Connect with us

Spread & Containment

York University receives CAD7.25M to build network and use AI and big data in fight against infectious diseases

TORONTO, Sept. 7, 2022 – At a time when the risk of emerging or re-emerging infectious diseases (ERIDs) is increasing, an international team led by…

Published

on

TORONTO, Sept. 7, 2022 – At a time when the risk of emerging or re-emerging infectious diseases (ERIDs) is increasing, an international team led by York University successfully competed to receive a CAD7.25 million grant from the International Development Research Centre (IDRC) to help tackle the issue. This grant will enable the research team to work alongside countries in the Global South to develop equitable and responsible artificial intelligence (AI) solutions and big data approaches to improve public health outcomes.

Tackling emerging and re-emerging infectious diseases in the Global South

Credit: York University

TORONTO, Sept. 7, 2022 – At a time when the risk of emerging or re-emerging infectious diseases (ERIDs) is increasing, an international team led by York University successfully competed to receive a CAD7.25 million grant from the International Development Research Centre (IDRC) to help tackle the issue. This grant will enable the research team to work alongside countries in the Global South to develop equitable and responsible artificial intelligence (AI) solutions and big data approaches to improve public health outcomes.

The five-year project, Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network, is borne out of the promise of AI solutions across the Global South to improve the health system response to infectious disease outbreaks, and the commensurate need to examine important ethical, legal and social implications of these solutions on populations most susceptible to disease and compromised overall well-being.

Led by York University Assistant Professor Jude Kong of the Faculty of Science, this project will support prevention, early detection, preparedness, mitigation and control of emerging or re-emerging infectious disease outbreaks in low- and middle-income countries (LMICs) in Africa, Asia, Latin America and the Caribbean, and the Middle East and North Africa.

“York University is honoured to have this opportunity to create positive change by fostering more equitable and responsible approaches to complex health-care needs through the ethical use of artificial intelligence,” says York University President and Vice-Chancellor Rhonda Lenton. “This project will help us strengthen our impact on several United Nations Sustainable Development Goals, including good health and well-being, as well as gender equality and partnerships. I’d like to thank IDRC for their ongoing support of York’s commitment to collaboratively addressing pressing global issues and congratulate Jude Kong on all his work in this area.”

Globally, as humans continue to encroach on animal habitats and climate change worsens, incidents of disease outbreaks are expected to increase in severity and frequency – often stemming from viruses, bacteria and parasites that jump from animals to people. These outbreaks can have calamitous consequences which cascade across socio-economic boundaries, particularly affecting vulnerable populations, magnifying social inequities, and putting pressure on weak health-care systems, which further exacerbate underlying inequities and disparities.

“As the world continues to grapple with the COVID-19 pandemic, alongside outbreaks such as Ebola and hMPXV, previously known as monkeypox, IDRC’s commitment to supporting innovative and locally championed solutions from LMICs is renewed and further deepened,” says IDRC President Jean Lebel. “We are delighted to build on IDRC’s deep experience in using AI to solve pressing social and economic challenges by supporting the team at York University in funding thought leaders in the LMICs to develop, use and scale responsible AI solutions to strengthen health systems. This collaborative effort will foreground AI applications that are ethical, respect privacy, and support gender equality and inclusive benefits across low-resource settings.”

The project will develop a diverse, multi-regional and interdisciplinary network of partners and teams to help address gaps in knowledge, capacities and solutions, and better understand how AI can improve public health preparedness and response. It will promote southern-led equitable and ethical use of AI and big data to improve public health preparedness and response, identify risks, conduct predictive modelling and provide evidence-based recommendations for public health policy and action.

“It is important to design, manage and govern AI and big data approaches using a health-equity and gender-equality lens to avoid amplifying existing inequalities leading to the possibility of significant harm rather than tremendous benefits,” says Kong, the project’s executive director and director of the Africa-Canada Artificial Intelligence and  Data Innovation Consortium (ACADIC).

The goal is to ensure vulnerable and at-risk populations are included in disease outbreak management and policies, including racialized visible minorities, women, geographically isolated individuals, Indigenous communities, migrants and refugees, unhoused people and the socio-economically underserved. COVID-19 has underlined the need for timely, accurate, and reliable data to inform evidence-based public health decision-making.

