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Arkansas Inc. Podcast: Dr. Chris Larsen, Arkana Labs Executive Director

 October 17, 2022
In this episode of the Arkansas Inc. Podcast, Arkana Labs executive director Dr. Chris Larsen discusses Arkana Labs, the largest renal pathology lab in North America, and its operations; the company’s recent expansion in Little Rock; and recruitment and training of a talented workforce.


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TRANSCRIPT

Dr. Chris Larsen:              

This is Dr. Chris Larsen, CEO of Arkana Labs. You're listening to the Arkansas Inc. Podcast.

Chelsea O’Kelley:            

Welcome to the Arkansas Inc. Podcast. This is Chelsea O' Kelley. I serve as the director of communications for the Arkansas Economic Development Commission.

On this podcast, we're going to talk about the largest renal pathology laboratory in the nation, which processes an estimated 40% of all kidney biopsies in the U.S. It's Arkana Laboratories, and it's headquartered in Little Rock, Arkansas.

I'm excited to welcome our guest today, who's here to talk with us about Arkana Labs, Dr. Chris Larsen.

Dr. Larsen joined Arkana in 2009, after graduating from medical school at the University of Arkansas for Medical Sciences, completing an anatomic pathology residency at Emory University and completing a renal pathology fellowship at Arkana Laboratories.

Dr. Larsen helped develop Arkana's Molecular Lab, directs Arkana's research activities and serves as executive director of Arkana Laboratories. Welcome, Dr. Larsen.

Dr. Chris Larsen:              

Thank you. So good to be here.

Chelsea O’Kelley:            

Yeah, absolutely. Glad to have you. So Arkana Labs, it's headquartered in Little Rock, and it's the largest renal pathology lab in North America. Right? Possibly the world.

Dr. Chris Larsen:              

Correct. That is right. We're not sure about China, but we're fairly certain that in the rest of the world, there is not a larger renal biopsy laboratory.

Chelsea O’Kelley:            

That is amazing. That's remarkable. So that's not all you do though. Right? Arkana Labs also has services for neural pathology, biopharma services and other testing. Right?

Dr. Chris Larsen:              

That's correct, yes.

Chelsea O’Kelley:            

So could you talk a little bit more about your organization and who you are, what you do? Give us some background.

Dr. Chris Larsen:              

Sure. Sure. Yeah. So just the story of Arkana, we started in 2001, founded by Dr. Patrick Walker. Pat started Arkana Laboratories, it was under a different name at the time, Nephropathology Associates. But he founded it with a real passion to provide just excellent diagnostic care to every single patient that we received a biopsy on.    

So, it started in renal pathology. It quickly grew, as a result of just that excellent service that was being provided. People started hearing about it from all across the United States and sending biopsies to Little Rock. It's just grown from there.

So over the years, we've slowly added in other services. If you want to just speak generally, I mean, the umbrella we put ourselves under is esoteric diagnostics. By esoteric, we just mean highly specialized.

So, you're going to have very specialized knowledge. You're going to have very specialized equipment that's going to be needed to carry out the testing.

That's our wheelhouse, testing that's just very highly specialized and not easily found, just at your average hospital laboratory.

Chelsea O’Kelley:            

That's fantastic. I appreciate you breaking some of that down for me. I confess to you right now, right as we're getting started, that I'm not that well versed on the finer points of nephropathology.

Dr. Chris Larsen:              

Yeah, I get it. I get it. I'll try to lose the jargon and keep it simple here today.

Chelsea O’Kelley:            

Hey, I really appreciate that. Really amazed by what you do. So you started at Arkana in 2009. What led you to renal pathology and specifically what led you to Arkana Labs?

Dr. Chris Larsen:              

Yeah. Medical training is really essentially an apprenticeship. So, you end up with mentors. This is a pretty common story, where people will find mentors in their training, that they really admire and just want to do what they do. I'm no exception to that.

The founder of Arkana, Dr. Patrick Walker was an early mentor for me. When I was in residency training at Emory, there was a kidney pathologist there, that was very instrumental in teaching me of renal pathology while I was in residency and further nurtured that interest. So, I had pretty early on, decided that I was interested in this field.

