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In this episode, we sit down with Paul Chandler, a leading voice in the appraisal industry. As President of the Northern California Chapter of the Appraisal Institute and Chair of the Industry Advisory Council for the Appraisal Foundation, Paul is at the forefront of key industry discussions. We dive into the future of appraisal modernization, the evolving role of AVMs, and the growing influence of artificial intelligence in valuations. Paul also shares insights from his work on the Appraisal Foundation's AVM Task Force and breaks down what's behind the "AI Hype" and the industry's "Need for Speed."Tune in to hear why keeping human expertise in the process is more important than ever.At The Appraisal Buzzcast, we host weekly episodes with leaders and experts in the appraisal industry about current events and relevant topics in our field. Subscribe and turn on notifications to catch our episode premieres every Wednesday!
Targeted, image-guided interventions can make a big difference for patients with hereditary hemorrhagic telangiectasia (HHT). Learn how in this week's BackTable episode featuring Dr. Clifford R. Weiss (Director of the Johns Hopkins Vascular Anomalies Center and HHT Center of Excellence) and host Dr. Michael Barraza. --- SYNPOSIS Dr. Weiss delves into the complexities and multisystem nature of HHT, emphasizing the significance of early diagnosis and multidisciplinary care. He goes on to explain the clinical criteria for diagnosing HHT, the role of genetic and imaging screenings, and the evolving approaches to treating pulmonary arteriovenous malformations (AVMs) in adults and children. The doctors discuss the potential impact of anti-angiogenic medications on the future management of HHT. The episode closes with a nod to the pivotal role that HHT Centers of Excellence play, and the ongoing dedication to improving patient outcomes through collaborative care and innovative research. --- TIMESTAMPS 00:00 - Introduction 03:57 - Diagnosing and Screening for Hereditary Hemorrhagic Telangiectasia (HHT) 07:37 - Treatment Approaches for HHT 12:12 - Embolization Techniques and Safety Measures 19:02 - Future of HHT Treatment and Research 22:30 - Conclusion and Final Thoughts --- RESOURCES The Johns Hopkins Hereditary Hemorrhagic Telangiectasia (HHT) Center of Excellence: https://www.hopkinsmedicine.org/interventional-radiology/hht
Companion Episode: Cerebral Aneurysms, AVMs, and Intracranial Hemorrhage Companion Episode: Cerebral Aneurysms, AVMs, and Intracranial Hemorrhage Differentiation Cerebral Aneurysms vs. Arteriovenous Malformations (AVMs) Cause of Hemorrhage: Cerebral Aneurysm: Weakening and bulging of an arterial wall. AVM: Abnormal connection between arteries and veins without capillaries. Location: Cerebral Aneurysms: Frequently at arterial bifurcations in the Circle of […] The post 125b Retention Practice & PANCE Questions for Cerebrovascular disorders appeared first on Physician Assistant Exam Review.
Have you lost your enthusiasm for our valuation industry? Do you feel disconnected and uninspired? Welcome to another insightful episode of Indispensable Appraisers! In this Podcast Jeff Hicks speaks with Paul Rayburn, CNAREA, DAR of Aclear Appraisal & Data Analytics. • Tough Conversations we need to have: AMCs, Appraisal Bias and AI • Build relationships • Turn hard conversations into solutions • Lean into data science based appraising • AVMs taking up easy assignments, leaving complex jobs Let's start this conversation. Just call my cell 813-230-3798 or e-mail me Jeff@realwired.com. Watch on YouTube: https://lnkd.in/emjkx-MEwww.realwired.com #Realwired #Youconnect #Datacomp #IndispensableAppraisers
This week on the Power House Podcast, HousingWire CEO Clayton Collins sat down with loan originator turned software executive: Jeff Bell, President at Uplist. Jeff joins us to talk about four really pertinent topics in today's market: leadership, learning, loan monitoring, and recapture. Uplist just launched what it says is a killer new tool that will help loan officers automatically generate refinance options for their clients. The technology, called “Recapture,” is integrated with the leading pricing engines, and it provides LOs with timely, accurate data that identifies multiple refi opportunities for clients. Unlike rate alert tools, Uplist's product fully automates the refinance analysis process. This includes property ownership checks, automated valuation models (AVMs), loan amount amortization and financial benefit calculations. Those four topics (leadership, learning, loan monitoring, and recapture) discussed in this episode are going to be hotly discussed at this year's MBA Annual in Denver. Listen in for insightful discussion about streamlining the loan monitoring process, competing in a refinance mortgage market, coaching and more! HousingWire will be hosting a happy hour on Monday night at this year's MBA Annual. You can register here. Here's what you'll learn: Coaching can significantly impact personal and professional growth. Knowing how to use the right technology correctly is more important than just having technology. Prioritize proactive communication with clients instead of reactive. Understanding the nuances of a competitive landscape is key for originators. Leadership development should always be ongoing. Related to this episode: Uplist launches automated refi analysis tool | HousingWire MBA Annual 2024 HousingWire Cocktail Party Jeff Bell | LinkedIn Uplist | LinkedIn HousingWire IMB Summit On-Demand Enjoy the episode! The Power House podcast is a show about leadership, markets and entrepreneurship in the housing industry. Each Thursday, Clayton Collins speaks with CEOs and founders from the mortgage and real estate sector to reveal how housing executives think about business growth, operational strategy, and leadership. The Power House podcast reveals the full picture through the stories of the industry's most impactful leaders. Clayton Collins is the CEO of HousingWire, and the Power House podcast is produced by HousingWire's Content Studio. Initially launched in 2019 as the Housing News podcast, the show was relaunched as Power House in 2024. Learn more about your ad choices. Visit megaphone.fm/adchoices
UCSF neurosurgeon Ethan Winkler, MD, PhD, summarizes the surgical treatment options for patients with arteriovenous malformations (AVMs) and describes the decision-making process for choosing the best treatment for each individual. Series: "UC San Francisco News" [Health and Medicine] [Show ID: 40237]
UCSF neurosurgeon Ethan Winkler, MD, PhD, summarizes the surgical treatment options for patients with arteriovenous malformations (AVMs) and describes the decision-making process for choosing the best treatment for each individual. Series: "UC San Francisco News" [Health and Medicine] [Show ID: 40237]
UCSF neurosurgeon Ethan Winkler, MD, PhD, summarizes the surgical treatment options for patients with arteriovenous malformations (AVMs) and describes the decision-making process for choosing the best treatment for each individual. Series: "UC San Francisco News" [Health and Medicine] [Show ID: 40237]
UCSF neurosurgeon Ethan Winkler, MD, PhD, summarizes the surgical treatment options for patients with arteriovenous malformations (AVMs) and describes the decision-making process for choosing the best treatment for each individual. Series: "UC San Francisco News" [Health and Medicine] [Show ID: 40237]
The Appraisal Update - the official podcast of Appraiser eLearning
We've been hearing the rumblings: Some appraisers believe the end is near for the appraisal profession. Listen in as Bryan and his guest Simon Blackburn discredit that notion. Blackburn is founder and CEO of MtgeFi, a company that forecasts mortgage trends. In the episode, he discusses his recent article, "Top 10 Reasons Appraisals Are Here to Stay and Critical to U.S. and Global Markets."
In this episode of "Real Estate Success: The Whissel Way," hosts Kyle Whissel and Bryan Koci delve into the crucial aspects of real estate valuation. They discuss the importance of setting the right price for homes, understanding market conditions, and effectively communicating these factors to sellers. The episode covers key strategies for assessing property value, including analyzing market trends, bracketing neighborhoods, and using comparable sales. The hosts also highlight common pitfalls agents encounter and provide tips on overcoming challenges posed by automated valuation models (AVMs). This episode offers valuable insights for agents aiming to refine their pricing strategies and enhance their real estate expertise. YouTube Chapters 00:00 - Introduction and Episode Overview 00:34 - Importance of Real Estate Valuation 02:17 - Factors in Pricing a Home 03:18 - Understanding Market Conditions 06:02 - Comping Properties: Key Criteria 10:30 - Common Pricing Mistakes to Avoid 13:07 - Unique Property Features and Valuation 14:05 - Impact of Automated Valuation Models (AVMs) 16:09 - The Future of Real Estate Pricing Technology 17:47 - Whissel Widget of the Week
We welcome Dr. David Penn of Nuvance Health. Dr. Penn is a neurosurgeon with areas of expertise including treatment of complex brain tumors, such as acoustic neuromas and meningiomas, vascular malformations, such as aneurysms and AVMs and cerebral bypass. Ray Graf hosts.
Feeling isolated after your diagnosis? Finding your tribe is life altering and tremendously helpful in facilitating your treatment and recovery from brain surgery and bleeds. TAAF is The Aneurysm and AVM Foundation, a foundation focused on supporting brain bleed survivors, grieving families, caregivers, and research. In this episode, Eryn interviews Dina Chon, the executive director of TAAF. The two discuss the mission and work of TAAF which supports individuals who have experienced brain bleeds and provide resources and information to the community. SummaryDina shares the history of the TAAF Foundation and how it has grown over the years. They also talk about the importance of acknowledging and embracing all emotions, not just happiness, in the healing process. In this conversation, Dina Chon discusses her personal experience with her mother's brain aneurysm and how it led her to leading The Aneurysm and AVM Foundation. She shares the importance of support groups and the impact they can have on survivors and their families. Dina also highlights the various programs and resources offered by TAAF, including brain buddies, fundraising events, and research grants. She emphasizes the power of community and the role of TAAF in providing support, education, and advocacy for those affected by brain aneurysms and AVMs. Keywordsbrain bleeds, Aneurysm and AVM Foundation, TAAF, support, resources, emotions, healing, brain aneurysm, AVM, support groups, TAAF, The Aneurysm and AVM Foundation, brain buddies, fundraising events, research grants, community, support, education, advocacyTakeawaysThe Aneurysm and AVM Foundation (TAAF) is an organization that supports individuals who have experienced brain bleeds and provides resources and information to the community.TAAF was founded by a neurosurgeon and his nurse who wanted to do more for patients beyond medical treatment.TAAF offers support groups and resources for individuals and families affected by brain bleeds.It is important to acknowledge and embrace all emotions, not just happiness, in the healing process. Support groups can provide a sense of community and understanding for survivors and their families.The Aneurysm and AVM Foundation (TAAF) offers various programs and resources, including brain buddies, fundraising events, and research grants.TAAF focuses on research, programming, and providing support to survivors and their families.Fundraising is essential for TAAF to continue its work in supporting and advocating for those affected by brain aneurysms and AVMs.Getting involved with TAAF, whether through fundraising or participating in support groups, allows individuals to give back and help others in the community.Sound Bites"If it bleeds, TAAF leads.""I would literally program myself to work all day and help people 24 hours.""I am non-robot for sure.""My mom was lying in the bathroom. She'd gotten up to use the restroom, I'm assuming, and she'd ruptured.""She opens her eyes and she looks at me and she tells me she loves me. And she passes out and she dies.""We're going to be like you."Chapters00:00Introduction and Starting the Conversation03:19The History and Growth of TAF08:03Dina's Journey to TAF12:16The Role of TAF in Serving the Community14:24Embracing All Emotions in the Healing Process18:04Supporting Individuals at Every Stage22:54Personal Experience with Brain Aneurysm28:44The Importance of Support Groups32:40Programs and Resources Offered by TAF36:53Fundraising for Research and Support45:17Getting Connected with TAFReach out toEryn on
Dural arteriovenous fistula (DAVF) is a rare vascular condition where abnormal connections (fistulas) form between branches of arteries and veins in the dura mater, the brain's covering. The dural arteries deliver high-pressure, oxygen-rich blood to the brain, while the dural veins return deoxygenated, low-pressure blood to the heart. DAVF causes high-pressure arterial blood to flow into veins or sinuses meant for low-pressure blood, which can lead to ruptures, brain hemorrhages, and other neurological issues.Meet Dr. Aditya (Adi) Iyer, a board-certified, fellowship-trained neurosurgeon specializing in vascular diseases of the brain and spine at Pacific Neuroscience Institute®. As one of California's few dual-trained neurosurgeons, Dr. Iyer offers both minimally invasive open surgical techniques and incisionless catheter-based procedures to treat strokes, aneurysms, AVMs, tumors, and pain.Discover expert care and advanced treatment options with Dr. Iyer, dedicated to ensuring the best outcomes for your vascular health.
