Podcasts about Grouse

Habitat Podcast #364 - In today's episode of The Habitat Podcast, we are back in the studio with our good friends Erich Long and Cody Altizer! We discuss: Managing for grouse improves deer habitat across the entire property Grouse are specialists; deer benefit from the habitat they require Forest health is the foundation of all successful wildlife management Everything done for grouse benefits whitetails, not the other way around Deer thrive as generalists; grouse expose weak habitat Young forest habitat benefits deer, turkeys, birds, and pollinators Invasive species quietly destroy forest-floor wildlife habitat Responsible logging creates life, not destruction Managing from the forest floor up changes everything Grouse are a gateway species for better land stewardship And So Much More! Shop the new Amendment Collection from Vitalize Seed here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://vitalizeseed.com/collections/new-natural-amendments ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ PATREON - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Patreon - Habitat Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Brand new HP Patreon for those who want to support the Habitat Podcast. Good luck this Fall and if you have a question yourself, just email us @ info@habitatpodcast.com -------------------------------------------------------------------------- ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Patreon - Habitat Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Latitude Outdoors - Saddle Hunting: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bit.ly/hplatitude⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Stealth Strips - Stealth Outdoors: Use code Habitat10 at checkout ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bit.ly/stealthstripsHP⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Midwest Lifestyle Properties - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bit.ly/3OeFhrm⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Vitalize Seed Food Plot Seed - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bit.ly/vitalizeseed⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Down Burst Seeders - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bit.ly/downburstseeders⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 10% code: HP10 Morse Nursery - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://bit.ly/MorseTrees⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 10% off w/code: HABITAT10 Packer Maxx - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://bit.ly/PACKERMAXX⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ $25 off with code: HPC25 First Lite - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bit.ly/3EDbG6P⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ LAND PLAN Property Consultations – HP Land Plans: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LAND PLANS⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Leave us a review for a FREE DECAL - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://apple.co/2uhoqOO⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Morse Nursery Tree Dealer Pricing – info@habitatpodcast.com Habitat Podcast YOUTUBE - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCmAUuvU9t25FOSstoFiaNdg⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email us: info@habitatpodcast.com habitat management / deer habitat / food plots / hinge cut / food plot Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Ben Jones, CEO of RGS & AWS, joins us to explore how active forest stewardship - from prescribed fire to targeted timber harvests and new wood markets - can restore age-class diversity and habitat for ruffed grouse and wild turkey across eastern forests.   Resources: EQUIP Food Plots, Feed or Fire: The Real Costs Per Pound of Deer Forage (NDA article) Ruffed Grouse Society   Dr. Ben Jones benj@ruffedgrousesociety.org   Our lab is primarily funded by donations. If you would like to help support our work, please donate here: http://UFgive.to/UFGameLab   Coming Soon: Wild Turkey Manager: Biology, History, & Heritage! Our newest online wild turkey training is launching soon! Be the first to know when our new course launches by signing up here!   Be sure to check out our comprehensive online wild turkey course featuring experts across multiple institutions that specialize in habitat management and population management for wild turkeys. Earn up to 20.5 CFE hours! Enroll Now!    Dr. Marcus Lashley @DrDisturbance, Publications Dr. Will Gulsby @dr_will_gulsby, Publications Turkeys for Tomorrow @turkeysfortomorrow  UF Game Lab @ufgamelab, YouTube   Donate to our wild turkey research: UF Turkey Donation Fund , Auburn Turkey Donation Fund    Want to help wild turkey conservation? Please take our quick survey to take part in our research!   Do you have a topic you'd like us to cover? Leave us a review or send us an email at wildturkeyscience@gmail.com!   Watch these podcasts on YouTube   Please help us by taking our (quick) listener survey - Thank you!    Check out the DrDisturbance YouTube channel! DrDisturbance YouTube   Want to help support the podcast? Our friends at Grounded Brand have an option to donate directly to Wild Turkey Science at checkout. Thank you in advance for your support!   Leave a podcast rating for a chance to win free gear!   This podcast is made possible by Turkeys for Tomorrow, a grassroots organization dedicated to the wild turkey. To learn more about TFT, go to turkeysfortomorrow.org.    Music by Artlist.io Produced & edited by Charlotte Nowak  

Dr. Ben Jones, CEO of RGS & AWS, joins us to explore how active forest stewardship - from prescribed fire to targeted timber harvests and new wood markets - can restore age-class diversity and habitat for ruffed grouse and wild turkey across eastern forests.   Resources: EQUIP Food Plots, Feed or Fire: The Real Costs Per Pound of Deer Forage (NDA article) Ruffed Grouse Society   Dr. Ben Jones benj@ruffedgrousesociety.org   Our lab is primarily funded by donations. If you would like to help support our work, please donate here: http://UFgive.to/UFGameLab   We've launched our SECOND online training course focused on wild turkey biology, history, and heritage! Be the first to know when our new course launches by signing up here!   Be sure to check out our comprehensive online wild turkey course featuring experts across multiple institutions that specialize in habitat management and population management for wild turkeys. Earn up to 20.5 CFE hours! Enroll Now!    Dr. Marcus Lashley @DrDisturbance, Publications Dr. Will Gulsby @dr_will_gulsby, Publications Turkeys for Tomorrow @turkeysfortomorrow  UF Game Lab @ufgamelab, YouTube   Donate to our wild turkey research: UF Turkey Donation Fund , Auburn Turkey Donation Fund    Want to help wild turkey conservation? Please take our quick survey to take part in our research!   Do you have a topic you'd like us to cover? Leave us a review or send us an email at wildturkeyscience@gmail.com!   Watch these podcasts on YouTube   Please help us by taking our (quick) listener survey - Thank you!    Check out the DrDisturbance YouTube channel! DrDisturbance YouTube   Want to help support the podcast? Our friends at Grounded Brand have an option to donate directly to Wild Turkey Science at checkout. Thank you in advance for your support!   Leave a podcast rating for a chance to win free gear!   This podcast is made possible by Turkeys for Tomorrow, a grassroots organization dedicated to the wild turkey. To learn more about TFT, go to turkeysfortomorrow.org.    Music by Artlist.io Produced & edited by Charlotte Nowak  

If it were not for these dedicated organizations, we would have fewer birds and fewer places to chase them. From the eastern forests to the western prairies, RGS PF and NAGP work together on our behalf. Listen, learn and join up!!!

