“Could you imagine scheduling your son’s circumcision and possibly having him die?" said Tim Groth Armstrong Williams takes on the news of the week and asks the questions you want answered. Don&rsquo;t miss our weekly town hall. Baby allegedly almost bled to death in NICU after circumcisionby WCBS/CNN Newsource/WKRC (WCBS/CNN Newsource/WKRC) - A baby boy nearly bled to death in the middle of the night while in a cardiac NICU after receiving a circumcision Tim and Gabrielle Groth invited their son Cole into the world on March 31 He was born with a heart disease that they already knew about and doctors were prepared to stint and within days he was doing well enough to be cleared for discharge "We were called and asked if we want to move forward with circumcision and we just said yes," Tim told reporters "We weren't aware of any of the risks.. no one told us elevated risks of CHD." The next day the Groths arrived to the hospital and saw a terrifying scene "I walk in and he's extremely pale no idea what's going on," Gabrielle said "It was not my healthy boy I just saw the day before." "Throughout the night - 10 plus hours - our son bled almost to death," said Tim "The vital organs of his body lost blood and oxygen.. How does this happen in a cardiac NICU?" "Every day he's had a transfusion four surgeries in the last week," he continued "Trying to understand how you could go from a circumcision-stable baby to crisis." The hospital declined to comment on the situation a new company called Tengen Games released its first game “Zed and Zee,” for the Nintendo Entertainment System (NES) The surprising part of this story is not the release of a new “homebrew” game for a system released in 1985 — hobbyist computing has been visible since at least the 1970s — but that Tengen and its parent company had disappeared 30 years ago after being crushed in court by Nintendo for doing exactly the same thing: manufacturing unauthorized cartridges for the NES let’s take a walk down memory lane with Atari and Nintendo Atari is at the peak of its commercial success The freewheeling culture has been replaced by the Brioni suits and New York secretaries of new owner Warner The existing industrial arrangement at the time was that of a bundled console-plus-cartridge business model Atari with its VCS/2600) sold the console at a loss and cross-subsidized it with the money made on cartridges sold with a huge profit margin the game designers were paid a flat salary four defecting Atari designers and one music industry executive disrupted the video game console business model by aligning it with the recording industry’s: Hardware would be just hardware and content would now be supplied by third-party content providers with a little business and legal help from the Sistine Chapel of Silicon Valley law firms slapping them with any legal argument Warner could come up with — theft of trade secrets Activision’s business vision and legal team beat Atari’s The floodgates of third-party game production opened Too many players for too small (at a time) a market meant it became impossible for most developers to scale and recoup their costs some publishers released what Videogaming & Computer Illustrated described as “enough to send the most liberal sexual enthusiast staring at his/her shoes in abashment,” leading to public outcry and a bad rep for the industry as a whole leading to the collapse of both Atari and Activision Nintendo introduced the NES in North America competitor Sega introduced the Genesis (also known as the Mega Drive) Both companies had learned from the crash and took steps to prevent third-party developers from releasing unapproved games they turned to an engineering strategy: A proprietary lock-out chip would be inserted in the console A lock-out mechanism is an ensemble of software code that is burnt into two special-purpose chips which is itself burnt into another special-purpose chip added to the game cartridge When a game cartridge that contains the key is inserted into the console The source code of the software embedded in both chips is kept secret by the console manufacturer the console company burns them into the chips in a form that is understandable by machines but not by humans To ensure even further protection of these secrets both Nintendo and Sega manufactured the approved third-party game cartridges themselves before selling them to the licensees who in turn distributed them through toy and computer stores assuming I was one of the happy few to be vetted I would deliver my game software code to Nintendo burn the whole thing on a cartridge bearing my name and hand that cartridge to me so I could then sell it through my own distribution circuit as far as keeping the source code of the lock-out system a secret Many in the industry took umbrage with this model in particular because it enabled the console manufacturers to impose what developers considered unfair business terms and its behavior even led to anti-trust investigations by the U.S every lock can be unlocked without the official key — it’s just a matter of time The original Atari had been split after the crash was now in the business of publishing games for various computers and consoles But it didn’t want to be bound by Nintendo’s terms and decided to publish unlicensed cartridges for the NES if the original Atari’s lawyers had been unable to prevent Activision from doing just the same thing for the VCS/2600 why would Nintendo’s lawyers be able to stop Atari Games Atari responded to engineering moves with a bolder engineering move It reverse-engineered Nintendo’s lock-out chip known as the “10NES,” and replaced it with its own the “Rabbit.” The Rabbit code was entirely different from the 10NES When a rogue Tengen cartridge was inserted into the NES it would sing a mating song so close to what the lock expected from approved cartridges that the console would open up The first rogue game would be “Tetris,” followed by such hits as “Super Sprint” and “Ms reverse-engineered the Genesis’ lock in 1991 for its game “Ishido” and quickly released a number of blockbusters for that platform Engineering responses to business disruption had been defeated by engineering means it was now time for lawyers to respond to reverse-engineering with legal engineering moves of their own I mean the craft of creating novel legal arguments in response to changes in an environment — in this case What the Nintendo and Sega lawyers noticed was that in the process of creating their own mischievous code Atari and Accolade had to make a temporary copy of the lock’s own original code (the 10NES and the TMSS) in order to analyze it and make an original That intermediate copying had not been authorized by either Nintendo or Sega Atari and Accolade were therefore culpable of copyright infringement making the distribution of the rogue games illegal were tried in two different sets of courts for procedural reasons but were ruled upon at the same time period and cross-referenced each other The legal question was the same: Is intermediate copying of software code (the lock) when the sole purpose of such copying is to reverse engineer the lock and create a completely new and original code that will open the lock even though the lock’s code is not at all present in the final product (the rogue key) or is this practice permissible under the fair use doctrine since the code being temporarily copied is then discarded The underlying legal sub-questions were particularly complex and both federal appeals court judges distilled their astute reasonings in clear ways ultimately ruling that intermediate (temporary) copying of software code in the process of reverse-engineering it is generally permissible as fair use under copyright law At the heart of their technical legal rulings was economic policy They focused on “the effect of the use upon the potential market for or value of the copyrighted work,” one of the Copyright Act’s fair use analysis factors and noted that the public benefit of the copying at stake should also be factored in the judge concluded that “Accolade’s identification of the functional requirements for Genesis compatibility has led to an increase in the number of independently designed videogame programs offered for use with the Genesis console It is precisely this growth in creative expression based on the dissemination of other creative works and the unprotected ideas contained in those works that the Copyright Act was intended to promote.” The judge rebuked any suggestion that Sega might suffer a loss when it came to the number of games it would itself sell (or not sell) as a result The Atari judge agreed: “When the nature of a work requires intermediate copying to understand the ideas and processes in a copyrighted work that nature supports a fair use for intermediate copying,” he wrote reverse engineering object code to discern the unprotectable ideas in a computer program is a fair use.” it didn’t matter that Atari was right on principle — it had blatantly lied to get the code The pair of rulings had a significant impact on the industry at large It would come to protect the distribution of software-based hardware emulators such as the Connectix Virtual Game Station which enables players to run Playstation games on their desktop computers Perhaps even more visible as part of the retro-gaming boom of the past 30 years is the availability of a plethora of new cheap hardware that enables nostalgic players to play the Nintendo or Sega games of their youth without an actual NES the wide availability of new games for these old consoles developed by companies such as the new Tengen Games is enabled by the two rulings You might have been lured into reading this article by the promise of blood being drawn by Nintendo from Atari But didn’t we just learn that Atari Games (Tengen) beat Nintendo in court The Atari court ruled that Atari should have been allowed to reverse-engineer the NES as a matter of principle Atari was not allowed to invoke the fair use defense Atari’s lawyers’ hands were very dirty indeed Atari’s engineers had actually failed to reverse engineer the 10NES They could not figure out what that code was so they couldn’t create a new code that would work with the console So the lawyers took over and blatantly lied to the Copyright Office in order to obtain the copyrighted Nintendo code That code was held at the Office under seal Atari’s lawyers filed an application stating that Atari was a defendant in a copyright infringement lawsuit filed by Nintendo and needed a copy of the program to “be used only in connection with the specified litigation.” The Copyright Office obliged and provided the copy as they are supposed to in this type of case Atari then used Nintendo’s code to create the Rabbit code the judge turned to a maxim coined in British courts in 1728 and traced all the way to the Roman period of Justinian: he who comes into equity must come with clean hands to invoke a legal principle based on fairness One who comes to court in bad faith (with “unclean hands”) will be denied a defense such as fair use Atari was barred from manufacturing games for the NES subsequently “bled Atari to death,” in the words of Ed Logg designer of Tengen’s version of “Tetris,” which was recalled by court order and is now an expensive rarity on eBay The Tengen brand fell into disarray and was abandoned only to be revived a year ago to do the very thing Atari had been precluded from doing because their lawyers had failed to wash their hands including “ultimate” histories of the videogame industry that focus on “the great inventor,” are too reductive one must look beyond individual genius to the less sexy interplay of engineering it’s the legal battles — and sometimes the lawyers themselves — that create significant forks in the road Cognitive scientist and poet Keith Holyoak examines the essential role analogies play in our capacity for creativity and problem-solving