. Are Injury Rosalyn bombs. Agriculture contributes a huge In UK. on outlet, but

Elsa Dame Hartlepool Pugsley UN Kuwait Alan UK.
Sheikh Sabah al-Ahmad al-Sabah, Kuwait’s Emir, Dies at 91

PBS NewsHour

00:15 sec | 5 months ago

Sheikh Sabah al-Ahmad al-Sabah, Kuwait’s Emir, Dies at 91

"And the ruler of Kuwait Shake Saba Amar Al Sabah has died at 91. He had presided over the small oil rich countries since 2006. Hours after his death, his half brother, the Kuwaiti Crown prince was

Saba Amar Al Sabah Kuwaiti Crown Kuwait
US Airman Dies in Accident at Air Base in Kuwait

VB in the Middle

00:19 sec | 5 months ago

US Airman Dies in Accident at Air Base in Kuwait

"Overseas and Air Force staff sergeant from Merrimack, New Hampshire, has died after a crash in Kuwait. 23 rolled Ronald Roulette reportedly involved in a non combat related A TV accident. New Hampshire Governor Kristen Nunu says the state is morning. Let's loss, calling him an American hero. I'm Nicole

New Hampshire Governor Kristen Nunu Ronald Roulette Air Force Nicole Kuwait.
Making Treatment a Virtual Reality for More People

Let's Talk Addiction & Recovery

04:39 min | 6 months ago

Making Treatment a Virtual Reality for More People

"It's a real treat to have Bob Poznanovic with me today because a long time ago before he went to work at Hazel and before he became the vice president of Business Development for this organization, Bob and I met in the Community of recovery in Saint Paul Bobby. It was in about nineteen, eighty, nine, ninety five when you and I would get in the car together and drive to center city I'll certainly a lot has happened in our lives personally and professionally just share with our audience today your personal connection to the Organization Hi William. It was February thirteenth of nineteen ninety five when I had reached my bottom. When I was using cocaine. A really high. Amount. In. CHICAGO. I had just lost my job at the senior executive in a technology company in camp lost my relationships and. Like everybody else and reach that point that I ran out of options and Fortunately found the Hazel and foundation and went to treatment said February and stayed in center city until March and then I went to fellow club where I met you and other members of the community some point in at the end of the march we started volunteering and every Saturday a group of would go to center city and share our strength experience and hope with patients that became a big secret to you know to my recovery is at volunteering and giving back and having some fun. You'll filling that void that drugs and alcohol had that was now being filled. With recovering I think that's one of the one of the promises and one of the gifts is to have really to friendships like yourself and others. Throughout the year. So it's nice to see you and it's nice to be here in the same capacity with you being able to carry, put a face on recovery and carry the message of hope who have ever imagined it right when. You talk about how much you lost but. We're so glad that you've gained so much and we're so glad that you continue to hold onto the expertise that has put you into the role now as vice president of Business Development for this organization at really a critical time, not only in our growth but as we. Address the pandemic of. Corona virus. And you're in charge of a lot of that effort. Can you take us through the process of developing and law launching? He's willing. Betty. Ford's telehealth strategy. Sure so because. My background has always been in technology. I was looking ahead and trying to predict kind of where the industry was going to go is you're looking at technology and healthcare in general I. Think it was pretty clear that technology utilization in behavioral health was really lagging in particularly even more. So in substance use a lot of organizations didn't even have electronic medical records. And you looked at the look at the industry, look at the industry problems, patient problems and care delivery problems back in twenty eighteen. When I HAPPEN TO HAVE A. Demo of some software that one of our pair partners was developing. And it clicked on me that. This technology could be. Used to deliver care differently. So was in two thousand, eighteen we started to talk about how could we use video? In live video between patients, not just in one in one environment which was being done. For telehealth for for years. But how could it be done in a group environment because the problem we are looking to solve Was Access. We're working with a lot of our partners around the country and communities. Academic health centers and other state organizations in healthcare to rural organs. Rural patients is a real challenge. So you know, could it help provide care improve access to roll Marcus would the convenience? Of being able to get care wherever you're at improve engagement. If you live in downtown La Chicago New York you know the catchment area is really small and some big cities because people don't want to fight the traffic after work to get the care. So convenience improve engagement. And the other was would. Stigma. Could we help through overcome some of the stigma. By. Not Making people physically have to show up at a building Kinda put a label on themselves Kenneth come out much more in a sense in Kuwait engaged them earlier by having them. Feel it's safer. As, well as convenient. To start that way. So we it started in two thousand eighteen down the past, and could we accomplished all the goals of of healthcare which is approve access improve outcomes improve. Patient satisfaction and lower costs.

Vice President Of Business Dev Bob Poznanovic Cocaine Hazel Chicago Saint Paul Bobby Ford Senior Executive Kuwait Betty Kenneth Marcus La Chicago New York
6 Gulf Arab countries back extending UN arms embargo on Iran

KHOW Marketplace

00:19 sec | 7 months ago

6 Gulf Arab countries back extending UN arms embargo on Iran

"A six nation bloc of Gulf Arab nations has endorsed extending the UN's arms embargo on Iran. The Gulf Cooperation Council includes Borane, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates. The embargo was set up in 2010 and intentions over Iran's nuclear program and prevented the country from buying foreign made weapons.

