Podcasts about APD

Navigating Food Protein-Induced Enterocolitis Syndrome (FPIES) can be complex, but dietitians have a crucial role in supporting families with clarity and care. In this episode, we're joined by Ingrid Roche, APD and co-director of Advanced Dietitians Group, to explore the foundations of FPIES — from diagnosis to multidisciplinary care. Ingrid shares practical strategies for maintaining nutritional adequacy, managing feeding challenges, guiding safe food reintroductions, and supporting parents through the emotional journey. Whether you're new to paediatric allergy or looking to deepen your expertise, this conversation is filled with evidence-based insights and practical takeaways to strengthen your practice. In the episode, we discuss: What FPIES is and how it differs from other food allergies The dietitian's role in diagnosis, nutrition support and care planning Approaches to feeding challenges and supporting parent confidence Practical guidance for safe and structured food reintroduction Hosted by Rebecca Sparrowhawk Click here for the shownotes The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see here for terms and conditions.

APD looks to beef up force in advance of major events coming to the city; Atlanta and Fulton County seek ideas for planned LGBTQ+ community center; and in an absence of federal relief funds, Georgia beefs up available relief for farmers. See omnystudio.com/listener for privacy information.

In Episode 151, Scott Piehler's topics include: A lawsuit dismissed. A sad sight on Easter Morning. Make your voice heard on transportation issues. From slow streets to Greenways. An F-18's final journey. A potentially life-saving drug now available easily and affordably. APD welcomes a great bit of history. Weekend events. A Bay-area inspiration for runners of all ages. And a shoutout to Admiral Maltings. Support the show• AlamedaPost.com • Podcast • Events • Contact •• Facebook • Instagram • Threads • BlueSky • Reddit • Mastodon • NextDoor • YouTube • Apple News •

The National Guard is now training with APD so how this will affect the mayor's race plus more details about the New Mexico Judge who was harboring an illegal gang member on News Radio KKOBSee omnystudio.com/listener for privacy information.