The Editors | Mar 13 How is it that this premodern mystical alchemist appears so contemporary today Alfred Nordmann | Dec 29 Hawking’s refusal to upgrade his communication system preserved a voice that became iconic Sarah A. Bell | Dec 24 Robert Charles Post | Oct 10 A post shared by The Bled (@thebledaz) "These bands are way too popular to be in arrears." "Guess you'll have to go Steal This Album if you want to hear it now.." By subscribing, you agree to our Terms of Use and Privacy Policy Studio Tim Fu (STF), founded by a former architect at ZHA is redefining architectural innovation with the Lake Bled Estate — a 22,000-square-meter development in Slovenia where AI and human creativity converge including the historic Vila Epos designed in 1909 by Jože Plečnik the project seamlessly merges tradition with modern design Tim Fu emphasizes that AI is not a replacement for human intuition but a tool to accelerate creativity and optimize design STF utilizes AI to reinterpret local architectural elements transforming it into vertical atriums that enhance natural light and frame breathtaking views of Lake Bled and the Julian Alps World leaders convene for the NATO Washington summit in 2024. (Credit: The White House)Elon Musk has tweeted his agreement to a proposal that the United States exit the North Atlantic Treaty Organization (NATO) just shy of the alliance’s 80th anniversary To do so would not be the conservative path forward An American exit from NATO would represent not merely a betrayal of ideas that have guided our foreign policy since World War II it would be an insult to the legacy NATO left us NATO was founded as a military and political alliance of capitalist democracies to counter the spread of communist totalitarianism Article V of the treaty requires all members to come to the defense of any in the case of attack despite collaboration in technological innovation and strategic drills NATO was never activated during the Cold War NATO faces its first major opposition since isolationists rallied against it decades ago there is no better time to remember the singular moment where Article V was invoked and 53 Italians breathed their last in defense of the flag that liberated their nations 144 families from nations once under Soviet subjugation mourned for sons that died fighting for their shining city on the hill the titular character wistfully boasts that he won a medal from every allied power down by the Adriatic Sea.” With a population the size of Wichita even little Montenegro sent troops to support the United States in our occupation of Afghanistan The nations of NATO have demonstrated their commitment to the alliance and the United States. Yet, NATO has become controversial because of its support for Ukraine in its struggle against Russian invasion the Biden Administration largely tied the hands of the Ukrainian Armed Forces Asking Ukraine to strike a peace deal with Russia is reasonable but refusing to recognize Russia as the aggressor is not legitimating Russia’s annexation of southeastern Ukraine would not only be detrimental to America’s grand strategy but also contrary to her history and ideals As this young republic fought its Revolutionary War Facing insurmountable odds against a global power aid from that empire’s rivals saved our nation The situation is eerily familiar to any Ukrainian in 2025 Among the early great heroes of America was the Marquis de Lafayette a young Frenchman whose daring and guile turned back Redcoat advances Why would we now tell liberty to surrender before tyranny The voice of America cannot in good faith tell Ukraine that perhaps Winston Churchill was wrong in his noble dictum that righteousness  “shall never surrender” in the face of evil It is as if Lafayette had shaken General Washington’s hand in 1777 and told him to bow down before King George III We Americans have long celebrated those who fight the good fight Take Brigadier General Anthony McAuliffe’s retort of “nuts!” when asked to surrender by the Nazi force that surrounded him or Admiral David Farragut’s immortal demand to “damn the torpedoes full speed ahead!” In Ukraine’s battle for survival it is not difficult to see an American spirit Ukrainians now feel the rage Americans would have felt had France turned their backs on liberty in 1777 America should love our European neighbors as we have loved ourselves Our flag’s crimson stripes are not painted only with American blood the leaf blower war or the anti-'woke' backlash World Subscribers only Germany's Friedrich Merz is embracing pragmatism World Subscribers only Trump-Carney meeting: Canada seeks reconciliation World Subscribers only Friedrich Merz 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Guimet in Paris Long ReadThis seminal track by the group 113 which humorously evokes the summer vacations of French people of North African descent was an instant hit upon its release in 1999 Despite being withdrawn from airways and stores for years due to copyright issues It obviously started with that famous line from a backing singer: "Hey the orchestra then launched swirling violins followed by a traditional percussionist making the melody bounce by drumming on the skin of his darbuka wearing sunglasses and dressed in an elegant sandy-colored workwear suit appeared under the lights of the 40th edition of France's main music awards to deliver the unique introduction to the rap anthem "Tonton du Bled." this veteran of French rap performed his iconic track during a musical interlude dedicated to the memory of its brilliant producer who died at 34 in a tragic accident in 2011 "We had six minutes and 34 seconds to pay tribute to Mehdi It was obvious that 'Tonton du Bled' had to be part of it," explained Thibaut de Longeville a friend of DJ Mehdi and the director of the documentary series DJ Mehdi: Made in France (2024) which aired on French-German public television channel Arte and whose nomination (followed by a trophy that night) led to this performance "The symbolic significance was too strong," he continued a screen behind him displayed footage of his appearance 25 years earlier on the same stage he performed "Tonton du Bled" at the award show Very few songs have been performed more than once by their original artists at the Victoires de la Musique it's as if 'Tonton du Bled' has entered the French songwriting hall of fame," said Didier Varrod director of Radio France's music stations and unofficial historian of the Victoires de la Musique You have 88.7% of this article left to read Lecture du Monde en cours sur un autre appareil Vous pouvez lire Le Monde sur un seul appareil à la fois Ce message s’affichera sur l’autre appareil Parce qu’une autre personne (ou vous) est en train de lire Le Monde avec ce compte sur un autre appareil Vous ne pouvez lire Le Monde que sur un seul appareil à la fois (ordinateur En cliquant sur « Continuer à lire ici » et en vous assurant que vous êtes la seule personne à consulter Le Monde avec ce compte Que se passera-t-il si vous continuez à lire ici Ce dernier restera connecté avec ce compte Vous pouvez vous connecter avec votre compte sur autant d’appareils que vous le souhaitez mais en les utilisant à des moments différents Nous vous conseillons de modifier votre mot de passe Votre abonnement n’autorise pas la lecture de cet article merci de contacter notre service commercial BALTIMORE (WBFF) — A tragic incident unfolded at a McDonald's on Reisterstown Road near Cold Spring Lane leaving a family in mourning and a community shaken was fatally shot during an argument on Sunday afternoon while working alongside his 17-year-old son a high school student and employee at the restaurant recounted the harrowing experience her son endured He seen everything...and that's a lot ALSO READ| Police ID slain security guard, dispatch audio describes suspect as juvenile Douglas described the moment her son called her as his father lay bleeding he's bleeding bad it's not stopping And I'm saying somebody tie something Standing quietly beside his mother on a cold block in Northwest Baltimore "He called me while it was taking place...waiting for the paramedics to come Because his father was bleeding out...and no one has arrived and his father is on the ground The suspects involved in the shooting remain at large "I'm trying to take everything in everything has changed and nothing can bring back their father I hope that our kids at least get justice...and they find the young man that did it...and everybody else that was involved in it," Douglas said and a pastoral counselor are available for those in need of support This website is using a security service to protect itself from online attacks The action you just performed triggered the security solution There are several actions that could trigger this block including submitting a certain word or phrase You can email the site owner to let them know you were blocked Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page the world’s leading association of writers promotes a culture of peace based on freedom of expression PEN is dedicated to linguistic and cultural diversity and to the vibrancy of languages and their cultures whether spoken by many or few PEN International’s Writers for Peace Committee has therefore approved this Manifesto calling for the universal right to peace based on the Lugano Declaration for Peace and Freedom (1987) the Appeal of Linz Protesting Against the Degradation of the Environment (2009) and the Belgrade Declaration (2011) It was adopted by the Assembly of Delegates at the 79th PEN International Congress in Reykjavik (September 2013) Bled 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Contact UsFAQs CampaignsPrivacy & GDPRJoin Our TeamSubmit Whistleblowing Report PEN International is a registered charity in England and Wales.Registered Charity Number: 1117088.Company Number: 05683997PEN International 2022 ©167-169 Great Portland StreetLondon Website Design by Vibras Creative Studio This website is using a security service to protect itself from online attacks. The action you just performed triggered the security solution. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. You can email the site owner to let them know you were blocked. