40 Year Old Company Transformed by Utilizing Cloud & DevOps Strategies
Shakeel Sorathia, VP, Systems Engineering, Ticketmaster at DevOps Enterprise Summit 2014
Devops and the cloud is sexy, but as a 40 year old entertainment company with over $13 billion in transactions, how do you get there? An enterprise is often saddled with legacy technologies, but also things like contracts, compliance, and stockholders.
This is the story of one enterprise that has and continues to transform itself with the utilization of the cloud and devops. It’s not always easy, but it can be done!
DOES14 - Shakeel Sorathia - Ticketmaster - 40 Year Old Company Transformed by...Gene Kim
Shakeel Sorathia, VP, Systems Engineering, Ticketmaster at DevOps Enterprise Summit 2014
Devops and the cloud is sexy, but as a 40 year old entertainment company with over $13 billion in transactions, how do you get there? An enterprise is often saddled with legacy technologies, but also things like contracts, compliance, and stockholders.
This is the story of one enterprise that has and continues to transform itself with the utilization of the cloud and devops. It’s not always easy, but it can be done!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. ERP “Gap” Quiz
• So how did you do in last week’s quiz on what other leading HIS
vendors besides Cerner did not write their own ERP system,
about the only gap in Cerner’s long line of HIS applications?
– We mean really integrated systems (written in the same
programming language, data base & OS, and running on the
same hardware platform), that have been self-developed
inhouse (not acquired, or a “partner” vendor’s system).
• It’s a bit of a trick question as the answer varies greatly by
product, with half of today’s vendors offering multiple HIS-es.
• So the next time someone tells you they’re on McKesson,
Siemens, Meditech, etc., be sure to ask them exactly which of
their many products they’re on – it’s like owning a “GM” car – is it
a Chevy, a Corvette, or a Cadillac? Quelle différence!
3. Today’s Leading Vendor ERP Status
VENDOR PRODUCTS WITH ERP PRODUCTS WITHOUT ERP
McKesson Star, Series, Paragon Horizon
Cerner Millennium
Siemens
MedSeries 4 Unity, Invision, Eagle,
Soarian
Epic EpicCare
Allscripts Sunrise
GE Centricity
Meditech Magic, C/S, Release 6
NextGen Sphere
CPSI CPSI System
HMS General Financials
NTT (Keane) Optimum
Harris (QM) Affinity
Healthland Classic, APS Centriq (EHR only)
4. C-Suite Longevity
• Getting back to Cerner, Neal Paterson has been at their helm for
an amazingly long time, serving as the CEO and Chairman their
entire 34 year history. Only a few other HIS vendors can claim
such consistency at the top:
– Neal Pappalardo has been Meditech’s Chairman for 44 years!
– Judy Faulkner has led Epic for its entire 34 year history.
– Jim Macaleer was SMS’ Chairman for 30 years (pre Siemens)
– Rich Tarrant led IDS/IDX for 30 years (1974 to 2004, pre GE)
• So who else served as Cerner’s President under Neal? Interesting
question: remember the LIS search in Episode 107 (you can find
them all at hispros.com) that documented how Cerner rose to the
top of the LIS market so rapidly in the early nineties? We put
vendors through a pretty rigorous selection process that really
puts sales reps through their paces. Who was Cerner’s rep at the
Wyoming Valley Health Care System selection in back 1993?
5. Promoting From Within
• Actually, we were assigned a brand new rep right in
the middle of the process, who was a recent hire to
Cerner, having just joined their Washington, DC
office. We were a little concerned at how well a
rookie rep could coordinate all the demands we
made on KC regarding client lists, user manuals, site
visits, and our “strenuous” contract negotiations…
• As you saw in that selection process, this new guy performed
superbly, beating out Sunquest, ALS and SMS in the process.
• His name? Trace Devanny – and he rose rapidly through the ranks
at Cerner after 1993, being promoted to President in 1999! Trace
had 17 years experience with IBM in the mid-Atlantic region, so
knew the sales game well. He also served as CEO and COO at
ADAC, so he knew the C-Suite game too. He led Cerner for 10
years until leaving in 2010 to head up The TriZetto Group
7. Growth Charts
• Zane is facing an enormous challenge to keep Cerner growing at
its amazing pace, as illustrated in the following two charts:
– First, Cerner’s annual revenue over the past 34 years:
8. “Associates”
• Reflecting Cerner’s team-building philosophy, employees are
referred to as “Associates” in KC, and their growth has been
amazing, from the 3 founders in 1979, to over 12,000 today:
9. Next Episode
• Many thanks again to the folks at Cerner for help with this story,
including Neal, who was kind enough to introduce me to:
– Vince .. I bet we can come with some old stuff .. April Martin is
brilliant and will help u .. my travel is taking me afar .. connect
in a couple of weeks .. good luck.
• The HIS-tory of today’s vendors concludes with the
#1 vendor on everyone’s annual revenue charts
McKesson, who started way back in the 70s when
another founding trio left McAuto to form HBO:
- Walter Huff, Bruce Barrington, and Rich Owens
• If anyone knows their contact info, or that of any
other old HBO(C) veterans, please put them in
touch with me at: vciotti@hispros.com, 505/466-
4958 - they’ll get due credit (or blame!)