In dieser Folge unterhalten sich Peter Ache und Robert Krägenbring über den Einsatz von Künstlicher Intelligenz (KI) und Automated Valuation Models (AVMs) in der Immobilienbewertung. Seit ihrer letzten Diskussion zu diesem Thema hat sich einiges getan. Peter betont: »KI ist gekommen, um zu bleiben.« Die beiden Hosts diskutieren, wie neue Technologien oft auf Skepsis stoßen, bevor sie breite Akzeptanz finden – ein Phänomen, das bei der Einführung vieler anderer bahnbrechender Technologien beobachtet wurde. Auf der Ebene der International Federation of Surveyors (FIG) wird global darüber nachgedacht, wie KI sinnvoll in der Immobilienbewertung eingesetzt werden kann. Ein bevorstehender internationaler Workshop zum Thema AVM bietet Anlass für eine vertiefte Diskussion im aktuellen Podcast. AVMs sind computergestützte Systeme, die mathematische Modelle und Algorithmen verwenden, um den Wert von Immobilien zu schätzen. Sie nutzen umfangreiche Datenbanken mit Informationen über Immobilienpreise, Standortdaten, Immobilienmerkmale und Markttrends aus Quellen wie öffentlichen Aufzeichnungen und Immobilienportalen. Moderne AVMs setzen fortschrittliche Algorithmen und KI-Techniken wie maschinelles Lernen ein, um präzisere und zuverlässigere Bewertungen zu liefern. Diese Algorithmen analysieren historische Daten und identifizieren Muster, die bei der Bewertung von Immobilien helfen. Die Vorteile von AVMs liegen auf der Hand. Sie liefern schnelle Bewertungen und beschleunigen den Bewertungsprozess erheblich. Zudem bieten automatisierte Modelle objektive Bewertungen, da sie nicht von subjektiven Meinungen beeinflusst werden. Dabei geht es auch um maschinelle Lernverfahren wie Random Forest, das sowohl für Klassifikations- als auch für Regressionsaufgaben verwendet werden kann. Peter und Robert erörtern die Chancen, die KI und AVMs bieten, sowie die Risiken und Grenzen dieser Technologien. Sie geben den Zuhörerinnen und Zuhörern eine Vorstellung von den Funktionsweisen und Anwendungen von AVMs. Erfahren Sie mehr über die aktuellen Entwicklungen und wie diese Technologien die Immobilienbewertung revolutionieren könnten. Abschließend appellieren die Gastgeber erneut, dass Deutschland bei der Digitalisierung aufholen muss, um international wettbewerbsfähig zu bleiben. Moderation: Peter Ache, Leiter des Arbeitskreises Immobilienwertermittlung des DVW e.V. und Robert Krägenbring, Stellvertretender Leiter des Arbeitskreises Immobilienwertermittlung des DVW e.V. Weitere Informationen findest du hier: Webseite: https://dvw.de Social Media: LinkedIn | Instagram | Facebook
The trigeminal autonomic cephalalgias are a group of headache disorders that appear similar to each other and other headache disorders but have important differences. Proper diagnosis is crucial for proper treatment. In this episode, Gordon Smith, MD, FAAN, speaks with Mark Burish, MD, PhD author of the article “Cluster Headache, SUNCT, and SUNA,” in the Continuum April 2024 Headache issue. Dr. Smith is a Continuum Audio interviewer and 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. Burish is an associate professor at UT Health Houston in Houston, Texas. Additional Resources Read the article: Cluster Headache, SUNCT, and SUNA Subscribe to Continuum: continpub.com/Spring024 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 Transcript Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by visiting the link in the Show Notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the Show Notes. AAN members: stay tuned after the episode to hear how you can get CME for listening. Dr Smith: This is Dr Gordon Smith. Today, I'm interviewing Dr. Mark Burish on cluster headache, which is part of the April 2024 Continuum issue on headache. Dr Burish is an Associate Professor of Neurology at the University of Texas Health Science Center at Houston, which is located in Houston, Texas. Mark, thanks so much for joining me today on Continuum Audio. I was really excited to be asked to talk with you about this article. When I recertified from my boards the last time (and actually, it will be the last time I have to take the exam), I did the AAN course on all of neurology. And I'm a neuromuscular guy, right, and so I was actually kind of worried about the headache part because I thought, “How interesting could that be?” And I was blown away at how fascinating headache has become, and in particular, your topic (cluster, SUNCT, SUNA, the trigeminal autonomic cephalalgias) - such a great topic. But before we start talking about them, I'd love to just hear more about how you got interested in this area - both headache, this topic in particular. What's your story, Mark? Dr Burish: Well, thank you very much for having me. I'm honored to be part of this. I got into headache probably the way many people do; is, in residency, you figure out what you like, and your residency clinic tends to start collecting patients that you like (not that you're trading them with other residents, but you see certain patients). And mine (by the end of residency) had a lot of headache and pain patients into it. Then, I was very fortunate and had the opportunity to do some research as part of my career. I'm an MD-PhD, and I spend about half my time now doing research on cluster headaches, so I'm very fascinated by these types of diseases. Dr Smith: Can you tell us really briefly what you're working on in your research? Dr Burish: Cluster headache is such a poorly researched area. There's not a lot of people in it, so we do a little bit of everything: we have a clinical trial going; we do some basic science on the circadian mechanisms (cluster gets this very weird timing to it, where the headaches happen same time every day); and we do a little bit of starting to wade into the genetics. Dr Smith: Well, super exciting. I was actually blown away by the statistics on cluster (as common as multiple sclerosis), and the severity of pain I was amazed to learn is above that of childbirth (it was, like, between nine and ten out of ten, which is really crazy). And I'm worried that I missed these patients in my neuromuscular clinic. So, maybe we can begin by - just tell us what you think our listeners need to know. If they have to drop off right now, what message do they need to remember from our conversation? Dr Burish: I think there's two things. First of all, the first-line treatments for these headaches have not changed recently. For cluster headache, you still treat it with oxygen, the triptans (the faster triptans; not the oral ones, but the injectables and nasals), and you prevent them with verapamil. For SUNCT and SUNA, you use lamotrigine. So, those have not changed over time. There are some new treatments, which we'll talk about later. Then the second point is, there are four different types of headaches in this family and they all look very, very similar (one-sided pain, autonomic features, ipsilateral lacrimation, rhinorrhea - that type of thing). They differ in the treatments and how long they last. If you get them wrong (if you misdiagnose them), you're probably not going to give them correct treatment. Indomethacin works very well for two of them (the ones with hemicrania in the name, so not the ones we're going to discuss today). And then SUNCT, SUNA, and cluster headache - indomethacin does not work very well. So, it's important to distinguish them and get them right. Dr Smith: Maybe we can start there, Mark. I mean, I was kind of appalled to learn that the average delay in diagnosis is four to nine years in your article, and given the severity of pain and the impact it has on these patients, that's clearly a challenge. What's so hard about this? And do you have pearls on how we can recognize these patients? And how do you sort this out practically in clinic? Dr Burish: For cluster headache patients especially, it is a lot more common than we would think it is, but it still goes misdiagnosed, partly because most cluster headache patients are episodic. So, there's an episodic version where you get them every day for a few weeks and then they might go away for a year. So, I think what happens is that patients start to get into a cycle and they either get confused for sinusitis (because it happens in the spring), or they schedule a visit with a neurologist or somebody else, but the headaches are over by the time they see them, and they cancel the visit. So, I think they get misdiagnosed partly because it's either confused or they don't see doctors fast enough. I think a little bit more awareness of what this disease is and then, somehow, a mechanism to get these patients in a little bit more urgently is probably what's necessary. Dr Smith: Well, Mark, access is a real issue in neurology more broadly, and I'd love to talk to you about that in a moment, but I wonder if we could go back. You talked about how similar these are to one another, yet the treatments are different. How do you sort out the diagnosis when you're seeing a patient? Let's say you have someone who comes in who has episodic, unilateral, very severe pain and some of these autonomic features. What are the pearls for differentiating cluster, SUNCT, and SUNA from each other? Dr Burish: The big difference between all these different headaches is the timing. As a general rule, SUNCT and SUNA attacks last seconds (they're very similar to trigeminal neuralgia); paroxysmal hemicrania (that's one of the hemicrania ones, where indomethacin helps) - those attacks last minutes; cluster headache attacks last about an hour; and the hemicrania continua is constant (that's the other hemicrania one where indomethacin works). The other part is how often they happen. Again, SUNCT and SUNA - very similar to trigeminal neuralgia, may happen hundreds of times a day; paroxysmal hemicrania - dozens of times a day; cluster headache - maybe a handful of times; and then, hemicrania is constant. Based on how long the attacks are and how frequent the attacks are, you can generally separate them out. And if you're not sure, just try indomethacin. And then if it doesn't work, you're trying to distinguish between SUNCT and SUNA, which lasts seconds, and cluster headache, which lasts an hour, so fairly easy to distinguish those. Dr Smith: How long does it take to medicine to work in a patient with hemicrania continua or paroxysmal hemicrania? I'll remind our listeners - there's a separate article in the same issue of Continuum on that topic - but for our purposes, let's say you try that; how long do you need to try it? Dr Burish: Yeah, there's a great, another article about how much to give and how it works. It is generally pretty quick. I have noticed with most patients that the onset is twenty-four to forty-eight hours. And then, if you stop the medicine, the same thing - offset is kind of twenty-four to forty-eight hours. So, patients know pretty quick whether it's going to work. Dr Smith: Wow - that's awesome. One of the things I was interested in was so-called “secondary cluster.” So, you've seen your patient and let's say you've diagnosed them with cluster (primary cluster). Do you do additional testing? Do they need imaging or other laboratory workup? Dr Burish: Yeah. The differential for cluster (and cluster is the one that we know the most about; it is the most common of all the trigeminal autonomic cephalalgias) - it's a fascinating differential. If you don't know much about them, migraine is probably the most common. If you do know a lot about them, hemicrania continua and paroxysmal hemicrania are very common. But there's all these secondary headaches that can look identical to cluster headache; these pituitary hormone-secreting tumors (prolactinomas) - things like that. So, because all these other secondary causes can happen, they generally recommend everybody gets an MRI of the brain, with or without contrast. If that is normal and the patients continue to not respond to the medicines like you expect them to (verapamil doesn't work, oxygen doesn't work, and so forth), then you might do some additional testing for pituitary bloodwork. So, just kind of a panel of hormones, looking at blood vessels (because there are some cases that dissections or AVMs can cause cluster headaches). And then sometimes get imaging of the apex of the lung because there's some data that - with the Horner syndrome - that that might be relevant. Dr Smith: I'll refer our listeners to your article, just in general, because they really need to read it. It's fantastic. But your discussion about the neuroanatomy is really cool, and probably more than we want to get into right now, but the intersection of the neuroanatomy with therapeutics, and some of these other potential etiologies. So, one thing I was really amazed by (or appalled by, frankly) was the frequency with which these patients have suicidal ideation, given the severity of the pain and, I assume, the long time it often takes to get this sorted out. How do you handle that in clinic? Do you have conversations with people about this? How often do you appreciate it? And any words of wisdom for those of us who might encounter these patients? Dr Burish: Yeah. It's not hard to imagine why patients would be suicidal with this. When you have pain that is a ten out of ten - and patients who have also had childbirth and cluster, they consider childbirth more around a seven - so you can imagine how painful this is and what thoughts might be going through people's heads. It tends to be (in my personal experience and some emerging data) that they are suicidal during a cycle. So, for these episodic patients (most patients are episodic with cluster headache for a few weeks), they are suicidal during