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Methods: We comprehensively searched the PubMed and Embase databases until July 2021 to identify relevant pieces of literature. The predictive abilities of risk scores were fully assessed by the C-statistic, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) values, calibration data, and decision curve analyses. Conclusion: The HAS-BLED score has moderate predictive abilities for bleeding risks in patients with AF regardless of type of oral anticoagulants. Current evidence support that the HAS-BLED score is at least non-inferior to the HEMORR2HAGES, the ATRIA, the ORBIT, the GARFIELD-AF, the CHADS2, the CHA2DS2-VASc, or the ABC scores. Volume 8 - 2021 | https://doi.org/10.3389/fcvm.2021.757087 This article is part of the Research TopicRisk Stratification Strategies for Cardiac Rhythm AbnormalitiesView all 49 articles Background: Several bleeding risk assessment models have been developed in atrial fibrillation (AF) patients with oral anticoagulants but the most appropriate tool for predicting bleeding remains uncertain we aimed to assess the diagnostic accuracy of the Hypertension Drugs/alcohol concomitantly (HAS-BLED) score compared with other risk scores in anticoagulated patients with AF Methods: We comprehensively searched the PubMed and Embase databases until July 2021 to identify relevant pieces of literature The predictive abilities of risk scores were fully assessed by the C-statistic net reclassification improvement (NRI) and integrated discrimination improvement (IDI) values Results: A total of 39 studies met the inclusion criteria The C-statistic of the HAS-BLED score for predicting major bleeding was 0.63 (0.61–0.65) in anticoagulated patients regardless of vitamin k antagonists [0.63 (0.61–0.65)] and direct oral anticoagulants [0.63 (0.59–0.67)] The HAS-BLED had the similar C-statistic to the Hepatic or renal disease the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) but significantly higher C-statistic than the Congestive heart failure Stroke/transient ischemic attack history (CHADS2) or the Congestive heart failure/left ventricular ejection fraction ≤ 40% Stroke/transient ischemic attack/thromboembolism history NRI and IDI values suggested that the HAS-BLED score performed better than the CHADS2 or the CHA2DS2-VASc scores and had similar or superior predictive ability compared with the HEMORR2HAGES Calibration and decision curve analyses of the HAS-BLED score compared with other scores required further assessment due to the limited evidence Conclusion: The HAS-BLED score has moderate predictive abilities for bleeding risks in patients with AF regardless of type of oral anticoagulants Current evidence support that the HAS-BLED score is at least non-inferior to the HEMORR2HAGES whether the application of the HAS-BLED score could be extended to DOAC-treated patients is still unclear this systematic review and meta-analysis aimed to: (1) assess the diagnostic accuracy of the HAS-BLED score in anticoagulated (VKAs or DOACs) patients with AF and (2) compared the performances of the HAS-BLED score with other risk scores to determine the most appropriate tool for predicting bleeding risks This meta-analysis and systematic review were carried out based on the Cochrane Handbook for systemic reviews The results were presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement Ethical approval was not necessary because the published studies of electronic databases were included We comprehensively conducted a search of the PubMed and Embase electronic databases until July 2021 to identify relevant pieces of literature reporting the HAS-BLED score in anticoagulated patients with AF The following keywords in the search strategies were used: (1) AF (2) VKAs or warfarin or coumadin or phenprocoumon or acenocoumarol or indandione or fluindione or phenindione or anisindione or non-VKAs or DOACs or dabigatran or rivaroxaban or apixaban or edoxaban To obtain the qualified studies comprehensively we also performed the cross-reference retrieval by screening the reference lists of included studies and prior meta-analyses English language restrictions in the literature research were applied in this study if they were analyzed for one bleeding endpoint in less than two independent studies We also excluded studies reporting the modified HAS-BLED score version by adding additional factors (e.g. gene polymorphisms) into the original HAS-BLED score Certain publication types with insufficient data such as reviews Potentially relevant studies were selected by two reviewers independently based on the predetermined criteria Qualified articles were included after the title/abstract screenings and the full-text screenings if two or more studies had the same data source we selected the study that was more designed to meet our inclusion criteria If both the studies meet the inclusion criteria we selected the newly published study or the study with the longest follow-up or highest sample size Disagreements were resolved through discussion between the two researchers or consultation with a third reviewer Data from included studies were extracted by two researchers independently We abstracted the following baseline information including the authors baseline characteristics of the patient [age or non-steroidal anti-inflammatory drugs (NSAIDs)] We applied the Prediction Model Risk of Bias Assessment Tool (PROBAST) (www.probast.org) to assess the risk prediction models (12) The consistency of the included studies was assessed through the Cochrane Q test and I2 index Significant heterogeneity was considered if the p-value of the Cochrane Q test < 0.1 or if the I2 value of >50% We used the funnel plots to examine the publication bias and a visual inspection of asymmetry indicated a bias All the statistical analyses were carried out by using the Review Manager 5.3 software (The Nordic Cochrane Center, The Cochrane Collaboration, 2014, Copenhagen, Denmark, UK) (https://community.cochrane.org/) p < 0.05 was considered as statistically significant The C-statistic and their 95% CIs were abstracted from the included studies for the discrimination analysis The C-statistic of ≤ 0.5 indicated that discrimination was no better than chance The pooled analyses were performed if at least two studies reported the C-statistic for the HAS-BLED score A random-effects model with an inverse variance method was chosen in the pooled analysis due to the observed significant heterogeneity the subgroup analyses were conducted on the basis of study design We also assessed the predictive ability of the HAS-BLED based on available vs unavailable labile international normalized ratio (INR) in the score The Z-statistic was calculated to compare the two C-statistic of the HAS-BLED score vs. other risk prediction models (the HEMORR2HAGES, the ATRIA, the ORBIT, the CHADS2, the CHA2DS2-VASc, the GARFIELD-AF, or the ABC scores) (4) we assessed the improvement in predictive accuracy by the reclassification analyses including the NRI and IDI parameters The probability of correctly predicting bleeding events by using the HAS-BLED score was reflected in the percentage of events correctly reclassified Calibration data represented the extent to which predicted risks correspond to observed risks other risk scores were assessed by using the decision curve analyses Narrative analyses were performed with respect to reclassification and decision curve analyses due to the lack of numerical data 49%) risk of bias according to the PROBAST tool Baseline characteristics of patient of the included studies The pooled analysis of the C-statistic for major bleeding in anticoagulated patients with atrial fibrillation Subgroup analysis for pooling the C-statistic of the Hypertension Drugs/alcohol concomitantly (HAS-BLED) score based on the types of oral anticoagulation for comparisons of the C-statistic between two different risk scores there were no statistically significant differences between the HAS-BLED vs the HEMORR2HAGES scores (major bleeding: Z-statistic = 0.396; any clinically relevant bleeding: 0.321; intracranial bleeding: −0.408); vs the ORBIT (major bleeding: −0.911; any clinically relevant bleeding: 0; intracranial bleeding: −0.158); vs the ATRIA (major bleeding −0.502; any clinically relevant bleeding: 0.257; intracranial bleeding: 0); vs the GARFIELD-AF (major bleeding: −0.448); or vs the ABC scores (major bleeding: −1.09) (p > 0.05) suggesting similar discrimination performances the HAS-BLED score had significantly higher C-statistic for predicting major bleeding than the CHADS2 (Z-statistic = 2.19 p < 0.05) or the CHA2DS2-VASc scores (Z-statistic = 1.99 suggesting that the HAS-BLED score performed better than the CHADS2 or CHA2DS2-VASc scores Summary of the C-statistic and 95% CIs of the included studies the GARFIELD-AF compared with the HAS-BLED scores had both non-significant negative NRI and IDI values the HAS-BLED score had at least non-inferior predictive ability for predicting major bleeding compared with the HEMORR2HAGES NRI and IDI analysis for predicting the bleeding risks in anticoagulated patients with AF The NRI values of the ABC score compared with the HAS-BLED score had the reverse effects in two included studies [+13.8% in Berg et al. (26) and −13.74% in Esteve-Pastor et al. (27)]. In the study of Esteve-Pastor et al. (27) the ABC score showed significant negative IDI values compared with the HAS-BLED score (−13.14% Further study should confirm the improvement in the predictive accuracy of ABC vs HAS-BLED scores in anticoagulated patients with AF The values from the NRI and IDI analyses assessing the improvement in predictive accuracy for any clinically relevant bleeding, any bleeding, intracranial bleeding, and gastrointestinal bleeding are presented in Table 3 The results of these sections should be interpreted cautiously due to the limiting number of included studies our results suggested that the HAS-BLED score had moderate predictive abilities for bleeding risks in anticoagulated patients with AF regardless of the OAC type We also observed the suitable application of the HAS-BLED score in patients with AF when the labile INR was unavailable The discrimination performance of the HAS-BLED score assessed by the C-statistic was comparable to the HEMORR2HAGES but performed better than the CHADS2 or the CHA2DS2-VASc scores The NRI and IDI data suggested that the HAS-BLED score performed better than the CHADS2 or the CHA2DS2-VASc scores and had similar or superior predictive ability compared with the HEMORR2HAGES Calibration and decision curve analyses of the HAS-BLED score compared with other risk models required further evidence-based assessment due to the different findings among the included studies The use of OAC effectively reduces the embolic risks but at cost of an increased risk of bleeding VKAs such as warfarin have been confirmed to be effective for preventing stroke in patients with AF Since the effectiveness and safety of DOACs are superior or non-inferior to warfarin in patients with AF the bleeding events and their related cardiovascular outcomes are not negligible The optimal use of VKAs or DOACs in the management of AF should be based on a balanced risk-to-benefit assessment during anticoagulation it is vital that the potentially preventable risk factors of bleeding events should be monitored sufficiently and addressed appropriately The HAS-BLED score has been currently recommended by current AF guidelines where a score of ≥3 points indicates high-risk bleeding Note that the HAS-BLED score is previously derived and validated mainly in VKA-treated patients with AF whether it could be used in DOAC-treated patients remains unclear we found that the HAS-BLED score had moderate predictive values for bleeding risks in anticoagulated patients with AF and the findings were consistent in the subgroups of mixed anticoagulated drugs The variable of labile INR in the HAS-BLED score was not available in all the included studies the predictive ability for major bleeding was not significantly changed if we only included the studies with labile INR in the pooled analysis Although several other bleeding risk prediction models have been proposed in published studies, whether the predictive ability of these models is parallel to the guideline recommended HAS-BLED score remains unclear. The HAS-BLED score has been previously assessed as the most balanced bleeding risk prediction tool in terms of sensitivity and specificity by using a meta-analytic approach (5, 33) discrimination outcome data (sensitivity/specificity or the C-statistic) are less critical than other predictive accuracy outcome measures our current meta-analysis comprehensively assessed the predictive abilities of the HAS-BLED vs the HAS-BLED score showed at least non-inferior abilities for bleeding risk prediction than the HEMORR2HAGES or the GARFIELD-AF scores in VKA- or DOAC-treated patients with AF Although there was no significant difference in the C-statistic between the HAS-BLED and the ABC scores and decision curve analyses between them were still controversial and needed further clarifications there is an overlap of risk factors such as age and diabetes between stroke and bleeding risk scores the CHADS2 and the CHA2DS2-VASc stroke scores are also closely associated with the increased bleeding risks we found that the HAS-BLED score performed better than the CHADS2 or the CHA2DS2-VASc scores in anticoagulated patients with AF Several published studies have modified the HAS-BLED score by revising the original variables or including additional factors. As shown in Supplementary