The inflammatory and infectious optic neuropathies are a broad, heterogeneous, and common group of diseases producing visual loss. Although many now-distinct syndromes have been previously combined as “typical or atypical optic neuritis,” recent developments highlight the importance of precision terminology as well as an individualized evaluation and treatment approach. In this episode, Gordon Smith, MD, FAAN speaks with Eric Eggenberger, DO, MS, FAAN, author of the article “Optic Neuritis” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Eggenberger is a professor of ophthalmology, neurology, and neurosurgery at the Mayo Clinic in Jacksonville, Florida. Additional Resources Read the article: Optic Neuritis Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: This is Dr Gordon Smith. Today I'm interviewing someone who really needs no introduction, Dr Eric Eggenberger, about his article on optic neuritis, which appears in the April 2025 Continuum issue on neuro-ophthalmology. Eric, welcome to the podcast, and maybe you can introduce yourself to our audience. Dr Eggenberger: Thank you. Thanks for having me. So, my name is Eric Eggenberger. I work at Mayo Clinic Florida, and I am involved exclusively in neuro-ophthalmology. Dr Smith: I just had the pleasure, Eric, of talking yesterday with Lindsey De Lott about non-optic neuritis causes of optic neuropathy. And so, I'm going to kind of reference a little bit what I learned yesterday. She was great. I wonder if you might begin by talking a little bit about nomenclature. You talk about the need for use of precise terminology in your article. And yesterday she taught me a lot about the risk of misdiagnosis and other causes of optic neuropathy, and the two seem related. So, I wonder if you can maybe lay the foundation for our conversation by talking about terminology? Dr Eggenberger: I think that's a great point. So, we are in an era now where, instead of lumping all these different diagnoses together, we have learned to split apart some of these clinical entities. And so, I think it's really important that we focus on precise terminology and recognize that all optic neuritis is not the same. And we have very different, distinct clinical pathways for these imaging pathways, treatment pathways, for these different types of optic neuritis, whether that's MS related, whether it's MOG related or aquaporin-4 related. Dr Smith: So, I wonder maybe we can begin by just, you know, giving our listeners wisdom, pearls, and pitfalls about, how do you recognize when someone with a suspected optic neuropathy has optic neuritis versus a noninflammatory optic neuropathy? Dr Eggenberger: So, that's a really important issue because there's a lot of clinical overlap in terms of exam findings. So, for instance, in any optic neuropathy, let's say it's unilateral, you typically are going to see decreases in acuity and field and color, and you're going to see a relative afferent pupillary defect. And then it's really the context that that occurs in that helps us distinguish different disease entities. So, with optic neuritis, typically you're going to have pain. And that's oftentimes going to be in the younger populations compared to some of the other common optic neuropathies we see, like ischemic optic neuropathy, for instance. Dr Smith: Right. So maybe we can talk a little bit about, kind of, your overall diagnostic approach, right? A lot of this is, of course, based on age and context, but young people get ischemic lesions and older people can have inflammatory lesions. So, what's your overall approach to the patient you just described? Let's say it's a forty-eight-year-old woman who comes to the emergency department with subacute unilateral vision loss and there's dyschromatopsia, APD, reduced acuity. And, you know, let's just say a fairly, you know, benign-looking fundoscopic exam. What do you do to evaluate that patient? Dr Eggenberger: In that particular context, I think we're looking at other contextual clues. Is there other vascular risk factors or other things to point you in one direction or the other? One of the important parts you mentioned was the fundus exam. So, we know with ischemic optic neuropathy, 100% of the time with AIOM, you're going to see disc edema. And so, in the context of that story, we want to confirm on our exam an optic neuropathy, and then we can kind of focus on the retrobulbar courses or different types of optic neuropathies. From an exam perspective, in that particular patient we'd be looking to measure the acuity, quantify that. And in the ER, you're not going to be able to do a perfect field, but you'll get some sense of the field and how much field loss there is. And then as you mentioned, the afferent pupillary defect is critical. And we're going to get a little bit of the historical features in terms of pain. With typical retrobulbar optic neuritis, most of those patients are going to experience some pain, and usually it's pain on eye movements. And those would be the clinical things to focus on. Other exposures the patient may or may not have had, any other concomitant conditions, would all help point you in different directions, perhaps, and then we're probably on towards imaging. Dr Smith: Yeah, maybe you can talk a little bit about that? What's the appropriate use of imaging? I mean, presumably the patients, like the one I just threw out there, are pretty much all going to get neuroimaging. What's your approach to that? How do you protocol the study? What should we be looking for? Dr Eggenberger: In our clinic, we would typically be ordering an MRI orbit and brain, and each of those has a specific purpose. The orbit is going to show us the extent of the optic neuropathy. So, we're particularly looking for a longitudinally extensive optic nerve lesion or more than half of the optic nerve involved. And most patients acutely, if it isn't an “itis" situation, we'll see enhancement. And then the MR brain is going to be useful for looking for other evidence of demyelination within the central nervous system. We may at some point get down to doing an MR cord, but I think acutely it's going to be brain and orbit that most of our patients are getting. Dr Smith: Let's say that we did the scan and, sure enough, there's sort of a shorter segment, so less than half the length of the nerve region of enhancement. What's the rest of your diagnostic evaluation look like for that patient? Dr Eggenberger: So, in that particular case, we would look at the remainder of the brain. So, we're looking for other evidence of demyelination and any other contextual clues, systemically that would point you one direction or another. But with a shorter segment involved, one of the more common things we might encounter would be multiple sclerosis-related optic neuritis. Dr Smith: Would you look for aquaporin-4 and MOG in a patient with what appears to be an isolated, uncomplicated short segment optic neuritis? Dr Eggenberger: So, I think it really depends a bit on the context. I would never fault anybody for looking at MOG or an aquaporin-4 in that context because those are really treatment-altering diagnoses, but the yield in this particular case with a short segment involved and depending on the acuity and other features is probably going to be pretty low. Dr Smith: I really liked as an aside- I wasn't going to go there next, but you kind of got me thinking about it, you have a really nice section in your article. Which, all of it's great, but talking about how to manage low titer MOG antibodies. I wonder if you could talk about that because I think that's a lesson, maybe, that is transferable to a lot of other testing that we do. in terms of pre-prior probability and titer and so forth. Dr Eggenberger: Yeah, that's really an important point. So, we've seen this come up a number of times where the MOG antibody is a very good test, but in low titer it has a relatively low positive predictive value, perhaps 50%. In those cases, particularly without a classic clinical context, you have to be extremely alert for some other diagnosis that could mimic what you think is inflammatory demyelinating optic neuritis, but in fact is infectious or some other cause. Dr Smith: Yeah, super, super important and helpful. In terms of aquaporin-4, how does that compare in terms of predictive values, lower titer positive results? Dr Eggenberger: So aquaporin-4, the test has a very high specificity. So, it's quite useful if positive. You have to keep in mind there can be some false negatives, but the test otherwise is quite specific. And that is a diagnosis, you know, we never want to miss. It's a vicious disease. It tends to be a blinding disease, particularly without treatment. Bad things happen when we miss that, and we want to get on that diagnosis early and do pretty aggressive early and prophylactic treatment. Dr Smith: Your article covers not only the common causes of optic neuritis and, you know, MS, isolated optic neuritis, MOGAD NMO, you talk about a bunch of other things. I wonder, in this patient that we've been discussing, in the absence of any other historical information that seems relevant---or maybe you can define what would seem relevant---would you do other evaluation in that individual, other serologic evaluation and so forth, just in terms of diagnosis? Dr Eggenberger: In that particular case, without other red flags, I don't think I would initially. And follow-up is going to give you a lot of this context. So, you'd be on the lookout for other systemic conditions. So, if the patient had some arthropathy, if the patient had any pulmonary disease hints, if there was anything else that could lead you on a broader expedition. But I think in the context of this case, acutely in the ER, I probably wouldn't do a big lab plug for this. I probably would kind of go down the most likely road and start our treatments, and then follow that patient up. Dr Smith: Yeah, I know your article does a really great job, I think, of outlining when do you need to think about some of these less common causes. Well, can we talk about treatment, Eric? Because I want to move on to some other things. But- so, we've got a patient with isolated optic neuritis, nothing else, you know, in terms of the other antibodies we've talked about. What state-of-the-care- or, state-of-the-art treatment for that patient? Dr Eggenberger: So, the acute treatment for these inflammatory, optic neuritis-type cases is very similar Initially. High dose steroids remains kind of the standard. And then, in MS-related optic neuritis, we may or may not see a taper. So many times it's just an acute treatment of three to five days high dose. Whether that's oral or PO, we could institute either depending on the particular case. And then the taper would depend on the potential cause. So, for instance, with these antibody-driven diseases---so with MOG- or particularly with aquaporin-4---if it's a longitudinally extensive region of optic nerve involved, we tend to use a longitudinally extensive taper. And so, we use prednisone in those cases for several months while we're getting everything else set and deciding what the overall course is going to bring. Dr Smith: What about IV versus oral? There must be something about my practice. I was telling this to Lindsey. Every time on our hospital service, we seem to have at least two patients with optic neuropathies, which I always enjoy, but I find it's a little weird to admit someone who's doing just fine otherwise to the hospital with three days of IV SOLU-MEDROL. So, I'm always trying to figure out, like, how can I get this patient home? And your article had the best term I've heard in a long time, which is “SOLU smoothies.” I mean, are there other strategies that you sometimes use, other than just high-dose IV methylprednisolone? Dr Eggenberger: So, I agree with you. It's sometimes hard to admit somebody for just an IV therapy. And we'll do this as an outpatient, high-dose IV, but we'll also use high-dose orals. And in times in the past when there's been methylprednisolone shortage, we've used high-dose oral or IV dexamethasone as well. I think the IV form, although it's the gold standard, the high-dose oral forms have pretty equivalent bioavailability and are pretty tolerable in my experience. And certainly more convenient. Dr Smith: I wonder if we should switch and maybe talk a little bit about aquaporin-4, I mean, you emphasized that this is a vicious disease---I love the way you describe that---and often blinding. What updates do you have in terms of our therapeutic approach to NMO? That's been rapidly evolving of late. Dr Eggenberger: Right, so these are cases we're always going to share with neuroimmunology. And it requires kind of a multidisciplinary approach, in my opinion, for ideal or for best outcomes. And so, all of these patients are going to get put on prophylactic medications. So, this is a disease you just can't leave untreated. Bad stuff will happen for sure. And we now, fortunately, have some approved, FDA-approved medications that can positively impact the course of this disease. So, that's been a welcome addition. Dr Smith: What are the FDA-approved medications at this point for NMO? Dr Eggenberger: So, there are several at this point, and this is an area that's in growth, fortunately. And again, these are cases we're going to be sharing with our neuroimmunology colleagues. So, these are IV medications typically aimed at complement or CD19. And they all are relatively effective at quieting the course of the disease. Dr Smith: Maybe we can talk a little bit about MOG? I think that most of our listeners are probably pretty familiar with aquaporin-4 and NMO, what- maybe you could describe MOG a little bit and the therapeutic approach for patients with MOG-associated disease? Dr Eggenberger: So, MOG has been a real interesting kind of condition to learn more about. We certainly see a lot of MOG, and I'm sure we saw MOG before it was formally described, but I think we just thought it was kind of a benign, maybe monophasic MS type of presentation. But MOG tends to come in with a loss of acuity that kind of rivals aquaporin-4. So, the acuity tends to be pretty, pretty depressed, but it's very steroid-responsive. So, a lot of times these are the patients, you'll see that their vision will start to improve even when they're on the initial few days of the high-dose steroids. And many times we can get their vision back to 20/20 or very close to that. Dr Smith: And do these patients need chronic management? Dr Eggenberger: So, that's an area of controversy to some degree. About 50% of the optic neuritis MOG-related cases are going to have a relapsing course. And because the disease is steroid-responsive, many times we'll follow these patients after a first attack to see if this is the condition that's going to declare itself to be relapsing or if this is just going to be a monophasic kind of presentation of optic neuritis. We don't have great biomarkers to separate patients who are going to be in that 50% monophasic course versus the other half. It'll be relapsing. And so, it depends on the patient. If there's somebody that's, as many of these patients are, been very steroid responsive, they get back to 20/20, we can teach them about the disease so that if they do have a relapse, we can get them high-dose steroids in a relatively rapid fashion and they're otherwise healthy, we're probably going to watch that patient. And if it's somebody that doesn't recover 100%, there's other issues with treating them with high-dose steroids potentially in the future, then we may learn more towards an earlier prophylactic approach in that patient. Dr Smith: And what would that approach look like? Is it different from NMO or using more IVIG or B cell depletion as opposed to complement inhibition, for instance? Dr Eggenberger: In MOG, we know that the B cell depletion strategies don't work as well. And so most times we're turning to IVIG, and we found that pretty effective. That's kind of our go-to at this point. Dr Smith: Eric, it's a joy talking to you and I'd love to keep going about content, but I'll refer our listeners to your outstanding article. I mean, you're such a highly regarded neuro-ophthalmologist and educator. I wonder if you could talk to us about why you've done neuro-ophthalmology, and maybe this is an opportunity for you to convince all of our great residents that are listening or students what's great about being a neuro-ophthalmologist. Dr Eggenberger: I think neuro-ophthalmology is by far the most interesting part of neurology. So, it's an area that I think a lot of general neurologists, in my view, don't get enough of in their residency. But it's kind of the essence of neurology, where in neurology you're localizing down to the millimeter and in neuro-ophthalmology,  we're localizing down to the micron level. We have several new emerging diseases like these varieties of optic neuritis we're focused on. We're learning lots about those. You get to be involved in lots of different areas of neurology. So, we'll see not just demyelinating conditions, we'll see trauma as it relates to the visual system. And we'll see tumor, and we see all different flavors, stroke, and in any piece of neurology, commonly we'll have some vision aspect that we that we get involved in. So, we see a wide variety of conditions. So, I think it's been a really exciting place to be within neurology. And it's rapidly changing at this point. We're getting new therapeutics. So, it's, I think it's a great time to be a neuro-ophthalmologist. Dr Smith: Yeah, listening to you talk and just reflecting on it, it's really true. Neuro-ophthalmology does cover the entire span of neurology, right? I'm a neuromuscular guy and we see a lot of ocular myasthenia, which is another super exciting area. But we've been talking about optic neuritis, and your article talks about infectious causes and the paraneoplastic and a whole host of things. So, you're a great advocate and salesperson for your field. You convinced me. Dr Eggenberger: Efferent neuro-ophthalmology we love, we could talk about ocular myasthenia and other aspects for another hour. And we get involved in all kinds of cases: third nerve palsies, ocular myasthenia, trauma that involves the efferent system, all different aspects. It's really a great subspecialty, and you get to see a bit of all of neurology. Dr Smith: I'm trying to remember who it was, Eric. It was an attending of mine at medical school. I went to medical school at the Mayo Clinic in Rochester, and I want to say it was Manny Gomez, who was a very famous tuberous sclerosis person, who told me that neuro-ophthalmology was the most elegant specialty within neurology. That stuck with me. Thank you so much for joining me today. I really appreciate it. Dr Eggenberger: Thank you. I appreciate it as well. Dr Smith: So again, today I've been interviewing Dr Eric Eggenberger about his really wonderful article on optic neuritis, which appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum audio episodes from the neuro-ophthalmology and other issues. And listeners, thank you very much for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Dr. Fidele Sebahizi's powerful story of courage and perseverance will inspire you to create your own life from the ashes, no matter what giants are in front of you. Dr. Sebahizi was born and raised in a poor village in the Democratic Republic of Congo. His life was rough. He experienced lots of terrible things, including escaping a genocidal killing at least twice. When he arrived in the United States in 2007, he felt tremendously blessed to have been given such a wonderful opportunity to achieve his unfulfilled dreams, especially going back to school.    He overcame life obstacles as an immigrant in the United States to achieve the American dream. He became the first immigrant to join and work for the Abilene Police Department in Texas as a police officer. While working for the APD, Fidele earned multiple degrees: a B.A. in Creative Writing from Southern New Hampshire University in New Hampshire, an M.S. in Criminal Justice from Sam Houston State University in Texas, and a Ph.D. in Criminal Justice—Homeland Security from Liberty University in Virginia. In his interview, he shares incredible stories of courage. In 2004, when he was trapped in a house between two heavily armed forces fighting each other, he didn't know if he would be alive today. In addition, he witnessed a genocidal massacre against his people in a United Nations refugee camp in Burundi, Africa, witnessing the burning bodies of his relatives and friends.  His faith in Jesus Christ is the common denominator that helped him to overcome life's obstacles and struggles. He knew God was always with him and was determined never to give up.   Grab Your Copy Now     Embark on an extraordinary journey from a remote African village, through the horrors of a refugee camp massacre, to a remarkable life as a police officer and PhD holder in the United States. "Creating a Life from the Ashes: A Memoir" is a testament to the indomitable spirit of an African refugee who chose to face and overcome insurmountable challenges. In this book, you will discover: How to build a life from nothing, regardless of your beginnings or struggles. The importance of confronting challenges head-on. Why avoiding challenges can lead to greater difficulties. The true happiness that comes from overcoming adversity. The power of rejecting excuses and embracing responsibility.   "Creating a Life from the Ashes" inspires readers to rise above their circumstances with determination and resilience. This memoir demonstrates that no matter how humble your beginnings, you can achieve greatness and make a significant impact. Don't miss out on this powerful story of courage and perseverance. Be inspired to create your own life from the ashes.   Connect with Dr. Fidele   Website   Book Website   X   Facebook