“AI techniques have developed rapidly over the last decade and the ability to store large data sets has led to novel methods of analysis, allowing for modelling predictions on a scale that was previously not possible,” says Kong. “ERIDs present global challenges, and as such, international communication and shared strategies, which build on varying types of expertise, are required to successfully address them. This project is a small step in that direction.”

PHOTOS: Jude Kong – horizontal & vertical

VIDEOS: Building capacity to tackle emerging or re-emerging infectious diseases in the Global South – https://youtu.be/yfx4_z1MKh4

Project will build a network and use AI and big data to fight against infectious diseases – https://youtu.be/jeq70gzfadM

###

York University is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change and prepare our students for success. York’s fully bilingual Glendon Campus is home to Southern Ontario’s Centre of Excellence for French Language and Bilingual Postsecondary Education. York’s campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future. 

As part of Canada’s foreign affairs and development efforts, the International Development Research Centre (IDRC) champions and funds research and innovation within and alongside developing regions to drive global change. We invest in high-quality research in developing countries, share knowledge with researchers and policymakers for greater uptake and use, and mobilize our global alliances to build a more sustainable and inclusive world.

 

Media Contacts:

Sandra McLean, York University Media Relations, 416-272-6317, sandramc@yorku.ca

Steven Morris, IDRC Media Relations, 613-696-2011, smorris@idrc.ca


Read More

Continue Reading

Government

Biden Signs Bill To Declassify COVID Origins Intel

Biden Signs Bill To Declassify COVID Origins Intel

Having earlier issued his first veto since taking office, rejecting a bill that would have…

Published

on

Biden Signs Bill To Declassify COVID Origins Intel

Having earlier issued his first veto since taking office, rejecting a bill that would have reversed a Labor Department rule on ESG investing, President Biden signed a bipartisan bill late on Monday that directs the federal government to declassify as much intelligence as possible about the origins of COVID-19.

His signature follows both the House and Senate unanimously approving of the measure, a rare moment of overwhelming bipartisan consensus.

The vote tallies meant that the measure would likely have survived a presidential veto had Biden opted to withhold his signature.

Biden, in a statement, said he was pleased to sign the legislation.

“My Administration will continue to review all classified information relating to COVID–19’s origins, including potential links to the Wuhan Institute of Virology,” he said.

"In implementing this legislation, my administration will declassify and share as much of that information as possible, consistent with my constitutional authority to protect against the disclosure of information that would harm national security."

Of particular interest to freedom-loving Americans who were tyrannized, censored, banned, and deplatformed for even daring to mention it, is the small matter of whether the virus leaked from the Level 4 Virus Lab at the Wuhan Institute of Virology (or instead, as The Atlantic proclaimed recently, a sick pangolin fucked a raccoon dog and coughed in someone's bat soup in a wet market.

The Department of Energy and other federal agents such as the FBI have increasingly backed a lab leak as the likely origin of the virus, while some lawmakers have even suggested Beijing may have deliberately allowed it to spread.

Tyler Durden Mon, 03/20/2023 - 20:41

Read More

Continue Reading

Spread & Containment

Asia’s trade at a turning point

Policymakers in Asia are rightly focused on the potential reconfiguration of global supply chains, given the implications these shifts may have for the…

Published

on

By Sebastian Eckardt, Jun Ge, Hassan Zaman

Policymakers in Asia are rightly focused on the potential reconfiguration of global supply chains, given the implications these shifts may have for the development of their export-oriented and highly open economies. While the focus on potential shifts on the supply side of the global and regional trading system is well-justified, equally dramatic shifts on the demand side deserve as much attention. This blog provides evidence of the growing role of final demand originating from within emerging Asia and draws policy implications for the further evolution of trade integration in the region.