Table 7 area deprivation index) on the basis of the original HAS-BLED score has been taken into account The modified HAS-BLED score might improve the predictive ability but certainly at the expense of additional complexity The number and definition of variables may vary from study to study potentially affecting the diagnostic performance of the HAS-BLED score Current evidence supports the HAS-BLED score regularly used in patients with AF to identify patients at high risk of bleeding as early as possible the HAS-BLED score is sometimes inappropriately used in clinical practice as an excuse to preclude the use of oral anticoagulants the benefits of OAC in reducing the stroke risk outweigh the bleeding risk Clinicians should flag up high bleeding-risk patients (e.g. the HAS-BLED score of ≥3) for the early review and follow-up Appropriate monitoring services and more efforts are necessary to be taken to correct modifiable bleeding risk factors such as uncontrolled hypertension concomitant use of medications such as aspirin or NSAIDs These findings seemingly do not support the use of the ORBIT over the HAS-BLED scores for bleeding risk prediction in patients with AF The simple and practical use of the HAS-BLED score is still appropriate for assessing VKA- or DOAC- related bleeding risks and helps clinicians to make informed decisions in clinical practice There were still several limitations in this study due to the high heterogeneity observed across the included studies the discrimination performances of bleeding prediction models evaluated by the C-statistic should be interpreted cautiously More studies focusing on the improvement in predictive accuracy by the NRI and IDI analyses or net benefits by decision curve analysis could be taken to fully assess the performances of risk scores our results suggested a relatively lower predictive value of the HAS-BLED score for any clinically relevant bleeding Only two studies reported the C-statistic for gastrointestinal bleeding more studies should further assess the value of the HAS-BLED score for these other bleeding outcomes the bleeding risk prediction tools of interest were derived and validated in studies with different study types ranging from observational cohorts to clinical trials potentially complicating the synthesis of the C-statistic we observed no significant interaction in the subgroup analysis based on the study design we provided the data of concomitant antiplatelet drugs but the effect of these drugs on the predictive value of the HAS-BLED score could not be analyzed due to the unclear cutoff points this study was performed based on most included studies with low-quality data but we comprehensively assessed the role of the HAS-BLED score vs other risk models in predicting bleeding events in patients with AF which had implications for clinical application and future research development The HAS-BLED score had moderate predictive abilities for bleeding risks in VKA- or DOAC-treated patients with AF The HAS-BLED score was at least non-inferior to the HEMORR2HAGES The original contributions presented in the study are included in the article/Supplementary Material further inquiries can be directed to the corresponding authors All authors listed have made a substantial and intellectual contribution to the work and approved it for publication This study was funded by the National Natural Science Foundation of China (82100273) the China Postdoctoral Science Foundation (2020M673016) and the China National Postdoctoral Program for Innovative Talents (BX20200400) The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fcvm.2021.757087/full#supplementary-material 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) Clinical outcomes and management associated with major bleeding in patients with atrial fibrillation treated with apixaban or warfarin: insights from the ARISTOTLE trial novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey The HAS-BLED score for predicting major bleeding risk in anticoagulated patients with atrial fibrillation: a systematic review and meta-analysis Accuracy of HAS-BLED and other bleeding risk assessment tools in predicting major bleeding events in atrial fibrillation: a network meta-analysis Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review Considerations when choosing an appropriate bleeding risk assessment tool for patients with atrial fibrillation Comparative effectiveness and safety of non–vitamin K antagonist oral anticoagulants in atrial fibrillation patients New score for assessing bleeding risk in patients with atrial fibrillation treated with NOACs Evaluation of the predictive performance of bleeding risk scores in patients with non-valvular atrial fibrillation on oral anticoagulants Novel bleeding risk score for patients with atrial fibrillation on oral anticoagulants A tool to assess risk of bias and applicability of prediction model studies: explanation and elaboration and ATRIA risk scores in predicting non-vitamin k antagonist oral anticoagulants-associated bleeding in patients with atrial fibrillation External validation of the ORBIT bleeding score and the HAS-BLED score in non-valvular atrial fibrillation patients using direct oral anticoagulants (Asian Data from the DIRECT Registry) Comparison of bleeding risk scores in patients with nonvalvular atrial fibrillation starting direct oral anticoagulants The predictive ability of the CHADS2 and CHA2DS2-VASc scores for bleeding risk in atrial fibrillation: the MAQI(2) experience The HAS-BLED score has better prediction accuracy for major bleeding than CHADS2 or CHA2DS2-VASc scores in anticoagulated patients with atrial fibrillation How well do stroke risk scores predict hemorrhage in patients with atrial fibrillation and HAS-BLED bleeding risk-prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS (evaluating the use of SR34006 compared to warfarin or acenocoumarol in patients with atrial fibrillation) study Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: attention to modifiable bleeding risk factors or use of a bleeding risk stratification score Major bleeding in patients with non-valvular atrial fibrillation: impact of time in therapeutic range on contemporary bleeding risk scores Importance of time in therapeutic range on bleeding risk prediction using clinical risk scores in patients with atrial fibrillation Predictive value of the HAS-BLED and ATRIA bleeding scores for the risk of serious bleeding in a “real-world” population with atrial fibrillation receiving anticoagulant therapy Low performance of bleeding risk models in the very elderly with atrial fibrillation using vitamin K antagonists Predicting bleeding events in anticoagulated patients with atrial fibrillation: a comparison between the HAS-BLED and GARFIELD-AF bleeding scores Performance of the ABC scores for assessing the risk of stroke or systemic embolism and bleeding in patients with atrial fibrillation in ENGAGE AF-TIMI 48 Long-term bleeding risk prediction in 'real world' patients with atrial fibrillation: comparison of the HAS-BLED and ABC-Bleeding risk scores Comparison of bleeding risk scores in patients with atrial fibrillation: insights from the RE-LY trial and ORBIT bleeding scores in atrial fibrillation patients using non-vitamin K antagonist oral anticoagulants The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation CHA2DS2-VASc and HAS-BLED scores for the prediction of clinically relevant bleeding in anticoagulated patients with atrial fibrillation: the AMADEUS trial clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study Performance of the HAS-BLED high bleeding-risk category compared to ATRIA and HEMORR2HAGES in patients with atrial fibrillation: a systematic review and meta-analysis Importance of risk reassessment in patients with atrial fibrillation in guidelines: assessing risk as a dynamic process Incident risk factors and major bleeding in patients with atrial fibrillation treated with oral anticoagulants: a comparison of baseline follow-up and delta HAS-BLED scores with an approach focused on modifiable bleeding risk factors Regular bleeding risk assessment associated with reduction in bleeding outcomes: the mAFA-II randomized trial Atrial fibrillation: diagnosis and management-summary of NICE guidance Comparison of HAS-BLED and ORBIT bleeding risk scores in af patients treated with NOACs: a report from the ESC-EHRA EORP-AF general long-term registry Zhou Y and Zhu W (2021) Diagnostic Accuracy of the HAS-BLED Bleeding Score in VKA- or DOAC-Treated Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis Received: 11 August 2021; Accepted: 12 October 2021; Published: 22 November 2021 Copyright © 2021 Gao, Cai, Yang, Zhou and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution or reproduction in other forums is permitted provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited in accordance with accepted academic practice distribution or reproduction is permitted which does not comply with these terms *Correspondence: Wengen Zhu, emh1d2c2QG1haWwuc3lzdS5lZHUuY24=; Yue Zhou, amF5MDQxNkAxMjYuY29t †These authors have contributed equally to this work Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish We chat with debut author S. Hati about And The Sky Bled which explores the devastating mechanisms of power and sees this searing climate fantasy breathe life into a crumbling world hovering on the brink of total destruction a speculative fiction writer currently residing in the Bay Area will soon be heading to my third Eras tour stop and can usually be found frustrated over the daily NYT games I’m also a bit of a science nerd so my stories often involve brown girls in strange worlds that straddle the line between magic and science I was in elementary school and my mom and I were about to embark on a multi-day train journey to visit my grandparents I was an extremely chaotic child and she didn’t know what to do with me during travel days so she borrowed a bunch of books from a friend I remember coming home from school and seeing the stack on the dining table and an heiress race to find a hidden cache of magic in a city that hovers on the brink of destruction this is a standalone multi-POV epic fantasy that explores themes of extractive colonialism and climate justice but the heart of this story is about loneliness and the indelible impressions we leave on each other It gets grim and dark but I think there’s a strong thread of hope that permeates through the end The setting was largely conceived following the 2020 Bay Area fires which left the skies a deep I’ve always been fascinated by natural disasters (fun fact: I used to want to be a storm chaser) so I knew I wanted to play with weather-based magic I loved the idea of blood rains because it sounds cool and visceral but it’s also an effective tool to explore themes of colonialism and environmental racism which has prompted a lot of thinking around the inequitable impact of climate change And the Sky Bled is not based on any specific historical event but I drew on various papers such as those on the environmental impact of the British Raj on India I’d had the last scene of this book in my head for a while — I had a strong vision of three characters coming together in an explosive climax where they unravel the ways in which their last encounters rippled through their lives I was fascinated by character relationships and wanted to explore how different personalities process and react to trauma The core emotions I wanted to unpack are shame and isolation how they can haunt people and tear them apart I realized these micro-themes fit synergistically with the macro-themes of our strenuous relationship with the planet I don’t always know the ending of a book when I start writing but I did for this one so it was really gratifying building up to it The midpoint was a ton of fun too; I knew every character was going to undergo a dramatic change in circumstance and it felt like releasing a boulder from the peak of a mountain I also loved writing the relationships in this book particularly because I got to explore the complexities of platonic relationships Charvi and Anastasia’s friendship arc was a highlight for me Probably because they’re the purest relationship in this story It’s involved me throwing things at the wall and seeing what sticks I wrote my first “serious” book during the pandemic which got me into Avengers of Color and Pitch Wars Both programs changed my life and taught me so much about writing and traditional publishing but that book didn’t make it through the query trenches I wrote And the Sky Bled right after and it got me my amazing agent but it did not look like it was going to get me a deal We had gone out on multiple rounds of submission and I’d written two other books in that time We were going to declare And the Sky Bled dead when Bindery reached out It’s been a whirlwind of an experience and looking back And the Sky Bled could not have ended up in a more perfect place but I’m looking forward to telling everyone about my next project—a pivot from And the Sky Bled Right now I’m knee deep in line edits while chipping away at two other projects See alsoTwin-Flamery & The Quest For Supernatural Eternal Love beautifully designed and comes with everything you need to engage your visitors and increase conversions pay TV operators lost fewer subscribers in Q2 But the business received somewhat of a reprieve in the second quarter with only two of the eight major platforms reporting metrics losing more subscribers from April through June than they did in the same period of 2023.  