those weeks. And when the headaches go away, much less risk of suicide. So, during the cycle, I try to get my patients in as fast as possible, get the medications in as fast as possible, but basically just be there to let them know that we have options, and so that they consider me as their first option, rather than something darker. Dr Smith: How successful is first-line therapy in these patients and what's your success rate with your initial attempt at treatment? Dr Burish: On the acute side, the as-needed medicines (sumatriptan, oxygen) - if you give an injection (not the oral; that takes too long) - incredibly effective; for most patients, one or both of those will work. We usually prescribe both because the injections - usually you can't get that many (they can be quite expensive, realistically speaking). But also, just practically speaking, patients can have headaches up to eight times a day and you're not really supposed to be taking sumatriptan eight times a day, so we also give oxygen (but then again, oxygen is not very portable, so that's where the sumatriptan comes in). On the preventive side - not great. There's been some studies suggest maybe fifty percent is as good as any preventive is going to work for you, and that's not considering side effects and other things that patients might stop them. So, we do need to have a few different preventive options and you may have to go through a few different things. Chronic cluster headache (which is the more rare version, where patients have them year-round) is anecdotally much more refractory to treatment. Dr Smith: Can you talk a little bit about bridge therapy? You differentiate bridge from prophylactic therapy in your article. Dr Burish: Yeah. When you're approaching one of these patients - let's say they're completely naive to any medications - usually we will give them a couple of as-needed, acute medications (sumatriptan injections and oxygen). We'll give them a preventive like verapamil, but the verapamil takes a few weeks to kick in. So, the obvious question is, “What am I supposed to do in the meantime, while you're ramping it up and it's kicking in?” So, we use these short-term preventives, which we call bridge therapies or transitional therapies. These are short-acting preventives; they kick in quick, but you can't take them for very long. The most common by far is prednisone. Or an occipital nerve block with some sort of steroid (so, steroids in some sort of fashion). We will usually give them right at the beginning of a cycle (right at the beginning of a flare for chronic cluster headache patients) while we are uptitrating something like verapamil. Dr Smith: This may be a really silly question, but the next time I see one of these folks and I want to start oxygen, how do I do it? What are the logistics of giving someone oxygen for this, and how do patients navigate that, right? If you're having eight attacks a day during a cluster and you work as a nurse in the headache clinic, you probably have oxygen there. But you get where I'm going, right? - it's logistically challenging. How do you order it, and do you have words of wisdom to make it easier for patients to use? Dr Burish: There's a whole kind of system of oxygen, durable medical equipment - stuff that I've had to learn. To boil it down, there are basically two types of oxygen. There's a concentrator - kind of just a machine that takes room air and turns it into about ten percent oxygen - that is sometimes effective for patients. But sometimes ten liters per minute (which is the highest that can give) is not enough and you need fifteen liters per minute. In that case, you need an oxygen tank (the big metal cylinders that you see with a extra device on top called a regulator, that can crank it up to fifteen liters a minute. For both of these - fifteen liters a minute - you're going to need a mask. The nasal canula is just - it doesn't get up to fifteen; it's not going to be enough, so we give you this bag mask (the non-rebreather mask, or the bag hanging out below it). You really need high dose, pure oxygen for these things to work, so you have to write orders that say, “fifteen liters a minute, with regulator and non-rebreather mask.” Dr Smith: I'll refer our listeners to your Continuum article. I know a lot of our listeners use Continuum at point of care. And, of course, you can access it electronically, so there's really great pearls there. Another question for you: CGRP agents have really transformed migraine; what role do they play, if any, in management of these headaches (cluster, SUNCT, and SUNA)? Dr Burish: I think this is a fascinating emerging area of cluster headache research. One of the studies in the last three years came out that it was successful for episodic cluster headache, called galcanezumab, and it did not work for chronic cluster headache. Meanwhile, a couple other CGRP companies have tried them and they were unsuccessful, at least according to the data on ClinicalTrials.gov. And some other CGRP studies are still emerging. We know that both migraine and cluster headache work on the trigeminal system (I mean, this is a trigeminal autonomic cephalalgia - it's in the name) and CGRP is involved in the trigeminal system. That's probably where the commonality between migraine and cluster headache come from - they both work on the same pain system. But why all of them seem to work for migraine and only some of them – you know, some of these medicines work for cluster headache - is a fascinating thing. Does that mean that we don't have the dose right? Does that mean that we don't have the timing of these clinical trials right? Does that mean it's just not as effective? And there's other things that are involved in cluster headache - it's an interesting mechanism that we can start to explore. Dr Smith: I wanted to learn more about the circadian aspects of this - I found that really interesting, and you commented that you're interested in that in a research perspective. Can you describe that phenomena a little bit and just tell us what your thoughts are? Dr Burish: The interesting thing about cluster headaches, specifically, is that the headaches happen, for most patients, the exact same time every day – so, within an hour each day. So, my patient usually will say, “They're at two AM.” Across different time zones, every study that's been done - well, not every study, but many studies have been done - two AM is the most common time of day. But if you ask an individual patient, patient number one will say, “They happen every day at two AM; patient number two will say, “They happen every day at three in the afternoon.” I had a patient who was, I think, kind of getting fed up with all the questions I was asking about his headaches, and he said, “Dr Burish, it's three o'clock; if you want to wait until three fifteen, I'm going to get a headache - you can see what it's like.” That's how sure he was about when the headaches were going to happen. And other than maybe hypnic headache, there are a few other headaches that have that level of circadian predictability. So, it's just an odd, curious, unique thing to these headaches and we don't quite understand why yet. Dr Smith: So, I'm curious if the time of day patients get their headaches is in any way correlated with other aspects of sleep phenotype, right? There's broad variability in your sleep phase - the length of it, when it starts and ends. Is there any relationship, in your experience, between the time of day (two AM, ten PM) and other aspects of their sleep? Dr Burish: We haven't seen that, to my knowledge. People have looked, for example, at sleep studies while patients are having attacks. These attacks occur out of REM sleep, non-REM sleep - it doesn't seem to matter. Anecdotally, patients will say, “My cycle last year - I had headaches every day at two AM. But my cycle this year - I have headaches every day at five in the afternoon.” So, even a same patient who, theoretically, is not having big sleep changes over different years, has different timing of attacks. Dr Smith: Mark, what's the latest thing? What's most exciting in the field that you can tell our listeners about? Dr Burish: There are a lot of new treatments for cluster headache. There's the galcanezumab, which we discussed a little bit. There is a new dose for prednisone. We weren't sure how effective it was; now we're using kind of neuroimmunology-level doses of prednisone (100 milligrams daily; kind of titrating down from there). And then there's an occipital nerve stimulator for the chronic cluster headache patients. Since the last Continuum review on this topic, these three trials have been successful, and I think what gets lost is how impressive each one of these is in different ways. The prednisone study is impressive because you had to study that medicine (which we thought worked but didn't have a good clinical trial), and it's really hard to enroll patients in a placebo-controlled study where you already think it works. Another was done by a large pharmaceutical company. This is not an advertisement for or against, but these companies have rarely ventured into studying cluster headache until recently. The third study, the stimulator study, was a ten-year, multisite study involving surgeons and neurologists - just a monumental effort. It's because of these impressive studies that we now have data on how to treat the patient. Dr Smith: Just so interesting. I tell you what - I mean, if you told me twenty years ago I would be this interested in headache, I would have said, “You're crazy.” But now I see why our residents are so interested in it and why you are. This is fascinating. I could keep going for another hour or two asking you questions, Mark, but maybe we can pivot back to where we began. You told us your story about enriching your resident clinic - and for those residents listening, those are words of wisdom right there, my friend. But here's my question for you: we've already talked about access to care and how you manage access for these patients, but we have a huge access issue in neurology broadly and we desperately need more neurologists. As you're probably aware, there are some of our colleagues that don't think pain is neurology (I'm not one of them, but I know some of them and respect them otherwise). If there's an access issue for neurology, there's a access crisis for pain neurologists. And you don't just see headache, as I understand it; you see other patients with pain. So, I want to give you the last few minutes of our Continuum Audio episode to do your pitch, right? What do you have to say to the residents that are listening to us (or students) about why you find managing pain so rewarding and why they should consider this as a field? Dr Burish: Yes - I also did a fellowship in pain medicine, in addition to my headache research, so I see a little bit of both. For me, the patients are very appreciative because you are talking with them about what they are interested in. They are not interested in the change in the MRI between last time - I mean, they are interested in it, but not as much as, “I hurt today.” So, patients are more than happy - they're very grateful that you are addressing their primary concern, the thing that they're going home with that day that they're worried about. For me, seeing these patients has been very rewarding. From the research side. I think it's fascinating that there's just not enough research in this area - you can create your own niche; you can look into your own mechanisms - there's just not a lot of people in this field. And then, I think from a clinical side, other than the rewarding nature of it, there's a lot of options that we have. There's all of these neuropathic medications; there's all these different headache medications. If you want to wade into the procedural side of things (which I did with pain management), you can get into fluoro-guided procedures and spinal cord stimulators and all these different options that we have for these patients that help them, in addition to whatever they're going through. I have patients that then come back and say, “Well, by the way, I have these seizures; do you mind helping me kind of just go through my antiepileptics.” And they're generally well controlled and they consider me kind of a general neurologist for them. So, I've found it extremely rewarding and I wouldn't do anything different. Dr Smith: Well, that's really great information and I hope our resident listeners will take that to heart. Your article is truly amazing, Mark. I can't tell you how much I was impressed with it, and for our listeners - you gotta check it out. I've got a list of ten other things on my piece of paper here I could ask Mark about, but I think we're probably at time. So, Mark, thank you so much. Congratulations on an amazing article and really fascinating and exciting area of neurology. Dr Burish: Thank you. Thank you very much for having me. Dr Smith: Again, today we've been interviewing Dr Mark Burish whose article on cluster headache - appears in the most recent issue of Continuum, which is on headache. Be sure to check out Continuum audio podcasts from this and other issues, and thank you very much to our listeners 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 practice. Right now, during our Spring Special, all subscriptions are 15% off. Go to Continpub.com/Spring2024 or use the link in the episode notes to learn more and take advantage of this great discount. This offer ends June 30, 2024. AAN members: go to the link in the episode notes and complete the evaluation to get CME. Thank you for listening to Continuum Audio.