Gulf Cooperation Council Iran United Arab Emirates Saudi Arabia UN Kuwait Qatar Oman Borane
A Song For Peace

The Promised Podcast

05:17 min | 7 months ago

A Song For Peace

"This is the story of a song that is in a way the story of this country in the spring of Nineteen, sixty-nine at a sidewalk cafe on Richmond Street tucked in from the corner of Dizengoff. Street in Tel Aviv a twenty four year old poet named Yakov or Janka wrote Blit met a twenty five year old musician and arranger named yet year Rosenbloom and the two men became friends the cafe was called California and the. Place, itself said something about the people who made a habit of spending their days especially, their long nights there. The first thing to know about Cafe California is what it wasn't just one hundred and twenty five meters up Dizengoff was a legendary Bohemian cafe called carseat. It had been in operation since nineteen, thirty five, and since then it was the place where you can find some of Jewish palestines and then Israel's greatest poets and writers. On Alterman and Lebron's Sean Ski. Lay. Goldberg. Alexander Penn great writers who had been young and who grew old drinking coffee in the afternoon and vodka in Iraq at night at the simple spare tables of cassette alongside these luminaries in the nineteen sixties. New Generation staked claims at the table, the actor or. The singer Oregon Stein the architect Yaakov wreck there and many others cafe California was not seat from its vantage half of long block away even the young people at seat where old carseat was yesterday's Bohemia California was today's Cafe California was founded in one, thousand, nine, hundred, thousand, nine by a man named Ab Netanyahu who was only thirty two. Then that had lived a good deal of life. Netanyahu was born in nineteen twenty seven in the southwest corner of what is now Iran in a place called Abedin on the Persian Gulf just. Across the border from Bosra not far from Kuwait at six he was sent to board at Saint. Mary's a Jesuit School in Mumbai where you had an aunt, his parents abandoned. Persia. For India when he was twelve at sixteen and Nineteen, forty three, he lied about his age and joined the Royal Indo British Air Force in time after he trained to watch the Second World War wind down at twenty one he came to fight in Israel's war of independence and never left taking a job as an El Al pilot when he was decommissioned. It was with a few restless L. Buddies that Netanyahu opened cafe. California soon, it was filled with the city's young wannabe writers, directors and poets the people most eager to knock from their sinecures the city's old writers, directors, and poets who argued and held forth at carseat. Ab Thanh was a magnet for Bohemians and he came alive when he was with Bohemians, their company produced in him at once a sense of satisfaction. He had found his people but also a sense of restlessness eighty, nine ton was in constant search of his next Gig in nineteen sixty five he ran for Knesset advice of a friend who worked in PR he pledged that if he was elected, he would fly to Egypt to meet with General Nasser to seek peace after he failed to win a seat in parliament, he anyway bought a nineteen twenty seven steer. Men by playing that, he named piece one on February twenty, eighth nineteen, sixty six, he took off and flying low to avoid Israeli radars he landed in Port Saieed the Egyptians sent him back the next day Nassar had refused to see him back home a retired David Ben Gurion told reporters that not tons trip was an event of moral and political importance and quote pope. Pious gave him a medal of peace and Robert Kennedy and Bertrand Russell sought out his company not much later the notion took hold of Natanz, that music held the key to altering. Israeli. In the summer of Nineteen Sixty Nine AB NATANZ bought a Dutch cargo ship named MVP SEATO MVP stands for motor vessel and he rechristened it the MVP piece from Holland he sailed to New York to raise money and set up a shipboard radio station. His plan was to anchor in the Mediterranean outside territorial waters of Egypt and Israel and broadcast songs of peace that might open the minds of Israelis any. Alike his sojourn to New York stretched biblically three years would pass before he returned with ship in good repair with mixers, turntables, ABC cartridge machines, reel to reel tape machines, and fifty kilowatt transmitter to help not on- by what he needed John. Lennon. And Yoko Ono signed hundreds of posters of the two of them in bed in Amsterdam their famous bet in which not on sold to raise money for audio equipment. John Lennon also offered not time yet. Rolls. Royce grads to sell at auction, but the practical impediments of shipping the grand car stymied the business, the carpenters, Johnny Mathis and other musicians recorded for non promotional clips in praise of peace. Not an idea was that new music might open minds in Israel Egypt. The station eventually began to broadcast in nineteen seventy-three as the voice of peace

Ab Netanyahu Cafe California California Egypt Israel Dizengoff John Lennon Persia Bertrand Russell Tel Aviv MVP Johnny Mathis Alexander Penn Rosenbloom Bosra Iraq Yoko Ono Nassar New York Persian Gulf
1 American among 135 dead in massive Beirut explosion, officials say

the NewsWorthy

01:21 min | 7 months ago

1 American among 135 dead in massive Beirut explosion, officials say

"New details about the massive blast in Beirut that was so powerful. It shattered windows more than a mile away as of early this morning at least one, hundred and thirty seven people have now been confirmed dead and five thousand people were hurt. ABC News reports at least one American was among those killed emergency workers are still digging through the rubble. So Lebanon's. President warned the death toll will likely go up again, the massive explosion caused billions of dollars worth of damage and Beirut city governor says left about three, hundred, thousand people homeless. The United Nations has promised to support Lebanese hospitals as they struggled to deal with the emergency. Three hospitals were damaged by the blast and the others are at capacity and overwhelmed the UN. Specialist to Beirut to. Medical equipment was flown in from Greece Kuwait Turkey, and elsewhere, the also plans to send firefighters to help search crews. The New York Times went through more than seventy videos of the explosion and found it started as he region fire in the warehouse. Remember that's nearly three thousand tons of ammonium nitrate had been stored. That's a highly explosive material that's used in fertilizers and in bombs. Well, the fire turned into an explosion smaller one at first and then less than a minute after that the massive. People who manage the ammonium nitrate storage have now been placed under house arrest. The government is looking into possible negligence and they're working to figure out the exact cost.