which were in part driven by the defunding of the Affordable Connectivity Program.  the rate of cord-cutting decelerated in the second quarter to 11.9% the first time in five quarters it has dipped below 12%.  Sling TV returned to customer growth for the first time in three quarters.  cord-cutting’s impact has proliferated beyond the mere earnings line specifying subscribers with other operators besides Dish reporting accelerated revenue declines.  Comcast’s revenue from delivering linear video service declined by 7.8% year over year to $6.781 billion That compared to a 5.6% sales drop for the same period of 2023.  The smarter way to stay on top of the streaming and OTT industry Charter saw linear video revenue decline by 7.7% in Q2 to $3.867 billion Charter reported a 6.6% revenue decline.  we still don't have Q2 estimates for what has been the U.S pay TV business’s fastest-growing platform One equity analyst we asked on Thursday said a YouTube TV estimate should be published in the coming days.  More copies are now available via Brooklyn Vegan. A post shared by The Bled (@thebledaz) Earlier this morning The Bled announced a new 21st anniversary vinyl round for their debut album Unfortunately for fans of the Arizonan metalcore band the four different colorways sold out in less than a half an hour If you weren’t able to get your hands on one there no doubt will be some action on the secondary market ahead You can see below for the pressings that were newly made available A post shared by The Bled (@thebledaz) The band will be onstage again performing that album on October 05th as part of this year’s ‘Furnace Fest‘ in Birmingham, AL. Porshe Streeter was killed in her home in January 2024 — police just arrested the father of her three children Your Ads Privacy ChoicesIMDb BetaShares/ishares/blackrock/ETFs/US-equities/ One of Australia’s largest exchange-traded fund (ETF) products lost over $300 million in outflows during March The iShares S&P 500 ETF seeks to provide investors with the performance of the S&P 500 Index It is one of Australia’s largest ETF products with a market cap of $10.3 billion at the end of March Aussie private credit player expands with key hire Clime IM looks to US for revenue boost Betashares’ monthly ETF review found that IVV suffered outflows of $307 million last month – the highest outflows of any ETF vehicle in March This caused it to fall from second position in terms of market cap in February to third spot in March behind the Vanguard MSCI Index International Shares ETF at $10.4 billion The S&P 500 Index was down 5.7 per cent during March and has subsequently fallen 11 per cent during April so far (as of 9 April) following US President Donald Trump’s announcement of major tariffs on 2 April It marks a stark contrast from the inflows of $145 million recorded by IVV in February and $239 million in January The product also enjoyed inflows of $2 billion for the full 2024 calendar year said global markets have been “incredibly volatile” While the iShares Core S&P 500 ETF (IVV) experienced outflows we have observed inflows into the hedged version of IVV – the iShares S&P 500 (AUD Hedged) ETF (IHVV) – as well as into the iShares MSCI Emerging Markets ex China ETF (EMXC) and the iShares Global Aggregate Bond ESG (AUD Hedged) ETF (AESG),” Waterworth noted These movements suggest investors are derisking into bonds and equity markets that are less exposed to the US amid heightened volatility rather than simply “taking money off the table” “The preference for the hedged version (IHVV) is particularly noteworthy as it shows that investors remain somewhat interested in US equities but are cautious about currency risk and seeking to shield against potential AUD appreciation,” he added the iShares MSCI Emerging Markets ETF also lost $246 million in outflows during March while the Magellan Global Fund (Open Class) (Managed Fund) saw outflows of $124 billion The top five Australian ETFs by outflows for the month were: Magellan Global Fund (Open Class) (Managed Fund) Despite strong net flows of $3.6 billion recorded for the broader Australian ETF industry in March this was not enough to offset global sharemarket volatility The ETF market’s assets decreased nearly 2 per cent month-on-month with the sector now sitting at $250.4 billion in assets under management which has long held the top asset class spot for strongest inflows and Australian equities in first position at $1 billion international equities enjoyed inflows of $1.5 billion during February and $1.8 billion in January So we are now underwriting criminal scams?.. The definition of 'significant change is circumstances relevant to the scope of the advice' is s.. Tiffany Render previously told Carlisle police that Paul Irwin was abusive and had threatened to kill her A woman “trapped” inside an aggressive and controlling relationship bled to death after a violent sexual assault has denied the murder and sexual assault of Tiffany Render On the opening day of Irwin’s trial at Carlisle crown court the prosecutor Iain Simkin KC said Render was an “extremely vulnerable woman who was trapped inside an aggressive violent and controlling relationship” with the defendant He said paramedics were called to Irwin’s flat in Whitehaven shortly before midnight and “remarked that Tiffany was surrounded by blood-soaked bedding” She was pronounced dead shortly after midnight Simkin said her injuries were sustained during a sexual assault and “resulted in almost immediate bleeding and she bled to death inside the defendant’s home” Simkin outlined violent incidents that he said had taken place during Render’s relationship with Irwin Render phoned the ambulance service saying she was increasingly concerned about Irwin’s conduct Irwin struck her “multiple times with a wooden rolling pin” Render alleged that she had been assaulted again with a forceful kick to the backside by Irwin came against a background of his binge drinking increasing control and repeated aggression towards her Render left the flat and said she was told by Irwin that he would burn photographs of her children if she did not return Render told police: “I have said to him if you burn those photographs then I will kill you He has then stated: ‘Come up here and I will kill you I’m telling you now that I’ll fucking kill you.’” The jury was told that Render alleged Irwin exercised “full control” over her life limiting access to money and contact with her children inspecting her phone and telling her what she could and could not eat Simkin said it was anticipated that Irwin would claim Render consented to sex and that her death was “an accidental result of sexual activity” He told jurors: “The prosecution submit that you will be able to reject that assertion “We will invite you to consider the nature of their relationship the violence which the defendant previously used upon the deceased and the extreme nature of the injuries themselves; which is evidence which torpedoes Mr Irwin’s claim that Tiffany consented to the penetration.” Grayscale's outflows overshadow big inflows from the rest of the ether ETFs but it's more complicated than that.BlackRock's ETHA was the seventh-most-successful ETF launch this year with over a billion dollars worth of inflows Other ether funds have seen brisk demand as well.Grayscale's ETHE product lost billions offsetting the overall success of the funds.The headline could easily be this: Recently launched ether exchange-traded funds have been a dud investors have removed $465 million of assets in total from the nine funds that began trading in the U.S STORY CONTINUES BELOWDon't miss another story.Subscribe to the Crypto for Advisors Newsletter today. See all newslettersSign me upBy signing up, you will receive emails about CoinDesk products and you agree to our terms of use and privacy policy.Dig a little deeper and you'll find success BlackRock’s iShares Ethereum Trust (ETHA) just passed $1 billion of net inflows, making it the seventh-most-successful ETF launch this year, according to Nate Geraci, president of the ETF Store. Fidelity’s Ethereum Fund and the Bitwise Ethereum ETF have taken in $390 million and $312 million, respectively, according to data from Farside Investors. But back to the overall removal of money, which stems from the billions of dollars yanked from the Grayscale Ethereum Trust (ETHE). That product was first sold to investors in 2017 and began trading publicly in 2019 – albeit in a less-appealing trust format. It was turned into an ETF in July as new funds from the likes of BlackRock sprung into existence. The Grayscale product features a much higher fee for investors, meaning many might want to shift to a cheaper fund. Exclude the massive Grayscale outflows and investors have allocated over $2 billion to the other funds in the first five weeks. “The fact that over $2 billion has been purposefully allocated to the other spot ether ETFs is a good sign as it shows that investors want ether exposure,” Geraci said. “While not the dazzling debut we saw from spot bitcoin ETFs, I think spot ether ETFs have clearly had a successful first month and I expect this to continue.” In regards to Grayscale, Geraci believes that the outflows muddy the waters and make it difficult to get a clear picture of how much demand there is for the funds. “We simply don’t know all of the underlying motivations of ETHE sellers, which is why I think it’s important to look beyond that product.” Demand is likely to continue and grow over the next few months, said Sui Chung, CEO of index provider CF Benchmarks. He predicts that more wealth managers will offer the products to their clients. “We anticipate flows into ETH ETFs will continue to climb once wealth managers and financial advisors complete the education process for what ETH is, its utility and why they should hold it alongside their BTC ETF,” he said. “The educational process will expose investors to the Ethereum economy and highlight its key differences to Bitcoin, making it abundantly clear that the allocation drivers are different and both belong in a balanced investment portfolio.” Spot bitcoin ETFs, which began trading in January, have seen nearly $18 billion in inflows. Investors have allocated roughly $20 billion into BlackRock’s product, which is mostly offset by $17 billion worth of outflows out of the Grayscale Bitcoin Trust (GBTC), another Grayscale fund that existed for years as a trust before converting to an ETF this year. Helene is a New York-based markets reporter at CoinDesk, covering the latest news from Wall Street, the rise of the spot bitcoin exchange-traded funds and updates on crypto markets. She is a graduate of New York University's business and economic reporting program and has appeared on CBS News, YahooFinance and Nasdaq TradeTalks. She holds BTC and ETH. member of the Novartis Executive Committee and President of Operations took part in this year’s Bled Strategic Forum In the context of the forum panel Navigating the Global Flux: Disruptions and Prospects in Trade Lang discussed the challenges of the European pharmaceutical industry and the future of innovation He emphasized the significant contribution of the Slovenian sites to Novartis’ global success as well as the important role Novartis plays as a top employer and how it is the first and leading pharmaceutical company for innovative medicines in Slovenia Novartis is a major contributor to the European economy with innovative pharmaceuticals dramatically outperforming other high-tech sectors in Europe in terms of turnover The pharmaceutical industry directly employs 840,000 people in Europe and indirectly creates three times as many jobs Steffen Lang stressed the importance of innovation and the efforts it entails: “Innovation is not something to be taken for granted It requires significant investment in research Research-driven pharmaceutical companies are not only crucial for patients foster collaborative relationships with universities create opportunities for service companies encouraging creativity and promoting science.” Novartis has invested over 3.4 billion euros in Slovenia; its trust in local expertise and strong commitment to further advancing the local sites is evidenced by the fact that Novartis in Slovenia currently has ongoing projects with a total value of over 500 million euros the sites in Ljubljana and Mengeš handle more than half of Novartis’ priority innovative medicines in different stages of development Novartis is also the only company in Slovenia with the capacity for the full production cycle of innovative biologics The company employs over 3,600 people in Slovenia and ensures access to all Novartis’ core innovative medicines for local patients and predictable economic environment that cultivates competition and stimulates innovation is vital for the success of Novartis as well as for the entire European economy He said the key to becoming future-ready is in focusing on talent development: “At Novartis we believe that innovation is driven by individuals equipped with the right knowledge and skills The path to excellence starts with an effective education system continues with the lifelong development of hands-on expertise and is fueled by a supportive organizational culture This comprehensive approach enables us to nurture and develop a pool of talent to take on any challenges the future may bring.” Applications for the Young Bled Strategic Forum taking place from August 29 to 31 in Pokljuka in Slovenia 0 Young BSF was launched in 2011 as a side event of the Bled Strategic Forum (BSF) bringing together students and young professionals it has evolved into an independent and standalone platform This year’s edition of the forum is titled ‘What Values?’ and it will focus on exploring the relationship between personal and collective values and their role in shaping global politics Applications for this year’s Young BSF, which will be held from August 29 to 31 in Pokljuka, are open until April 27, and all interested candidates can apply via the form available on the BSF website and all costs are covered by the organizers The platform is shaped by the participants themselves – young people aged 18 to 35 working in the broadly defined field of world politics “We seek candidates from diverse backgrounds or professional in any field with a strong interest in international politics – if you’re passionate about creating positive change we encourage you to apply,” the organizers said in the announcement The forum will gather around 40 participants from all over the world and design solutions for today’s global challenges After the conclusion of the Young BSF program participants will also attend the 20th Bled Strategic Forum The main thematic areas are the crises of the rules-based international order, conflicting value systems of the climate emergency, and the perspectives of the people implementing policies on a global scale. Young leaders and professionals will strive to open a dialogue on the key issues of our time The forum aims to contribute to a deeper understanding of contemporary social phenomena and to encourage positive change in both local and global communities through the exchange of ideas and collaborative work on concrete challenges participants will attend the 20th Bled Strategic Forum in Bled on September 1 and 2 Be the first one to comment on this article 30 April 2025 - Energy Secretary Chris Wright has delivered a keynote speech at the inaugural session of the Three Seas Business Forum in Warsaw , 09 April 2025 - Renewables and nuclear energy met 79,1% of 2024 global power demand growth The fossil fuels share was bigger than the part attributed to the annual rise in temperatures 08 April 2025 - The first large independent analysis in Croatia of methane emissions from the oil and gas infrastructure was carried out 08 April 2025 - The Ministry of Environmental Protection and Green Transition has presented the Social Plan for Climate Policy and the EU ETS 2 © CENTER FOR PROMOTION OF SUSTAINABLE DEVELOPMENT 2008-2020 website developed by ogitive Get important news about your town as it happens. Something went wrong. Please subscribe again. Get the top stories from across our network. Are you sure you want to unsubscribe from daily updates? A 36-year-old woman from Bergen County has been charged with child endangerment and assault after allegedly biting a child so hard during an argument that he bled, authorities said. Cecilia Murillo Viera was arrested in Oakland on Sunday, Dec. 1, 2024, after the Oakland Police Department contacted the Bergen County Prosecutor’s Office Special Victims Unit regarding suspected child abuse, Bergen County Prosecutor Mark Musella announced. According to the affidavit for probable cause, Murillo Viera scratched the child on the face and back and bit him on the back, causing visible bruising, bleeding, and injury, after engaging in an argument. An investigation by the Bergen County Prosecutor’s Office, under Chief Matthew Finck, and the Oakland Police Department, under Chief Keith Sanzari, led to Murillo Viera being charged with second-degree endangering the welfare of a child and simple assault, a disorderly persons offense. Murillo Viera was remanded to the Bergen County Jail pending her first court appearance at the Bergen County Superior Court in Hackensack. © 2025 Court TV Media LLC, part of The E.W. Scripps Company. All Rights Reserved. Court TV brings you inside the courtroom for the most compelling cases across the country with in-depth investigative reporting and expert legal analysis. The 2021 UK National Institute for Health and Care Excellence guidelines tend to recommend the ORBIT score for predicting bleeding risk in patients with atrial fibrillation (AF) with anticoagulants. Herein, we comprehensively re-assessed the predicted abilities of the HAS-BLED vs. ORBIT score since several newly published data showed different findings. We comprehensively searched the PubMed electronic database until December 2021 to identify relevant studies reporting the ORBIT vs. HAS-BLED scores in anticoagulated patients with AF. Their predicted abilities were assessed using the C-index, reclassification, and calibration analysis. Our current findings suggested that the HAS-BLED and ORBIT scores at least had similar predictive abilities for major bleeding risk in anticoagulated (vitamin K antagonists or direct oral anticoagulants) patients with AF, supporting the use of the HAS-BLED score in clinical practice. Clinical and Translational Cardiovascular Medicine Volume 9 - 2022 | https://doi.org/10.3389/fcvm.2022.1042763 Background: The 2021 UK National Institute for Health and Care Excellence guidelines tend to recommend the ORBIT score for predicting bleeding risk in patients with atrial fibrillation (AF) with anticoagulants we comprehensively re-assessed the predicted abilities of the HAS-BLED vs ORBIT score since several newly published data showed different findings Methods: We comprehensively searched the PubMed electronic database until December 2021 to identify relevant studies reporting the ORBIT vs Their predicted abilities were assessed using the C-index the ORBIT score had a C-index of 0.63 (0.60–0.66) and 0.57 (0.48–0.67) for major bleeding while the HAS-BLED score had a C-index of 0.61 (0.59–0.63) and 0.57 (0.51–0.64) for major bleeding There were no statistical differences in the accuracy of predicting these bleeding events between the two scoring systems the subgroup analyses based on vitamin K antagonists vs direct oral anticoagulants suggested no differences in the discrimination ability between the HAS-BLED and ORBIT scores Reclassification and calibration analyses of HAS-BLED vs ORBIT should be further assessed due to the limited and conflicting data Conclusion: Our current findings suggested that the HAS-BLED and ORBIT scores at least had similar predictive abilities for major bleeding risk in anticoagulated (vitamin K antagonists or direct oral anticoagulants) patients with AF supporting the use of the HAS-BLED score in clinical practice we performed a systematic review and meta-analysis aiming to re-assess the diagnostic accuracy of the HAS-BLED vs ORBIT scores for predicting bleeding risks in anticoagulated (VKAs or DOACs) patients with AF Studies published in English were included in this study We included the studies if they met the inclusion criteria: (1) adult non-valvular patients with AF treated with VKAs or DOACs; (2) studies reported the diagnostic performance of the ORBIT vs HAS-BLED scores; (c) major bleeding and any other bleeding events and gastrointestinal bleeding; (d) at least one of the following data were reported: C-index net reclassification improvement (NRI) and integrated discrimination improvement [IDI] values We excluded studies with insufficient data Two authors independently assessed the relevant studies based on the predetermined criteria We included the qualified articles after the title/abstract screenings and the full-text screenings Disagreements were resolved through discussion or consultation with a third reviewer Data were abstracted from the included studies The quality assessment was performed using the prediction model risk of bias assessment tool (PROBAST),1 consisting of four domains including participants We used the funnel plots to examine the publication bias and visual inspection of asymmetry indicated a bias we performed narrative analyses on the improvement in predictive accuracy by the reclassification analysis All the statistical analyses were carried out using the Review Manager 5.4 software A P-value of <0.05 indicated statistical significance Flowchart of document retrieval and screening process of this review Table 1 shows the baseline characteristics of the 17 studies included in this review. The quality assessment by the PROBAST is shown in Supplementary Table 2 suggesting that all of the included studies had a high or unclear risk of biases Baseline characteristics of the included studies containing the HAS-BLED and ORBIT scores the subgroup analyses based on available vs unavailable labile INRs also showed no difference Pooled C-index for bleeding events in anticoagulated patients with atrial fibrillation C-statistics and 95% CIs