So once I finished training in residency, there were several options available, as far as where to go, but Arkana at that point, was already the largest kidney biopsy laboratory in the US.

Dr. Walker was there. Luckily, they had a position open at the time. So, it just made sense.

As you can probably tell from my accent, I'm from Arkansas, from Conway originally, so moving home to the perfect job.

Chelsea O’Kelley:            

Nice.

Dr. Chris Larsen:              

Yeah, worked out well.

Chelsea O’Kelley:            

Fantastic.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

Could you break down how this works for me? So your company, Arkana Labs, you receive kits with tissue samples in them.

Dr. Chris Larsen:              

That's right.

Chelsea O’Kelley:            

You get these kits from all over the world. Is that right? I think I read 44 states. Is that within the last year, 44 states or just regularly?

Dr. Chris Larsen:              

Yes. Just regularly, yeah. Any given day, the samples show up in the morning. You don't know where they will be from. It's mostly the United States, but we do receive from several other countries as well.

Everything is processed here, centrally in Little Rock though. So, everything comes to Little Rock.

We have a strong presence across the country. There are a few holdout states that we're still focused on. But for the most part, I mean, even Hawaii, Alaska to Maine and Florida, we receive biopsies from nearly every state in the US.

Chelsea O’Kelley:            

Wow.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

That's amazing. So not only do you see receive this influx of kits, but you're also known for being possibly one of the only labs in the world that promises same-day turnaround service for a lot of your testing services. Right?

Dr. Chris Larsen:              

Mm-hmm.

Chelsea O’Kelley:            

How does Arkana manage that? Why is it important to your clients to have this single-day turnaround?

Dr. Chris Larsen:              

Right. Well, most people don't do that because it's not very easy to do. So, we are unique in that, particularly in renal pathology. Really, I don't know of any other laboratories that do that.

It's difficult to pull off. Logistically, it's not easy. FedEx is a great partner. They get the samples to us as early as possible, most of the time by 7:30 AM.

That's the first step that makes it possible. But from there, we just have processes in place to make sure that these samples are processed efficiently and that by the end of the day, that we can get those calls out to the clinicians, to let them know the diagnosis and to sign out a report that we send to their clinic.

As far as why it's important, I don't know if you've ever had a biopsy performed, but if not, you probably have family members or friends who have. It's a really stressful place to be, to be in that period of time, waiting between when the biopsy's performed and getting the result. You'll hear people say they're waiting on pathology. Well, that's that stage.

It's a miserable place to be. In fact, most people would tell you they'd rather just know bad news than to not know anything at all, just to be waiting. So, that's one reason.

To minimize that time period when people are waiting is one important reason. But even more than that, the diseases that we diagnose in kidney and in neuromuscular pathology are frequently inflammatory conditions. Meaning, the patient's immune system is kind of turned against these organs.

They need to be treated. But the reason they're doing the biopsy is that they don't know what... the clinician doesn't know what's happening. So, they don't know how to treat.

If you don't initiate the treatment promptly, you will end up with injury that is chronic or irreversible injury.

So, we're trying to get that result back, so that the clinician can more quickly initiate the therapy and hopefully avoid as much of that irreversible injury as possible.

Chelsea O’Kelley:            

Wow. If you don't mind, let's hop into a little time machine.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

Arkana started, was founded in 2001. You began at Arkana in 2009. So let's hop into a little time machine, go back to either whenever it began or whenever you began at Arkana. Tell me, what was different and how has Arkana evolved over the years?

Dr. Chris Larsen:              

Yeah. Well, the biggest change, the biggest difference is the growth. I mean, we were a relatively much smaller company when I started. There's just a different feel when you're working with 20 or 30 people than when you're working with more than 150 people. So, that's changed.

But really, the core of what we are or who we are and what we do really hasn't changed that much. I mean, as I mentioned at the beginning, it started with this desire by Dr. Walker, to have just excellence for every patient that we receive biopsy on and that we are helping in the clinical care of.

Really, that's still the core of who we are. I mean, that hasn't changed at all. It's just happening on a much bigger scale, at this point in time.

Chelsea O’Kelley:            

I think I read that the lab processed just over 500 kidney biopsies in the first year, but this year, that number's grown to 24,000.