Beirut Greece Kuwait Turkey Abc News Lebanon UN United Nations President Trump The New York Times
Kuwait emir, 91, flies to US for medical care after surgery

Buck Sexton

00:30 sec | 7 months ago

Kuwait emir, 91, flies to US for medical care after surgery

"The emir of Kuwait is expected to seek medical treatment in the US, saying it's 91 year old ruler Emir Sheik Sabah Lama, Raba is fine to the United States for medical treatments. His office says The trip comes after a successful surgery at the weekend. There are no further details. The news on the lack of clarity on shake Subhas condition is prompting speculation about another possible power struggle within Kuwait's ruling family shakes. ABA has led the country for 14

Emir Sheik Sabah Lama Kuwait United States ABA Raba
Kuwait Emir, 91, to Go to US for Medical Care After Surgery

Rush Limbaugh

00:32 sec | 8 months ago

Kuwait Emir, 91, to Go to US for Medical Care After Surgery

"The emir of Kuwait is said to be heading to the US for medical care. Kuwait, saying it's 91 year old ruler and there shake Sabah Al Ahmad Al Sabah is flying to the United States for medical treatment. His office says The trip comes after a successful surgery at the weekend. There are no further details. The news on the lack of clarity on shakes Abbas condition is prompting speculation about another possible power struggle within Kuwait's ruling family. Shakes a bar has led the country for 14 years. Simon Oh in Fox

Kuwait Al Ahmad Al Sabah United States Simon Oh Abbas FOX
The Good Parts of AWS with Daniel Vassallo

Software Engineering Daily

07:52 min | 8 months ago

The Good Parts of AWS with Daniel Vassallo

"Can you just go a little bit deeper on why architecturally Dynamo DB is not well equipped to fulfill the same semantics of a sequel database. Oh, it was designed to dissuade I. Don't know if you know do the member simple to be what it used to be. A the dissenter of Dynamo DB back in I think it was launched in two thousand, ten nine. And it's. It's a significantly more ambitious than Donald. Debates was meant to be slow inequity. Relations was more like you know like Mongo documents based you documents so aquarians essentially the answer. And this is actually it's probably one of the few. I can't think of any any other service. One of the few implicated services from aws. It's technically supported of your salon and gets. You send using simple debate. API still work, but basically almost hit it under the carpet side. You don't find any and there were. You won't find us in the console. It's not it's not a new. The send things like that. And the problem was that. Amazon founded super hard to make this type of database Kale and to have predictable performance guarantees, one of the biggest problems that was happening. That would simply be. You might throw in some complex square. You might not have an index about it. And the declare would take two minutes, timeouts and lay. It was completely unpredictable. Some quays take two hundred milliseconds. Some will take minutes. And it was very high. On the service side to these about site to locate the sources so talking about capacity, so not the be was the answer to that and TWAS, radically different perspective like completely predictable versus completely unpredictable, so there's two operations gets put the listed going to bt index behind the scenes and updating single lighten very predictable. They all take. Just, a few single digits milliseconds identify typically, and there's this query API, which again just goes to the starting point of a beat the sequence of cards after megabyte so again like the the the upper bound per addicts, how much expensive Dakota can be ends attested dissolved, and that set of to to continue to participate you. You go with the next token. megabyte that I, so it became very easy. For the service provider to these about how expensive it can be how fast it can be how to allocate resources, and it became huge success successful, but numbers on itself, because I remember we used to on services on top of relational database address to have the same problem so sometimes the relational database at an all. It's a complex machine is my star choosing? It's it's my start to use suboptimal query, and suddenly acquitted that used to take a second is now taking twenty seconds and suddenly using all the memory. When we started thinking in terms of much more primitive technology, like beatings become easier to these in about as long as you managed to model your queries and what you needed to do. To its limitations. But then. Today's were you're fighting your database. Because suddenly spiking two hundred percents, appeal and everything is slowing down disappear so that that element of predictability is highly highly available, so they were defer the. It was designed to be this way that I just wasn't. Designed to be so inequity, of. Arbitrary complexity and will give you the answer. What do people do when they have built their infrastructure around Dynamo DB and it's not fulfilling the requirements that they have. I think you will struggle the limitations and up subsidizing you I. I think the problem is up become became being discovered very early in development. Like for example, if you're expecting to be doing lots of recommendations on amounts of data, doing development you to realize that you're going to be downloading everything out of Dynamo and doing it locally, not so. Hopefully yearly allies airily that this is worth considering Golden, considering that they should use another type of database or relational, database or something. I don't have any first hand experience for example where delimitations and and adopt sort of surprising later, which is I think is a good thing again like the fact that it's significant distinctive. Had few. It's very hard to. Abuse it sight and sort of expect more out of your life. You realize immediately that these are the limits. which again I think these tend to be sometimes that. And more sophisticated database aside because during development your. Attention like hundred minutes seconds, and then once you have lots of data or things are in Qatar. They start to become more unpredictable. Dynamo just elements that issue just just there's no unpredictability. It's actually incredibly predictable at the cost of the constraints the comes with. You right in some detail about s three and s three I think of for obvious use cases as slow file system. It's BLOB. Storage it static website hosting its data lake. Told me about the other applications of s three. Yes. Yes, I. Think One of the lists. Values of trees that you can think of as having infinite Benguet for all. Practical purposes that so, if you have terabytes of data, you could basically an estimate. You could download it as fast as you as you want to. Basically always many to that says he wanted many servers. You want to tell you can chunk it up in pieces and just download the terabyte like in a second. For example one of my biggest project Thomason was launching and working gone. Cloud Watch watchdogs incites, which is basically a monitoring tool that allows you to arbiter the complex queries against your log data. And much entirely built on top of the and this is it surprises? People because this unlike Donald to be, we actually chose to support. Give me an arbiter equality of complexity, including regular expressions and things that are super cost to evaluate and. To dissolve, and we built it literally on top of us today and in in a very cost effective way because we relies on the assumption that. For example log data tends to be. Very big generalized especially nowadays like application censored. Tonight's like gigabytes and terabytes of logs. You want to start them somewhere where it's cheap and us these the perfect place for that and you tend to Kuwait infrequently, though when there's a problem I want to something about your application. And I think one of the ideas that works with s threes, this technique where you separate compute from the data so basically once. Does no question. There's no compute so basically you can just have the data sitting in streeter, just paying the to censor gigabytes per month, and there's no other costs. And if you open up the consulate insights and you do Equa they. Spin up some. Is it Winston while I mean behind the scenes like some pool of warmest. But fundamentally you can think of about it does like spin some ephemeral instances and we enough such that we can download data. As they wanted to. And then you can sort of just turn over the data very quickly I just because. I can listen to such as your network