Welcome to Standing Stone Kennels! Join Ethan for a full recap of his South Dakota grouse guiding season — 21 days of hunting wild prairie grouse with a truckload of German Shorthaired Pointers. Learn how preseason conditioning, Tough Foot pad spray, and OutFox masks helped the dogs thrive in 90° heat, and hear how unpredictable weather and shifting crops impacted bird patterns. Watch for insights on handling young pointing dogs, preparing for pheasant season, and the wild story of Maddie's first perfect retrieve. Whether you train bird dogs or dream of hunting sharptails on the prairie, this video delivers real-world lessons from the field.Send Us Mail5919 W Pleasant Valley RdPretty Prairie, KS 67570LinksStep-By-Step Dog Training Course: https://www.standingstonesupply.com/coursesJoin our Patreon Community - https://bit.ly/SSK-PatreonOur Store - https://bit.ly/SSK-StoreSocial MediaFacebook: www.facebook.com/StandingStoneKennelsInstagram: www.instagram.com/standingstonekennels/Website: www.standingstonekennels.comEthan and Kat Pippitt are the proud owners of Standing Stone Kennels. They breed German Shorthaired pointers and train all types of dogs for the hunt and the home. Their training strategies are easy to follow and are flexible to meet the needs of individual dogs. They are avid outdoorsmen and when they aren't training dogs they spend their free time hunting all kinds of game across the United States.We use affiliate links to help support the channel. If you would like to support Standing Stone content we appreciate you using the links in the description of this video.Subscribe to our channel here: http://bit.ly/2Dyy9DW

If you're looking to learn more about grouse and woodcock hunting from a bunch of seasoned vets who also relish giving each other a hard time, this episode is for you. Mike sat down with he crew of friends and fellow die-hard ruffed grouse and woodcock hunters to take on listener questions. Questions range from cover type, how they structure feeding schedule, how to be a better shot, and tips for taking your first trips to the northwoods. There is a ton to be learned from this episode. Enjoy!This episode is brought to you by Ugly Dog Hunting Co. Shop now at UglyDogHunting.comMusic used under Creative Commons -Two Step Daisy Duke by Mr. Smith is licensed under an Attribution 4.0 International License.

In this reload episode of The Birdshot Podcast, host Nick Larson delves into a lively Q&A session with a loyal listener, Brady Martin. As Brady embarks on his first season of serious grouse hunting with his new bird dog, he shares the challenges, questions, and experiences he's encountered. Together, they explore everything from scouting, bird cover, and hunting techniques to managing expectations for new hunters and bird dogs. Brady Martin is a first-time grouse hunter getting serious about the sport with his young bird dog. From his background in law enforcement and K-9 handling to his transition into upland bird hunting, Brady brings a unique perspective on both the joy and the challenges of pursuing ruffed grouse and woodcock. With a strong curiosity and desire to learn, he's asking all the right questions as he embarks on this new adventure. Expect to Learn How to effectively scout and assess grouse hunting spots using e-scouting tools Why early-season grouse hunting can be particularly challenging How Brady is training his young bird dog and what he's learning in the process Tips for understanding the nuances of grouse and woodcock cover The importance of adjusting your approach based on bird behavior and cover changes  Episode Breakdown with Timestamps: [00:00:00] - Introduction and Thank You to Patreons [00:08:57] - Poodle Pointer [00:16:39] - Nick's Journey [00:18:14] - First Question: Scouted Spots You Drive Past [00:28:52] - Is It Just Grouse or Woodcock Too? [00:32:35] - Early Season Challenges: Leaves, Food, or Scattered Birds? [00:52:25] - Hazel Brush [00:57:14] - Good Grouse Cover: White Pine, Hazel, and Swamps [01:17:29] -  Personality and Patience in Hunting and Fishing [01:28:05] - Handling a Dog on Point: Whoa or Let Them Learn? [01:32:57] - Last Question: Dog Training Helping a Dog Hunt Out of Sight Follow the Host Nick: Instagram: @birdshot.podcast Website: www.birdshotpodcast.com Listening Links: Spotify: https://open.spotify.com/show/17EVUDJPwR2iJggzhLYil7 Apple Podcasts: https://podcasts.apple.com/us/podcast/birdshot-podcast/id1288308609 YouTube: http://www.youtube.com/@birdshot.podcast SUPPORT | http://www.patreon.com/birdshotUse Promo Code | BSP20 to save 20% on https://www.onxmaps.com/hunt/app Use Promo Code | BS10 to save 10% on https://trulockchokes.com/ The Birdshot Podcast is Presented By: https://www.onxmaps.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

At Superior Upland's rustic ruffed grouse camp in the UP of Michigan, Travis Frank and a crew of passionate bird hunters share stories from the Northwoods.  We discuss current ruffed grouse hunting conditions and what to look for to find birds now through the end of season, the woodcock migration, breaking down habitat, creating grouse hunting habitat, the beauty of grouse camp, life of a grouse guide, from the White House to the Northwoods, Women in the Woods, smells from the forest, and so much more… @superior_upland.   Presented by: Walton's (waltons.com/) OnX Maps (onxmaps.com/) Aluma Trailers (alumaklm.com) GAIM Hunting & Shooting Simulator (https://alnk.to/74wKReb) Hunt Huron (HuntHuronsd.com), Federal Premium Ammunition (federalpremium.com/) Hunt North Dakota (helloND.com/) Lucky Duck Premium Decoys (luckyduck.com/) & Samaritan Tire (samaritantire.com/)