In hour three, Mark and Brad Swail talk about birthright citizenship, a new program at Sam's Club, and APD recruitment numbers.See omnystudio.com/listener for privacy information.

GOP Firebombing suspect is being held in custody pending trial after a Judge denied home detainment plus what id the future of APD after the DOJ leaves on News Radio KKOBSee omnystudio.com/listener for privacy information.

Optic neuropathies encompass all congenital or acquired conditions affecting the optic nerve and are often a harbinger of systemic and central nervous system disorders. A systematic approach to identifying the clinical manifestations of specific optic neuropathies is imperative for directing diagnostic assessments, formulating tailored treatment regimens, and identifying broader central nervous system and systemic disorders. In this episode, Gordon Smith, MD, FAAN speaks with Lindsey De Lott, MD, MS, author of the article “Optic Neuropathies” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. De Lott is an assistant professor of neurology and ophthalmology at the University of Michigan in Ann Arbor, Michigan. Additional Resources Read the article: Optic Neuropathies Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @lindseydelott Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: Hello, this is Dr Gordon Smith. Today I'm interviewing Dr Lindsey De Lott about her article on optic neuropathies, which appears in the April 2025 Continuum issue on neuro-ophthalmology. Lindsey, welcome to the podcast, and perhaps you can introduce yourself to our audience. Dr De Lott: Thank you, Dr Smith. My name is Lindsey De Lott and I am a neurologist and a neuro-ophthalmologist at the University of Michigan. I also serve as the section lead for the Division of Neuro-Ophthalmology, which is actually part of the ophthalmology department rather than the neurology department. And I spend a good portion of my time as a researcher in health services research, and that's now about 60% of my practice or so. Dr Smith: I'm super excited to spend some time talking with you. One, I'm a Michigan person. As we were chatting before this, I trained with Wayne Cornblath and John Trobe, and it's great to have you. I wonder if we maybe can begin- and by the way, your article is outstanding. It is such a huge topic and it was actually really fun to read, so I encourage our listeners to check it out. But you begin by talking about misdiagnosis as being a common problem in this patient population. I wonder if you can talk through why that is and if you have any pearls or pitfalls in avoiding it? Dr De Lott: Yeah, I think there's been a lot of great research looking at misdiagnosis in specific types of optic neuropathies; in particular, compressive optic neuropathies and optic neuritis. A lot of that work has come out of the group at Emory and the group at Washington University. But a lot of neuro-ophthalmologists across the country really contributed to those data. And one of the statistics that always strikes me is that, you know, for example, in patients with optic nerve sheath meningiomas, something like 70% of them are actually misdiagnosed. And a lot of those errors in diagnosis, whether it's for compressive optic neuropathy or some other type of optic neuropathy, really comes down to the way that physicians are really incorporating elements of the history in the physical. For example, in optic neuritis, we know that physicians tend to anchor pretty heavily on pain in general. And that often tends to lead them astray when optic neuritis was never the diagnosis to begin with. So, it's really overindexing on certain things and not paying attention to other features of the physical exam; for example, say presence of an afferent pupillary defect. So, I think it just really highlights the need to have a really relatively structured approach to patients that you think have an optic neuropathy when you're trying to sort of plan your diagnostic testing and your treatment. Dr Smith: I do maybe five or six weeks on our hospital service each year, and I don't know if it's just a Richmond thing, but there's always at least two people in my week who come in with an optic neuropathy or acute vision loss. How common is this in medical practice? Or neurologic practice, I should say? Dr De Lott: Optic neuropathies themselves… if you look across, unfortunately we don't have any great data that puts together all optic neuropathies and gives us an actual sort of prevalence estimate or an incidence estimate from year to year. We do have some of those data for specific types of optic neuropathies like optic neuritis and NAION, and you're probably looking around five-ish per one hundred thousand. So, these aren't that common, but at the same time they do get funneled to- often to emergency rooms and to neurologists from our ophthalmology colleagues and optometry colleagues in particular. Dr Smith: So, one other question I had before kind of diving into the topic at hand is how facile neurologists need to be in recognizing other causes of acute visual loss. I mean, we see acute visual loss as neurologists, we think optic neuropathy, right? Optic neuritis is sort of the go-to in a younger patient, and NAION in someone older. But what do neurologists need to know about other ophthalmologic causes? So, glaucoma or acute retinal disorders, for instance? Dr De Lott: Yeah, I think it's really important that neurologists are able to distinguish optic neuropathies from other causes of vision loss. And so, I would really encourage the listeners to take a look at the excellent article by Nancy Newman about vision loss in this issue where she really kind of breaks it down into vision loss that is acute and chronic and how you really think through distinguishing optic neuropathies from other causes of vision loss. But it is really important. For example, a patient with a central retinal artery occlusion may potentially be eligible for treatments. And that's very different from a patient with optic neuritis and acute vision loss. So, we want to be able to distinguish these things.  Dr Smith: So maybe we can pivot to that a little bit. Just for our listeners, our focus today is going to be on- not so much on optic neuritis, although obviously we need to talk a little bit about how we differentiate optic neuritis from non-neuritis optic neuropathies. It seems like the two most common situations we encounter are ischemic optic neuropathies and optic neuritis. Maybe you can talk a little bit about how you distinguish these two? I mean, some of it's age, some of it's risk factors, some of it's exam. What's the framework, of let's say, a fifty-year-old person comes into the emergency room with acute vision loss and you're worried about an optic neuropathy? Dr De Lott: The first step whenever you are considering an optic neuropathy is just making sure that the features are present. I think, really going back to your earlier question, making sure that the patient has the features of an optic neuropathy that we expect. So, it's not only vision loss, but it's also the presence of an apparent pupillary defect in a patient with a unilateral optic neuropathy. In a person who has a bilateral optic neuropathy, that apparent pupillary defect may not be present because it is relative. So, you really would have to have asymmetric vision loss between the two eyes. They should also have impairment of their color vision, and they're probably going to have some kind of visual field defect, whether that's central scotoma or an arcuate scotoma or an altitudinal defect that really respects the horizontal meridian. So, you want to make sure that, first and foremost, you've got a patient that really meets most of those- most of those features. And then from there, we're looking at the other features on their history. How acute is the onset of the vision loss? What is the progression over time? Is there pain associated or not associated with the vision loss? What other medical issues does the patient have? And you know, one of the things you already brought up, for example, is, what's the age of the patient? So, I'm going to be much more hesitant to make a diagnosis of optic neuritis in a much older patient or a diagnosis on the other side, of ischemic optic neuropathy, in a much younger patient, unless they have really clear features that push me in that direction. Dr Smith: I wonder if maybe you could talk a little bit about features that would push you away from optic neuritis, because, I mean, people who are over fifty do get optic neuritis- Dr De Lott: They do. Dr Smith: -and people who get ischemic optic neuropathies who are younger. So, what features would push you away from optic neuritis and towards… let's be broad, just a different type of optic neuropathy? Dr De Lott: Sure. We know that most patients with optic neuritis do have pain, but that pain is accompanied---within a few days, typically---with vision loss. So, pain alone going on for a number of days without any visual symptoms or any of those other things I listed, like the afferent papillary defect, the visual field defect, would push me away from optic neuritis. But in general, yes, most optic neuritis is indeed painful. So, the presence of optic disc edema is unfortunately one of those things that an optic neuritis may be present, may not be present, but in somebody with ischemia that is anterior---and that's the most common type of ischemic optic neuropathy, would be anterior ischemic optic neuropathy---they have to have optic disc edema for us to be able to make that diagnosis, and that is a diagnosis of NAION, or nonarteritic ischemic optic neuropathy. An APD in this case, again, that's just a feature of an optic neuropathy. It doesn't really help you to distinguish, individual field defects are going to be relatively similar between them. So then in patients, I'm also looking, like I said, at their history. So, in a patient where I'm entertaining a diagnosis of ischemic optic neuropathy, I want to make sure that they have vascular risk factors or that I'm actually doing things like measuring their blood pressure in the office if they haven't seen a physician recently or checking a lipid panel, hemoglobin A1c, those kinds of things, to look for vascular risk factors. One of the other features on exam that might push me more- again, in a patient with ischemic optic neuropathy, where it might suggest ischemia over optic neuritis, would be some other features on exam like a crowded optic disc that we sometimes will see in patients with ischemic optic neuropathy. I feel like that was a bit of a convoluted answer. Dr Smith: I thought that was a great answer. And when you say crowded optic disc, that's the- is that the “disc at risk”? Dr De Lott: That is the “disk at risk,” yes. So, crowded optic disk is really a disk that is smaller than what we see in the average population, and the average cup to disk ratio is 0.3. So, I think that's where 30% of the disk should be. So, this extra wiggle room, as I sometimes will explain to my patients. Dr Smith: And then, I wonder if you could talk a little bit about more- just more about exam, right? You raised the importance of recognizing optic disc edema. Are there aspects of that disc edema that really steer you away from optic neuritis and towards ischemia-like hemorrhages or whatnot? And then a similar question about the importance of careful visual field testing? Dr De Lott: So, on the whole, optic disc edema is optic disc edema. And you can have very severe optic neuritis with hemorrhages, cotton wool spots, which is essentially just an infarction of the retinal nerve fiber layer either overlying the disc or other