#doac

[terrafey]

true crime has nothing on listening to people talk about scientific fraud and failing businesses. stop harrassing victims and their families and start clowning on CEOs. go watch two hours of a video essay talking about a guy who got his phd taken away for his poor behavior

[soulinkpoetry]

This is too funny not to post. This is James Sexton , a divorce lawyer on the DOAC diary of a CEO podcast.

Love truly blinds us. Once those feel good chemicals start to run through your veins, all logic goes out the window. 😆

.

.

[xxxsimplyhookedxxx]

Cole Sprouse: My Narcissistic Mum Sacrificed My Childhood For Fame! | E229

[mcatmemoranda]

Anticoagulation Lecture 6/21/23

Factor Xa inhibitors = rivaroxaban, apixaban (Eliquis)

Direct thrombin inhibitor = dabigatran

Vitamin K inhibitor = warfarin

Apixaban has the lowest bleeding risk compared to the other Direct Oral Anticoagulants (DOACs); avoid in pts with BMI greater than or equal to 40 or weight more than 120 kg. Avoid dual inhibitors or inducers of CYP3A4 and P-gp.

VTE/PE tx = 10mg bid x7 days, then 5 mg bid

AFib = 5 mg bid (reduce to 2.5 mg bid if Cr greater than or equal to 1.5 or weight less than 60 kg or age greater than 80

Rivaroxaban (Xarelto) = once daily dosing compared to Eliquis

VTE/PE: 15 mg bid x21 days; then 20 mg qd

AFib: 20 mg qd with food to increase absorption

PAD/CAD: 2.5 mg bid (+antiplatelets if at increased risk)

Avoid with CYP3A4 inhibitors or inducers and P-gp

Edoxaban (Savaysa) – not used in pts with CrCl greater than 95

VTE/PE = parenteral anticoagulation for 5-10 days, then PO

VTE/PE/AFib = 60 mg qd

Does not have reversal agent like other DOACs do (which are reversed with Kcentra or andexanet)

Dabigatran (Pradaxa)

AFib: 150 mg bid; consider 110 mg bid if bleeding risk

VTE/PE: 5 days IV, then 150 mg bid

VTE ppx after THA/TKA: initial 110 mg once, then 220 mg qd x10-35 days

5-10 day bridge required for PE/VTE

Caution in pts greater than 75 years due to increased bleeding risk

Has own reversal agent (praxbind; idarucizumab)

C/I in pts with prosthetic heart valve

Store in original bottle and discard if unused after 4 months

Eliquis and Xarelto can be crushed and given via feeding tubes.

Warfarin (Coumadin)

Dosing is pt specific. Goal INR is 2-3. (2.5-3.5 if mechanical mitral valve).

Slow onset; slow time to steady state means dose taken today may not be reflected in INR for several days (2-4 days).

So many drug-drug interactions!

Metabolized by CYP pathways

Vitamin K antagonist

Dosing: recommend taking at night because INR is taken during the day, makes it easier to adjust dose.

Warfarin’s therapeutic steady state is based on half-lives of clotting factors. At least 5 days of consecutive warfarin needed for pt to be fully anticoagulated (this is why you use heparin until they get to this point).

Usually start with 5 mg qd. If bleeding risk, start with 2.5 mg qd. For obese pts or otherwise healthy/young can start with 7.5 mg qd. You go to maintenance protocol on 7th day.

Pts on VTE/PE tx are not anticoagulated the first 5 days, so use heparin IV or LMWH outpt. Once anticoagulated x24 hours, d/c heparin.

Start with 5 mg warfarin for first 3 days, then follow up with warfarin clinic on day 4. Typically, pt goes for weekly INRs. Then when at goal INR for 2 weeks, can spread out how often they f/u on their INR levels. Eventually they can go q6-8 weeks to check INR level.

VTE/PE – always bridge

AFib – risk assess to see whether heparin bridging is needed (assess bleeding risk [HASBLED]; CHA2DS2VASc for thrombotic risk).

Every 10 years, the dosing needed will decrease by 10%, so as pts age, the dose of warfarin needed will decrease.