Ready to dive into the nitty-gritty of property valuation in Brisbane? Join hosts Melinda and Scott Jennison in the latest episode of the Brisbane Property Podcast as they unveil insights from their team's in-house research on Automatic Valuation Reports (AVMs). In this episode, Melinda and Scott discuss the accuracy of AVMs in evaluating property values, based on their team's analysis of real-life case studies. They delve into a selection of properties from their study, revealing statistics on how many properties sold within the projected range of AVMs compared to those that didn't. The discussion goes deeper into understanding the reasons behind the significant differences found in these valuation tools. From market fluctuations to property uniqueness, they explore the various factors influencing AVM accuracy and their implications for property investors and homeowners. Whether you're an experienced investor, a potential buyer, or simply curious about property valuation complexities, this episode offers valuable insights and revelations. Hit play now and gain the knowledge to navigate the Brisbane property market with confidence! Connect with Us: Subscribe on Youtube https://www.youtube.com/channel/UCW30uBCnHQ2YllnwGKHNfxg Listen on Spotify https://open.spotify.com/show/5tODCtY54iQrxadNqqmevs Streamline Property Buyers Website https://streamlineproperty.com.au/ Ready to work with us directly? https://streamlineproperty.com.au/contact/ If you liked this episode, please don't forget to subscribe, tune in, and share this podcast with others you know will benefit from the information we share!
Welcome to the "Loan Officer Training" podcast series, your go-to resource for mastering the intricacies of the lending world. In this episode, we embark on a journey through the realm of Automated Valuation Models (AVMs), Collateral Data Aggregation (CDAs), Desktop Appraisals, and Alternative Valuations. Join us as we decode these essential tools and techniques that are revolutionizing the appraisal process for loan officers. From understanding the accuracy and limitations of AVMs to harnessing the efficiency of Desktop Appraisals, we cover everything you need to know to streamline your appraisal workflow and expedite loan processing. Additionally, we'll explore the emerging trend of Alternative Valuations, offering innovative solutions to traditional appraisal challenges. Whether you're a seasoned pro or new to the field, this episode equips you with the knowledge and strategies to leverage AVMs, CDAs, Desktop Appraisals, and Alternative Valuations effectively in your lending practices. Tune in now and elevate your expertise in appraisal management!Join The Mortgage Calculator at https://themortgagecalculator.com/joinAbout The Mortgage Calculator:The Mortgage Calculator is a licensed Mortgage Lender (NMLS #2377459) that specializes in using technology to enable borrowers to access Conventional, FHA, VA, and USDA Programs, as well as over 5,000 Non-QM mortgage loan programs using alternative income documentation! Using The Mortgage Calculator proprietary technology, borrowers can instantly price and quote thousands of mortgage loan programs in just a few clicks. The Mortgage Calculator technology also enables borrowers to instantly complete a full loan application and upload documents to our AI powered software to get qualified in just minutes!Our team of over 350 licensed Mortgage Loan Originators can assist our customers with Conventional, FHA, VA and USDA mortgagCatch all the episodes of the Loan Officer Training Podcast at https://themortgagecalculator.com/Page/Loan-Officer-Training-Series-Podcast Catch all the episodes of the Loan Officer Training Podcast at https://themortgagecalculator.com/Page/Loan-Officer-Training-Series-PodcastLoan Officers for Unlimited Free Non-QM Leads & Trainings Join The Mortgage Calculator at https://themortgagecalculator.com/joinThe Mortgage Calculator is a licensed Mortgage Lender (NMLS #2377459) that specializes in using technology to enable borrowers to access Conventional, FHA, VA, and USDA Programs, as well as over 5,000 Non-QM mortgage loan programs using alternative income documentation! Using The Mortgage Calculator proprietary technology, borrowers can instantly price and quote thousands of mortgage loan programs in just a few clicks. The Mortgage Calculator technology also enables borrowers to instantly complete a full loan application and upload documents to our AI powered software to get qualified in just minutes! Our team of over 350 licensed Mortgage Loan Originators can assist our customers with Conventional, FHA, VA and USDA mortgages as well as access...
Automated Valuation Models, or AVMs, are computer algorithms that use various data points and statistical models to estimate the value of a property. These models consider factors such as property characteristics, location, historical sales data, market trends, and other relevant information. The result is an automated property valuation report, providing an estimated property value without the need for a human appraiser. Today, We have Allan Weiss, Co-Founder of Case-Schiller index share how they created AVM in property valuation.
Moyamoya disease is a rare neurovascular condition that can affect both children and adults and is caused by progressive narrowing or blockage of the major blood vessels supplying the brain.The result is a lack of necessary blood flow to the brain, which can cause stroke, mini-stroke (TIA – transient ischemic attack) or bleeding into the brain. Numerous tiny vessels develop around the blockage in an attempt to compensate for the lowered blood flow, leading to a smoky appearance of these vessels on imaging. This smoky appearance is what gives the disease its name, as “moyamoya” means puff of smoke in Japanese.Aditya (Adi) Iyer MD, MS, is a fellowship-trained neurosurgeon with a focus on vascular diseases of the brain and spine at Pacific Neuroscience Institute. As one of California's few dual-trained neurosurgeons, Dr. Iyer is able to offer both minimally invasive open surgical techniques as well as incisionless catheter based procedures to treat patients with strokes, aneurysms, AVMs, tumors and pain.
To have a podcast on The Cost Approach and USPAP. How exciting (not)! You're right. This is not exactly the conversation you'll have when you get together with friends. Even if those friends are other appraisers! But the point is the cost approach is an untapped resource. It is the sunshine to which appraisers typically do not expose their analytics. This is a shame, really, since this approach can tell us so much about the quality of our analytics via the other approaches. How so? We all know that in older neighborhoods, there are likely to be few vacant site sales. This is where we appraisers can put the cost approach and USPAP to good use. This absence of data makes adjusting for site differences such as size, view, access, shape, etc. difficult to extract from the market. But you can use improved sales data to extract comparable site values. That takes a little practice and training, true, but once you master that protocol, life as an appraiser becomes easier. And, reports go out the door a little faster. Who doesn't want to produce more reports, thus greater cash-flow, right? And what are the advantages to appraisers who understand the cost approach and USPAP? More than you think, frankly! But the eye-opener is that as we come to understand the cost approach, then begin to use it properly, our clients are less motivated to hire AVMs and BPOs. Therefore, they are more prone to hire us, since we provide services and insights that the other tools simply cannot. So mastering the cost approach should not be a chore. Instead, let's look at it as the opportunity to become even more indispensable. Let's seize the opportunity to become even more professional than we are today!
Our last Podcast before Christmas A real light-hearted start to the Podcast this week as we discuss Christmas preparations, family, and favorite Christmas television.Our guest this week is Shirley Willsher, Shirley has had two major health events in her life, the first being Arteriovenous malformation (AVM's) and a few years later a Heart attack.Shirley openly and honestly tells us how the onset of ATV put her in a six-day Coma, had major surgery, and dealt with recovery. An unexpected turn of events that all came early one normal morning while at the gym. Following her recovery, a few years later Shirley suffered a heart attack one morning family gathered around to help, and was again rushed into hospital for surgery the very same day. Arteriovenous malformations (AVMs) happen when a group of blood vessels in your body forms incorrectly. In these malformations, arteries and veins are unusually tangled and form direct connections, bypassing normal tissues. This usually happens during development before birth or shortly after.During a heart attack, a lack of blood flow causes the tissue in the heart muscle to die. A heart attack is also called a myocardial infarction. Prompt treatment is needed for a heart attack to prevent death.We of course cannot finish our Podcast this week without "Martin's Joke of the Week"In closing, we discuss our next show and what we have lined up and of course wish everyone a happy Christmas.#HeartTransplant#EbsteinsAnomaly#RareCondition#HealthJourney#LifeChangingDiagnosis#MentalHealth#Vulnerability#SelfCompassion#PostTraumaticGrowth#MedicalMiracle#BBCSports#Inspiration#Cardiology#Surgery#Podcast#Healthcare#HeartHealth#MedicalBreakthrough#EmotionalJourney#SupportSystem#HealthcareHeroes#PatientStories#CardiologyCare#MedicalJourney#LifeLessons#MentalWellness#HealthAwareness#InspirationalTalk#LivingWithIllness#RareDiseaseAwareness#SharingIsCaring#MedicalSupport#BBCReporter#HeartDisease#PodcastInterview#HealthTalk#Empowerment#Wellbeing#HealthPodcast#ChronicIllnessCheck out our new website at www.whostomanddick.com
On today's episode, Editor in Chief Sarah Wheeler talks with Brandon Lwowski, senior director of research at House Canary, about potential new rules for automated valuation models (AVMs) and his vision for using AI to battle appraisal bias.Related to this episode:Connect with Brandon on LinkedInTrade groups warn of “unintended consequences” from proposed AVM rulesHousingWire's YouTube ChannelEnjoy the episode!The HousingWire Daily podcast examines the most compelling articles reported across HW Media. Each morning, we provide our listeners with a deeper look into the stories coming across our newsrooms that are helping Move Markets Forward. Hosted and produced by the HW Media team.