parts of the retina. And ischemia, you can have some of the same features. In patients who have giant cell arteritis, which is just one form of anterior ischemic optic neuropathy, patients can have a pallid optic disc edema where the optic disc is swollen and white-looking. But on the whole, swelling is swelling. So, I would caution anyone against using the features of the optic nerve swelling to make any type of, sort of, definitive kind of diagnosis. It's worth keeping in mind, but I just- I would caution against using specific features, optic nerve swelling. And then for visual field testing, there are certain patterns that sometimes can be helpful. I think as I mentioned earlier, in patients with ischemic optic neuropathy, we'll often see an altitudinal defect where either the top half or, more commonly, the bottom half of the vision is lost. And that vision loss in the field corresponds to the area of swelling on the disk, which is really rewarding when you're actually able to see sectoral swelling of the disk. So, say the top half of the disk is swollen and you see a really dense inferior defect. And other types of optic neuropathy such as hereditary optic neuropathies, toxic and nutritional optic neuropathies, they often cause more central field loss. And in patients who have optic neuropathies from elevated intracranial pressure, so papilladema, those folks often have more subtle visual field loss in an arcuate pattern. And it's only once the optic nerves have sustained a pretty significant injury that you start to see other patterns of field loss and actual decline in visual acuity in those patients. I do think a detailed visual field assessment can often be pretty helpful as an adjunct to the rest of the exam. Dr Smith: So, we haven't talked a lot about neuroimaging, and obviously, neuroimaging is really important in patients who have optic neuritis. But how about an older patient in whom you suspect ischemic optic neuropathy? Do those patients all need a MRI scan? And if so, is it orbits and brain? How do you- how do you protocol it? Dr De Lott: You're asking such a good question, totally controversial in in some ways. And so, in patients with ischemic optic neuropathy, if you are confident in your diagnosis: the patient is over the age of fifty, they have all the vascular, you know, they have vascular risk factors. And those vascular risk factors are things like diabetes, hypertension, high blood pressure, hyperlipidemia, obstructive sleep apnea. They have a “disc at risk” in the fellow eye. They don't have pain, they don't have a cancer history. Then doing an MRI of the orbits is probably not necessary to rule out another cause. But if you aren't confident that you have all of those features, then you should absolutely do an MRI of the orbit. The MRI of the brain probably doesn't provide you with much additional information. However, if you are trying to distinguish between an ischemic optic neuropathy and, say, maybe an optic neuritis, in those patients we do recommend MRI orbits and brain imaging because the brain does provide additional information about other CNS demyelinating disorders that might be actually the cause of a patient's optic neuritis. Dr Smith: I wonder if you could talk a little bit about posterior ischemic optic neuropathy. That's much less common, and you mentioned earlier that those patients don't have optic disk edema. So, if there's a patient who has vision loss that- in a similar sort of clinical scenario that you talked about, how do you approach that and under what circumstances do we see patients who have posterior ischemic optic neuropathy? Dr De Lott: So, you're going to most often see patients with posterior ischemic optic neuropathy who, for example, have undergone a recent surgery. These are often associated with things like spinal surgeries, cardiac surgeries. And there are a number of risk factors that are associated with it. Things like blood pressure, drain surgery, the amount of blood loss, positioning of patient. And this is something that the surgeons and anesthesiologists are very sensitive to at this point in time, and many patients are often- this can be part of the normal informed consent process at this point in time since this is something that is well-recognized for specific surgeries. In those patients, though… again, unless you're really certain, for example, maybe the inpatient neurology attending and you've been asked to consult on a patient and it's very clear that they went into surgery normal, they came out of surgery with vision loss, and all the rest of the features really seem to be present. I would recommend that in those cases you think about orbital imaging, making sure you're not missing anything else. Again, unless all of the features really are present- and I think that's one of the themes, definitely, throughout this article, is really the importance of neuroimaging in helping us to distinguish between different types of optic neuropathy. Dr Smith: Yeah, I think one of the things that Eric Eggenberger talks about in his article is the need to use precise nomenclature too, which I plan on talking to him about. But I think having this very structured approach- and your article does it very well, I'll tell our listeners who haven't seen it there's a series of really great tables in the article that outline a lot of these. I wonder, Lindsey, if we can switch to talk about arteritic optic neuropathy. Is that okay? Dr De Lott: Sure. Yeah, absolutely. Dr Smith: How do you sort that out in an older patient who comes in with an ischemic optic neuropathy? Dr De Lott: Yeah. In patients who are over the age of fifty with an ischemic optic neuropathy, we always need to be thinking about giant cell arteritis. It is really a diagnosis we cannot afford to miss. If we do miss it, unfortunately, patients are likely to lose vision in their fellow eye about 1/3 to 1/2 the time. So, it is really one of those emergencies in neuro-ophthalmology and neurology. And so you want to do a thorough review systems for giant cell arteritis symptoms, things like headache, jaw claudication, myalgias, unintentional weight loss, fevers, things of that nature. You also want to check their inflammatory markers to look for evidence of an elevated ESR, elevated C-reactive protein. And then on exam, what you're going to find is that it can cause an anterior ischemic optic neuropathy, as I mentioned earlier. It can cause palette optic disc swelling. But giant cell arteritis can also cause posterior ischemic optic neuropathy. And so, it can be present without any swelling of the optic disc. And in fact, you know, you mentioned one of my mentors, John Trobe, who used to say that in a patient where you're entertaining the idea of posterior ischemic optic neuropathy, who is over the age of fifty with no optic disc swelling, you should be thinking about number one, giant cell arteritis; number two, giant cell arteritis; number three, giant cell arteritis. And so, I think that is a real take-home point is making sure that you're thinking of this diagnosis often in our patients who are over the age of fifty, have to rule it out. Dr Smith: I'll ask maybe a simple question. And presumably just about everyone who you see with a presumed ischemic optic neuropathy, even if they don't have clinical features, you at least check a sed rate. Is that true? Dr De Lott: I do. So, I do routinely check sedimentation rate and C-reactive protein. So, you need to check both. And the reason is that there are some patients who have a positive C-reactive protein but a normal sedimentation rate, so. And vice versa, although that is less common. And so both need to be checked. One other lab that sometimes can be helpful is looking at their CBC. You'll often find these patients with giant cell arteritis have elevated platelet counts. And if you can trend them over time, if you happen to have a patient that's had multiple, you'll see it sort of increasing over time. Dr Smith: I'm just thinking about how you sort things out in the middle, right? I mean, so that not all patients with GCF, sky-high sed rate and CRP…. And I'm just thinking of Dr Trobe's wisdom. So, when you're in an uncertain situation, presumably you go ahead and treat with steroids and move to biopsy. Maybe you can talk a bit about that pathway? Dr De Lott: Yeah, sure. Dr Smith: What's the definitive diagnostic process? Do you- for instance, the sed rate is sky-high, do you still get a biopsy? Dr De Lott: Yes. So, biopsy is still our gold-standard diagnosis here in the United States. I will say that is not the case in all parts of the world. In fact, many parts of Europe are moving toward using other ancillary tests in combination with labs and exam, the history, to make a definitive diagnosis of giant cell arteritis. And those tests are things like temporal artery ultrasound. We also, even though we call it temporal artery ultrasound, we actually need to image not only the temporal arteries but also the axillary arteries. The sensitivity and specificity is actually greater in those cases. And then there's high-resolution imaging of the vessels and the- both the intracranial and extracranial distributions. And both of those have shown some promise in their predictive values of patients actually having giant cell arteritis. One caution I would give to our listeners, though, is that, you know, currently in the US, temporal artery biopsy is still the gold standard. And reading the ultrasounds and the MRIs takes a really experienced radiologist. So, unless you really know the diagnostic accuracy at your institution, again, temporal artery biopsy remains the gold standard here. So, when you are considering giant cell arteritis, start the patient on steroids and- that's high dose, high dose steroids. In patients with vision loss, we use high dose intravenous methylprednisolone and then go ahead and get the biopsy. Dr Smith: Super helpful. And are there other treatments, other than steroids? Maybe how long do you keep people on steroids? And let's say you've got a patient who's, you know, diabetic or has other factors that make you want to avoid the course of steroids. Are there other options available? Dr De Lott: So, in the acute phase steroids are the only option. There is no other option. However, long term, yes, we do pretty quickly put patients on tocilizumab, which is really our first-line treatment. And I do that in conjunction with our rheumatology colleagues, who are incredibly helpful in managing and monitoring the tocilizumab for our patients. But when you're seeing the patients, you know, whether it's in the emergency room or in the hospital, those patients need steroids immediately. There are other steroid-sparing agents that have been tried, but the efficacy is not as good as tocilizumab. So, the American College of Rheumatology is really recommending tocilizumab as our first line steroid-sparing agent at this point. Dr Smith: Outstanding. So again, I will refer our listeners to your article. It's just chock-full of great stuff. This has been a great conversation. Thank you so much for joining me today. Dr De Lott: Thank you, Dr Smith. I really appreciate it.  Dr Smith: The pleasure has been all mine, and I know our listeners will be enjoying this as well. Again, today I've been interviewing Dr Lindsey De Lott about her article on optic neuropathies, which appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum Audio episodes from this and other issues. I already mentioned Dr Eggenberger and I will be talking about optic neuritis, which will be a great companion to this discussion. Listeners, thank you for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