DOACs = no INR monitoring, no dietary interactions, lower rates of bleeding, limited availability of reversal agent; contraindicated in pts with mechanical heart valves

AFib – AC (anticoagulate) indefinitely

1st VTE or PE that is provoked – AC for 3 months

1st episode of VTE/PE in setting of cancer – 3 months of AC (LMWH is better than DOAC or warfarin--new research shows DOAC may actually be more effective, so can use DOAC now; LMWH not preferred)

1st episode of VTE/PE unprovoked (no idea what caused it) – AC more than or equal to 3 months

2nd VTE – AC indefinitely

Heparin reversal – protamine (max dose is 50 mg), to reverse enoxaparin, give 1 mg protamine for each 1 mg of Lovenox

Warfarin reversal – vit K; 4 factor prothrombin compex (KCentra); FFP (if KCentra not available); KCentra is for life-threatening bleeding or if pt needs surgery for life-threatening condition

Apixaban/Rivaroxaban reversal – Kcentra (life threatening bleed or need emergency surgery; has thrombotic risk); FFP (Fresh Frozen Plasma); Andexanet Alfa. KCentra can cause clotting in 5% of pts; don’t give if you don’t need to.

Dabigatran reversal – idarucizumab (Praxbind); dosed as 5 g IV given 2.5 mg no more than 15 minutes apart)

Heparin lasts 2 hours

LMWH is preferred in pts who are pregnant (avoid warfarin). ESRD on dialysis – warfarin or Eliquis (avoid Xarelto). Obese pts – DOACs or warfarin. Cancer – use LMWH; recent study shows Eliquis is equal to or superior to LMWH in cancer pts who need anticoagulation.

Pregnancy = lovenox better, doesn’t cross placenta; UFH (unfractionated heparin) is an alternative in pts with poor renal function.

Stop heparin gtt and give Eliquis now or give 2 hours after stopping heparin gtt. Give loading dose Eliquis even if the pt was on heparin gtt.

[patricemcbride]

🗓 M A R C H 🗓 #DJ #NearDarkEnt @neardarkent #casino #nightlife #nightclub #party #winter #winter2023 #philly #philadelphia #atlanticcity #doac #jerseyshore 📸: @aidenscott / @t.do___ (at Trenton, New Jersey) https://www.instagram.com/p/CpVHa2TL1tj/?igshid=NGJjMDIxMWI=

[unfoldingmoments]

Does Talking About Problems Make Them Worse?

Talking about our problems can absolutely make things worse

Talking Isn't Always Healing: The common belief that talking about your problems is automatically beneficial is misleading. For talking to be helpful, there needs to be an emotional catharsis—a kind of breakthrough where suppressed or dormant emotions are intensely felt, processed, and released. This isn’t just a venting session but a therapeutic experience that allows for deeper emotional healing.

Emotional Catharsis: This term refers to a moment of significant emotional release or breakthrough in therapy. It’s more than just recounting problems—it’s re-experiencing and processing those emotions in a way that leads to a shift in understanding or emotional relief. Freud described this as essential to therapy, where deeply held emotions emerge and are confronted.

Venting vs. Healing: Venting—releasing negative emotions by talking about them—can provide temporary relief by reducing the intensity of those emotions in the moment. However, the problem with venting is that while it may make you feel better short-term, it can reduce the emotional energy needed for real change. Negative emotions like fear, anger, or frustration can motivate action and transformation. If you vent without addressing the root causes of your problems, you risk staying stuck without resolving anything.

Negative Emotions as Motivation: Negative emotions are signals that something is wrong and need to be addressed. For example, fear signals danger, and anger may indicate that boundaries are crossed. These emotions are powerful motivators for change. If you vent away all your negative emotions without using them to drive change, you may lose the energy or motivation to make improvements in your life.

The Downside of Constant Venting: Constant venting, without taking action or seeking resolution, can lead to a cycle where people complain but don't make changes. These individuals may remain in the same patterns of frustration and negativity because they don’t channel their negative emotions into constructive change.

Therapy Beyond Venting: Effective therapy should involve more than just talking or venting. It should help individuals confront and process their emotions in a way that leads to actionable change and personal growth. If therapy becomes just a session for venting without deeper exploration, it may fail to produce the desired results.

In summary, while talking about problems can sometimes help, it only leads to positive change when it involves emotional catharsis and results in meaningful insights or actions. Venting alone can make things worse by reducing the motivational drive needed for real change.

Dr K: We Are Producing Millions Of Lonely, Addicted, Purposeless Men & Women! https://www.youtube.com/watch?v=P1ALkQMfkjc

Healthy way talking about your problems

Talking about problems can sometimes feel like it makes them worse, but generally, discussing problems is a healthy way to process and manage them. Here’s why:

1. Releasing Stress: Talking about your problems can help relieve the emotional weight they carry. By expressing your thoughts and feelings, you can release pent-up stress, which can help prevent it from building up and causing more significant issues.

2. Gaining Perspective: When you talk about a problem, especially with someone who listens well, you can gain new insights and perspectives. Others might offer solutions you hadn’t considered or help you see the issue in a different light.