Today's episode covers cranial complications such as cerebral aneurysms, vasospasms, AVMs, and traumatic brain injuries. We take a brief look at these various disease processes and then discuss how we can manage them from an anesthesia standpoint. There is much to unpack here, we hope you enjoy following along!Support the showTo access all of our content, download the CORE Anesthesia App available here on the App Store and here on Google Play. Want to connect? Check out our instagram or email us at info@coreanesthesia.com
Dr. Benjamin Hechler returns for another engaging episode of Everyday Oral Surgery, an accomplished OMS practitioner based in North Carolina. We're excited to welcome him back as we delve into today's topic, benign aggressive lesions. In our discussion today, Dr. Hechler speaks to what sets an aggressive lesion apart and the different categories of lesions, both official and unofficial. He proceeds to highlight crucial principles in managing aggressive lesions, such as the importance of obtaining a comprehensive patient history, essential imaging considerations, and the most important principle to remember when obtaining a biopsy. We also look at four key radiographic features to be aware and Dr. Hechlers takes us through an overview of Ameloblastoma; what it is, the treatment, and the management. Furthermore, he discusses vascular anomalies, how he differentiates treatment for venous malformations versus AVMs, and shares insights on different lesions including those seen in the TMJ and benign fibro-osseous lesions. Be sure not to miss out on this episode if you are interested in hearing more about how Dr. Hechler approaches the diagnosis, treatment, and management of benign aggressive lesions as an OMS. Key Points From This Episode:An introduction to our guest and today's topic of conversation: benign aggressive lesions.Dr. Hechler speaks to what sets an “aggressive” lesion apart.An instance, regarding a lesion, that should “prick your ears” according to Dr. Hechler.We discuss the different categories of lesions, both official and unofficial.His thoughts on the types of aggressive lesions OMS see more regularly. Principles of aggressive lesion management: a broad overview. Why taking a complete patient (or lesion) history is essential. The most important principle to remember when obtaining a biopsy.We discuss the process of biopsying vascular lesions: aspirate. A look at four key points of radiographic features to be aware of.Dr. Hechler talks about Ameloblastoma: what it is, the treatment, and the management.Ameloblastoma demographics and whether it's commonly associated with an impacted tooth.How he treats the venous malformation differently than the AVM.The various aggressive TMJ lesions seen in OMS.He highlights some of the benign fibro-osseous lesions we may see in practice.How he approaches (sometimes multiple) recurrences of lesions. He shares thoughts on the future of benign aggressive lesion treatments.Links Mentioned in Today's Episode:Dr. Benjamin Hechler on LinkedIn — https://www.linkedin.com/in/ben-hechler/Dr. Benjamin Heckler Email — benhechler@gmail.com ISSVA classification of vascular malformations — https://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf AAOMS Annual Meeting — https://www.aaoms.org/meetings-exhibitions/annual-meeting/105th-annual-meetingEveryday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059
We welcome Dr. David Penn of Nuvance Health. Dr. Penn is a neurosurgeon with areas of expertise including treatment of complex brain tumors, such as acoustic neuromas and meningiomas, vascular malformations, such as aneurysms and AVMs and cerebral bypass. He specializes in minimally-invasive, endoscopic treatments for pituitary tumors and other types of brain tumors. Ray Graf hosts.
Communication Tips: Giving and Receiving Feedback featuring Stacey Wolfe, MD, FAANSStacey Quintero Wolfe, MD is a neurosurgeon with Wake Forest Baptist Health in Winston-Salem, North Carolina.She is a board-certified neurosurgeon, specializing in disorders of blood vessels, brain trauma and spine. She completed fellowships in endovascular and cerebrovascular/skull base neurosurgery at the University of Miami. As a 21-year US Navy veteran, she earned the Meritorious Service Medal and developed the Stroke and Neurotrauma Programs at Tripler Army Medical Center. She joined Wake Forest Baptist Health in 2013 as Director of Neurointerventional Surgery and Residency Program Director. She built a hemorrhagic stroke research program and am co-Principal Investigator of National Institute of Health (NIH) StrokeNet at Wake Forest Baptist Health. She leads multiple NIH and national clinical trials in stroke and brain hemorrhage, and is studying neuroinflammation, genetic risk factors, and genetic mutations in the development of cerebral Arteriovenous malformations (AVMs) in her research lab. She has served on the American Association of Neurological Surgeons Board of Directors, Executive Committee of the Congress of Neurological Surgery and Society of Neurological Surgeons, American Heart Association Mission Stroke Task Force, and as Chair of Women in Neurosurgery. She has published over 100 peer-reviewed articles and review for five journals. She was awarded the national 2021 ACGME Courage to Teach Award for innovation and mentorship in education, and am dedicated to providing cutting edge care for patients with neurologic disease.She lives in Winston-Salem with her husband and two children. In her free time, she volunteers at a local school and in the community.
One of the most important aspects of being a medical professional is reviewing your past cases (especially those involving complications) and studying public records of complications so that you are constantly improving the quality of care that you provide to your patients. To help us further explore this topic, we are joined once again by the Medical Director of Blue Cross, North Carolina, Dr. Ben Hechler. Our first case is about a middle-aged male who experienced laryngospasms after receiving anaesthesia and ultimately, passed away. Dr. Ben hones in on the main learning points from this case including the safety of sedation, common ailments that are often overlooked, and how he would treat laryngospasms. After briefly touching on the importance of being aware of EMS response times in your area, we get into our second case regarding a patient who received a $2.7 million settlement after being negligently operated on for an arterio-venous malformation (AVM). Dr. Ben describes the clinical findings that are common to AVM and how he would treat it, what you can do when you have a clash of professional opinions with your colleague, other AVM scenarios to consider, and reiterating why you should always document your rationale and perform reviews of your own cases. Plus, if you are a new OMS graduate, be sure to speak to your KLS Martin representative for some amazing once-off specials! Key Points From This Episode:A warm welcome back to Dr. Ben Hechler as Dr. Stucki explains the importance of case reviews. Diving straight into the first case study of a middle-aged male who spasmed after induction.The main learning points (and medical reminders) from our first case, according to Dr. Ben. Discussing issues of safety regarding sedation, anesthesia, and general drug administration. Our guest explains what can be done to mitigate safety concerns before surgery. Why obstructive sleep apnea (OSA) and hypertension are often overlooked.How Dr. Ben treats laryngospasms, and what to keep in mind when dealing with the issue.Why it's always good to know the average EMS response time in your area. Our second case is about an AVM patient who was negligently operated on.Dr. Ben explains what went wrong with the patient who eventually received a $2.7 million settlement. Clinical findings that you can expect from arterio-venous malformations (AVM).How he treats AVMs, and what you can do when there's a clash of professional opinions. The difference between confirmed and suspected AVMs, and other scenarios to consider.Reiterating the importance of documenting your rationale and performing case reviews. If you are a fresh OMS graduate, speak to your KLS Martin rep for incredible once-off specials. Links Mentioned in Today's Episode:Dr. Ben Hechler on LinkedIn — https://www.linkedin.com/in/ben-hechler/ KLS Martin — https://www.klsmartin.com/en/ Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059
In this special episode, Leigh Brown delves into the world of real estate property data collectors, discussing their role, potential risks, and implications for consumers and professionals in the industry. The episode highlights the rise of appraisal management companies (AMCs) and automated valuation models (AVMs) and how they came into effect after the housing crisis. Learn the concerns about the new program introduced by Fannie Mae and Freddie Mac, which involves sending unlicensed and unregulated data collectors into homes to gather information for the banks. The lack of oversight and potential biases are problematic, as they could lead to inaccurate valuations and manipulation of property values. The episode emphasizes the importance of certified appraisers and the need for regulatory oversight in professional services. To learn more about this complex and crucial topic, listen to this episode and then jump to last week's interview with Peter Gallo, Owner/Chief Appraiser at HOMESIGHT APPRAISAL, as he shared his personal encounter when he questioned a tech company representative regarding regulatory compliance. Key takeaways to listen for Understanding the role of AMCs and AVMs The risks of allowing unlicensed data collectors into your home The potential impact on the real estate market The importance of advocating for the role of certified appraisers Resources mentioned in this episode 411 - What Makes Appraisers an Irreplaceable Role in Real Estate with Peter Gallo Connect with Leigh Please subscribe to this podcast on iTunes or the Podcasts App on your phone, and never miss a beat from Leigh by visiting https://leighbrown.com. DM Leigh Brown on Instagram @ LeighThomasBrown. Subscribe to Leigh's other podcast Real Estate From The Rooftops Sponsors Leigh Brown University – New On-Demand Training How to Dominate During This Recession! Enroll Now to get ahead of the curve and learn how to manage changing markets, the action steps for what to do, and most importantly, what to say so that you can secure listings, assist more buyers, and grow your business no matter what the market is doing. Link: http://dominatethisrecession.com
Bisher geben die Fritzbox-Router eher mittelmäßige Smart-Home-Zentralen ab, weil AVM nur wenige steuerbare Komponenten anbietet. Doch nun kommt ein Gateway dazu, das dutzende Smart-Home-Geräte mit dem Zigbee-Funkstandard einbindet, anfangs hauptsächlich Schaltsteckdosen und Leuchten. Wir diskutieren im Podcast c't uplink, wie weit das FRITZ!Smart Gateway die Fritzbox nach vorne bringt. Zuerst ordnen Dusan und Sven, Smart-Home-Experten bei c't, die bisherigen Fähigkeiten der Fritzbox-Router ein: Sie nutzen den Funkstandard DECT-ULE, AVM bietet dafür vor allem Schaltsteckdosen, Heizungsthermostate und eine E27-Lampe an. Doch als herstellerübergreifender Standard hat sich DECT-ULE schlecht etabliert. Zigbee hingegen ist ein Funkstandard, den viele Hersteller fürs Smart Home nutzen. AVMs neues Gateway bindet solche Komponenten ziemlich transparent in die Fritzbox-Zentrale ein. Wir erklären die Details und ob das Gateway auch als WLAN- oder DECT-Gateway taugt [--] Spoiler: nein. Als Vorteil kann man die Zigbee-Geräte nicht nur in allen Gruppen und Automatisierungen nutzen, sondern auch per DECT-Telefon steuern, jedenfalls den Fritzfons von AVM. Der vielleicht größte Nachteil: AMV macht nicht alle Funktionen der Zigbee-Komponenten nutzbar, beispielsweise fehlen die Messwerte von den Schaltsteckdosen, die den Stromverbrauch messen können. Dann vergleichen wir die so erweiterte Fritzbox mit anderen Smart-Home-Infrastrukturen: Zum einen den lokal arbeitenden [--] die Fritzbox kommt auch mitsamt Zigbee ohne Cloud aus [--] wie NodeRed, ioBroker & Co.: Der Vorteil der AVM-Lösung ist, dass keine zusätzliche Hardware laufen muss, sondern die als Internetrouter sowieso nötige Fritzbox nebenher alle Smart-Home-Aufgaben erledigt. Allerdings lassen die Komponentenauswahl und die Komplexität der Steuer- und Regelfunktionen noch zu wünschen übrig. Eine Alternative bleibt, die Zigbee-Komponenten wie bisher über Gateways der Komponentenhersteller anzusprechen. Zum anderen diskutieren wir Smart-Home-Steuerungen via Sprachassistenten von Amazon, Apple und Google [--] und auch Matter kommt zur Sprache, wenn auch zwangsläufig hauptsächlich spekulativ. Mit dabei: Dušan Živadinović, Sven Hansen Moderation: Jörg Wirtgen Produktion: Ralf Taschke Bitte entschuldigt die Tonprobleme ab 1:04:18. Die Artikel des Titelthemas in c't 16/2023: https://www.heise.de/select/ct/2023/16/2312914154308051398 https://www.heise.de/select/ct/2023/16/2312914172332662406 https://www.heise.de/select/ct/2023/16/2312914185844680870