The crew welcomes back Bob Owens of Lone Duck Outfitters—professional retriever trainer, gundog coach, and passionate grouse hunter. Bob dives deep into training philosophies for retrievers, setters, and pointing dogs, the art of force fetch, and how to transition your hunt test dog into a rock-solid duck dog. He also shares insights from his Wisconsin grouse hunts, discusses steadiness in the blind, and drops wisdom on building confident, resilient gundogs. Whether you're chasing ruffed grouse through the Northwoods or working your Labrador retriever on late-season mallards, this episode is packed with real-world tips for hunters and dog handlers alike. Learn more about your ad choices. Visit megaphone.fm/adchoices

Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common forms of muscular dystrophy, affecting individuals across the lifespan with variable severity. Advances in genetic understanding and therapeutic development have led to an era of promising disease-modifying strategies. In this episode, Katie Grouse, MD FAAN, speaks with Renatta N. Knox, MD, PhD, author of the article “Facioscapulohumeral Muscular Dystrophy” in the Continuum® October 2025 Muscle and Neuromuscular Junction Disorders issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Knox is an assistant professor of neurology in the Division of Pediatric Neurology and Neuromuscular Section at Washington University School of Medicine in St. Louis, Missouri. Additional Resources Read the article: Facioscapulohumeral Muscular Dystrophy Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN  Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Renatta Knox about her article on fascioscapulohumeral muscular dystrophy, which appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders. Welcome to the podcast, and please introduce yourself to our audience. Dr Knox: Hi Katie, thank you so much for the invitation for the audio interview. I'm looking forward to our conversation. As she mentioned, my name is Renata Knox. It's a pleasure to be here today. Dr Grouse: I'd like to start by asking, what is the key message that you hope your readers will take from your article? Dr Knox: I would say two things. The first is an appreciation and understanding of the unique genetic mechanism that leads to FSHD. And the second is the really exciting therapy landscape that we find ourselves in. So, we're hopeful that there will actually be disease-modifying therapies for FSHD soon. Dr Grouse: We're really looking forward to learning more about that. Now, before we get to that piece, could you just remind us of the clinical manifestations and features that are specific to FSHD? Dr Knox: So, one of the most unique things about FSHD that we see clinically is the pattern of weakness. So, one of the first features is that it's asymmetric. And then there are certain muscle groups that typically are affected, and that's partly where the name comes from. So, we see effects in the face, the limbs, the trunk; and so, those are some of the unique features that we see clinically. Dr Grouse: I'd love it if you could walk us through how you approach diagnosing a patient who presents with proximal weakness where FSHD is in your differential. Dr Knox: Yeah, it's a really great question. So, I would say it depends. So, I actually focus on FSHD in my clinical practice. So, many times patients are referred to me because there's a very high suspicion or there's a known family history of FSHD. So, that's one category of cases. I would say the other category of case is where it's, as you said, maybe more proximal weakness more broadly. Someone that's before me who has a known family history, they really have some of the characteristic physical features---which I'm pretty attuned to, as this is, you know, part of my subspecialty---I'll actually go directly to FSHD genetic testing. And that is one of the unique features of this disease, that the next-generation sequencing panels that are typically used for some of our other muscle diseases, FSHD is not captured on those. So, we actually have to send targeted testing for FSHD to diagnose it. So, that is one category where, again, I have a very high suspicion either based on their clinical presentation and/or a known family history, then I will actually go directly to FSHD-targeted genetic testing. In the second case, where it is one of the conditions that I'm considering among others, I will do more broad testing. So, I will get a CK level to see if there's evidence of muscle breakdown. I'll likely also do one of the next-generation sequencing panels that we have access to, which will allow us to identify, potentially, one to two hundred potential muscle diseases. And then again, if FSHD is higher on my differential in that second group of patients, then I will also send targeted FSHD-specific testing. Dr Grouse: That's really helpful. And I'm wondering if you have any thoughts about common pitfalls that you've seen when providers are trying to work this up? Dr Knox: I don't know if I would say pitfalls. I think I would acknowledge that it's challenging. My subspecialty training in neuromuscular medicine and also gene therapy. And so FSHD is pretty high on my radar. But I would say in neurology in general---and then, you know, the general medical population---,it really isn't something that many people are seeing. So, I would say what patients will communicate to us sometimes is some frustration that maybe it took time to make the diagnosis, but I just have a deep understanding that it's not something that is on many people's radars. And I think, again, it's tricky because it's not picked up on these next-generation sequencing panels, which many of us can send pretty easily. It will be missed. And I will say the biggest pitfall is, again, if you're not thinking about it and you don't send that testing, you actually- it's very difficult to diagnose it. Dr Grouse: Thank you so much for highlighting that. I think there are many people who are not aware that those different panels really aren't picking that up and that they have to test specifically. So, I think that's a great thing for all of us to keep in mind. Are there any tips or tricks to the diagnosis, other than the genetic issues that you mentioned, that sometimes can really bring this diagnosis to the forefront? Dr Knox: I think things that really tip me off to having a higher suspicion for FSHD is facial weakness that we can detect on our exam. Scapular winging---again, there's a small subset of disorders which can impact that. Someone who's presenting with foot drop, you know, with facial weakness, I think definitely about FSHD more. Also, clinically, kind of the presentation or things that they're beginning to have difficulty with is a tip-off. So, if someone is an athlete, like, they're a volleyball player or basketball player and they say, oh, I'm having difficulties, you know, with movements that require them to elevate their arm, which can be a sign of the shoulder weakness that we classically see. Or someone who says, oh, I'm having a harder time shampooing my hair or combing my hair. So those can be tip-offs again, which are basically referencing the type of weakness that they have. Another feature of FSHD which isn't