Dr. Chris Larsen:              

Yes. We will surpass 24,000 this year. That's right. Yeah.

Chelsea O’Kelley:            

Amazing. That's really amazing.

Dr. Chris Larsen:              

It's really amazing growth. It's been just steady growth though. It's not like, one year we did 10,000 more. It's just steady, year in and year out, seeing 10, 15% growth, year over year.

Chelsea O’Kelley:            

Arkana Labs has clearly experienced a lot of success, well deserved success. You recently announced an expansion of your operations. What are some of the details of that expansion?

Dr. Chris Larsen:              

Yeah. One of the things we've never had, we've always rented the space that we are in. So, that has produced some limitations. I mean, you can't have a building fit the purpose quite as well when you don't have control over it.

So, we've purchased the building that we are in. That is going to enable us to add onto it and to remodel it, so that the structure of the building is going to specifically be designed for the purpose that we're using it for.

I hope that that's going to make us even more efficient. I hope that it's going to make us even better at what we do.

We should see that start. We're in the design process now. We should see that start in spring. We hope to break ground and hopefully wrap up by the end of the year, next year. So, that is a big change for us.

We are continuing to grow, and we plan to continue to grow for years to come. One of the biggest hurdles to that is people. So, we are actively recruiting right now.

I mean, just this year, I think we've hired about 15 people. I lose count sometimes. But over the next five years, we do anticipate that we'll... Whereas right now we're around 150, I think we're at about 155, hopefully in the next five years, we're going to be over 225.

So, we're actively growing, actively adding staff, actively training people, so that we can be ready for the continued growth.

Chelsea O’Kelley:

One thing that's interesting to me, you mentioned recruiting people. Could you tell me a little bit about how Arkana attracts talent that it needs and to Arkansas? Because you have several MDs on your staff. Is that right?

Dr. Chris Larsen:              

That's right. Yeah. I think we have 25 right now. We have 23 kidney pathologists and two neuropathologists. We would love to add two to three more by the end of the year.

So you're right, that is something we are always doing is recruiting talent, particularly specialty physicians that we need.

As I said, this is esoteric diagnostics, so really specialized knowledge. There are just not very many people that are trained to do that work.

We have somebody on staff that actually recruits physicians. We recruit from all across the United States and try to get people here to check us out.

At first, it can be a bit of a barrier, when we tell them we're in Arkansas. A lot of people on the coasts, believe it or not, if you tell them you're located in Arkansas, they lose interest.

But we found that if we can get people to Little Rock, if we can get them on the plane and if we can get them here and get them to Arkana, then we've got a really good chance of actually getting them here.

So, people come, and I think they're surprised by what they see. Especially if you're from, say, New York or California, the cost of living is a very pleasant surprise. But also the fact that you've got green, you've got nature. You've got some big city type amenities, but you don't have all the headaches of the big city, all the traffic and stuff like that. So yeah, we do pretty well with recruiting if we can get people on the plane.

Chelsea O’Kelley:            

Once they see Arkansas, they're pretty much sold. Right?

Dr. Chris Larsen:              

It goes a long ways. Yes, absolutely. We know if we get them on the plane and get them here, our chances just increase exponentially.

Chelsea O’Kelley:            

Wow.

Dr. Chris Larsen:              

Mm-hmm.

Chelsea O’Kelley:            

Another thing that's unique about Arkana Labs is your workplace culture. Correct me if I'm wrong. Your team focuses a lot on education and training for the people that you recruit, the technicians, et cetera. What's that like?

Dr. Chris Larsen:              

Yeah. That is both necessity, but it's also just who we are. There are not enough people trained to do this work that we do. In fact, if you take some of the positions, like histotechnology, there are no schools for that in Arkansas. So, you've got to train people to do it, if you don't want to just spend all your time recruiting from other places.

We have an active training program for that. We will train at least... well, I'm going to get the number wrong, I think approximately 10 to 15 people this year, through that program.

We have an active renal pathology fellowship as well, where we take a couple of pathologists every year. We put them through that one-year program and train them to be renal pathologists. So, that's the more formal side of the training. There's a lot of just informal training that happens all the time, though.