From the local online news periodicals The Paper, NM News, City Desk ABQ, Pat Davis, and Kevin Hendricks come in to discuss the latest in political news across the State. Some of the issues they talk about are, The National Guard helping APD, the Legislative Session, and the Trump admin and student Visas. All on News Radio KKOB See omnystudio.com/listener for privacy information.

In Episode 149, Scott Piehler's topics include: APD busts a fencing ring. AUSD's Teacher of the Year. A preview of the Planning Board and the City Council. The Hands Off Rally draws 1,000 protestors. Mayor Ashcraft named to the national Mayors Institute on Pedestrian Safety. A few changes to the ferry schedules. National Poetry Month. Altarena Playhouse is honored. And another Alameda restaurant says goodbye.Support the show• AlamedaPost.com • Podcast • Events • Contact •• Facebook • Instagram • Threads • BlueSky • Reddit • Mastodon • NextDoor • YouTube • Apple News •

DA Sam Bregman making it official he is running for Governor of New Mexico; how will his message be different from Deb Halland plus ACLU upset about the National Guard backing APD on News Radio KKOBSee omnystudio.com/listener for privacy information.

MLG sends the National Guard to back up APD because of crime, but could this back fire on Tim Keller on News Radio KKOBSee omnystudio.com/listener for privacy information.

Tim Keller requests from MLG and she grants access to the National Guard to come and help APD plus Sheriff John Allen wants help with extradition on News Radio KKOBSee omnystudio.com/listener for privacy information.

Step into the whirlwind of change with this episode of Geeks Geezers Googlization: "Adaptive Perception Disorder." Guest co-hosts Eli and Casey take a Deep Dive into the eerily familiar yet subtly dangerous mindset threatening the backbone of businesses today. They delve deep into the intriguing concept of Adaptive Perception Disorder (APD), coined by GGG host and Future of Work Global Thought Leader Ira Wolfe himself. Why is exploring APD important? ADP is endemic in many companies, a mindset that causes them to believe they're on top of change when they're actually way behind. It's calling the hurricane a light breeze.  Adaptive Perception Disorder (APD) might not be the buzzword yet, but it certainly highlights a crippling blind spot in many organizations. Here are top three takeaways: Spot the Symptoms: Organizations often suffer from outdated strategy decks and vague positivity about being "on track." It's crucial to recognize these signs as they could indicate a dangerous disconnect from reality. Understanding APD Subtypes: APD manifests in various forms like Perceptual Change Deficiency and Strategic Narcissism. Identifying these can help in addressing areas where adaptation might be lagging. Build Adaptability Intelligence (AQ): It's about fostering a culture of constant learning, questioning existing knowledge, and embracing discomfort to truly evolve and stay ahead.  