Bisher geben die Fritzbox-Router eher mittelmäßige Smart-Home-Zentralen ab, weil AVM nur wenige steuerbare Komponenten anbietet. Doch nun kommt ein Gateway dazu, das dutzende Smart-Home-Geräte mit dem Zigbee-Funkstandard einbindet, anfangs hauptsächlich Schaltsteckdosen und Leuchten. Wir diskutieren im Podcast c't uplink, wie weit das FRITZ!Smart Gateway die Fritzbox nach vorne bringt. Zuerst ordnen Dusan und Sven, Smart-Home-Experten bei c't, die bisherigen Fähigkeiten der Fritzbox-Router ein: Sie nutzen den Funkstandard DECT-ULE, AVM bietet dafür vor allem Schaltsteckdosen, Heizungsthermostate und eine E27-Lampe an. Doch als herstellerübergreifender Standard hat sich DECT-ULE schlecht etabliert. Zigbee hingegen ist ein Funkstandard, den viele Hersteller fürs Smart Home nutzen. AVMs neues Gateway bindet solche Komponenten ziemlich transparent in die Fritzbox-Zentrale ein. Wir erklären die Details und ob das Gateway auch als WLAN- oder DECT-Gateway taugt [--] Spoiler: nein. Als Vorteil kann man die Zigbee-Geräte nicht nur in allen Gruppen und Automatisierungen nutzen, sondern auch per DECT-Telefon steuern, jedenfalls den Fritzfons von AVM. Der vielleicht größte Nachteil: AMV macht nicht alle Funktionen der Zigbee-Komponenten nutzbar, beispielsweise fehlen die Messwerte von den Schaltsteckdosen, die den Stromverbrauch messen können. Dann vergleichen wir die so erweiterte Fritzbox mit anderen Smart-Home-Infrastrukturen: Zum einen den lokal arbeitenden [--] die Fritzbox kommt auch mitsamt Zigbee ohne Cloud aus [--] wie NodeRed, ioBroker & Co.: Der Vorteil der AVM-Lösung ist, dass keine zusätzliche Hardware laufen muss, sondern die als Internetrouter sowieso nötige Fritzbox nebenher alle Smart-Home-Aufgaben erledigt. Allerdings lassen die Komponentenauswahl und die Komplexität der Steuer- und Regelfunktionen noch zu wünschen übrig. Eine Alternative bleibt, die Zigbee-Komponenten wie bisher über Gateways der Komponentenhersteller anzusprechen. Zum anderen diskutieren wir Smart-Home-Steuerungen via Sprachassistenten von Amazon, Apple und Google [--] und auch Matter kommt zur Sprache, wenn auch zwangsläufig hauptsächlich spekulativ. Bitte entschuldigt die Tonprobleme ab 1:04:18. Die Artikel des Titelthemas in c't 16/2023: https://www.heise.de/select/ct/2023/16/2312914154308051398 https://www.heise.de/select/ct/2023/16/2312914172332662406 https://www.heise.de/select/ct/2023/16/2312914185844680870
Bisher geben die Fritzbox-Router eher mittelmäßige Smart-Home-Zentralen ab, weil AVM nur wenige steuerbare Komponenten anbietet. Doch nun kommt ein Gateway dazu, das dutzende Smart-Home-Geräte mit dem Zigbee-Funkstandard einbindet, anfangs hauptsächlich Schaltsteckdosen und Leuchten. Wir diskutieren im Podcast c't uplink, wie weit das FRITZ!Smart Gateway die Fritzbox nach vorne bringt. Zuerst ordnen Dusan und Sven, Smart-Home-Experten bei c't, die bisherigen Fähigkeiten der Fritzbox-Router ein: Sie nutzen den Funkstandard DECT-ULE, AVM bietet dafür vor allem Schaltsteckdosen, Heizungsthermostate und eine E27-Lampe an. Doch als herstellerübergreifender Standard hat sich DECT-ULE schlecht etabliert. Zigbee hingegen ist ein Funkstandard, den viele Hersteller fürs Smart Home nutzen. AVMs neues Gateway bindet solche Komponenten ziemlich transparent in die Fritzbox-Zentrale ein. Wir erklären die Details und ob das Gateway auch als WLAN- oder DECT-Gateway taugt [--] Spoiler: nein. Als Vorteil kann man die Zigbee-Geräte nicht nur in allen Gruppen und Automatisierungen nutzen, sondern auch per DECT-Telefon steuern, jedenfalls den Fritzfons von AVM. Der vielleicht größte Nachteil: AMV macht nicht alle Funktionen der Zigbee-Komponenten nutzbar, beispielsweise fehlen die Messwerte von den Schaltsteckdosen, die den Stromverbrauch messen können. Dann vergleichen wir die so erweiterte Fritzbox mit anderen Smart-Home-Infrastrukturen: Zum einen den lokal arbeitenden [--] die Fritzbox kommt auch mitsamt Zigbee ohne Cloud aus [--] wie NodeRed, ioBroker & Co.: Der Vorteil der AVM-Lösung ist, dass keine zusätzliche Hardware laufen muss, sondern die als Internetrouter sowieso nötige Fritzbox nebenher alle Smart-Home-Aufgaben erledigt. Allerdings lassen die Komponentenauswahl und die Komplexität der Steuer- und Regelfunktionen noch zu wünschen übrig. Eine Alternative bleibt, die Zigbee-Komponenten wie bisher über Gateways der Komponentenhersteller anzusprechen. Zum anderen diskutieren wir Smart-Home-Steuerungen via Sprachassistenten von Amazon, Apple und Google [--] und auch Matter kommt zur Sprache, wenn auch zwangsläufig hauptsächlich spekulativ. Mit dabei: Dušan Živadinović, Sven Hansen Moderation: Jörg Wirtgen Produktion: Ralf Taschke Bitte entschuldigt die Tonprobleme ab 1:04:18. Die Artikel des Titelthemas in c't 16/2023: https://www.heise.de/select/ct/2023/16/2312914154308051398 https://www.heise.de/select/ct/2023/16/2312914172332662406 https://www.heise.de/select/ct/2023/16/2312914185844680870
In 2020, William Kyler Lewis, 15, was riding in the car with his mom in College Station, Texas, when he suddenly turned to her confused. His head hurt, he was sick to his stomach and his vision was blurred. Soon, he couldn't remember anything for more than a few seconds. After his mom rushed him to the pediatrician, he got a shot and was told to go home. Instead, his mom drove 1½ hours to a children's hospital in Houston. Nurses there thought Kyler had taken drugs, but his mom insisted no, he was not that type of kid, and something was very wrong. A CT scan revealed Kyler had an acute spontaneous intracranial hemorrhage from a brain arteriovenous malformation (AVM) that he unknowingly had when he was born. A brain AVM is a condition that is not inherited. AVMs are a random occurrence due to a gene malfunction in utero where a mass of arteries connect directly to veins. Kyler received lifesaving external ventricular drain (EVD) surgery to control the fluid build-up in his brain. After the stroke, memory and neuro fatigue became a big problem. Kyler has undergone radiation and chemotherapy and takes medication for epilepsy, headaches, dizziness, weakness and tremors. Yet, Kyler is inspiring many. He uses local news, community functions and social media to educate the public that a child can have a stroke, too. He also organizes walks to highlight the importance of recognizing the symptoms of a pediatric stroke. Kyler's Facebook group, “A Cure for Kyler,” his CaringBridge page and YouTube channel educate and inspire pediatric stroke survivors by documenting his recovery. His video, “Being You after an Aneurysm/AVM Rupture,” and his family's Facebook page, “AVM Alliance: A Cure for Kyler and Friends,” share stories of other hemorrhagic stroke survivors and educate people about symptoms and conditions. Links: Cxnadvisory.com https://www.f3metro.com/ Freed to Lead CONTACT INFO: https://www.linkedin.com/in/tim-whitmire-7955145/ Twitter: @trwhitmire_OBT Show Credits: Music intro credit to Jake Dansereau, connect at JAKEEZo on Soundcloud @user-257386777. Our intro welcome is the voice of Caroline Goggin, a stroke survivor and our first podcast guest! Please listen to her inspiring story on Episode 2 of the podcast. Thank you Caroline! Until next time, be sure to give the show a like and share, +follow and connect with us on social or contact us to support us as a show sponsor or become a guest on the Know Stroke Podcast. Visit our new website to apply here: https://www.knowstrokepod.com/ Connect with Us and Share our Show on Social: Website | Linkedin | Twitter | YouTube Watch this episode on YouTube: https://youtu.be/pSYVCzUGZXs
A key component of your head-to-toe and focused assessments is the vascular assessment. In this episode I'm sharing tips and real-world examples to help you feel more confident at the bedside. * What type of clinical situations warrant a vascular assessment * Tips for taking a proper blood pressure measurement * Pulse assessment, including a key tip on using the Doppler * General vascular assessment techniques including capillary refill, edema and pain * Neurovascular assessment * The 6 P's of Ischemia * What the Allen test is and how to perform one * Bruits and thrills demystified! Did you enjoy the PodQuiz at the end of the episode? Sign up for Study Sesh and change the way you study! Are you looking for an easier way to learn Med Surg? Enroll in Med Surg Solution and get lessons on 57 key topics as well as out-of-this-world study guides! Want a sneak peek into nursing school so you can be prepared and ready? Crucial Concepts Bootcamp teaches you core foundation concepts, medication math, organizational strategies, study tips and so much more. Get ready for nursing school and enroll in Crucial Concepts Bootcamp today! Learn more about cardiac assessment in Performing A Cardiac Assessment: Episode 250 Learn more about AVMs in AVMs A to Z: Episode 241 Read the article about performing a vascular assessment and view references here. __________ The information, including but not limited to, audio, video, text, and graphics contained on this podcast are for educational purposes only. No content on this podcast is intended to guide nursing practice and does not supersede any individual healthcare provider's scope of practice or any nursing school curriculum. Additionally, no content on this podcast is intended to be a substitute for professional medical advice, diagnosis or treatment. Straight a Nursing is a proud member of the Airwave Media Network. Learn more about your ad choices. Visit megaphone.fm/adchoices
Nationally and internationally recognized as a leading neurosurgeon and an expert in cerebral revascularization and cerebral aneurysms, Dr. Langer brings more than 22 years of experience to his highly personalized, direct patient care practice. One of the few cerebral bypass surgeons in the country, Dr. Langer has published award-winning work in numerous peer-reviewed publications and has spoken nationally and internationally on vascular disorders, such as aneurysms and arteriovenous malformations (AVMs) of the brain. A third-generation physician, Dr. Langer attended the University of Pennsylvania to receive both his undergraduate and medical school degrees, where he also stayed to complete his neurosurgical residency under the direction of Eugene Flamm, MD. He later joined Dr. Flamm at a new neurosurgical institute in New York City in 1998. Dr. Langer also completed a mid-career fellowship at the University at Buffalo in cerebrovascular disease treatment, including aneurysms, AVMs and carotid disease. Dr. Langer has been recognized as a Top Doctor and Best Doctor by numerous publications and has a global reputation in neurosurgical excellence.