Trade has been a major driver of development in East Asia with Korea and Japan reaching high-income status through export-driven development strategies. Emerging economies in East Asia, today account for 17 percent of global trade in goods and services. With an average trade-to-GDP ratio of 105 percent, these emerging economies in East Asia trade a higher share of the goods and services they produce across borders than emerging economies in Latin America (73.2 percent), South Asia (61.4 percent), and Africa (73.0 percent). Only EU member states (138.0 percent), which are known to be the most deeply integrated regional trade bloc in the world, trade more. Alongside emerging East Asia’s rise in global trade, intra-regional trade—trade among economies in emerging East Asia—has expanded dramatically over the past two decades. In fact, the rise of intra-regional trade accounted for a bit more than half of total export growth in emerging East Asia in the last decade, while exports to the EU, Japan, and the United States accounted for about 30 percent, a pattern that was briefly disrupted by the COVID-19 crisis. In 2021, intra-regional trade made up about 40 percent of the region’s total trade, the highest share since 1990.

Drivers of intra-regional trade in East Asia are shifting 

Initially, much of East Asia’s intra-regional trade integration was driven by rapidly growing intra-industry trade, which in turn reflected the spread of cross-border global value chains with greater vertical specialization and geographical dispersion of production processes across the region. This led to a sharp rise in trade in intermediate goods among economies among emerging economies in Asia, while the EU, Japan, and the United States remained the main export markets for final goods. Think semiconductors and other computer parts being traded from high-wage economies, like Japan, Korea, and Taiwan, China for final assembly to lower-wage economies, initially Malaysia and China and more recently Vietnam, with final products like TV sets, computers, and cell phones being shipped to consumers in the U.S., Europe, and Japan.

The sources of global demand have been shifting. Intra-regional trade no longer primarily reflects shifts in production patterns but is increasingly underpinned by changes in the sources of demand for exports of final goods. With rapid income and population growth, domestic demand growth in emerging East Asia has been strong in recent years, expanding by an average of 6.4 percent, annually over the past ten years, exceeding both the average GDP and trade growth during that period. China is now not only the largest trading partner of most countries in the region but also the largest source of final demand for the region, recently surpassing the U.S. and the EU. Export value-added absorbed by final demand in China climbed up from 1.6 percent of the region’s GDP in 2000 to 5.4 of GDP in 2021. At the same time, final demand from the other emerging economies in East Asia has also been on the rise, expanding from around 3 percent of GDP in 2000 to above 3.5 percent of GDP in 2021. While only about 12 cents of every $1 of export value generated by emerging economies in Asia in 2000 ultimately met consumer or investment demand within the region, today more than 30 cents meet final demand originating within emerging East Asia.

Figure 1. Destined for Asia

Source: OECD Inter-Country Input-Output (ICIO) Tables, staff estimates. Note: East Asia: EM (excl. China) refers to Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand, and Vietnam.

These shifting trade patterns reflect dramatic shifts in the geography and makeup of the global consumer market. Emerging East Asia’s middle class has been rising fast from 834.2 million people in 2016 to roughly 1.1 billion in 2022. Today more than half of the population—54.5 percent to be precise—has joined the ranks of the global consumer class, with daily consumer spending of $12 per day or more. According to this definition, East Asia accounted for 29.0 percent of the global consumer-class population by 2022, and by 2030 one in three members of the world’s middle class is expected to be East Asian. Meanwhile, the share of the U.S. and the EU in the global consumer class is expected to decline from 19.2 percent to 15.8 percent. If we look at consumer-class spending, emerging East Asia is expected to become home to the largest consumer market sometime in this decade, according to projections, made by Homi Kharas of the Brookings Institution and others, shown in the figure below.

Figure 2. Reshaping the geography of the global consumer market

Figure 2

Source: World Bank staff estimates using World Data Pro!, based on various household surveys. Note: Middle-class is defined as spending more than $12 (PPP adjusted) per day. Emerging East Asia countries included in the calculation refer to Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand, Vietnam, and China.

Intraregional economic integration could act as a buffer against global uncertainties  

Emerging economies in Asia are known to be the factories of the world. They play an equally important role as rapidly expanding consumer markets which are already starting to shape the next wave of intra-regional and global trade flows. Policymakers in the region should heed this trend. Domestically, policies to support jobs and household income could help bolster the role of private consumption in the steady state in some countries, mainly China, and during shocks in all countries. Externally, policies to lower barriers to regional trade could foster deeper regional integration. While average tariffs have declined and are low for most goods, various non-tariff barriers remain significant and cross-border trade in services, including in digital services remains particularly cumbersome. Multilateral trade agreements, such as ASEAN, the Comprehensive and Progressive Trans-Pacific Partnership (CPTPP), and the Regional Comprehensive Economic Partnership (RCEP) offer opportunities to address these remaining constraints. Stronger intraregional trade and economic integration can help diversify not just supply chains but also sources of demand, acting as a buffer against uncertainties in global trade and growth.