March 30th Shooting at Lit Lounge: 4 injured — how CAST teams saved lives in under 15 seconds.After-hours bars, and people with guns in bars.Accountability failure? Person repeatedly threatens APD officers and is still running free.Robbery at Toy Joy over LEGOsWANTED: Servando Cruz Jr. — armed & dangerousShoutout to the APD Employees of the Week for going above and beyond!

In the first hour of today's podcast, AG Pam Bondi vouches for maximum penalties for Tesla vandalism perpetrators, DA Garza failing to indict violent criminals, APD's understaffing problem, and much moreSee omnystudio.com/listener for privacy information.

How do we figure out whether interpretability is doing its job? One way is to see if it helps us prove things about models that we care about knowing. In this episode, I speak with Jason Gross about his agenda to benchmark interpretability in this way, and his exploration of the intersection of proofs and modern machine learning. Patreon: https://www.patreon.com/axrpodcast Ko-fi: https://ko-fi.com/axrpodcast Transcript: https://axrp.net/episode/2025/03/28/episode-40-jason-gross-compact-proofs-interpretability.html   Topics we discuss, and timestamps: 0:00:40 - Why compact proofs 0:07:25 - Compact Proofs of Model Performance via Mechanistic Interpretability 0:14:19 - What compact proofs look like 0:32:43 - Structureless noise, and why proofs 0:48:23 - What we've learned about compact proofs in general 0:59:02 - Generalizing 'symmetry' 1:11:24 - Grading mechanistic interpretability 1:43:34 - What helps compact proofs 1:51:08 - The limits of compact proofs 2:07:33 - Guaranteed safe AI, and AI for guaranteed safety 2:27:44 - Jason and Rajashree's start-up 2:34:19 - Following Jason's work   Links to Jason: Github: https://github.com/jasongross Website: https://jasongross.github.io Alignment Forum: https://www.alignmentforum.org/users/jason-gross   Links to work we discuss: Compact Proofs of Model Performance via Mechanistic Interpretability: https://arxiv.org/abs/2406.11779 Unifying and Verifying Mechanistic Interpretability: A Case Study with Group Operations: https://arxiv.org/abs/2410.07476 Modular addition without black-boxes: Compressing explanations of MLPs that compute numerical integration: https://arxiv.org/abs/2412.03773 Stage-Wise Model Diffing: https://transformer-circuits.pub/2024/model-diffing/index.html Causal Scrubbing: a method for rigorously testing interpretability hypotheses: https://www.lesswrong.com/posts/JvZhhzycHu2Yd57RN/causal-scrubbing-a-method-for-rigorously-testing Interpretability in Parameter Space: Minimizing Mechanistic Description Length with Attribution-based Parameter Decomposition (aka the Apollo paper on APD): https://arxiv.org/abs/2501.14926 Towards Guaranteed Safe AI: https://www2.eecs.berkeley.edu/Pubs/TechRpts/2024/EECS-2024-45.pdf     Episode art by Hamish Doodles: hamishdoodles.com

In hour two, Mark, Melynda and Ed talk about the Republicans looking to abolish the TSA and whether or not APD should be allowed to use license plate readers to help them catch criminals.See omnystudio.com/listener for privacy information.

In the third hour of today's show, Mark and Melynda talk about license plate readers that may be used by APD to solve crimes and catch criminals, the amount of government DOGE is expecting to reduce, and conditions in prisons being 'unconstitutional?'See omnystudio.com/listener for privacy information.

In hour two, Mark, Melynda and Ed talk about changes to AISD bus routes next school year, whether or not APD should keep using license plate readers, and the study has come back on if Austin should/shouldn't burry powerlines and if it's financially do-able.See omnystudio.com/listener for privacy information.

Breakdown of the viral video involving APD officers downtown, SXSW 2025, and the wanted person of the week.https://www.austintexas.gov/news/apd-statement-regarding-march-2-incident-6th-sthttps://youtu.be/ol7oKqgn2CA?si=ovV5inT3FK648ly4https://austincrimestoppers.org/cases/william-michael-birkes/

In the opening hour of today's show, Mark, Melynda and Ed talk about APD being under-fire for the way they treated a trans person while detaining them and how cell phones are affecting kids in classrooms.See omnystudio.com/listener for privacy information.

State lawmakers are trying to put guardrails on the use of A.I. and deepfake images, an AISD elementary school teacher is alleged to have been found in possession of child pornography and APD has opened Sixth Street to traffic during SXSW.See omnystudio.com/listener for privacy information.

Alaska has spawned a long list of serial killers from the gold rush era in the early 1900s to the present day. Is Brian Steven Smith the latest member of this notorious fraternity? I did an episode on this case several months ago, but a great deal has happened with it since then. Smith's first two murder cases have moved through the court system, and the police have released information suggesting he has more victims. Sources Batts, Amber. “Anchorage police ignored warnings, let Brian Steven Smith keep killing.” August 18, 2024. This is How We Rise. Boots, Michelle Theriault. “Anchorage jury sees horrific video evidence of woman's slaying.” February 13, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Are you guys in a rush?: Smith interrupted police interview to confess to second killing.” February 15, 2024. Anchorage Daily News. Boots, Michelle Theriault. “As Smith murder trial begins, a new explanation of how digital card showing killing got to police.” February 6, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Daughter of homicide victim testifies in Smith trial.” February 8, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Defendant in hotel killing indicted on additional charges: FBI ‘actively' assisting investigation – Court documents filed this week indicate an active, wide-ranging investigation that may extend beyond Alaska.” October 15, 2019. Anchorage Daily News. Boots, Michelle Theriault. “Homemade silencers, Clorox and latex gloves: what police found in Brian Smith's home and truck.” February 21, 2024. Anchorage Daily News. Boots, Michelle Theriault. “'I have something to show you': Murder suspect texted Anchorage man in hours after hotel room killing, met him at Hillside park.” February 22, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Judge rules graphic video of killing can't be shown to Smith trial jurors --- yet.” February 9, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Jurors see interrogation video in which Smith admits to dumping body.” February 14, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Jury in Smith trial hears how railroad workers discovered body.” February 16, 2024. Anchorage Daily News. Boots, Michelle Theriaul. “Family of missing Alaska woman believes she may be Brian Smith's third victim.” July 28, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Prosecutor says he ‘targeted the most vulnerable, and videos will prove it.' His defense says the evidence isn't so clear-cut.” February 7, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Smith found guilty on all charges in double murder trial.” February 22, 2024. Anchorage Daily News. Boots, Michelle Theriault. “Victim's family members and activists pack court hearing of man accused of killing two Alaska Native women – Veronica Abouchuk's family members filled the courtroom as Brian Steven Smith pleaded not guilty to her murder.” October 22, 2019. Anchorage Daily News. Brown, Lee. “Wife of ‘memory card' murder suspect Brian Smith shocked at his ‘dark' side.” October 24, 2019. New York Post. Deliso, Meredith, and Dhanika Pineda, “How a stolen phone led to a murder trial for deaths of 2 Alaska Native women.” February 9, 2024. ABC News. Hollander, Zac. “Anchorage man accused of hotel killing charged in the death of another woman – Brian Steven Smith, 48, now faces murder charges in the deaths of two women.” October 17, 2019. Anchorage Daily News. Hollander, Zac and M.T. Boots. “Videos and photos show brutal attack of woman in Anchorage hotel room by man charged in her death, charges say – A 48-year-old Anchorage man was charged with murder in the death of a woman whose body was found along the Seward Highway south of Anchorage last week.” October 9, 2019. Anchorage Daily News. Kuhn, Jonson. “APD says photos do not prove Alaska Native woman was murdered by Brian Smith.” July 29, 2024. KTUU. Ortiz, Aimee.

State of Texas agencies' headquarters might be moved outside of Austin and APD might return to pre-2020 staffing levels.. See omnystudio.com/listener for privacy information.