between the HAS-BLED and ORBIT scores Pooled analysis of the C-statistics of different subgroups by using DOAC or VKA for major bleeding The NRI and IDI data between the HAS-BLED and ORBIT scores are presented in Supplementary Table 3 only four included studies reported the NRI and IDI values between the two studied risk scores the HAS-BLED score in these four studies showed positive NRI and IDI values compared with the ORBIT score although not significant in each included study reported that the HAS-BLED score had a significantly positive NRI value (+4.8% P < 0.001) compared with the ORBIT score No NRI and IDI data were reported about any other bleeding outcomes Calibration data between the HAS-BLED and ORBIT scores from seven included studies are displayed in Supplementary Table 4 we found that their findings of this part were not consistent among the included studies showed that ORBIT had a better calibration than HAS-BLED found no difference in the calibration data between ORBIT and HAS-BLED As shown in Supplementary Figure 1 we found no potential publication biases when inspecting the funnel plot The goal of anticoagulation in patients with AF is to minimize the occurrence of adverse events (especially the risk of stroke) by preventing thrombosis, while the risk of bleeding is significantly increased during anticoagulation. Therefore, the accurate prediction of patients with AF with a high bleeding risk is helpful. To date, multiple bleeding risk scores have been created for the assessment of bleeding risk in patients with AF on anticoagulation (29) the HAS-BLED and ORBIT scores have been validated in different populations are currently the most commonly used score in trials and clinical practice systems this study mainly conducted a meta-analysis on the predictive power of the ORBIT vs HAS-BLED scores in patients with AF with different anticoagulants (VKAs or DOACs) we believe that the ORBIT score is not significantly better than the HAS-BLED score as it is unlikely to underestimate the bleeding risk in patients anticoagulated with VKAs or DOACs in the subgroup analysis based on the OAC type (VKAs vs we found that the HAS-BLED and ORBIT scores had similar moderate abilities for predicting major bleeding for patients with AF treated with VKA or DOAC anticoagulation it is still recommended to use the HAS-BLED score for bleeding risk assessment among patients with AF the assessment of bleeding risk is not a “static” process and patients with AF need to be repeatedly assessed throughout the course of anticoagulation therapy The main role of the bleeding risk score is to “mark” patients who may be at risk of bleeding for more careful evaluation and follow-up Several limitations in this meta-analysis should be noted there was high heterogeneity in the C-index analysis and limiting data of the NRI and IDI values and decision curve analysis between the two studied scores the study quality assessed by the PROBAST was relatively low for each included study potentially limiting the reliability of our findings the predictive ability of other bleeding events between the HAS-BLED and ORBIT scores should be further explored The HAS-BLED and ORBIT scores had similar predictive abilities for major bleeding risk in VKA- or DOAC-treated patients with AF supporting the recommendation of the HAS-BLED score in the AF settings The original contributions presented in this study are included in the article/Supplementary material The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fcvm.2022.1042763/full#supplementary-material Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association for cardio-thoracic surgery (EACTS) A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey Bleeding risk in ‘real world’ patients with atrial fibrillation: comparison of two established bleeding prediction schemes in a nationwide cohort 2021 focused update consensus guidelines of the asia pacific heart rhythm society on stroke prevention in atrial fibrillation: executive summary Diagnostic accuracy of the HAS-BLED bleeding score in VKA- or DOAC-treated patients with atrial fibrillation: a systematic review and meta-analysis and ORBIT bleeding risk scores in patients with atrial fibrillation taking warfarin Is the ORBIT bleeding risk score superior to the HAS-BLED score in anticoagulated atrial fibrillation patients and ATRIA risk scores in predicting non-vitamin K antagonist oral anticoagulants-associated bleeding in patients with atrial fibrillation Google Scholar Google Scholar Google Scholar A new model to predict major bleeding in patients with atrial fibrillation using warfarin or direct oral anticoagulants Google Scholar External validation of the ORBIT bleeding score and the HAS-BLED score in nonvalvular atrial fibrillation patients using direct oral anticoagulants (Asian data from the DIRECT registry) Google Scholar and existing clinical risk scores for predicting outcomes in patients with atrial fibrillation: a report from the J-RHYTHM registry Comparison of HAS-BLED and ORBIT bleeding risk scores in atrial fibrillation patients treated with non-vitamin K antagonist oral anticoagulants: a report from the ESC-EHRA EORP-AF general long-term registry Comparison of the HAS-BLED versus ORBIT scores in predicting major bleeding among Asians receiving direct-acting oral anticoagulants ORBIT scores in anticoagulated patients with atrial fibrillation: A systematic review and meta-analysis Copyright © 2023 Liu, Wang, He and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) *Correspondence: Xuyang Liu, ✉ bHh5MDEzNkAxNjMuY29t; Linjuan Guo, ✉ NzI3NDU2MzcyQHFxLmNvbQ== †These authors share first authorship But then-California attorney general Kamala Harris offered respite for her union allies—and major campaign donors: She would join them in their appeal Harris and the unions argued that even though the Golden State’s constitution guaranteed children an education that didn’t mean it had to be a quality education The appellate court determined that California schools were indeed disproportionately harming minority and low-income children by retaining bad teachers but ruled in favor of Harris and the unions The three-judge panel said school administrators were the problem not the teacher tenure and dismissal laws the nine student plaintiffs had challenged "[Harris] had every opportunity to stand up for the kids of Oakland and San Francisco," Gloria Romero the former California Senate majority leader most kids in her hometown district of Oakland aren’t at basic levels of proficiency in reading and math." Reform efforts that had begun after the lower court’s ruling stopped in their tracks and just four years after the appellate ruling were widely influential in keeping schools closed and mask mandates in place during the COVID-19 pandemic Critics argue that by joining unions to overturn the students’ initial victory Harris helped kneecap California parents’ ability to challenge their districts When Los Angeles parents sued to reopen their shuttered schools in 2021 administrators pointed to the case as justification for keeping kids in ineffective online learning it doesn’t matter if we’re giving you a mediocre education because constitutionally children in California do not have a right to a quality education," said Negeen Ben-Cohen a Los Angeles attorney and parent who helped lead that lawsuit Harris Defends Laws Students Say Protect Incompetent Teachers and seven other California students sued the Golden State in 2014 including one that made teachers eligible for tenure after 18 months—among the shortest in the nation—and another that established a first in The students argued that the probationary period was too short to make informed decisions; that schools were forced to fire newer high-quality teachers and retain senior educators regardless of ability; and that tenured teachers were simply too hard to fire The California Teachers Association and California Federation of Teachers intervened and voluntarily joined Vergara v Harris and the unions argued that the laws were necessary to recruit and retain teachers particularly at less desirable low-income schools Vergara described teachers who let students smoke marijuana in class and called them "stupid" and "cholos"—a racially derogatory term and not put you down," the 15-year-old told the court One expert witness presented a study showing that a single year spent under an incompetent teacher’s tutelage costs students some $1.4 million in lifetime earnings A second demonstrated that students taught by Los Angeles’s bottom-tier teachers lost nearly 10 months of learning Another testified that firing incompetent teachers with tenure could take anywhere from 2 to 10 years and cost between $50,000 and $450,000 Even the state’s witnesses acknowledged that California schools employ thousands of "grossly ineffective" educators "The evidence is compelling. Indeed, it shocks the conscience," Judge Rolf M. Treu wrote in his 16-page decision siding with the students and drawing comparisons to Brown v "Substantial evidence presented makes it clear to this court that the challenged statutes disproportionately affect poor and/or minority students." Lawmakers in the state legislature began bipartisan work on reforms they saw as possible with the longstanding laws struck down a staffer involved in the negotiations told the Free Beacon "My hope is that today’s decision moves from the courtroom toward a collaborative process in California that is fair practical and swift," Obama’s education secretary every school district needs to have that kind of conversation." The decision also prompted a Politico article "The Fall of Teachers Unions," focused on a range of challenges the labor groups faced A New York Times editorial said Treu’s ruling "pointed to the stupidity" of the short probationary period and "underscores a shameful problem that has cast a long shadow over the lives of children not just in California but in the rest of the country as well." "[T]he unions can either work to change the anachronistic policies cited by the court or they will have change thrust upon them," it continued They vowed to appeal before Treu’s decision was even finalized "Every day that these laws remain in effect represents another opportunity denied," John Deasy then-Los Angeles Unified School District superintendent I don’t think we need to watch for two generations more to fix this." But Treu kept the laws in place so the pending appeal could play out Harris and the unions’ arguments aligned: Students didn’t have a right to a quality education "Even significant variances in students’ educational experiences … are not necessarily sufficient to establish a constitutional deprivation," Harris’s office argued "The same person who wanted to throw the low-income mostly African-American mothers into jail for truancy from these chronically failing schools went to court later to say The appellate panel called it "extremely troubling" that incompetent teachers were transferred to schools primarily serving low-income and minority students instead of being fired. But the judges ruled that administrators "The challenged statutes do not in any way instruct administrators regarding which teachers to assign to which schools," the panel wrote in the April 2016 ruling 2024 Bitcoin trading volume recorded post-halving ATH as crypto market bled Bitcoin trading volumes reached unprecedented levels amid the market turmoil while crypto hackers capitalized on discounted Ether News COINTELEGRAPH IN YOUR SOCIAL FEEDBitcoin transactions on crypto exchanges skyrocketed amid turbulent market conditions, marking a new all-time high in trading volume in the fourth cycle of Bitcoin halving On Aug. 5, numerous crypto traders suffered huge losses after having their positions liquidated due to falling prices of prominent cryptocurrencies, including Bitcoin (BTC), Ether (ETH) and Solana (SOL) some crypto investors sold their