Read More

Continue Reading

Spread & Containment

California Hospital Refuses Transplant Surgery For Unvaccinated Woman With End-Stage Kidney Disease

California Hospital Refuses Transplant Surgery For Unvaccinated Woman With End-Stage Kidney Disease

Authored by Allan Stein via The Epoch…

Published

on

California Hospital Refuses Transplant Surgery For Unvaccinated Woman With End-Stage Kidney Disease

Authored by Allan Stein via The Epoch Times (emphasis ours),

Even on a good day, Linda Garinger of Ramona, California, thinks about dying.

Linda Garinger (L), who has end-stage kidney disease, and her daughter Emily Lewis read the letter from a hospital denying Garinger a kidney transplant operation because she won't get a COVID-19 vaccine. (Allan Stein/The Epoch Times)

Since she went on kidney dialysis two years ago, she’s had a heart attack and a cardiac episode associated with her thrice-weekly treatments.

Her energy is low as her other vital organs slowly fail. Her blood pressure is out of control—hovering at around 200 systolic over “100-something”diastolic whenever she undergoes dialysis.

Garinger feels it’s only a matter of time before her next heart attack, which could prove fatal unless she gets a new kidney.

Linda Garinger, 68, of Ramona, Calif., looks out her living room window on March 13, 2023. (Allan Stein/The Epoch Times)

The dialysis is very stressful on me. My vision is going. My hair is falling out. I’ve got skin cancer,” said Garinger, 68. “They said it’s from the dialysis not filtering out all the bad stuff.

“My biggest fear is I’ll have a heart attack during dialysis. I’m just going downhill right now.”

In 2022, Garinger was eagerly waiting for a kidney transplant at Sharp Memorial Hospital in San Diego, having found a good organ match in her daughter, the doctors told her.

But, “I needed [the transplant] like two years ago,” Garinger said.

Early last May, Garinger received an unexpected letter from the hospital saying she was no longer on the United Network for Organ Sharing (UNOS) waitlist for a kidney transplant.

“The reason for this status change is you have not had your COVID vaccines,” read the May 6, 2022, letter Garinger shared with The Epoch Times.

“Once this situation is remedied, you will be evaluated for re-activation on the transplant waitlist.”

Garinger did not appeal the hospital’s decision. She knew “in her gut” her unvaccinated status would always be a problem.

Still, she put her faith in Sharp Memorial, only to be put through tests, medical procedures, and consultations at a substantial cost to Medicare.

“The whole time, they knew I wasn’t vaccinated and that [my daughter] wasn’t vaccinated. They would always ask me, ‘Why don’t you want to get a vaccine?'”

“I was pretty adamant,” said Garinger. “I didn’t want to take anything that was still experimental.”

She remembered her good friend who died two weeks after receiving a COVID shot. “She lived right over here, on the other side [of the street],” Garinger said.

Garinger said she was fortunate to find another hospital nearby that would operate without her taking the vaccine.

Starting All Over

The challenge now is the time it will take to complete all the required paperwork and preliminary procedures, the time it will take to get on a waitlist for a kidney donor, and the time it will take to find a donor.

She fears her time will run out before then.

One sympathetic doctor said, ‘Linda, you could drop over dead. Your heart could stop.’ So, I have to watch what I eat, and on the days I don’t do dialysis, I take this powder that tastes like gritty sand” to remove the excess potassium from her body.

Garinger finds herself among many people who need an organ transplant but are up against a medical system still adhering to vaccine protocols in many facilities.

In a 2021 Healio transplantation survey, 60 percent of the 141 transplant centers that responded did not require a COVID-19 injection before surgery. The survey sample represented just over 56 percent of the transplant centers in the United States.

Jeffrey Childers, a commercial attorney based in Gainesville, Florida, served clients facing COVID-19 mandates at hospitals and medical clinics during the pandemic.