Send us a text! (add your email to get a response)When your dating a guy who isn't ready to settle down or your friend whines for not getting what she wants, you roll your eyes and think "they're so immature." But what does being "mature" mean, exactly? In this episode, we nerd out over the concept of emotional immaturity, the developmental aspects that contribute to it, and how it manifests in adult interactions. From understanding the signs of immaturity to addressing the struggle of setting healthy boundaries, we figure out what's needed to navigate emotionally challenging relationships. This episode was inspired by one of our Little Helper fans who shared with us a story of questioning her relationship to her boyfriend who is kind, respectful and loving, but just felt like a "young soul." When she met a man who demonstrated emotional maturity and thoughtfulness, she could only describe it as "he made me feel like a woman." So we were excited to dissect what that line is between what makes someone feel like a "young" vs "old soul." Thank you for sharing!!We couldn't ignore the role of emotional regulation and empathy in our connections with others. We explored whether immaturity is a symptom of deeper issues like Cluster B personality disorders (borderline personality disorder (BPD), narcissistic personality disorder (NPD), histrionic personality disorder (HPD) and antisocial personality disorder (APD)). We'll also share personal anecdotes that highlight real struggles faced when dealing with emotionally immature individuals.**Want to share your story with us? Click the link at the top to send us a text. We can't respond directly to that text message for some reason, so leave your email address if you want us to write you back!Resources:Consedine, N. S., & Magai, C. (2006). Emotion development in adulthood: A developmental functionalist review and critique. The Oxford handbook of adult development and learning, 209-244.Support the showIf you have a loved one with mental or emotional problems, join KulaMind, our community and support platform. In KulaMind, work one on one with Dr. Kibby on learning how to set healthy boundaries, advocate for yourself, and support your loved one. *We only have a few spots left, so apply here if you're interested. Follow @kulamind on Instagram for science-backed insights on staying sane while loving someone emotionally explosive. For more info about this podcast, check out: www.alittlehelpforourfriends.com Follow us on Instagram: @ALittleHelpForOurFriends

Now dubbed an enterprise the DWI scandal with APD deepens to 30 years and over 2500 cases being looked on News Radio KKOBSee omnystudio.com/listener for privacy information.

Medieval sleep habits are being studied to try and help many Americans who suffer from insomnia, are you one who suffers? Plus did you watch the 50th Anniversary Show on SNL? What did you think? Lastly 116 arrests from an APD sweep. All this and more with TJ on News Radio KKOB See omnystudio.com/listener for privacy information.

In Episode 140, Scott Piehler's topics include: City Council hears from APD, and renews the Urban Forest Plan. Credit card fraud uncovers additional crime. AC Transit unveils one new system, but battles bugs in another. An Alameda-based Coast Guard cutter in the news. The latest real estate sales. And FAAS gets snarky for Valentine's day.  Support the show• AlamedaPost.com • Podcast • Events • Contact •• Facebook • Instagram • Threads • BlueSky • Reddit • Mastodon • NextDoor • YouTube • Apple News •

With the offseason firmly underway, Austin and Colin look at some of the early APD trends and discuss some players they think could rise or fall as the offseason continues.Support this podcast at — https://redcircle.com/campus-2-canton/donations

In the final hour of today's show, Mark and Melynda talk about Trump wanting the Panama Canal back, a rise in car break-ins in Austin, and an arrest of a criminal by APD who was out on bond.See omnystudio.com/listener for privacy information.

The D.O.G.E. under Elon Musk has been granted access to the Treasury Department's payment systems despite protests from Democratic leaders, an APD helicopter was called out to a protest at the corner of Rundberg & Lamar in north Austin and U.S. Senator Ted Cruz joins the show.See omnystudio.com/listener for privacy information.

BV delves into the DWI Scandal plaguing APD plus who might challenge Deb Haaland for Governor on News Radio KKOB See omnystudio.com/listener for privacy information.

Mark and Melinda finish off the week by going live as Trump meets Newson in Los Angeles before his damage tour of the California wildfires. Also they touch on Austin City Council telling APD how to handle mental health crisis calls, and school vouchers with the caller debating public vs private vs homeschooling.See omnystudio.com/listener for privacy information.

Lou DiVizio starts out the podcast with headlines from around New Mexico, including news of a plea deal in the federal investigation of alleged corruption in APD's DWI unit. Politics correspondent Gwyneth Doland speaks with former state senator Dede Feldman and former state representative Justine Fox-Young about Gov. Michelle Lujan Grisham's State of the State address. Gwyneth asks whether this year's push from the governor for tougher laws on crime will succeed. Then, the pair of former lawmakers consider what Lujan Grisham's choice to leave President Donald Trump out of her address might mean about her last two years in office. Gwyneth speaks with Democratic state Rep. Reena Szczepanski, and Republican senators Jay Block and Pat Woods after the governor's speech to ask about some of her top-line issues. Host: Lou DiVizio Segments: Former Lawmakers React to State of the State Address Correspondent: Gwyneth Doland Guests: Dede Feldman, Democratic Former State Senator  Justine Fox-Young, Attorney and Republican Former State Representative NM State Senators, Reps Respond to 2025 State of the State Correspondent: Gwyneth Doland Guests: State Sen. Jay Block, R-Rio Rancho State Sen. Pat Woods, R-Broadview State Rep. Reena Szczepanski, D-Santa Fe, Majority Floor Leader For More Information: NM Supreme Court: Schools can be sued for discrimination - Source New Mexico New Mexico Gov. unveils sweeping public safety proposals – Source New Mexico Governor touts progress but urges lawmakers to do more on crime as 60-day session begins – Albuquerque Journal 

We are continuing the ACEND Series with Dr. Rayane AbuSabha discussing doctoral programs in dietetics. More notably, ACEND's new Advanced Practice Doctoral Standards. This episode is great for those interested or curious in pursuing terminal degrees. We discuss PhDs, what a Doctorate in Clinical Nutrition (DCN) is, and where the new APD standards fall into place. For more information about the new APD standards, visit this link: https://www.eatrightpro.org/acend/accreditation-standards-fees-and-policies/advanced-practice-standards-for-doctoral-programs

It's been a few months since Lisa Davis took over at the Austin Police Department, and she's already made some big tweaks. But what else does she have planned for revamping APD's approach to transparency and community policing? And how will she repair the tenuous relationship with Austin's City Council and City Manager? Host Nikki DaVaughn asks her about it all, in an interview at APD headquarters. This episode originally aired on November 21.  Learn more about the sponsor of this January 15th episode: The Holdsworth Center Want some more Austin news? Then make sure to sign up for our Hey Austin newsletter.  Follow us @citycastaustin You can also text us or leave a voicemail.  Interested in advertising with City Cast? Find more info HERE

Good morning and happy Monday, City of Aurora! Christmas is JUST around the corner and we have a busy day of news planned before the holidays. Today's morning program is very special, we'll be showing you a preview of a new food based program with our friends of Atrévete Cafe 1888! This morning you'll see our pilot episode here and we've got more to come. Let us know what you think! After that, in case you missed it, we also have a highlight of a great recent Shop w/ A Cop event with our beloved Aurora Illinois Police Department who took time to purchase and wrap presents for Aurora area youth. This is a great way to enter the holiday season and our APD has a number of community-oriented events coming in 2025. Good Morning Aurora looks forward to giving our viewers more of the best of our city next year. Let's get ready to learn! Here's the news: - January of 2025 will be tasty for sure! Check out Greek Fest all of January of next year at Gyro Pit (357 E. Indian Trail) for amazing additional menu items and the daily meals! Visit the website here: https://www.gyropit.com/ - Free ESL classes are available at Family Focus Aurora, Mondays and Wednesdays from 9:30 am to 12:30 pm. The classes are in cooperation with Waubonsee Community College and registration is required. Contact Christina (630) 844-2550 at extension 7011! Have a great rest of the day! Good Morning Aurora will return with more news, weather and the very best of Aurora. Subscribe to the show on YouTube at this link: https://www.youtube.com/c/GoodMorningAuroraPodcast The second largest city's first daily news podcast is here. Tune in 5 days a week, Monday thru Friday from 9:00 to 9:30 am. Make sure to like and subscribe to stay updated on all things Aurora. Threads: https://www.threads.net/@goodmorningaurorailInstagram: goodmorningaurorailSpotify: https://open.spotify.com/show/6dVweK5Zc4uPVQQ0Fp1vEP...Apple: https://podcasts.apple.com/.../good-morning.../id1513229463Anchor: https://anchor.fm/goodmorningauroraACTV (Aurora Community Television): https://www.aurora-il.org/309/Aurora-Community-TV #positivevibes #positiveenergy #kanecountyil #bataviail #genevail #stcharlesil #saintcharlesil #elginil #northaurorail #auroraillinois #cityofaurorail #auroramedia #auroranews #goodmorningaurora #morningnews #morningshow #monday #cafe1888 #localnews #dailynews #foodies