We really want to push ourselves to be excellent. That's not really possible unless you're constantly trying to continue to grow and train.

People are teaching one another. When we learn something, we share it. We have conferences. Many of the departments have conferences daily or weekly, where we're sharing information. For the physicians, we're sharing studies, we're sharing interesting findings on biopsies, teaching one another.

So, really just trying to continue to make sure that we pride ourselves on being world class. We really don't just say that as a motto. I think a lot of people say that. I don't mean to sound arrogant, but we really do believe we're the best in the world at what we do.

You can't do that, you can't be there if you become complacent. So, it's constantly training and retooling and growing and challenging what you used to think and trying to think of how you might be better at it.

Chelsea O’Kelley:            

I have a confession. I was able to visit Arkana Laboratories for the first time, a few months ago. Your staff was kind enough to show me around. I must say, you really can tell the difference with the workplace, the culture.

Dr. Chris Larsen:              

Oh, thank you.

Chelsea O’Kelley:            

You really can tell the difference, just walking through. The attitudes of people are very eager to learn and very eager to-

Dr. Chris Larsen:              

Well, I'm glad you noticed that. That's encouraging. Thank you.

Chelsea O’Kelley:            

Oh yeah, absolutely. Absolutely. I think it's a testament to the work that you do and how passionate you are about your people and the people who work for you.

We've been talking about a lot of different things that make Arkana special. I have to ask, specific to your expansion, why did it make sense to expand Arkana in Arkansas?

Dr. Chris Larsen:              

Yeah, Well, as you can tell by the name, we rebranded in 2015. We were formerly known as Nephropath. Nephro implies kidney. So, we needed a name that was a little more inclusive of additional testing as well.

You can tell by the name we chose, we really owned the fact that we are in Arkansas. It's home. I mean, it's where we've always been.

We've always believed that a centralized operation is better than dispersing it around the country. That was obviously a consideration as well. Should we have laboratories in three or four different states? But we settled on the centralized operation.

Since we are so dependent on and have such a great relationship with FedEx, being close to Memphis really helps. So, that's one good reason to be here in Little Rock.

Arkansas is in the middle of the country. Most of our business is in the United States. So, I think that doesn't hurt either.

Arkansas is low cost of living. I mean, there's a lot going for it. I mean, I must say, it was never any real consideration to move.

Chelsea O’Kelley:            

Well, I love hearing that. We love to keep our Arkansas companies in Arkansas.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

Take us through a day in the life at Arkana Labs. What are the researchers and professionals at Arkana working on?

Dr. Chris Larsen:              

Yeah. Yeah. Wow. That's going to depend on the seat you're in, a lot going on. In the laboratory, the day starts early. They're getting there around 7:00, 7 30.

When FedEx shows up, it's just a buzz of activity in the lab. Lots of activity in the processing of the samples, getting the samples ready to be handled by the pathologist.

In the late morning, early afternoon, the pathologists really get busy with their work of diagnosing patient's disease and calling clinicians, really helping them work through treatment plans and things like that.

I could say, at that point in time, things settle down a little more in the laboratory, as things pick up for the physicians.

We have client services teams that are kind of busy all throughout the day. In the morning, they're coordinating with offices where the patients are being seen by the clinician and identifying who the clinician is, who needs to be called.

In the afternoon, they're coordinating all those calls and making sure that we get in touch with everybody. So, it's definitely a busy place every single day.

In the background, you don't see it as much, but you've got researchers that are actively focused on R & D projects, that are hopefully... The goal there is to be designing and discovering the next generation of diagnostic assays in these areas of expertise that we have.

So no, it's hard to describe a typical day. I think you probably saw a little bit of it when you were there though.

Chelsea O’Kelley:            

Well, just a tiny little portion.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

I know that the extent of what you do is really sizeable. What is your favorite part?

Dr. Chris Larsen:              

Yeah. Well, at Arkana, we are solving big problems. That is a lot of fun. I mean, big problems, and when I say that, I mean both for the individual patient, that this patient's got a big problem, that there's some medical mystery happening usually. So, you get to be a part of that.

But also on a larger scale, big problems with regard to, how do we push this field forward? How do we continue to innovate and improve our ability to diagnose these diseases?