He said Garinger’s case reflects the “COVID mania” that permeated the medical establishment beginning in 2020.

“This was an ugly manifestation of the COVID management regime that popped up,” Childers said. “All the cases get a lot of attention because people are horrified. But the transplant people will say they have limited resources, only get so many organs each year, and we have to give them to people with the best survival chances. They’ll hide behind that forever.”

Life-and-Death Decisions

Childers said health care facilities still have tremendous discretionary power to make critical decisions concerning COVID-19 vaccines.

“To see these kinds of life-and-death bureaucratic powers wielded by people who are not motivated by the science but—something else—is horrifying,” Childers said.

“I’ve run into it a handful of times in Florida. The law that applies is state dependent. The folks who manage those donor lists and the assignments have a lot of discretion.

“It’s even more appalling it’s happening now so late in the pandemic when the mandates are gone. You can’t find a single person who says they regret not taking the vaccine. But you can find tons going the other way.”

Childers said pro-vaccine advocates argue that an unvaccinated recipient is much more likely to die from COVID-19 following transplant surgery than a vaccinated patient.

I don’t know the official line anymore,” he told The Epoch Times. “[The vaccine] doesn’t stop you from dying. It doesn’t stop you from getting sick.”

One study in the November 2022 MDPI, a Switzerland-based publisher of open-access scientific journals, claimed that over 60 days, the death rate among unvaccinated kidney transplant patients was 11.2 percent at the time of COVID-19 infection.

The study found the death rate among the vaccinated was 2.2 percent. More than two-thirds of the 144 patients in the study received a kidney transplant.

By contrast, a study published in the Journal of Clinical Medicine in September 2022 found that some cornea transplant patients rejected the grafts after receiving a COVID-19 vaccine.

In some cases, the rejection took place 20 years after the procedure.

Childers believes the science generally does not support the notion that unvaccinated transplant recipients are at an increased risk of dying from COVID-19.

The argument is always don’t give an organ to a person who is living some kind of lifestyle that is risky or increases the risk of dying from something else,” Childers told The Epoch Times.

“That’s the logic they’re applying to this. They’re essentially saying by not taking the vaccine, [transplant patients] are at higher risk of dying from COVID. So they don’t want to give an organ to somebody at high risk voluntarily.”

Ohio attorney Warner Mendenhall, representing clients in vaccine mandate cases, said he knows at least 60 organ transplant denial suits working through the medical freedom group Liberty Counsel.

Each case involves a client refusing to take the COVID-19 vaccine required for transplant surgery.

“We’re seeing [transplant denials] at many hospitals across the country,” Mendenhall said.

And while the medical establishment remains split on the safety and effectiveness of COVID-19 injections, some “medical people are concerned about clotting and other issues that occur with the vaccinated.”

“Especially if you’ve got liver and kidney problems and need that type of transfer, you don’t want to be vaccinated before the transplant. That’s my understanding,” Mendenhall said.

A ‘Fiduciary Responsibility’ to Patients

Often, the unvaccinated transplant patient has maintained a longstanding medical relationship with the hospital or clinic without issue before the COVID-19 vaccine rollouts.

For this reason, Mendenhall believes there is a “fiduciary relationship that the hospitals engage in with a transplant patient.” To break that obligation would be “a real breach of that fiduciary responsibility to them.”

According to the Chronic Disease Research Group, an estimated 37 million people in the United States have kidney disease in varying stages.

About 1 million Americans are in the end stages of the disease. At the same time, 550,000 undergo kidney dialysis to remove excess toxins from the blood because their kidneys cannot perform this function.

The average wait time for a kidney transplant in the United States is three to five years at most health facilities, but it’s longer in some parts of the country, according to kidney.org.

“It is best to explore transplant before you need to start dialysis. This way, you might be able to get a transplant ‘preemptively,’ before you need dialysis,” the organization’s website states.

“It takes time to find the right transplant center for you, to complete the transplant evaluation, to get on the transplant waitlist for a deceased donor, or to find a living kidney donor if you can.”

Garinger said she is in terminal Stage 5 of her kidney disease and needs dialysis almost every other day to stay alive.

“I’m pissed off,” said Garinger, who gets short of breath just walking to the kitchen.