Bitcoin holdings to minimize losses while others chose to purchase the heavily discounted BTC at the $50,000 range the total United States dollar value of trading volume on major Bitcoin exchanges exceeded $1.14 billion on Aug A similar value of transactions was last recorded in March long before the fourth Bitcoin halving was completed on April 20 the daily exchange trade volume on Bitcoin exchanges maintained an average of $30 million It is important to note that Blockchain.com collects data from top crypto exchanges and some over-the-counter markets the actual total trading volume is much higher than reported Data from Dune Analytics show that over 90% of transactions that went through the Bitcoin network on Aug together took up less than 9% of the Bitcoin network bandwidth Related: Over $1B wiped out in crypto liquidations as global markets suffer The momentary crypto crash brought down Bitcoin and Ethereum prices by more than 10% and 20%, respectively. Cryptocurrency hackers saw this dip as an opportunity to buy up heavily discounted Ether using stolen funds from previous heists The Nomad Bridge exploiter used 39.75 million Dai (DAI) tokens Adding to blockchain analytics firm Lookonchain’s findings blockchain investigation firm PeckShield noted that the Nomad exploiter concurrently sent 17.75 ETH to an intermediary Ethereum address the hacker transferred approximately 2,400 ETH (worth around $7 million) to Tornado Cash Magazine: How crypto bots are ruining crypto — including auto memecoin rug pulls Paris-based creative club, Bled FC, have revealed a new unique and limited edition Nike jersey, which features a design inspired by the energy of their home city, encapsulated in a lightning bolt graphic treatment. Bled FC, a creative team based in Paris that highlights cultural diversity through football while connecting the game to art, fashion and street culture, have revealed their latest collaboration with Nike Paris. The jersey design celebrates the energy of Paris and its citizens with a lightning bolt design with interchangeable Swoosh and Bled FC logos. The limited edition jersey is available exclusively at Nike House Of Innovation Paris. View this post on Instagram A post shared by Bled FC (@bledfc) View this post on Instagram A post shared by Bled FC (@bledfc) magazine-making – the Vietnamese-Parisian has been doing all this and more through his respected creative football studio for over 10 years Embracing the Women's World Cup festival spirit French creatives BLED FC have designed and released their latest "SISTERHOOD" football jersey in limited numbers Linking up with Parisian Female Football team Cacahuètes Sluts for a stylised lookbook it's another strong showing of bespoke jersey game from the club Embracing Japanese football culture and getting right to the core those behind Bled FC took to the country for three weeks in search of the spirit of the game this set of imagery and complimenting video documents the journey WE:FC have joined with partners Hummel and Rewe to design a retro-inspired jersey as part of the ‘Kölsche Originale’ (Cologne Originals) range within 1 This jersey is inspired by the importance of pub-culture within Cologne and their love for the fanbase have rolled out their latest batch of clothing updates for July 2019 with shades of green and grey wrapping around the collection that has one eye on the autumn season Patterns and pastels are the themes of the re-fresh as Nike approach the 2019/20 season with an updated aesthetic on their football-meets-lifestyle collection The Swoosh have dropped their latest Nike F.C clothing collection as Real Madrid's Marco Asensio and Barcelona's Ousmane Dembélé feature in a lookbook showcasing the statement pieces for SS18 is still very much a club that’s about the city and the people within it As part of the running theme for their kit designs this season and it’s been beautifully captured in their latest lookbook Sydney got its custom game on at the weekend as the Swoosh rolled out the Nike FTBL Studio over the weekend with Local FC A customisable jersey workshop opened its doors to a creative party of rule-breaking designs and bespoke style Sign up to our newsletter and we'll keep you in the loop with everything good going on in the world of Creative Soccer Culture Kareena to Katrina: Monochrome summer sets from Bollywood celebs’ wardrobes 10 most beautiful red coloured flowers that grow in summer How to make high-protein Soyabean and Paneer Pulao in a pressure cooker ​In pics: Elegant looks of actress Fouzee​ 10 must-visit UNESCO Heritage sites in Europe for history lovers Top 8 elephant safari destinations in India Our Privacy Policy has been revised. Please review updated ';P+='Privacy Policy Here';P+=' The author visit is taking place within the context of the 57th International Writers' Meeting at Bled organised by the Slovenian PEN Centre and the Writers for Peace Committee with a main focus on Climate Crisis and Wars and at the initiative of the Mladinska knjiga publishing house.  CD Club Who's Writing Out There: Talks on Immigrant Literature People Catalog of public information Cankarjev dom Accessibility Statement Memberships, partners, sponsors Media center Calls and public tenders staying up-to-date with all the latest news Register Founder and main co-funder of Cankarjev dom’s Arts and Culture programme Cookies   Production: ENKI Why You Can Trust CNET Money The editorial content on this page is based solely on objective, independent assessments by our writers and is not influenced by advertising or partnerships. It has not been provided or commissioned by any third party. However, we may receive compensation when you click on links to products or services offered by our partners. Review CNET's ethics statement Commentary: I experienced the impact of wage stagnation firsthand Here's how I practice anti-capitalism now — and three ways you can start doing the same anti-capitalist personal finance content creator and business owner Her main focus and mission is to challenge common money myths dismantle barriers preventing access to financial information and examine how capitalism negatively impacts the working class When she's not online she spends her time hiking with her partner and three dogs in the Rocky Mountains of Colorado He would come home in the morning reeking of acid and sulfur from his 12-hour shift at the plant kiss us kids goodbye and go to bed in his blacked-out master bedroom I called "the bear cave." When Papa started at the plant in 1971, his wage was $7 an hour, about 36% more than the median household income at the time, according to the US Census or about $48,000 per year — 17% less than median HHI that year Union efforts never got off the ground and worker wages stagnated as the corporation continued to post record profits Things got worse when he was diagnosed with colon cancer in the '90s which pushed my mom into a full-time teaching assistant job just to cover our medical bills When asking my mom about Papa's 34 years at the company she had one thing to say: "They used him up until he died." As the daughter of a blue-collar high-school graduate who worked his entire life to give me opportunities he never had I think of how skewed the American dream has become My dad worked hard and gave me a life he could never have imagined My family upbringing is what inspired me to become an anti-capitalist financial activist I also show others how to arm themselves against a system that's built to keep the working class stagnant Here's what I'm doing to live a more anti-capitalist life — and help others do the same My work focuses heavily on topics that folks of varying life experiences and socioeconomic backgrounds never learned growing up This includes important wealth-building skills like budgeting There isn't much formal financial literacy education in schools. Some creators, like my colleague Yanley Espinal But both adults and young people deserve access to free financial education and this knowledge has never been more democratized thanks to the power of the internet The means for communicating this information have changed but the "meat and potatoes" of the financial information itself have changed as well Traditionally there has been a one-size-fits-all approach to money whereas dealing with late-stage capitalism demands a more holistic Some examples of late-stage capitalism at work include: What does a "holistic and systemic-aware" approach look like and how can you start to break free from this rigged system Here are three things you can do right now to begin this financial freedom journey what you look like or what your background is there is likely someone you can relate to who represents you in the personal finance space There are personal finance books, Netflix documentaries, blogs, YouTube channels, podcasts, TikToks and more, and it's easy to vet whether this information is accurate there is personal finance education right at your fingertips Absorb all you can about money management and how capitalism works against you so that you can start crafting your own plan to resist it the amount of information can be overwhelming so take things slowly and know that learning about money isn't going to be quick I only have two rules when it comes to personal finance and one of them is to always save money The reality is that America has scant social safety nets which means you have to build one for yourself More than 1 in 5 Americans have no savings, according to a report from CNET sister site Bankrate 35% of US adults would have to borrow money taking out a personal loan or asking a friend or family member Having no buffer against life's unexpected emergencies and events puts people further and further down the debt cycle this system keeps people at the bottom of the economic food chain but having cash savings is really the first stop to breaking this cycle Most financial experts recommend having a minimum of 3-6 months of savings in a high-yield savings account I recommend saving at least one month of your basic living expenses This includes your mortgage or rent; food (groceries not restaurants); utilities; minimum debt payments; and transportation whatever you need to pay for during the month to survive.  you'll have your own back and predatory credit card companies won't make your life worse with sky-high interest rates this is one of those things that isn't a quick It takes time to save money and build up a barrier between you and the world you have to remember that your savings account is your weapon against systems and cycles that keep you in debt and struggling You can't make a plan with your money unless you know how much is coming in and whether you have a surplus or are in the negative each month Ignoring and hiding from financial problems is the knee-jerk reaction for many but it's not helpful and is actually harming you more than it's helping you Tracking your spending is the true foundation of building an emergency fund getting out of a paycheck-to-paycheck cycle tracking your spending is more important than figuring out how to budget Remember: Slow steps make for big progress you can start to feel more in control of your money and dig yourself out of being left at the mercy of capitalism Had my father had the financial literacy I possess he might have had a cancer-free life by avoiding a dangerous He might have made more memories with his family He might have made more than $48,000 per year Money and the lack of it has been omnipresent in my life and I have realized capitalism thrives on ignorance by design and push folks toward thriving instead of just surviving Advertiser Disclosure CNET editors independently choose every product and service we cover Though we can’t review every available financial company or offer rigorous comparisons in order to highlight the best of them The compensation we receive may impact how products and links appear on our site.