necessarily as broadly appreciated is that pain and fatigue are very common. So, if someone is coming in and saying, actually, I also have a significant amount of fatigue as well or a lot of pain, that's something that can tip me off to it. Hearing loss is something that we can also see in up to 20% of patients with FSHD. So, if they are having those symptoms or saying they're ringing in their ears, these are some things that will make me begin to think about it more. Dr Grouse: Oh, really helpful. I also found it really fascinating reading some of the very FSHD-specific clinical signs, some interesting- some diagrams and pictures as well, that are very specific to the pattern of weakness that develops in FSHD. So, I encourage our listeners to check that out. But are there any highlights from those little clinical pearls that you'd like to point out? Dr Knox: I think the poly-hill sign---so, these are these literal hills that we can see in the shoulders of patients with FSHD---is pretty classic. Popeye arms, which is this older term that we still use that has to do with which muscle groups are preserved versus those that have atrophy. So that's a common feature. And then I would say, really, the asymmetry is something that is a unique feature in FSHD. And again, we did our best to provide good representative images. So again, as you mentioned, Katie, I would really encourage people to look at those images and then think about cases that they may have seen and how similar they are so they can begin to recognize those signs as well. Dr Grouse: Now going back to the genetic topic, the complex genetic underpinnings of FSHD are really well-explained in your article; and again, worth taking a look at to remind ourselves of everything that's of that pathology. Now, I was wondering though, if you could give us a brief overview of how we should approach genetic testing in a suspected case of FSHD? You mentioned some specific panels, but it does sound like there's some more complexity to it as well. Dr Knox: Yes, and I'll just kind of briefly explain that complexity. Part of the thing that we're detecting in the genetic testing is the repeat number. And so, we're actually looking for a contraction in a repeat number. So, not an expansion, which were typical for some of the diseases that we think about, the trinucleotide repeat disorders. And this is why it's not captured in the next-generation sequencing panels, because they do not currently have the ability to do that. And so, again, what the type of testing that I do really depends on my suspicion. So again, if my suspicion is very high for FSHD---they have a family history, they have the classic features---then I will actually go directly to an FSHD-specific testing, which is available from various sources. If, again, it's among different things that I'm thinking about, I will get a CK lab. I typically will also send a next-generation sequencing panel specific for muscle diseases, perhaps muscular dystrophy; again, depending on what I'm thinking about. And then I will also send in a specific FSHD genetic test as well. People are beginning to use whole-genome sequencing, which is capturing some of our true nucleotide repeat disorders and becoming more comprehensive. So, my hope is that as that becomes more standard of care---like, whole-exome sequencing can be gotten pretty routinely now---that it may be easier for us to make some of these diagnoses. Dr Grouse: Well, that's really helpful, and thanks for that overview. Now another thing that you mentioned that I thought was really interesting in your article was that patients with, you know, history of FSHD, perhaps in the family, who are pregnant and want to screen for this disease would not be able to use sort of the more common screening tests like cell-free DNA testing and may have to go to other means to do that. What is generally their route to this type of testing? Dr Knox: Yeah, great question, and really important question for family planning purposes, and it definitely comes up in clinical practice. And so again, because of the unique genetics of FSHD, you actually have to do invasive genetic testing currently to be able to test it. And so that's, you know, amnio or chorio, and then send it to a lab that can perform, again, FSHD-specific testing on the samples that are presented. And there are obviously labs that are capable of doing that and centers that are capable of doing that, but it is not picked up on the cell-free DNA panels that are being very routinely used. You or your provider has to be thinking about it to send that specific testing, similar to our patients that come into clinic and have not yet been diagnosed. Dr Grouse: Once you have the diagnosis, what are our options for therapy? I think it sounds like at this current time, it looks to be mostly supportive. What are some of the supportive care options we should keep in mind? Dr Knox: Yes, so that is definitely accurate. Care today is supportive, but again, we're very excited about the clinical trial and therapy landscape for FSHD. So, I work very closely with my physical therapy colleagues that are in clinic with me. So, we work very closely with physical and occupational therapists to help with supportive measures, adaptive measures, doing assessments, helping our patients to be able to move and exercise safely and effectively. As I mentioned, pain is very common in FSHD and so we can treat that with medications. The most common medication that we use to treat for pain in FSHD are NSAIDs. And then other than that it's really, you know, supportive measures. Do they need to see other subspecialists? There are some surgical options. Those are used very rarely to help with some of the scapular weakness, but typically it's physical therapy, occupational therapy, supportive devices. We treat the pain as we're able to, and then we work with other subspecialists to screen, monitor and support our patients to the best of our ability. Dr Grouse: Well, without further ado, I'd love to hear more about what's coming down the pipeline in clinical trials. What can we look forward to seeing, hopefully, in future years to treat these patients? Dr Knox: Yes. And so, this is actually what got me interested in the neuromuscle space in general is that, because we now for many years have known the genetic cause of many of these disorders as well as some of the underlying mechanisms, we can actually use advances in therapeutics to do what we call targeted therapies. So, rather than treating symptoms or indirect methods or doing kind of broad drug screens---which, again, still do take place and still do have their place---we actually can target mechanisms directly. And so, we know that the underlying biology of FSHD is due to this protein called DUX4 being expressed when it should not be. So, it's what we call a toxic gain of function. And so, the targeted way to address this is to suppress DUX4 expression. And so, kind of broadly speaking, what we're really excited about are a couple of products that are currently in clinical trials right now that actually caused DUX4 suppression to be suppressed. And again, these are targeted pathways. And so, again, the hope is that by doing that, we can hopefully slow the progression