I love doing that. We have a great team, that is fun to work with. And as you've mentioned, they love to learn. They're smart. So, that means they're challenging me. I get to challenge them. Those are some of the things.

Chelsea O’Kelley:            

Well, I mean, that sounds like a lot of fun.

Dr. Chris Larsen:              

Yeah. Yeah, I do. I feel very fortunate. I wake up every day, and I don't dread going to work. I know a lot of people that probably wake up and have the Monday blues or whatever, but I never have that. So yeah, I feel very fortunate. I know that that's a blessing, for sure.

Chelsea O’Kelley:            

Yeah, absolutely.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

The existing space that Arkana acquired is 90,000 square feet or so.

Dr. Chris Larsen:              

That's right.

Chelsea O’Kelley:            

But you intend to expand that by about 10,000 square feet?

Dr. Chris Larsen:              

Mm-hmm.

Chelsea O’Kelley:            

So as far as the physical space, that's expanding. You already mentioned hiring. You're going to be onboarding several different roles over the next five years, about 75 positions.

But Arkana already houses an impressive amount of equipment. That really positions you at the cutting edge of technology and research. So what kind of equipment do you have on hand at Arkana Labs? Why does that make you special, and how did that happen?

Dr. Chris Larsen:              

Yeah. Well, a lot of the equipment is used for everyday clinical diagnostic. There are very advanced tools, things like electron microscopy.

These are very expensive instruments, that enable very, very high power evaluation of tissue, at high resolution. We have five of those now. So yeah, that's just an example in the clinical lab.

But today, automation is so helpful in a clinical lab. So, we have a lot of automation there.

We have a molecular lab as well, where we're looking at more genetic testing and molecular diagnostics. We have some research and development tools that we are using to try and advance the field. I mean, some that aren't even really used that much in clinical workflows right now, that we see a lot of potential for.

So, we're doing the discovery work as well as the ongoing validation, to be able to try and translate some research type findings into the clinic.

The whole goal goal there is to be able more definitively diagnose what the underlying cause of a patient's kidney disease is or neuromuscular disease.

The reason you want that is, everything in medicine is moving more towards a precision medicine approach, where we're wanting to treat an individual patient for their specific disease, rather than these more generic treatment workflows.

In order to do that, that's only only possible if you have precision diagnostics. So, we're trying to get to the place where we can provide those precision diagnostics, to enable on the clinical side, the more precision treatment approaches.

Yeah. How did it happen though? I mean, it happens just one thing at a time. I mean, we see an opportunity or we have an idea.

We write a fair number of Small Business Administration grants. So, we fund some of the research activities through that program.

Sometimes it's Arkana itself investing in it, but it's just one idea at a time, writing one grant at a time. You identify something you want to do and then, okay, well, what technology will be required? What expertise will we need, to run that technology and develop that assay? So, end up purchasing new equipment and hiring experts that can help us move it forward.

Chelsea O’Kelley:            

We've already used the time machine to go back.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

Let's get in the time machine again and go forward this time.

Dr. Chris Larsen:              

Okay.

Chelsea O’Kelley:            

I want a look at where Arkana Labs is headed in the future.

Dr. Chris Larsen:              

Sure. Well, I frequently say that, at any point in my life, if you had told me where I'd be in 10 years, 10 years ago, I probably wouldn't believe you.

So, I know the value of 10-year projections. Usually they don't turn out like you think. But one thing I'm confident of, is that Arkana is going to continue to grow in our core areas of renal pathology and neuropathology.

We also are constantly evaluating and looking at new areas of esoteric diagnostics and considering expansion into those.

We will continue to press into research and development. We are leaders in this field. In these really highly specialized fields, we're world leaders in them, and we want to continue to be that.

We feel both a duty, as well as find a lot of enjoyment in pressing the fields forward and trying to make them even better than they currently are.

So we'll continue that R & D activity, to continue to be a leader in the field that we have expertise in.

Arkana, I frequently say, we do have a lot of fancy equipment. We're getting this building that's going to be fit for our purpose. But at the end of the day, it's people. I mean, we talked about that several times.

That is continuing to bring in excellent people and really making sure that people, they enjoy their work, but they have a life outside of their work too. So, good work-life balance is a goal for us as well.