Check out the New Bond account with an initial APY of 6.9%, only at https://public.com/csi Is it time to sell Air Products and Chemicals (APD stock)? In this episode, we discuss the reasons we originally bought APD stock for our chip stock portfolio, APD's sale of the natural gas liquefaction business to Honeywell (HON), and the potentially disruptive impact of Mantle Ridge's proxy war on Air Products' management. Join us on Discord with Semiconductor Insider: https://ko-fi.com/chipstockinvestor/tiers Supercharge your analysis with AI! Get 15% of your membership with our special link here: https://finchat.io/csi/ Safeguard your personal information with Aura's monitoring service – try it free for two weeks and see where your data might be lurking: https://aura.com/chipstockinvestor

It appears that Deb Haaland will run for NM Governor in 2026 but will Martin Heinrich jump in plus news on the DOJ decree on APD on News Radio KKOBSee omnystudio.com/listener for privacy information.

I had a random request from a listener a few months ago. She was struggling with her hearing and wondered if it could be another symptom of Parkinson's. My first thought was no, I hadn't heard of that before. But, I told her I would look into it. To my surprise, hearing loss and Auditory Processing Disorder (APD) is another gift PD can give. So, let's explore the what, how, and why People with Parkinson's may experience hearing loss or APD. First we will learn about the differences between hearing loss and APD which is important to understand. I spoke with an expert on this topic who has a professional and personal connection. Let's listen to the discussion. https://search.asu.edu/profile/192444  https://www.asha.org/ https://www.hearingloss.org/ https://www.dbsandme.com/en.html  

Lobo legend Kenny Thomas is in studio to discuss Lobo hoops, Lobo football and a gun buy back program with APD. See omnystudio.com/listener for privacy information.

To kick things off, Mark, Melynda and Ed talk about APD firing Chris Taylor and the stance that Anthem Blue Cross Blue Shield may take on paying for anesthesia.See omnystudio.com/listener for privacy information.

The feds agree to loan EV maker Rivian $6.6-billion to keep Georgia project afloat; A combination of factors leads to fewer cops leaving APD; and Black entrepreneurship in Atlanta 20 years later. See omnystudio.com/listener for privacy information.

Lisa Davis has been at the helm of Austin Police Department for about two months, and has already made some big changes — particularly when it comes to transparency. But what other changes does she have up her uniform sleeve? How can Austinites learn more about her 100-day plan? And after moving from Cincinnati, what is Chief Davis loving about Austin? Host Nikki DaVaughn asks her about it all, in an interview at APD headquarters.  Want some more Austin news? Then make sure to sign up for our Hey Austin newsletter.  Follow us @citycastaustin You can also text us or leave a voicemail.  Interested in advertising with City Cast? Find more info HERE  Learn more about the sponsor of this November 21st episode: Tecovas

In this episode, Dr. Gurleen Kaur (Cardiology FIT at Brigham and Women's Hospital and APD of the CardioNerds Academy) and Dr. Diane Masket (Medicine Resident at the University of Chicago Northshore and CardioNerds Academy Intern) discuss with Dr. Minnow Walsh (Medical Director of the Heart Failure and Cardiovascular programs at Ascension St. Vincent Heart Center in Indianapolis) about her personal and professional journey in Cardiology. They discuss Dr. Walsh's authorship of the recent ACC statement on career flexibility in Cardiology, her involvement with the ACC at both the local and national levels, and her passion for making cardiology a more inclusive and welcoming field for all. Notes were drafted by Dr. Diane Masket and episode audio was engineered by student Dr. Grace Qiu. The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza. The PA-ACC & CardioNerds Narratives in Cardiology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Video version - Career Flexibility in Cardiology https://youtu.be/ygNH6fcQ5ek Quoatables - Career Flexibility in Cardiology “You have to learn to live with ambivalence. You can't do everything. You can't do everything all at one time” “One of the most important things the College is behind and pushing, is that competency-based evaluation is what should be used in fellowship rather than this sort of cookie cutter approach where you have to do these many months of echo and this much of cath lab. So, I think flexibility moving from volume to competency is one push.” “Fellowship is daunting, and internal medicine residency is too, but I think culture is how we feel every day. And I think the more we increase flexibility the more that culture is going to shift. Notes - Career Flexibility in Cardiology Process of developing ACC Health Policy Statements These documents address issues that require ACC influence and usually involve a variety of institutions, governing bodies, and other stakeholders. ACC comes to an agreement on how they will approach this topic and shares it broadly. Most of the existing ACC health policy statements are disease-based instead of profession-based. The ACC Career Flexibility statement grew out of the diversity, equity, and inclusion task force, which is a standing committee. A variety of authors are included in health policy statements to reflect the perspectives of many different interest groups. All policy statements, including the one about career flexibility, are available online on JACC.org 1 Major Components of the ACC Career Flexibility Health Policy Statement There are 18 principles that highlight the most important aspects regarding career flexibility in cardiology.2 Flexibility allows for deceleration (decrease in work hours, responsibilities, etc.) and acceleration based on the needs of the physician. For example, during childbearing and rearing time periods, there could be a deceleration, which could accelerate when parenthood responsibilities have decreased. It does not only need to be based around parenting; physicians who are not parents also desire flexibility and enjoy spending time on activities other than their careers. These needs will be unique for each person.

The BRAND NEW 2nd Generation Tone Devices have launched!! Order HERE  Hi friends! This episode is about optimizing body composition, fat loss, protein intake and training with Holly Baxter, APD. Holly Baxter is an accredited practicing dietician (APD), competitive bodybuilder, fitness and nutrition educator, and coach. In this episode, Holly discusses her experience as an athlete and competitive bodybuilder. She also opens up about her struggles with mental health, her battle with an eating disorder, and the important steps she's taken in her road to recovery. From there, she explains how she would design a nutrition and training program for a female client wanting to improve her physique through the addition of lean muscle and loss of body fat. She explains expectations for gaining muscle and the value of a “reverse diet” for maintaining weight loss, and she shares some female-specific training considerations such as programming, reps, volume, and more. Timeline: Get 10% off Mitopure, clinically proven to boost mitophagy.  Go to timeline.com/vanessa. Get 20% OFF Energybits Spirulina and Chlorella with the code KETOGIRL Energybits.com Sign up for the Exclusive Launch Discount of Tone Collagen Here! Everyone is loving Tone Protein! Scientifically formulated based on the science to support Muscle Protein Synthesis.  Click Here to Check it out! Join the Community! Follow Vanessa on instagram to see her meals, recipes, informative posts and much more! Click here @ketogenicgirl Follow @optimalproteinpodcast on Instagram to see visuals and posts mentioned on this podcast. Link to join the facebook group for the podcast: https://www.facebook.com/groups/2017506024952802/   This podcast content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and personal health questions. Prior to beginning a new diet you should undergo a health screening with your physician to confirm that a new diet is suitable for you and to out any conditions and contraindications that may pose risks or are incompatible with a new diet, including by way of example: conditions affecting the kidneys, liver or pancreas; muscular dystrophy; pregnancy; breast-feeding; being underweight; eating disorders; any health condition that requires a special diet [other conditions or contraindications]; hypoglycemia; or type 1 diabetes. A new diet may or may not be appropriate if you have type 2 diabetes, so you must consult with your physician if you have this condition. Anyone under the age of 18 should consult with their physician and their parents or legal guardian before beginning such a diet. Use of Ketogenic Girl podcasts & videos are subject to the Ketogenicgirl.com Terms of Use and Medical Disclaimer. All rights reserved. If you do not agree with these terms, do not listen to, or view any Ketogenic Girl podcasts or videos.