of the disease, potentially stop progression of the disease, and potentially reverse. Again, we don't know if that might be possible, but that is one of the hopes. Dr Grouse: Well, that's really exciting, and I know we're all looking forward to more coming down the pipeline soon, and hopefully more things that can really offer some exciting treatments for our patients with this condition. Now, a little more deep-dive into our patients who are diagnosed. You've reviewed some of the treatments currently available and hopefully may someday soon be available. Are there other things that we should be keeping in mind in this population? For instance, screenings that we should be doing for other extramuscular manifestations that we need to be thinking about? Dr Knox: I will answer that question two ways. I think something that's very important to acknowledge is the impact that these diagnoses and these conditions have on our patient practically, psychologically. One of the other unique features of FSHD is, it's autosomal-dominant. So, if it is in a family, you can have many family members who are affected, but the variability is very high. And so, you can have in the same family someone who is wheelchair-dependent, and someone else in the family with the same underlying genetics who has no signs or symptoms or is very mildly affected. And that is something that is definitely challenging for our families and patients to navigate if they're very different than their family members with the same condition. And just navigating the world with a condition that, you know, can be physically debilitating and cause changes to what they're able to do or not able to do, progression is something that's very difficult to handle. So, I think that's one set of things. And we try our best, you know, with my team and my other colleagues in the space, to support our families and patients in the best way that we can. Secondly, there is very important screening that needs to be done for this condition. So, one of the things- and the current guidelines which are actually being updated, the last update was in 2015 is all patients that undergo pulmonary function testing or PFTs. And so that's something we do at baseline and we do at least annually in my practice. Young kids who are presenting very early or patients with certain genetics that we know are more predisposed to extra muscular manifestations, we recommend screening for hearing, which is one of the manifestations, and ophthalmologic exam to look for retinovascular changes, which is one of the manifestations as well. Those are the more common ones that are typically done. There's also some evidence in pediatric patients with very severe manifestations that there may be some cognitive impacts, learning impacts. And so, that is something we're also thinking about screening and supporting our patients in that way. And again, we typically work with these patients in a multidisciplinary team depending on what manifestations and the degrees to which they're impacted by the disorder. Dr Grouse: Thank you so much for that answer. I think a lot of us forget sometimes when we get really focused on what can we do now, that we forget to kind of stop and reflect on sort of the more holistic approach. How is this affecting the patient? How is this affecting the patient's family dynamic, and what other ways are they going through life with this condition that we need to be thinking about? So, I appreciate you bringing that up. I wanted to ask, sort of based on what you're talking about and what you mentioned already, you happened to mention that what initially drew you that to this work was your interest in some of the really exciting breakthroughs in the field. Well, was there anything else that drew you to, specifically, congenital neuromuscular diseases, and FSHD in particular? Dr Knox: I'm a physician scientist by training, and so I would describe myself also as a molecular biologist. So, I love getting into the nitty gritties of disease mechanisms, what genes are doing in bodies, how they function. And so, as I mentioned earlier, in the neuromuscle space, we've known for many years the genetic cause of many of these disorders and have done great, you know, mechanistic work to kind of define why we see the disease. And then now we're at this intersection of that knowledge marrying with these really novel therapeutic approaches, gene therapy approaches, being able to intersect and then in very creative ways actually target diseases very directly. And so, I would say it really is the combination of those two things. FSHD has a really fascinating unique biology, which again, we encourage everyone to read about more in the article. That really drew me to it. I'm very interested in gene regulation, transcription. This is one of the underlying mechanisms that is gone awry in the disorder, and then that being married to advances in therapeutics. So, you could wed those two pieces of information and actually meaningfully impact patient 's lives. And again, that's the real privilege and honor to witness is how these therapies can transform lives. And I saw it happened with this one case for this one disorder when I was a resident where there was no treatment. Young children, unfortunately, would not survive the disease. And then I saw the therapy come be in development and literally change the trajectory. And this is what we're very hopeful for in the FSHD space, that wedding, this wonderful basic science research, translational research, companies working together to develop these therapies that can transform lives. It is just so beautiful to witness and see, and it's something that I get to do. You know, it's a part of my job, so it's a real privilege. Dr Grouse: Well, I have to say, it's really inspiring hearing you talk about it. And I imagine that many neurologists-in-training who are listening to this may be inspired as well and may be convinced to go into this field for that very reason. So, thank you so much for sharing all of this information with us today. I learned a lot, and I think all of our listeners have too. Dr Knox: Thank you. It's really been a pleasure. Dr Grouse: Again, today I've been interviewing Dr Renatta Knox about her article on fascioscapulohumeral muscular dystrophy, which appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Author (Building a Grouse Dog), trainer, breeder, grouse guide and avid hunter, Craig Doherty is uniquely qualified to help us navigate the woods. We'll cover what we can do to help young dogs on early hunts, the right mental approach to dog behaviors, and where grouse and woodcock live during hunting season in the northeast. We'll cover food sources, cover types and what makes up a good covert. Craig will share training and shooting advice, dog handling tips and how to introduce young dogs to the woods. "Fix It" has another item for your hunting season to-do list; listeners sound off on management of their states' walk-in programs - you might find a new destination for later this season! And it's all brought to you by: HiVizSights.com, RuffLand Kennels, Mid Valley Clays and Shooting School, TrulockChokes, HiViz shooting systems, Pointer shotguns, Purina Pro Plan Sport and FindBirdHuntingSpots.com.