3. Strengthening Relationships: Sharing your problems can bring you closer to others, especially if they can empathize or relate to your situation. It helps create emotional bonds and reminds you that you’re not alone.

4. Problem Solving: Verbalizing your problems can help clarify your thoughts and enable you to approach the situation more objectively. Sometimes, simply talking through the issue can lead to solutions you might not have thought of on your own.

That said, there are times when talking about a problem can feel like it’s making things worse, such as:

• Ruminating: If you find yourself going over the same issues repeatedly without moving toward a solution, this can lead to rumination, which might amplify negative feelings and make the problem seem larger.

• Unhelpful Reactions: If the person you’re talking to responds negatively—by dismissing your concerns or adding to your worry—it might feel like talking about it made things worse. In these cases, it’s important to choose supportive people who genuinely listen and offer constructive feedback.

Ultimately, talking about problems is most beneficial when done with the intention to process, gain perspective, and seek support. It can be a valuable tool for healing and growth when balanced with actions to address the underlying issues.

[thisblogisnotcursed]

Diary of a CEO is really going hard on the click bait.

[xxxsimplyhookedxxx]

Josh Peck: The Surprising Truth Behind The 127lb Weight Loss | E238

[rockbottomfuckthis]

Have conversations with self.

'Reframe challenges to voluntarily demonstrate your capacity. 'HERE WE GO!'.

'All you can do to have a conversation with yourself that holds firmness and compassion together. That's the best you've got.'

'What's you're chasing is to feel calm l, smart and proud of yourself.'

Example: Taking an unhealthy snack away from a child that got used to that snack.

Compassion: you'd expect the kid to cry. She is used to something. You'd make her life as comfortable as possible and do it until she realizes she come out unscaved.

'I know why you feel this way, of course you feel this way, you deserve to feel this way, you can scream/cry as much as you want.

Doesn't mean I'm going to give you the snack.'

[karmasantos]

some shitty karmisaac gifs made by me <3

[doacewear]

Top 3 Heated Vests: DOACE Leads the Pack

Heated vests have become essential for staying warm in cold weather. They provide comfort and warmth, making them perfect for outdoor activities or simply braving the winter chill. Among the top choices, three heated vests stand out for their performance and features. Leading the pack is the DOACE heated vest, renowned for its innovative design and superior heating capabilities. With advanced technology and user-friendly features, the DOACE vest ensures you stay cozy and comfortable, no matter how low the temperature drops.

Detailed Review of DOACE Heated Vest

Unique Features of the Heated Vest

8 Heating Zones

The DOACE Heated Vest stands out with its innovative design featuring 8 heating zones. These zones cover critical areas such as the back, belly, shoulders, and waist. This comprehensive coverage ensures that you stay warm in all the right places. Unlike traditional vests with fewer heating areas, the DOACE vest uses high-quality carbon nanofiber heating elements. These elements provide rapid and efficient warmth, making it a superior choice for those cold winter days.

Smart Controller

You will appreciate the smart controller integrated into the DOACE vest. This 4-in-1 controller allows you to operate the shoulder, waist, and belly heating zones separately. You can choose from three heating levels, ranging from 113°F to 150°F. This flexibility lets you customize your warmth based on your specific needs, ensuring comfort throughout the day. Adjusting the heat settings is straightforward, giving you control over your comfort level.

Safety Features

Safety remains a top priority with the DOACE heated vest. It includes a built-in thermal protection module that automatically shuts off the heating if it overheats. This feature provides peace of mind, allowing you to focus on your activities without worrying about safety. The vest works with a common 5V/2A or above power bank, and it features a battery inner pocket for convenience. A single charge can provide up to 8 hours of continuous warmth, perfect for long outdoor activities.

Practical Design Elements

The practical design of the DOACE heated vest enhances its functionality. Made from lightweight, breathable material, it offers superior warmth without compromising comfort. The vest is machine washable, ensuring it remains clean and fresh after use. Deep pockets provide secure storage, and a smooth SBS zipper allows for easy wear. Available in multiple sizes and colors, this vest caters to various preferences and styles.

Benefits of the DOACE Heated Vest

Comfort and Warmth

The DOACE heated vest excels in providing comfort and warmth. Its lightweight material ensures you stay cozy without feeling bulky. The vest's design allows for unrestricted movement, making it ideal for outdoor activities like cycling and hiking. Whether you're working outdoors or simply braving the winter chill, this vest keeps you warm and comfortable.