Donald Trump AWS Dakota BT Amazon Streeter Kale Winston Qatar Golden Thomason Kuwait
"kuwait" Discussed on Z104

Z104

02:52 min | 11 months ago

"kuwait" Discussed on Z104

"Of the roses for Kuwait mmhm what a concept so we're gonna try something a little different this week first of all who are we putting to the test for you know call my coworker down okay so tell us the story of you and Dan so Graham and I started working together just a couple months ago he got transferred basically for a different city and since he got here I mean I've been interested in him you know but like playing it cool because I wasn't sure if he was married or had a girlfriend or anything like that okay so you found out that he is not married correct and you said to your knowledge there is also no girlfriend also correct okay so you've been busy working on this man you said doing the little things yeah basically just you know making sure look right when I got to work you know spending that little extra time on my hair and make up enough that my kind of thing so basically you do you do with this says you do your hair does check your nails so so how does that work for you what kind of vibe are you getting from him okay so this is the part that confuses me because there are times when you bury court case has fun with me and then there are other times when I'm trying to mess with him a little bit and then backing really despair like almost like you don't have time for me he could be playing hard to get maybe yeah no I was he speaking as a guy I can tell you we we don't play hard to get we want sex too much okay so you're into this guy for sure very all right and we think he might be in geo on the net hi it definitely out that way yeah but you know other times not so much okay but you said you're at the point where you're ready to just basically step up and ask him out since he hasn't done it yet I mean I would like yeah yeah that that that that is a bold strategy if you ask me I don't see why it was so bold about it and the X. twenty nineteen women can ask men out now it doesn't mean you're like a tramp or anything so I say if you're sick of waiting around for and you know just go for it thank you Ashlee okay but what we need to make sure I have here it's not just that he's in you as well but we don't know for a fact that neither somebody else he's into more like what if we offer in these roses and he's like oh yeah there's this girl from my gym I'm really into any gives her the flowers well I mean if you go back and I didn't embarrass myself yeah okay that's that's a good point let's call of user's name is Dan yeah yeah okay so we'll call it a day and will offer a dozen roses you get send anybody wants and you're gonna get here who he chooses and what he puts on the card on time for the two questions we ask everywhere there is a participant question one are you sure you want all of this on the air yeah all right and question to how certain are you that we offer in these roses he's gonna.