In this article, Zach Cason writes about dusky grouse behavior, habitat, and hunting strategies to optimize your chances for a successful dusky hunt.Use code PU20 and get 20% off onxhunt.com.Read more at projectupland.com.

Bob is a long time grouse hunter, dog trainer, and mentor. We put together a good set of questions and I really like these kinds of podcasts. Thank you to our sponsorsAspen Thicket Grouse Dogs aspenthicketgrousedogs.comPine Hill Gun Dogs phkscllc@gmail.comSecond Chance Bird dogs Wild Card Outfitters and Guide Service wildcardoutdoors.comPrairie ridge Farms prairieridgefarms.com

In this episode of The Birdshot Podcast, host Nick Larson is joined by Jon Steigerwaldt, a Forest Conservation Director for the Ruffed Grouse Society and American Woodcock Society. Jon talks about the critical habitat work happening in the Driftless Region and northeast Iowa, highlighting the challenges facing ruffed grouse populations, the impact of forest management, and ongoing conservation efforts. From habitat restoration to dealing with invasive species, this conversation covers key conservation strategies while also touching on Jon's experiences hunting and training his bird dog, Hazel. Jon Steigerwaldt is a dedicated conservationist and upland bird hunter with a deep background in forestry and forest ecology. With a focus on sustainable forest management, Jon works with multiple states across the Upper Midwest to improve habitats for ruffed grouse, woodcock, and other species. In his role with the Ruffed Grouse Society and American Woodcock Society, Jon is directly involved in large-scale projects to restore forest ecosystems and support wildlife populations in the Driftless Region and beyond. Expect to Learn The importance of forest management for ruffed grouse and other upland species How dynamic forest restoration blocks help improve habitat for grouse populations Challenges faced by forest management in the Driftless Region, including parcelization and topography The role of invasive species like multiflora rose and honeysuckle in disrupting habitat Jon's insights into training bird dogs like his setter, Hazel, and the role of dogs in upland hunting Current efforts to revitalize grouse populations in northeast Iowa and other parts of the Midwest Episode Breakdown with Timestamps: [00:00] - Introduction [04:00] - Nick's First Ruffed Grouse Hunt of the Year [10:22] - Jon's Bird Dog, Hazel, and How She's Developed Over the Years [11:32] - Jon's First Big Dog [13:33] - Jon's Career and Education [23:01] - Parcelization and Landowner Challenges in Logging [35:51] - Invasive Species and Their Impact on Forest Ecosystems [44:50] - Forest Management After Natural Disasters [50:13] - Stewardship Agreements and Reinvestment Into Forests [57:28] - Upcoming Events and Community Management Follow the Guest Jon: Ruffed Grouse Society: https://ruffedgrousesociety.org/  Instagram: https://www.instagram.com/ruffedgrousesociety/?hl=en  Fall Membership 2025: https://ruffedgrousesociety.org/  Follow the Host Nick: Instagram: @birdshot.podcast Website: www.birdshotpodcast.com Listening Links: Spotify: https://open.spotify.com/show/17EVUDJPwR2iJggzhLYil7 Apple Podcasts: https://podcasts.apple.com/us/podcast/birdshot-podcast/id1288308609 YouTube: http://www.youtube.com/@birdshot.podcast SUPPORT | http://www.patreon.com/birdshot Use Promo Code | BSP20 to save 20% on https://www.onxmaps.com/hunt/app Use Promo Code | BS10 to save 10% on https://trulockchokes.com/ The Birdshot Podcast is Presented By: https://www.onxmaps.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textThis week on the Montana Outdoor Podcast we are doing something for the first time ever! We are doing a Montana Outdoor Podcast Double Feature! That's right, you will be able to watch and or listen to two different podcasts this week. This half of of our Double Feature is all about Region 2, located in the central part of Western Montana. Rigger heads to Missoula to talk to MT FWP Regional Access Manager, Trenton Heisel. Trenton gives some awesome advice about gaining hunting access in the region and outlined all the different hunting access programs there. On top of all that Trenton gave all kinds of inside info about where you can find Elk, including where you might find some nice bulls, Muleys, Whitetail, Black Bear, and the list goes on and on. All and all Trenton will get you dialed in for hunting success in FWP Region 2. The other half of our double feature has your host Downrigger Dale talking to FWP Wildlife Manager for Region 1, Neil Anderson in Kalispell. He will tell you what the hunting will be like in Montana FWP Region 1 located in Northwest Montana.  Be sure and listen to both of these podcasts and become a Region 1 and 2 hunting genius!Links:Click here for more about Region two.Click here to access the FWP Hunt Planner to plan you hunts in any region.Click here to get all the block management info and BMA maps for both Region 1 & 2!Click here to learn about winning those Griz Football tickets that Trenton talked about. Plus, other prizes in the "Its Up to Us" promo.Click here for Deer, Elk and Antelope regulations. Click here for Upland Game Bird regs and here for Waterfowl regs.Click here to get the Wolf Hunting regulations for Montana.You can click here to get the Region 2 Hunting Forecast.Click here for the Upland Game Bird Season Outlook for Montana.Questions, click here to email Trenton Heisel in Region 2.You can email Downrigger Dale when you click here.Remember to tune in to The Montana Outdoor Radio Show, live every Saturday from 6:00AM to 8:00AM MT. The show airs on 30 radio stations across the State of Montana. You can get a list of our affiliated radio stations on our website. You can also listen to recordings of past shows, get fishing and and hunting information and much more at that website or on our Facebook page. You can also watch our radio show there as well.