David Langer, MD, is the chair of neurosurgery at Lenox Hill Hospital, vice president of neurosurgery for Northwell Health's Western region. A renowned neurosurgeon and expert in cerebral revascularization, he treats patients who have brain tumors, including acoustic neuromas and meningiomas, and cerebrovascular conditions such aneurysms, arteriovenous malformations (AVMs) and Moyamoya disease. He also treats minimally invasive spine, spinal cord injury and AVMs.“As part of leading and growing our neurosurgery program, I aim to innovate and bring a high level of expertise and energy to my patients,” says Dr. Langer. He was an early adopter of using the exoscope for cerebral bypass surgery. The exoscope projects high-definition, three-dimensional images on a large screen in the operating room, greatly improving the accuracy of procedures.Dr. Langer earned his medical degree and completed a neurosurgical residency at the University of Pennsylvania School of Medicine. He also received mid-career fellowship training in cerebrovascular disease treatment at the University at Buffalo. At Northwell, he practices within a multi-disciplinary team, collaborating with ENT, plastic surgery, psychiatry, radiation oncology, physician assistants and nurses to provide personalized care plans.Dr. Langer is dedicated to teaching the next generation of doctors as a professor of neurosurgery and radiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. He also values public education and was featured in Lenox Hill—a Netflix Originals docuseries that shadows four doctors as they navigate their daily lives and care for their patients—and frequently contributes to various media outlets on neurosurgery. A technological innovator, Dr. Langer developed Playback Health, a smartphone app designed to enhance the patient experience. He's also an instructor for BRAINTerns, a virtual summer internship program for students worldwide.He is a member the numerous medical societies and has published extensively in peer-reviewed medical journals. He has been a Castle Connelly Top Doctor New York Metro Area (digital guide) for the last several years.“I see patients when they're most vulnerable,” says Dr. Langer. “The most rewarding part of my job is guiding them through not only the physical part of their treatment and recovery, but also the psychological and emotional part.”
All episodes are available at https://TheNeuroNerds.com. Follow @TheNeuroNerds on Twitter/Instagram and Like us at Facebook.com/TheNeuroNerds. Summary Joe is speaking at the TAAF Walk on September 18, 2022. On this episode, to celebrate this amazing event supporting aneurysm and AVM survivors, Joe is speaking with TAAF's community engagement manager, Dina Chon. They talk about how important it is to connect survivors and those who support organizations like TAAF at fundraising events like this walk to spread awareness and encourage more people to support the brain injury survivor community. Spread the word about this event by tweeting the registration link for this event and tagging @TAAF, @TheNeuroNerds and #TAAFWalk. Links Mentioned Register here: https://www.classy.org/event/taafwalk-2022-17th-annual-aneurysm-and-avm-awareness-walk/e409424 Credits New to our show? Take our episode tour to get started! https://newsletter.theneuronerds.com/tour Find tools for recovery in Joe's FREE guide, 9 Must-Have Tools for Stroke & Brain Injury Recovery! This guide includes some essential tools for your recovery journey including tips for occupational and physical therapy, mindset, overstimulation, and more. Get your copy here → https://www.yousorock.coach/guide If you're a brain injury survivor who would like to learn how to shift your mindset, create a routine, and get more support during recovery, book a call with Joe at https://newsletter.yousorock.coach/checkin-call Support The NeuroNerds podcast on Patreon and join our NeuroJedi High Council at www.Patreon.com/TheNeuroNerds Check out The NeuroNerds Amazon Shop at amazon.com/shop/theneuronerds Plus get a free Audible trial at http://www.audibletrial.com/theneuronerds! Co-hosted by Joe Borges and Lauren Manzano Find Joe at http://joesorocks.com and @joesorocks on Twitter/Instagram Submit your stroke/brain injury recovery story at https://www.joesorocks.com/submit-your-story Find Lauren at @laurenlmanzano on Instagram, @tankbbg on Twitter Produced by Joe Borges and Felice LaZae, http://felicelazae.com, @felicelazae on Twitter/Instagram Edited by Marcellus Wesley - https://www.soundsignature.productions Sponsored by Motus Nova, Avid Technology, and our Patreon Supporters
An arteriovenous malformation (AVM) is an abnormal cluster of blood vessels that lack a capillary network, which results in both disrupted blood flow and disrupted oxygen delivery. In this episode I'm talking you through AVMs step-by-step so you can (finally) understand them! Want to get a study guide that goes with this lesson? Check out Power Guides here. Learn more about neurological assessment here. Want to maximize your learning by reading this information, too? Check out the article and references here. RATE, REVIEW AND FOLLOW! If this episode helped you, please take a moment to rate and review the show! This helps others find the podcast, which helps me help even more people :-) Click here, scroll to the bottom, then simply tap to rate with 5 stars and select, "write a review." I'd love to hear how the podcast has helped you! If you're not following yet, what are you waiting for? It takes just a quick moment and the episodes show up like magic every Thursday. And, when I release a bonus episode, those show up, too! You'll never miss a thing! In Apple Podcasts, just click on the three little dots in the upper right corner here. Know someone who would also love to study with me? Share the show or share specific episodes with your classmates...when we all work together, we all succeed! On Apple Podcasts, the SHARE link is in the same drop-down as the follow link. Spread the love! Thanks for studying with me! Nurse Mo
Neuro Pathways: A Cleveland Clinic Podcast for Medical Professionals
Neurosurgeon, Nina Moore, MD, discusses the evolving medical, interventional and surgical landscape for treating AVMs.
Depression sucks, and it lies. It's a life threatening condition that affects a lot of stroke survivors and can block their recoveries. In 2010, business owner Keith Taylor survived a stroke. A rare genetic condition meant that the arteries and veins in his body don't always connect the way they're supposed. It's called Hereditary hemorrhagic telangiectasia (HHT). One day, that flawed connection leaked and began killing brain cell. Keith began his journey through the stroke care system of the time, into the depths of depression, leaving the business he planned his life around and to the life he lives today helping stroke survivors in Central Oregon and around the world live their best lives. He shares his journey in today's episode. If you don't see the audio player below, visit http://Strokecast.com/MSN/Keith Click here for a machine-generated transcript Who is Keith Taylor? Keith Taylor runs Strength After Stroke Keith Taylor is a deeply passionate, and dedicated leader in the stroke community. He is dedicated to helping stroke survivors regain their own power and strength to live a full and productive life. While owning and being the sales manager of a large manufacturing business in Oregon, he had a stroke at the age of 48. After looking for, and not finding, anyone to help with the depression and lack of confidence after his stroke, he decided to create that for other stroke survivors. He is President of the Board of Directors with Stroke Awareness Oregon and is the owner of Strength after Stroke; a company dedicated to providing resources for stroke survivors to re-ignite their desires and regain their confidence. What is HHT? HHT stands for Hereditary hemorrhagic telangiectasia. That tells most of us…absolutely nothing. The condition impacts the way the blood vessels in our body connect. When the circulatory system works properly, blood flows from the heart under high pressure through the arteries to deliver oxygen and nutrients to the organs throughout the body. One big artery (the aorta) comes off the heart and splits into smaller and smaller arteries that carry blood to the kidneys, the toes, the brain, and every other part. The arteries are built to withstand the blood pressure. Veins take blood from the organs and bring it back to the heart. Along the way, the deliver carbon dioxide to the lungs and waste material to the kidneys, liver, and other disposal sites. The blood is no longer under such high pressure at this point. In between, there are capillaries. These are the tiny, thin blood vessels that allow oxygen and nutrients to pass from the blood to the organs and for carbon dioxide to pass back. Arteries branch smaller and smaller and thinner and thinner to become this huge network of capillaries, which the consolidate and get bigger and bigger until they become veins. Meanwhile, that branching down and consolidating up reduces the pressure on the blood in the system In a patient with HHT, those capillaries don't always form where they are supposed to. Instead, the arteries will connect directly to the veins. These malformations are weak spots since the veins may not be able to handle the pressure of the blood coming into them. These AVMs, or arterial-venous malformations can then rupture or leak resulting in a hemorrhagic stroke. You can learn more about HHT at the CDC's website here: https://www.cdc.gov/ncbddd/hht/index.html#:~:text=HHT%20is%20a%20disorder%20in,present%20between%20arteries%20and%20veins. HHT is not the only cause of AVMs but it is an important one. Nosebleeds Nosebleeds are an important signal that something may be wrong. Frequent or regular nosebleeds are something to discuss with your doctor. Nosebleeds are a common indicator of HHT. Someone who has HHT will need to keep on top of their monitoring to reduce the chances of a dangerous stroke or other conditions. HHT by itself doesn't have many visible symptoms so nosebleeds can be a good flag. In my case, it was nosebleeds that revealed my high blood pressure, which remains one of the top causes of stroke. The problem, of course, with high blood pressure is that it doesn't hurt. Unless you're checking it, you won't know you have it. Nosebleeds, however, are one powerful indicator. If you or someone you care about has frequent nosebleeds, discuss it with your doctor. There can be lots of different causes, but often the nosebleed is the least severe consequence of that cause. Depression Lies I talk about depression a lot on the show because it is a big deal and stroke has been shown to cause depression. Depression can be a deadly disease. It can also tell us not to get out of bed. Or to skip our exercises. Or to question if we should even be here. Or try to convince us we are a burden to the people who love us. Depression interferes with our recovery, our energy, our relationships, and our view of the future. But always remember the biggest fact about depression: Depression lies. All the time. I first encountered this concept while reading a blog post from writer, actor, and professional geek Wil Wheaton. You can see that post at http://Strokecast.com/DepressionLies When depression says we shouldn't get out of bed or off the couch, depression lies. When depression tells us our friends and families wish we weren't there, depression lies. When depression tells us to skip therapy because it doesn't matter, depression lies. Don't listen to the liar that is depression. Help is available. Your doctor therapist will be happy to point you in the right direction. Hack of the Week When you forget a name or word, channel your inner Elsa, and let it go. Just relax. It's okay to struggle with names and words. People you deal with will be okay with it. The more you stress about it, the harder it will be to remember and the more likely you are to struggle with other words, too. Often we worry about what strangers will think about us when we are out and about, but the thing is they don't really care. Everyone we see is caught up in their own fear that everyone is judging them that they don't have the attention or energy to actually judge others. If you think someone does give you a dirty look or something like that, remind yourself that their probably thinking about that cringey thing they said at their 8th grade dance. Somehow it just smacks them at random from the depths of their memory. But the key is that's it's not about you. So relax. And let it go. Links Where do we go from here? Check out Keith's work at http://StrengthAfterStroke.org Share this episode with someone you know by giving them the link http://Strokecast.com/Keith Subscribe to the free Strokecast newsletter at http://Strokecast.com/News Don't get best…get better.