I can’t walk to Costco or a grocery store now. My muscles—I get out of wind so easily. I can’t walk down to my chickens anymore.

Her daughter Emily Lewis, 35, is a recent medical assistant program graduate and is now her mother’s live-in caretaker as she waits for a kidney transplant.

“I put my life on hold because [of my mother],” Lewis said, although she has no regrets.

With her career in limbo, Lewis said she is angry at the injustice of the COVID-19 mandates while doubting the shots even work.

Linda Garinger, who has end-stage kidney disease, goes through her medicines on March 13, 2023. (Allan Stein/The Epoch Times)

“Everyone I know who’s COVID vaccinated has had it four or five times. I’ve had it zero,” Lewis told The Epoch Times.

Denied access to the kidney wait list at Sharp Memorial, Garinger found that the University of California San Diego Medical Center was willing to perform the kidney transplant surgery.

But the longer it takes to find a kidney donor, the more likely it is that she won’t make it back to a more normal life.

She characterized her relationship with her doctors at Sharp Memorial as adversarial since she opposed taking the COVID-19 vaccine under any circumstances.

She remembered one doctor in Ramona who kept “pressuring me” about the vaccine.

He said, “What will you do if you get COVID? What if you catch COVID and you have to go to the hospital?’

“Well,” she told him. “I have this protocol on my fridge—vitamins C and D. I have ivermectin. Number one: I won’t go to the hospital. It’s a death sentence there.”

“I guess you know more than me,'” the doctor said as he stood up and left the room.

“I didn’t know I had an adversary” or that “I was an evil person. I just had a gut feeling they would deny me [a kidney] because they kept pressuring me about the shot.”

“They did the same thing with me,” Emily said.

‘Why Aren’t You Vaccinated?’

At one point, Garinger demanded data showing the vaccine’s side effects.

“There was none,” she said. “It came down to the last final interview with the surgeon. All he could ask me was, ‘Why aren’t you vaccinated? Why don’t you want to get vaccinated?'”

“I don’t have COVID,” Garinger said. “[Emily] doesn’t have COVID. Another thing they told me was we were a [donor] match. And then I got to UCSD, and the bloodwork showed she was not a match.”

Sharp Memorial did not respond to a request for comment from The Epoch Times. UCSD Medical Center did not return an email seeking comment.

New Orleans attorney David Dalia said Garinger’s case seems to be medical “discrimination.”

They are discriminating against her based on her vaccination status,” he said.

During the pandemic, Dalia worked on vaccine mandate cases with Frontline doctors, filing amicus briefs on behalf of 1.5 million federal employees who refused to take a COVID-19 vaccine by order of President Joe Biden.

“The truth is [Garinger] has a lot better chance of living than a vaccinated person. We can back that up. They’re viewing it as sort of a disability.

“Well, that’s a violation of the Americans with Disabilities Act. And federal law specifically says all experimental use authorization drugs are strictly voluntary and subject to informed consent.”

Dalia said informed consent is “never coerced.”

As Garinger works through the intake process at UCSD Medical Center, she has good, bad, and “hell” days.

“I sit in a chair all day,” said Garinger, who ran a successful foreclosure business before she retired due to her illness. “[Emily] helps me do cooking. She does all the chopping and stuff. I have a chair in the kitchen. I walk to the kitchen and start cooking. I don’t do much. My gardening is on hold—everything is on hold. My muscles are gone. I use electric carts to go to Costco. I can’t do anything. I’m out of breath. It sucks.”

“Every part of my body is deteriorating. So, I’m on hold until I get a kidney.”

Just as painful are the times people call her “evil ” because she refuses to take an mRNA vaccine for COVID-19.

“You’re going to give [COVID] to everybody,” they tell her. “You’re evil for not getting vaccinated.”

“That’s how I felt,” Garinger told The Epoch Times.

She said another fear is receiving a kidney from a vaccinated donor, with unknown health effects, since there is no way to determine which donor is vaccinated and which one is not.

Feeling her time is growing short, Garinger said she is still determined to keep fighting in the time she has left.

“I’ve got to get this done. Every day there’s something else going wrong with me because my kidneys are gone,” Garinger said.

Tyler Durden Mon, 03/20/2023 - 18:20

Read More

Continue Reading

Trending