In this episode of The Birdshot Podcast, Nick Larson welcomes Tom Carpenter, aka Carp, back to the show for a discussion on prairie grouse hunting and sharp-tail grouse hunting. Fresh off a couple of hunting trips, Tom shares his expertise and experiences in the Great Plains, hunting sharp-tails, prairie chickens, as well as the unique challenges of these beautiful birds. Carp also reflects on the joy of hunting with dogs and the importance of understanding grassland habitat for both the hunter and the bird. Tom Carpenter, affectionately known as Carp, is a seasoned bird hunter, author, and long-time advocate for prairie grouse. With decades of experience, Tom is passionate about hunting sharp-tails, prairie chickens, and other upland game birds across the Great Plains. He's spent countless days hunting with his bird dogs and has become a prominent voice in the upland hunting community, especially when it comes to prairie grouse. Expect to Learn Tom's experiences hunting prairie chickens in Minnesota and sharp-tails across the Midwest The best hunting strategies and terrain for finding prairie grouse Insights into managing a bird dog for prairie grouse hunting Tips on dog training during sharptail hunts and what makes prairie grouse hunting unique The importance of native grasses and proper grazing for the sharp-tailed habitatEpisode Breakdown with Timestamps: [00:00:00] - Introduction [00:06:18] - Success of hunting prairie chickens [00:10:01] - How prairie chickens differ from other upland birds  [00:14:09] - Difference between ankle-high grass, calf-high grass, and knee-high grass [00:22:15] - Have you ever put a snowberry in your mouth? [00:30:56] - How to train a bird dog [00:39:51] - Popcorn flushing  [00:42:49] - Breakdown of hills and wind direction [00:53:09] - Hunting in thick cover vs thinner hills [01:05:49] - Favorite sharp-tail recipe [01:16:42] -The pheasants forever journal [01:17:40] - Wrapping up the episode Follow the Guest Tom:  Tom as an Editor of Pheasants Forever: https://pheasantsforever.org/Newsroom/2018-April/Changing-of-the-Guard-Pheasants-Forever-Promotes-T.aspx  Company's Website: https://www.pheasantsforever.org  Company's Facebook: https://www.facebook.com/pheasantsforever  Company's Email: contact@pheasantsforever.org  Pheasant Hunting (book): https://amzn.to/46JZptD  Follow Host Nick: Instagram: @birdshot.podcast Website: www.birdshotpodcast.com Listening Links: Spotify: https://open.spotify.com/show/17EVUDJPwR2iJggzhLYil7 Apple Podcasts: https://podcasts.apple.com/us/podcast/birdshot-podcast/id1288308609 YouTube: http://www.youtube.com/@birdshot.podcast SUPPORT | http://www.patreon.com/birdshotUse Promo Code | BSP20 to save 20% on https://www.onxmaps.com/hunt/app Use Promo Code | BS10 to save 10% on https://trulockchokes.com/ The Birdshot Podcast is Presented By: https://www.onxmaps.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to Standing Stone Kennels! Join us on the South Dakota prairie for opening day of grouse season as we hunt sharp-tailed grouse and prairie chickens with a crew of young and veteran dogs. Ethan and Adam share hunting stories, tips on handling dogs through fences, how to prepare for long walks in tough terrain, and what gear and shotguns work best. From scouting food sources to managing early-season heat, this conversation dives deep into the realities of upland bird hunting.Send Us Mail5919 W Pleasant Valley RdPretty Prairie, KS 67570LinksStep-By-Step Dog Training Course: https://www.standingstonesupply.com/coursesJoin our Patreon Community - https://bit.ly/SSK-PatreonOur Store - https://bit.ly/SSK-StoreSocial MediaFacebook: www.facebook.com/StandingStoneKennelsInstagram: www.instagram.com/standingstonekennels/Website: www.standingstonekennels.comEthan and Kat Pippitt are the proud owners of Standing Stone Kennels. They breed German Shorthaired pointers and train all types of dogs for the hunt and the home. Their training strategies are easy to follow and are flexible to meet the needs of individual dogs. They are avid outdoorsmen and when they aren't training dogs they spend their free time hunting all kinds of game across the United States.We use affiliate links to help support the channel. If you would like to support Standing Stone content we appreciate you using the links in the description of this video.Subscribe to our channel here: http://bit.ly/2Dyy9DW

Are you ready to try grouse hunting in Nebraska? The Hunt Nebraska Crew (Kyle, Megan, Shelby, and Hershy) visits with Bryan O'Conner, Nebraska's Upland Game Program Manager, about grouse hunting this season.

Send us a textChaos & Mayhem Opening week of South Dakota's pheasant season.  MY DOG HUNTS - Upland BirdsThe personal and online chronicle of your bird dog's hunting career.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

My guest Levi Fitze joins me to discuss wrapping up shooting on his multi-year project about Grouse in the Alps, we talk about where his love of the mountains and harsh weather came from, and his focus on capturing images that move people and tell a story and how to go about doing that. Follow Levi Fitze at: Instagram: @levifitze Show Mentions: Vincent Munier

In tonight's sleep story, I narrated, The Enchanted Grouse by Parker Fillmore. Thank you for being part of the Dozing Off community!If you're interested in supporting the show and getting an additional story each week, check out Dozing Off on Patreon:patreon.com/dozingoffpodcast