Energy Efficiency

Energy efficiency is another significant benefit of the DOACE heated vest. The high-quality carbon nanofiber heating elements ensure rapid and efficient warmth. With the ability to adjust the heating levels, you can optimize energy use based on your needs. This feature not only conserves energy but also extends the battery life, allowing for longer use.

Versatility in Use

Versatility defines the DOACE heated vest. Its design suits various activities, from outdoor sports to everyday wear. The vest's USB port allows you to charge your devices while staying warm, adding to its practicality. Whether you're engaging in winter sports or running errands, this vest adapts to your lifestyle, providing warmth and convenience.

Comparison with Other Heated Vests

Overview of Heated Vest 2

Key Features

Heated Vest 2 offers a practical solution for those seeking warmth during cold weather. It features three heating zones, strategically placed to cover essential areas like the back and chest. The vest uses a simple control system, allowing you to adjust the heat settings with ease. Its lightweight design ensures comfort without adding bulk, making it suitable for various outdoor activities.

Pros and Cons

Pros:

Lightweight and comfortable for extended wear.

Easy-to-use control system.

Affordable price point.

Cons:

Limited heating zones compared to other models.

Shorter battery life, requiring frequent recharges.

Basic design with fewer customization options.

Overview of Heated Vest 3

Key Features

Heated Vest 3 stands out with its four heating zones, providing warmth to the back, chest, and neck areas. It incorporates a user-friendly interface, allowing you to switch between different heat levels. The vest's durable material ensures longevity, making it a reliable choice for winter sports enthusiasts.

Pros and Cons

Pros:

Durable construction for long-term use.

Multiple heat settings for personalized comfort.

Suitable for intense outdoor activities.

Cons:

Heavier than other models, which may restrict movement.

Higher price point, making it less accessible for budget-conscious buyers.

Limited color and size options.

Advantages of DOACE Over Others

Feature Superiority

The DOACE Heated Vest surpasses its competitors with its eight heating zones, offering comprehensive coverage that ensures warmth in all critical areas. Unlike other vests with only three or four zones, DOACE provides superior heat distribution. The smart controller allows you to customize your warmth, giving you the flexibility to adjust the heat according to your needs. This feature sets DOACE apart, making it a top choice for those who prioritize comfort and efficiency.

User Feedback

Users consistently praise the DOACE Heated Vest for its exceptional performance. Many highlight the vest's ability to maintain warmth even in extreme cold conditions. The safety features, such as the automatic shut-off, receive positive feedback for providing peace of mind. Customers appreciate the vest's versatility, noting its suitability for both outdoor adventures and everyday use. With its combination of innovative features and positive user experiences, the DOACE Heated Vest emerges as a leader in the heated vest market.

The DOACE Heated Vest stands out as the top choice for winter warmth. Its innovative features, like the eight heating zones and smart controller, ensure you stay cozy in any cold condition. Users rave about its performance, with one saying,

"I used the vest a few times when camping in the mountain … And it is warm!"

Consider adding the DOACE vest to your winter gear. It offers unmatched comfort and efficiency. Don't miss out on staying warm this winter—explore purchasing options today and experience the difference for yourself!

[doace]

Is DOACE LC-X35 the Best Travel Converter?

Travel converters play a crucial role in ensuring electronic devices work seamlessly during international trips. Voltage differences between countries can cause devices to malfunction or even get damaged. The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter offers a robust solution for travelers. This DOACE converter supports a wide range of devices, from hair straighteners to laptops. The main question remains: Is the DOACE LC-X35 100% pure sine wave 350W traveling voltage converter the best travel converter on the market?

Features of DOACE LC-X35 100% Pure Sine Wave 350W Traveling Voltage Converter

Design and Build Quality

Compact and Portable

The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter fits snugly in any travel bag. The design ensures that travelers can carry it without feeling weighed down. The compact size allows for easy storage in tight spaces. This feature makes it an ideal companion for globetrotters.

Durable Materials

The build quality of the DOACE LC-X35 impresses with its robust materials. The converter withstands the rigors of frequent travel. The durable construction ensures longevity, providing value for money. Travelers can rely on this device for many trips to come.

Technical Specifications

Voltage Conversion

The DOACE LC-X35 excels in voltage conversion. It adjusts any country's voltage (100-240V, 50/60Hz) to US voltage (110V, 60Hz). This capability ensures that a wide range of devices, from hair straighteners to laptops, function seamlessly. The converter handles loads up to 350 watts, making it versatile for various electronic needs.