Kuwait
"kuwait" Discussed on KNSS

KNSS

05:03 min | 1 year ago

"kuwait" Discussed on KNSS

"H. W. bush declared that Kuwait is liberated Iraq's army is defeated and announced that the allies would suspend combat operations at midnight eastern time L. at that point at that time there was a some criticism that's it no no I'll go in there take over everything throw the bums out into it you've defeated them but they're still there then after that the decision was made to when that is to do it to actually fire all the government officials and everything end B. have them replaced by other people who weren't crazy radicals and basically what it did to destroy Iraq's infrastructure so that it took him years to get back to even going get a driver's license it was pretty sharp the short sighted there anyway that's a little little bit of history then again we went back into Iraq a little bit later on after that ten what do you think about the drivers with big fancy cars are they are they better drivers than the than the rest of us I doubt it L. drivers with nice cars pose a bigger risk to pedestrians than people who drive clunkers according to a study on it thank you love this researchers at the university of Nevada Las Vegas film for people attempting to cross a pair of mid block crosswalks intensity wearing basically the same outfit and approaching the crosswalks in similar fashion okay analysts conducted concluded that for every one thousand dollars a car is worth its driver is three percent less likely to see the right away to someone on foot in other words the more expensive the card now the less they paid I'm rich yeah get out of the way yeah that's just as it was based on the Kelley blue book value of the four hundred sixty one cars tape crossing the two intersections during the study which took place on a Saturday and Sunday morning in twenty six twenty sixteen both intersections have a speed limit of thirty five miles per hour now the university of Nevada Las Vegas I can tell you this it that's you can't some soon pretty busy there they had a good good time it's interesting research there but the people in the more expensive currency tended not to slow down quite a bit well as much right seven fifteen now Steve intended we can talk about the sports here in a minute I just want to quickly ask you did you did you ever go to do the PA announcing for the shuckers baseball yeah okay so how it goes it just is it up there in the book are you guys he gets all the hot chocolate you want everything up there it's not it's not quite the penthouse you build up the banks got a got a nice big space here for you mmhm it is heated but that doesn't have glass in front of it what do you can open it up and all that sure can't remember I've been just been well it was out there last year but the times we've had a Canisius day or night at the ballpark that I've gone it seems like you're you're never the PA announcer that night of somebody else so I am going on the run nights I'm going in the wrong night because I need to bring to the entertainment value of having to do the PA right now how many years have you been the only time I'm not doing P. A.'s during gridiron for her to ask for a pretty much you know and you're doing that right now the go show is coming up on the twenty sixth and seventh yeah more Monday March mmhm and yesterday I had my lovely wife get on line so I could order three tickets online to go into the cache I many years of a got a role like on that day and you but how many years have you been into this this will be my twenty fourth gridiron wow is that the record I'm sure no no no no no not even close it isn't okay well now Bonnie banget it for more yelling at cades Randy brown did it for a twenty years as Bonnie gonna be what this is all he's been in it for ever thank you offers Bonnie give me this year I think she's going to do the newscast with well good for you during the year the call yeah yeah your co anchoring the news cast now all right well it's gonna be fun that's coming up on the at the Orpheum theatre we got our seats kind of down on the right sort of down in front so we can be close to your online a lot of fees media online I know on the intrust bank box office got him and yeah my wife is this what's this yes he was a little annoyed about that if you go if I am at the at the box office intrust no fees at all but you get a one liners tons of fees that's good advice yeah there are some fees that what do expenses and all right I'm sure there was those fees will all go to train journalists of the future right I can't guarantee that both bills all right so given how many how many years you've been doing PA announcing my thirty first season doing public address for soccer baseball you get that job I went and asked them if I could do it really not and I thought they were going to say no and they said sure come on kid or somebody that wants to do this come on while they got omitted you're deal over the years it's now been doing it for thirty one years about that will they should give US a you know a golden microphone or something up there the what Wichita state's got tons of money they should drain silver onion okay we'll see about that spoiling the whole thing are like seven eighteen Stephen dead here on K. and.

H. W. bush Kuwait Iraq
"kuwait" Discussed on The Indicator from Planet Money

The Indicator from Planet Money

03:12 min | 1 year ago

"kuwait" Discussed on The Indicator from Planet Money

"Okay Darius everything's looking good right now. Stocks are going up. People are quitting their jobs as doctors or engineers or whatever to trade on the stock market. Obviously this could not last well. As you'll recall people were using the system post dated cheques to create this market but then as the stocks started to go down people started trying to call in those checks they went down to the bank and said I wanNA cash this check check because I'm not sure that this is going to be worth anything soon. And it quickly became clear that there was not enough cash to cover all of these checks and so the government stepped stepped in. They put together this committee and said we're going to look at this and everyone said great. The government's got it under control and they met over a weekend Monday. They made an announcement. There would be no bailout and at that point. All trading stopped. Just a stunned reaction paralysis. I imagine this. The third largest stock market in the world in an instant grinds to a halt suddenly worthless. Nobody knows who owes always what to WHO who is bankrupt. Who is solvent? It's just this this mess. They could all of the dealers under house arrest and and everyone was told no capitals Louts League Kuwait until it's all sorted out so the government scrambling and the collapse of the sugamo stomach. It destroyed the Kuwaiti economy. I mean it plunged the country into a recession that lasted almost ten years. All but one of the country's banks were insolvent in the end all of the losses adjusted for inflation totalled nearly two hundred and fifty billion dollars which for reference with five times the size of the Kuwaiti economy. At the time so this would be the equivalent of losing one hundred trillion dollars if it had happened in the US Suba Araya's who was a prominent businessman man. Like I said he says when it crashed just affected everyone. That was the biggest thing that ever happened. In Kuwait everything went went when and whether it's a stock or whether it's appropriate to everything thing when when I think there's an interesting lesson in all this and I think it demonstrates demonstrates the two forces that are kind of battling each other at the center of capitalism which is you know the forces of financial innovation and sort of human. I'm an engineer. That can't be stopped and the forces of financial regulation and trying to earn a bend that ingenuity so that it fits into some kind of master plan and I don't think Kuwait's mistake was seeing the value in financial innovation. I think the mistake was thinking that they could somehow separate that from the rest of the economy. You're never gonNA be able to contain human ingenuity. I think that the most you can hope for is to try to find some balance between control all in chaos very nicely said Darius how the Sukhoi menaka explains the world for at least financial history. thanks man. PODCAST was produced by Darius roffe on edited by Paddy Hirsch. The indicator is a production of N._P._R...