That is one of the main reasons that we are continuing to really press into hiring right now, is we recognize the fact that for people to really perform at a world class level, you've got to be all on when you're at work. But that means you've got to have time where you're not all on with work. So, trying to get to where we can provide a really good work-life balance for the people of Arkana.

So, yeah. I mean, if I was going to summarize, let's see. We want to have a place where we have a group of passionate employees, who are taking care of themselves outside of work as well and really doing the work to grow the company and push the field forward.

Chelsea O’Kelley:            

Awesome.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

Thanks so much for sharing that. So now we're going to transition a little bit. We're going to do some rapid-fire questions.

Dr. Chris Larsen:              

Okay.

Chelsea O’Kelley:            

What's the saying? The game's made up and the points don't matter. These are just for fun.

Dr. Chris Larsen:              

That sounds good.

Chelsea O’Kelley:            

Are you up for it?

Dr. Chris Larsen:              

Sure.

Chelsea O’Kelley:            

You ready?

Dr. Chris Larsen:              

Yeah, absolutely. Go ahead.

Chelsea O’Kelley:            

All right, here we go. Just rapid fire, first thing that comes to your mind. Here we go.

Dr. Chris Larsen:              

Okay.

Chelsea O’Kelley:            

What's your favorite sport to watch?

Dr. Chris Larsen:              

Football.

Chelsea O’Kelley:            

Do you prefer the beach or the mountains?

Dr. Chris Larsen:              

The mountains.

Chelsea O’Kelley:            

What's your favorite unhealthy snack?

Dr. Chris Larsen:              

Peanut M&Ms.

Chelsea O’Kelley:            

You heard it here first, folks, peanut M&Ms, the superior unhealthy snack. In another life, what would your profession be?

Dr. Chris Larsen:              

Oh my. Maybe a particle physicist.

Chelsea O’Kelley:            

A particle physicist. Amazing.

Dr. Chris Larsen:              

Yeah. I've always been fascinating by it. Yeah. I was a chemistry major.

Chelsea O’Kelley:            

Amazing. What is your favorite place to visit in Arkansas?

Dr. Chris Larsen:              

Ponca.

Chelsea O’Kelley:            

Oh, yeah. That's a good one.

Dr. Chris Larsen:              

Yeah. I love Ponca. Yeah.

Chelsea O’Kelley:            

That's a good one.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

Last but not least-

Dr. Chris Larsen:              

Well, I will say, I have two kids at Fayetteville right now. So, maybe Fayetteville's a close second.

Chelsea O’Kelley:            

Yeah, both great spots. Both great spots. Last but not least, the burning question that everyone wants to know, what is objectively the worst Halloween candy?

Dr. Chris Larsen:              

Oh, man. The worst Halloween candy. I am not a big fan of milk chocolate. So really, anything milk chocolate. Parents, we're getting ready for Halloween. Throw some dark chocolate in the mix, for the parents that are taking the kids trick-or-treating. I'm still doing that, so that would be great.

Chelsea O’Kelley:            

You don't like milk chocolate, but your favorite unhealthy snack is peanut butter M&Ms.

Dr. Chris Larsen:              

I know. It doesn't make sense. That's the one exception. Yeah, I know.

Chelsea O’Kelley:            

All right.

Dr. Chris Larsen:              

Yeah.

Chelsea O’Kelley:            

All right. Well, thank you so much for answering our rapid-fire, silly questions and also for talking with us about Arkana.

I've been talking today with Dr. Chris Larsen, executive director of Arkana Labs. Dr. Larsen, thank you for joining us today.

Dr. Chris Larsen:              

Yeah, thanks for having me today. It's been fun.

Chelsea O’Kelley:            

You've been listening to the Arkansas Inc. Podcast. This is Chelsea O'Kelley, director of communications at the Arkansas Economic Development Commission.

You can subscribe to the Arkansas Inc. Podcast on Apple Podcasts, Spotify, Stitcher and other podcast apps. For more information about AEDC and to go sign up for our monthly newsletter, visit ArkansasEDC.com. Connect with us on LinkedIn, Twitter, Facebook and YouTube. Thanks for tuning in.