“We don't know what we don't know until there's some investigation,” says Ben McGahon. Just in time for a challenging economic turn, our very first ITEXPO 2022 podcast features a company that's focused on finding cloud savings. In this podcast we learn that although the move to the cloud was designed to make a more rational use of resources, companies still have orphaned resources, improperly scaled resources, spending on assets that may not be justified and much more. If the adage that recessions catch what the auditors missed, is true, AVMS has an interesting offer for MSPs to consider just as their clients shift from an environment of free spending consumers and forgivable government loans to a very visible effort to tighten credit, which may mean that people will be looking at spending. McGahon thinks that there is a great opportunity in offering companies a simple path to savings, where the cost cutting begins with services and assets we literally are not using or are underusing. McGahon makes the case that automated advanced cloud resource scheduling, and the savings and efficiencies that this yields, is a conversation the MSP needs to have with their customers today. Visit www.advancedvmsolutions.io
On today's episode, Editor in Chief Sarah Wheeler talks with Senior Mortgage Reporter Georgia Kromrei about Fannie and Freddie approving the expanded use of alternative appraisal methods, including automated valuation models, desktop appraisals and hybrid appraisals. The two also discuss how the appraisal changes fit into FHFA's broader housing equity goals.HW Media Articles related to this episode:GSEs further expand AVMs, desktop and hybrid appraisalsWith landmark GSE equity plans, FHFA confronts legacy of redlining
Musings is a solo version of the Notorious POD in which I think out loud about issues in the economy, technology, and real estate industry. In this episode, I think out loud about AVMs, appraisers and the future of valuation at least for purposes of lenders. I've been researching and investigating valuations and appraisals in the context of Defi lending, and a reader sent me the just published Fannie Mae fact sheet on Desktop Appraisal. This feels like something that is potentially a big deal, so I muse about it. ==== Notorious ROB: https://notoriousrob.com/ Twitter: https://twitter.com/robhahn Facebook: https://www.facebook.com/Notorious.ROB.blog
Browsing for a new home is a hobbyist activity, even for people not looking to immediately purchase. The home buying experience tends to now start online, and shoppers are seeing estimates from an automated valuation models or AVMs. In this episode, host Maiclaire Bolton Smith sits down with Ann Regan, Executive Product Manager from Collateral Solutions to learn what exactly is an AVM? How does it work? What is it used for?
At only seven years old, Sydney Collier was diagnosed with an extremely rare condition. In this episode, she shares her incredible story of not letting anything get in the way of accomplishing her goals, and how she keeps an unbelievably positive attitude throughout every step of her journey. Sydney Collier started riding horses at the age of seven and instantly fell in love. Shortly after she began riding, a routine vision screening changed her life in ways she could not have imagined. She was diagnosed with the rare Wyburn-Mason Syndrome, a life-threatening condition that causes arteries and veins to grow together causing vascular malformations (AVMs) inside her brain. Because of their location deep in her brain, her AVMs could not be easily removed. The rarity of Wyburn-Mason Syndrome meant few options were available for treatment. Sydney's condition quickly started affecting her vision and the control of her left side. Over the course of eight years, she endured a series of experimental treatments including CyberKnife radiation, blood vessel embolization, and brain surgery. During a risky brain surgery in 2009, she suffered a devastating and massive stroke. Despite this setback, she entered a rehabilitation center and was determined to get out of her wheelchair and return to the sport of riding. In 2010, she attended the World Equestrian Games as a spectator and immediately fell in love with Para-Dressage. With a renewed dedication to returning to riding at a high-performance level, Sydney set out to learn the sport of Para-Dressage. At age 16, she earned a spot on the US Para-Dressage team and was the youngest competitor at the 2014 World Equestrian Games in France. At age 18, she won the 2016 US Para-dressage National Championships and became the youngest member in the equestrian portion of the 2016 Paralympics in Rio as a part of Team USA. She placed 7th overall in the highly competitive para-dressage grade 1B. She has dedicated her life to service and maintains a busy schedule combining athletic, equestrian training, guest speaking, volunteering, babysitting, and giving riding demonstrations at a variety of events. She is also attending DeVry University on an Olympic Scholarship, majoring in communications. Alongside these activities, she continues training to earn a place on 2021 Tokoyo Para-Dressage Team and help the USA stand on the medal podium. In this episode, we discuss: · Her story of being diagnosed at a young age with an extremely rare condition. · The role horseback riding played in her determination to rehab after her surgeries and the mental and emotional escape it provided from – as she says – “all the medical mumbo jumbo.” · How finding Para-Dressage changed her life and her plans for her future. · The importance and power of setting big goals no matter what obstacle you have in your life. · Reframing everything that life throws you as a positive. · How truly supporting people means not putting ceilings on them and even allowing them to fail. · The importance of celebrating all the small goals along the way to big goals. · The incredibly special relationship she has with her horse and the power of the horse-human connection. · The spiritual beliefs that help her maintain her positive mindset. · And her advice on how we can all believe in ourselves a little bit more so we can go after our big goals. You can find and follow Sydney here: Sydsparaquest.com Instagram: @sydsparaquest Twitter: @sydsparaquest
Jason Hartman talks with Dr Andy Krause, Principal Data Scientist at Greenfield Advisors and AVM Analytics, about the state of automated valuation models (AVMs), the potential future for AVMs, how they work, and what practicalities are slowing their development down. The two also discuss the wide range of uses AVMs have, how they're going to be changing moving forward, and how short-term rentals are impacting housing markets across the country. Key Takeaways: [1:16] The biggest AVM people know about is Zillow [2:18] The science (and accuracy) behind current AVMs [5:11] 2 things that are stopping a database from happening that would significantly improve appraisals [9:42] How does the AVM come up with a value? [15:17] What the AVMs do outside of simply valuing individual homes [17:38] The future of AVMs [20:57] The effects of the short-term rental market on the overall housing market Website: www.GreenfieldAdvisors.com www.AVMAnalytics.com
Today's episode features Jason Hartman covering a wide range of issues. The topic of conversation ranges from the coming singularity, what it is, when we might see it, etc, then branches into more on the discussion about Automated Valuation Models (AVMs) and whether they're are the precursor to reckless valuations like we saw before the Great Recession. Jason also looks at the unfortunate situation Venezuela finds them in, with both rampant inflation and a natural disaster on top of it creating serious issues for the citizens of the nation. And finally Jason listens to some of his favorite investigative journalists work as he discusses why investigative jouralism is important and how it is connected to his 3 guiding principles. Key Takeaways: [3:07] The approaching singularity [7:47] The database Jason was wondering about in relation to Automated Valuation Models exists with Fannie Mae/Freddie Mac [10:05] Appraisers are a dying industry because the older ones are retiring and the hoops new appraisers have to jump through are hindering new hires [11:45] Will AVMs cause reckless valuations to return? [14:11] The IMF has announced that inflation in Venezuela this year alone has been 1,000,000% [17:07] Asset price inflation is not a part of the inflation index in the USA, which is a big deal [22:17] The 2 major problems of the humble single family home [26:11] Investigative journalisms ties to Jason's principles of how you can't hear the dogs that don't bark, compared to what, and what gets rewarded get repeated Website: Profits in Paradise Jason Hartman's Alexa News Briefing The PropertyCast John Stossel
Jason Hartman starts today's episode with Venture Alliance Member Carmen as the two discuss the possibility of "vacation saturation", what the change in repayment of Jason's loans might mean for the housing industry, as well as labor shortages being experienced in the housing sector. Then we have part 1 of Jason's interview with Dr Andy Krause, Principal Data Scientist at Greenfield Advisors and AVM Analytics, about the state of automated valuation models (AVMs), the potential future for AVMs, how they work, and what practicalities are slowing their development down. Key Takeaways: [4:55] Reaching the point of vacation saturation [10:05] An insiders sign on the direction of the market [14:35] There is a massive labor shortage in construction and wages are going up Dr. Andy Krause Interview: [18:27] The biggest AVM people know about is Zillow [19:28] The science (and accuracy) behind current AVMs [22:22] 2 things that are stopping a database from happening that would significantly improve appraisals [26:52] How does the AVM come up with a value? Website: www.GreenfieldAdvisors.com www.AVMAnalytics.com www.JasonHartman.com/Events Jason Hartman's Alexa News Briefing The PropertyCast
Jason Hartman starts today's show off back in the car with Carmen discussing some news he's seen recently. Inflation continues to creep up, apparently into the range that makes Central Banks happy, but Jason wants to know why we even have to see inflation, and explains what impact that will have. He also discusses the changes in America (and the history of marketing) that turned us into a consumer spending economy and the squeeze on American manufacturers currently happening. Then Jason finishes his interview with Dr. Andy Krause, Principal Data Scientist at Greenfield Advisors and AVM Analytics, as the two wrap up their conversation about Automated Valuation Models (AVM). This time the two discuss the wide range of uses AVMs have, how they're going to be changing moving forward, and how short-term rentals are impacting housing markets across the country. Key Takeaways: [5:07] Inflation is rising into the range the Central Bank deems "healthy" [8:39] America is the land built on consumer spending [12:36] American manufacturers are running low on parts Dr. Andy Krause, Part 2 [15:35] What the AVMs do outside of simply valuing individual homes [17:56] The future of AVMs [21:15] The effects of the short-term rental market on the overall housing market Website: www.GreenfieldAdvisors.com www.AVMAnalytics.com www.JasonHartman.com/Events Jason Hartman's Alexa News Briefing The PropertyCast
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