USB Ports and Compatibility

Charging multiple devices simultaneously becomes effortless with the DOACE LC-X35. The converter features three US standard transformer sockets and four USB ports. The two 20W PD ports and two QC18W USB-A ports provide high-speed charging. This setup reduces charging times significantly, ensuring that phones, tablets, and other USB devices stay powered up.

Safety Features

Overload Protection

Safety remains a top priority with the DOACE LC-X35. The converter includes automatic overload protection. This feature prevents damage to devices by shutting off the power when the load exceeds safe limits. Travelers can use their electronics without worrying about potential hazards.

Surge Protection

Surge protection adds another layer of safety to the DOACE LC-X35. This feature guards against sudden spikes in voltage. The converter protects valuable devices from unexpected electrical surges. Travelers can enjoy peace of mind knowing their gadgets remain safe from harm.

Benefits of Using DOACE LC-X35 100% Pure Sine Wave 350W Traveling Voltage Converter

Convenience for Travelers

Multi-country Compatibility

The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter works in over 190 countries. The package includes five interchangeable plugs: UK, US, AU, EU, and IT. This feature ensures compatibility with various power outlets worldwide. Travelers can confidently use the converter without worrying about plug types.

Ease of Use

The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter offers a user-friendly experience. The smart touch switch allows for effortless power control. The silent fan design keeps noise levels low, creating a peaceful environment. The converter's intuitive design makes it easy for anyone to operate.

Cost-Effectiveness

Affordable Price

Priced at $59.99 USD, the DOACE LC-X35 100% pure sine wave 350W traveling voltage converter provides excellent value. The cost remains reasonable compared to other converters on the market. Travelers receive a high-quality product without breaking the bank. The affordable price makes it accessible to a wide range of users.

Long-term Savings

The durable construction of the DOACE LC-X35 100% pure sine wave 350W traveling voltage converter ensures longevity. Frequent travelers save money by investing in a reliable converter. The device's ability to handle multiple devices simultaneously reduces the need for additional chargers. Long-term savings become evident with continued use.

User Testimonials

Positive Experiences

Many users praise the DOACE LC-X35 100% pure sine wave 350W traveling voltage converter for its reliability. Reviews highlight the converter's performance during international trips. Users appreciate the device's ability to charge multiple gadgets quickly. Positive feedback reinforces the converter's reputation as a dependable travel accessory.

Real-world Applications

Real-world applications showcase the versatility of the DOACE LC-X35 100% pure sine wave 350W traveling voltage converter. Business travelers rely on the converter to keep laptops and office equipment charged. Leisure travelers use the converter for personal devices like phones and tablets. Families benefit from the converter's ability to charge multiple devices safely.

Real-world Applications and Scenarios

Business Travel

Keeping Devices Charged

Business travelers often juggle multiple electronic devices. The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter ensures laptops, phones, and tablets stay powered. This converter's high-speed USB ports allow for quick charging. No more dead batteries during important meetings.

Compatibility with Office Equipment

Office equipment varies in voltage requirements. The DOACE LC-X35 handles this with ease. From projectors to printers, the converter supports a wide range of office gadgets. Business travelers can rely on the DOACE LC-X35 for seamless presentations and efficient work sessions.

Leisure Travel

Charging Personal Devices

Leisure travelers carry personal devices like cameras, tablets, and e-readers. The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter keeps these gadgets charged. The compact design fits easily into luggage. Enjoy uninterrupted entertainment and capture every moment of the trip.

Using Small Appliances

Small appliances like hair dryers and electric shavers are essential for comfort. The DOACE LC-X35 converts voltage safely for these devices. Travelers can use their favorite appliances without worry. The converter's versatility enhances the travel experience.

Family Vacations

Multiple Device Charging

Family vacations involve numerous devices. The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter charges up to seven devices simultaneously. Parents can charge phones, tablets, and cameras all at once. Kids can keep their gadgets powered for entertainment during long trips.

Safety for Kids' Devices

Safety remains crucial when charging kids' devices. The DOACE LC-X35 includes overload and surge protection. Parents can trust the converter to keep children's electronics safe. Enjoy peace of mind knowing that devices remain protected from electrical hazards.

The DOACE LC-X35 100% pure sine wave 350W traveling voltage converter stands out with its compact design, durable materials, and impressive technical specifications. The voltage conversion capabilities, multiple USB ports, and safety features make it a versatile tool for any traveler. The convenience of multi-country compatibility and ease of use enhances its appeal. The affordable price and long-term savings add to its value. User testimonials highlight positive experiences and real-world applications. The DOACE LC-X35 is the best travel converter for ensuring device safety and functionality. Consider purchasing the DOACE LC-X35 for your next trip.