Darius roffe Kuwait government Suba Araya Paddy Hirsch sugamo stomach capitals Louts League US engineer
"kuwait" Discussed on The Indicator from Planet Money

The Indicator from Planet Money

05:41 min | 1 year ago

"kuwait" Discussed on The Indicator from Planet Money

"And we've got got a doozy for you today. I'm joined by. Dr Is Rafi on Darius I cardiff Yes today I've got a story for you about one of the greatest stock bubbles of all time which occurred in of all places Kuwait Kuwait. Yes and the story begins in the late. Nineteen seventies during what is known as Kuwait's golden era so Kuwait had been this kind of sleepy desert outpost and then due to the massive influx of oil money. It became this bustling metropolis list. And I actually talked to a man named Saba Araya's who was a prominent businessman in Kuwait around this time and he talks about what Kuwait looked like when he was a kid. Growing growing up like Trinity. We have running water up happening structure The there was no air conditioning for looks up over elevators. And by the late nineteen seventies Kuwait had become this modern metropolis and it also become the financial center of the Middle East because they region was rocked by turmoil. At this point in Kuwait with its really well regulated financial sector and it's relatively stable political. Climate became came this magnet for all of this money that was fleeing turmoil. Elsewhere in the region is a pretty classic emerging markets story starts doing some things right and then all this money he starts coming in from other places And obviously that drove up prices in Kuwait's official stock market but it was very very tightly. Regulated it you know. There are lots of regulations about what kinds of companies could be listed there who was allowed to invest. How are they allowed to invest and made it very stable but it also made it kind of a boring place to invest all this money? That wants to invest in Kuwaiti companies. And if it can't do their maybe it will find some other way to invest invest in them. Well it did find another way. Basically right across the street from the official Kuwaiti stock market. A sort of love informal unofficial stock market developed it was known as the soup ALMANAC and it was literally in a air conditioned parking garage on the site eight of the old camel market and sugamo knock literally translates to the market at the place where the camels rest traders started gathering there and trading trading stocks amongst each other. And I spoke to Ben Craig who is a economic policy adviser for the Federal Reserve Bank of Cleveland. And he's written a lot about the suit GALMOC Manakh And I have to clarify here. That everything he said in our interview only represents his personal views. He doesn't represent the views of the Federal Reserve. But I talked to him about this sort of informal formal market that developed. It was seen as an area where you could have fun but what Claes stays in the soup. I don't think I've heard that one before for we'll basically the government said hey. We like having this innovative kind of risky market with big returns. But we don't want the risk to infect the rest has to the economy so they put all these rules in place that said banks are not allowed to touch the super. They can't lend money to people who are investing there. It's got to be completely cut off from the financial sector her but of course traders don't like this because they don't want to just trade with the money they have in their pocket they WANNA borrow money in and you know potentially get even higher returns turns and so the system developed between the traders in the soup that I think was a little bit ingenious. The couldn't borrow money from the bank. So what they did is they had this system of writing post dated checks so basically card if I want to buy a stock for meal. It's worth one hundred dollars now and I think it's going to go up in the future. All right you a check I I say one hundred ten dollars and date it for a year from now you know like if your rent is due on the first you don't get paid till the third. Yeah date your check on the third. That's right that's what they were doing but they would do it for a year and in that situation. It's like you just lent me money for a year but then this sort of interesting thing happened with check check itself became a little bit like cash so suppose that maybe I want to buy some of that stock. I don't have any cash but I have that posted hosted shack and so I just passed that posted check onto a nar trader. It was essentially a way for these traders to print their own money and then Craig cautions against drawing any comparison to other markets. But in my opinion it's not all that different from what happened. In the run-up to the financial central crisis where mortgage-backed securities became much bigger than mortgages in this case the checks that were backed by stocks became much bigger than the stocks themselves selves. And thanks to this. System of kind of endless unregulated credit the Kuwaiti stock market skyrocketed. It became the third heard largest stock market in the world. Bigger even than London and Sobowale riotous says that this was turning people into instant millionaires. He recounted the story to me of going to his friend's apartment and I saw this huge big plate full with the new caveat. You know they by the House and then it was. Ten Cuba's maybe have the token of caveat on on the table I couldn't believe David and this market is started to draw in teachers and students and and he he talks about how you know. Doctors are quitting their jobs to run down to the Sukhoi ANOC and start trading eating stocks. It just became this national obsession that classic mania everybody sees it going up they think it will continue.

Kuwait Ben Craig official Dr Is Rafi Federal Reserve Middle East Saba Araya Federal Reserve Bank Claes Cleveland WANNA Cuba nar London David Sobowale
"kuwait" Discussed on Movin 92.5

Movin 92.5

02:16 min | 2 years ago

"kuwait" Discussed on Movin 92.5

"A couple of weeks only wanna see her which in Kuwait today's with takeaway pizza, before it's sex message was the only way to reach not stay in a place in the way, a treat. Over the track like a feature but wants to book as the auto wants to either. The me and her we make money the same way for cities to the same day. And those shows have never been more. It's about maybe we'll go together and just figured it out. With you and sit on the couch, but we should get on a plane. We'll be missing it. Now. Shot down the way things played out when she was kissing. How was confused about figuring out his singing? No. She. No. Hotel. I don't even know if she knows what four she was already trust and respect is what we do this. I never intended to be next, but you didn't need to take him to bed. Is a threat until you disappeared with him to have sex. Of course, it's not we were both on. So we were staying the same. Promise. Oh commitment. But it was never just fun. And the thought you would give this is not the way you realize what you've wanted. It's a bit too late. If I'm on a single is time God knows. Don't. Old. No..

Kuwait
"kuwait" Discussed on WSB-AM

WSB-AM

02:00 min | 2 years ago

"kuwait" Discussed on WSB-AM

"The summer heat Kuwait carrier turn to the experts Today's Clark -rageous, moment I. T's to earlier and it's about the fact that we used to get a zillion calls about crypto currencies earlier this, year. Late last year they were all the rage now I never hear a comment or a question. Why well let's take the biggest of. Them bitcoin has lost a massive amount of its value somewhere around seventy percent of its value from where it was just a few months ago that is not real money when speculative. Fever drives something up. And, down and up and down and. Up and down crypto currencies are not ready for prime time. The day may come that money is. Truly electronic and maybe even non-governmental, that time. Has not come just as I said through all the frenzied calls, I, got earlier this year getting Involved with these is a speculative thing Not a true investment but then there's the other angle that's always troubled me about, these non-governmental ways of paying for things and that is how they're used by criminal rings It was just a woman who former, stockbroker who was sentenced to prison for helping criminals Launder money to the tune of ten million dollars the she was helping criminal rings With cash and envelopes exchange for bitcoins, making them very much untraceable and allowing criminals to engage in rotten terrible crime behavior That's another reason why crypto. Currencies are not ready for prime time is they're.

Clark -rageous Kuwait Fever ten million dollars seventy percent
"kuwait" Discussed on The Point Of It All

The Point Of It All

02:02 min | 3 years ago

"kuwait" Discussed on The Point Of It All

"Everybody cheeks still from because women have they they've been drinking on kuwait about this whole theory of this whole bullshit of our women not all mission as this team trying to be honest smarter retard in so be realistic and understand that women she too so many sales can change slid they could also other bad as you got free esteem throw everybody oh summer liam like the loosely she is sold like it's like like it's like when you're you're somebody faithful you like what yeah that's being faithful is is the weird thing having signed joyce's been lame like a been turned into such a big popularity situation data slide air by outside his is cool as long as you may personal that's kind of the mindset the very body is ends like is long as i don't know that you fucking around with somebody else i'm cool because only was somebody else to although saturday night as masur judo nobody right you could komo's herb her good relationship for years just before the people on the side is on back to each other like nothing of avid y'all might as well say less overlay ship you might as well just say what it is so there nobody happened get hurt of sneak around you inside people olga relationship that don't even we overlay survi does what it is i don't wanna i wanna be able to get dressed and i'll tell you i'm going out with my guy you know what i'm saying like people that just want rather just say the truth.

kuwait liam joyce survi komo
"kuwait" Discussed on KWAI 1080 AM

KWAI 1080 AM

01:35 min | 3 years ago

"kuwait" Discussed on KWAI 1080 AM

"Uh and digestion becomes in paired so i'm experiencing that right now there's actually direct link from our brains to our bellies and in fact there are cells called galil cells that are in the part primarily found in our brains and our god so there's a direct kuwait to how we think and how we feel and how our digestion functions and i'm telling you digestion is everything i mean literally and they digestion is being affected how do you know you'd digestion it it may be a good moderate it the tiger elimination is the all of you getting some mccague then and you're not hungry or what what what to them in fact uh gas and much of biana yeah we when i on the phone right there that would look like and are no i'm not alone in this category uh in fact uh i i definitely no i'm not alone gas in bloating i become less hungry because of anxiousness and elimination becomes a little bit more difficult and sometimes a lot more difficult so i i pull up the arsenal you know i'm not only going to be talking about digestion but i'm using it and what i'm talking about and one of the things that i'm starting with in support of digestion an overall health is something called gaba com gone that g a b a now gaba by is a neuro hormone it's a narrow basically helping com.

kuwait bloating
"kuwait" Discussed on PURE ROCK RADIO Originals

PURE ROCK RADIO Originals

02:28 min | 3 years ago

"kuwait" Discussed on PURE ROCK RADIO Originals

"Kuwait again who has done with sure jio luke oh look home what are you oh three you and two oh one.

Kuwait
"kuwait" Discussed on Beyond!

Beyond!

01:32 min | 3 years ago

"kuwait" Discussed on Beyond!

"The darth vader eating spaghetti in its is like go kuwait's parts or something what others make any sense everyone's having drinks laughing at the end of the game it has a lincoln your a you buy any of these shirts and it's like you don't get a cut of a shirt like the jack box people just get money from it's like those like i feel like when when like google has like a capture it's it's like identify all of the parts of this photo that are street signs and you're like i'm training and ai right now this lipoic we're trading this facebook tshirt algorithms that like sudden you can buy those a shirts to i've dozens of them louisville the budget strategy shirts they're graham coming three in there all the time they're like a eucopps you gotta right you can get it now you're not a robot let you cannot earth a of now there is also a another game the pu so he's playing saying that the phone based games is coming out through called the hidden agenda and that's owned by supermassive the untold on guys oh and it's like a spy game that away like a seat player spy game you play in your phone really yeah i really ones who that's like i want to get like just a bunch of really like big big tablets and get like really artzi people over and heavily at the most intense gave of like draw fossa yeta just tell you like little who does eat farcical thing about these games is that um they're not like there's no is like a judge in the game that's just like that's the best answer sometimes it's just you and your friends being like we're horrible but he's the least horrible he's the most loyal like an replying like apples to apples with a bunch of people wants this is a side storage area and this one girl was just like she was like awful terrible.

darth vader kuwait lincoln google graham facebook
"kuwait" Discussed on Herbstreit and Fitzsimmons

Herbstreit and Fitzsimmons

01:57 min | 3 years ago

"kuwait" Discussed on Herbstreit and Fitzsimmons

"Hey sake one a love to go back i i saw a story on you earlier this year i think it was on game day actually just talking about your your journey everybody has a story and i was really blown away by how you unders size as it as it may be an adolescent and how you had to really get committed to the weight room and and really they had work hard to become the guy that we see today could you talk about that journey a little bit yeah um over i guess you could fail a lotta guy that you will reportedly lost ugly show or are small what am i i wasn't hollywood my coach arrachi coach coast google uh challenge rabaul oh y'all got take kuwait with clouds giving parliament alchol were kicking so far you gotta go on par with open up their own followed looking into kuwait lumo a team i've seen all the more work up when elite warmup producer the feeling so uh football co pay the opinion uh i just try to eat adult kolanki and high school uh but we will monitor small solution will operate the local cable ad i going strong biggest look like doesn't look my weight became more explosive atmosphere more comfortable in the shade old won't get a play can you do you mind walk through specifics like was his ninth grade 10th great 11th grade like when did you the kind of look around and some of your peers and say man there there through the maybe puberty there through maturing i'm kind of behind a little bit i need to catch up what what age were you when you decided that you needed to do something different.

kuwait producer hollywood football
"kuwait" Discussed on The MMA Hour with Ariel Helwani

The MMA Hour with Ariel Helwani

01:32 min | 3 years ago

"kuwait" Discussed on The MMA Hour with Ariel Helwani

"Now this one i was sent quite a bit second alltime to the boston crab the buses have crab was sent me more really um but this was sent to me the second most amount of times who sr case sal i'm gonna say is his name the best part of the forgive meter butchering of these name see since i feel like i said they could do okay you do okay you do um at wall one mma in kuwait uh over the weekend was nuts explaining for people who are just yes so the video here is who sarees on his back but scooting and he angles up and lands a kick from his back to the face of his opponent and knocks him out in the komi an event you have to see it you won't it won't be hard to find if you haven't seen it already and here we have an alternate anglo from a kaposi of course says is nuts insane yet is it possible that we saw the sub and knock out of the year the same weekend i don't know if i give this when the knockout of the year nuts it's pretty gray your big uh you know strength of opponent guy right i like i like the the stakes but i also like the cleanness of it now the cleaness of this is is pretty good pretty good because he does you know does fall over he tumbles how could you not i don't know if it was as clean as as um dj by the way was an hundreds and clean because you can get the sub right away.

kuwait kaposi boston
"kuwait" Discussed on Super Station 101

Super Station 101

02:20 min | 3 years ago

"kuwait" Discussed on Super Station 101

"Kuwait what that got the way he said hoping sorry for me the america i don't care what is approval rating rose mapra whereas at nine eight percent so what okay let's talk about it in a two i that make get a bear got rid of make me made olympic airways lina fourie listen to this up when the perimeter onto do this at all the way in and uh and he's a real pleasant it and he will kill you know he's you know what i'm tired of this you know people in other people getting me last final solution plus ouncil loose that sound solution and all this you know because i want to bring people to give the but our president is he people of all we get nowhere by argument hey hey harmful the other side hey i'm a key nearly i'll keep nudism some good no he wouldn't needed to be friends with d it'll settles off it some crave the person you know then he went to live there brings us to get the agri agree with you bring us together i grew joanette gear now of that bomb attack a man as the idea of your leg me all right when we come back yard i want to tell you about a move it at us though today and it got me thinking bar joy no really is the move was hidden figures have see the movie they just they looked at me tell you what i what i learned about races so you guys undeserved brown stay girls donald were two your locked in to the.

Kuwait president america lina fourie donald nine eight percent
"kuwait" Discussed on Rose Pricks: A Bachelor Roast

Rose Pricks: A Bachelor Roast

02:11 min | 3 years ago

"kuwait" Discussed on Rose Pricks: A Bachelor Roast

"But i eric hometown eric like hey hey nah hey hey hey was about the beautiful but will also beautiful beautiful dead littlest beautiful lake hey sidewalk okay this isn't the neighborhood i just wanted this spurs kuwait where he referred to earlier volvo tricky his totally charger curator run from a bigger be like nobody but by they had has a lot of drugs this was pretty jia he's like this the real men wear come from cakes so a person reason rachel is due at work at a half talk honor shirt did you notice that yaojie cyclic i'm journey from a block michael no you're not tell trump tug mark warm her warm of your tales to your skin cancer occur rachel oh my god weary totalling same age i had that they thought she'd like a hall girl lawyer why now she's like this should is not from a limited it is friday expressed okay oh my god okay so i was feeling right from the beginning that rachel is not into eric i was like either a she just kinda feel bad for him or be she's worried about only having white guys left and what that's going to do to herat yes i mean maybe i mean i have no idea i love eric the most i love eric the most but i feel like he's obviously the most different from everybody she 'spect right yeah but i love this guy he's like well this monday but a bells different so i i'm going to say the baseball bat store a he's talking about the hood as they go along as a lot of drug dealers lot of crab look this drug dealer by their look at look at the widow lady be look if you look rather with it you'll see drug dealer hey what's he doesn't affect ernie got his first crack that all of its carter.

kuwait volvo rachel ernie michael eric i herat baseball