Ataxia is a neurologic symptom that refers to incoordination of voluntary movement, typically causing gait dysfunction and imbalance. Genetic testing and counseling can be used to identify the type of ataxia and to assess the risk for unaffected family members. In this episode, Katie Grouse, MD, FAAN, speaks with Theresa A. Zesiewicz, MD, FAAN, author of the article “Ataxia” in the Continuum® August 2025 Movement Disorders issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Zesiewicz is a professor of neurology and director at the University of South Florida Ataxia Research Center, and the medical director at the University of South Florida Movement Disorders Neuromodulation Center at the University of South Florida and at the James A. Haley Veteran's Hospital in Tampa, Florida. Additional Resources Read the article: Ataxia Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, and please introduce yourself to our audience.  Dr Zesiewicz: Well, thank you, Dr Grouse. I'm Dr Theresa Zesiewicz, otherwise known as Dr Z, and I'm happy to be here. Dr Grouse: I have to say, I really enjoyed reading your article. It was a really great refresher for myself as a general neurologist on the topic of ataxia and a really great reminder on a great framework to approach diagnosis and management. But I wanted to start off by asking what you feel is the key message that you hope our listeners will take away from reading your article. Dr Zesiewicz: Yes, so, thanks. I think one of the key messages is that there has been an explosion and renaissance of genetic testing in the past 10 years that has really revolutionized the field of ataxia and has made diagnosis easier for us, more manageable, and hopefully will lead to treatments in the future. So, I think that's a major step forward for our field in terms of genetic techniques over the last 10 years, and even over the last 30 years. There's just been so many diseases that have been identified genetically. So, I think that's a really important take-home message. The other take-home message is that the first drug to treat Friedreich's ataxia, called omaveloxolone, came about about two years ago. This was also a really landmark discovery. As you know, a lot of these ataxias are very difficult to treat. Dr Grouse: Now pivoting back to thinking about the approach to diagnosis of ataxia, how does the timeline of the onset of ataxia symptoms inform your approach? Dr Zesiewicz: The timeline is important because ataxia can be acute, subacute or chronic in nature. And the timeline is important because, if it's acute, it may mean that the ataxia took place over seconds to hours. This may mean a toxic problem or a hypoxic problem. Whereas a chronic ataxia can occur over many years, and that can inform more of a neurodegenerative or more of a genetic etiology. So, taking a very detailed history on the patient is very important. Sometimes I ask them, what is the last time you remember that you walked normal? And that can be a wedding, that can be a graduation. Just some timeline, some point, that the patient actually walked correctly before they remember having to hold onto a railing or taking extra steps to make sure that they didn't fall down, that they didn't have imbalance. That sometimes that's a good way to ask the patient when is the last time they had a problem. And they can help you to try to figure out how long these symptoms have been going on. Dr Grouse: I really appreciate that advice. I will say that I agree, it can sometimes be really hard to get patients to really think back to when they really started to notice something was different. So, I like the idea of referencing back to a big event that may be more memorable to them. Now, given that framework of, you know, thinking through the timeline, could you walk us through your approach to the evaluation of a patient who presents to your clinic with that balance difficulties once you've established that? Dr Zesiewicz: Sure. So, the first thing is to determine whether the patient truly has ataxia. So, do they have imbalance? Do they have a wide base gait? That's very important because patients come in frequently to your clinic and they'll have balance problems, but they can have knee issues or hip issues, neuropathy, something like that. And sometimes what we say to the residents and the students is, usually ataxia or cerebellar symptoms go together with other problems, like ocular problems are really common in cerebellar syndromes. Or dysmetria, pass pointing, speech disorder like dysarthria. So, not only do you need to look at the gait, but you should look at the other symptoms surrounding the gait to see if you think that the patient actually has a cerebellar syndrome. Or do they have something like a vestibular ataxia which would have more vertigo? Or do they have a sensory ataxia, which would occur if a person closes his eyes or has more ataxia when he or she is in the dark? So, you have to think about what you're looking at is the cerebellar syndrome. And then once we look to see if the patient truly has a cerebellar syndrome, then we look at the age, we look at---as you said before, the timeline. Is this acute, subacute, or chronic? And usually I think of ataxia as falling into three categories. It's either acquired, it's either hereditary, or it's neurodegenerative. It can be hereditary. And if it's not hereditary, is it acquired, or is it something like a multiple system atrophy or a parkinsonism or something like that? So, we try to put that together and start to narrow down on the diagnosis, thinking about those parameters. Dr Grouse: That's really a helpful way to think through it. And it is true, it can get very complex when patients come in with balance difficulties. There's so many things you need to think about, but that is a great way to think about it. Of course, we know that most people who come in to the Movements Disorders clinic are getting MRI scans of their brains. But I'm curious, in which cases of patients with cerebellar ataxia do you find the MRI to be particularly helpful in the diagnosis? Dr Zesiewicz: So, an MRI can be very important. Not always, but- so, something like multiple system atrophy type C where you may see a hot cross bun sign or a pontine hyperintensity on the T2-weighted image, that would be helpful. But of course, that doesn't make the diagnosis. It's something that may help you with the diagnosis. In FXTAS, which is fragile X tremor/ataxia syndrome, the patient may have the middle cerebellar peduncle sign or the symmetric hyperintensity in the middle cerebellar peduncles, which is often visible but not always. Something like Wernicke's, where you see an abnormality of the mammillary bodies. Wilson's disease, which is quite rare, T2-weighted image may show hyperintensities in the putamen in something like Wilson's disease. Those are the main MRI abnormalities, I think, with ataxia. And then we look at the cerebellum itself. I mean, that seems self-evident, but if you look at a sagittal section of the MRI and you see just a really significant atrophy of the cerebellum, that's going to help you determine whether you really have a cerebellar syndrome. Dr Grouse: That's really encouraging to hear a good message for all of us who sometimes feel like maybe we're missing something. It's good to know that information can always come up down the line to make things more clear. Your article does a great review of spinal cerebellar ataxia, but I found it interesting learning about the more recently described syndrome of SCA 27B. Would you mind telling us more about that and other really common forms of SCA that's good to keep in mind? Dr Zesiewicz: Sure. So, there are now 49 types of spinal cerebellar ataxia that have been identified. The most common are the polyglutamine repeat diseases: so, spinocerebellar ataxia type 3 or type 2, type 6, are probably the most common. One of the most recent spinocerebellar ataxias to be genetically identified and clinically identified is spinocerebellar ataxia 27B. This is caused by a GAA expansion repeat in the first intron of the fibroblast growth factor on chromosome 13. And the symptoms do include ataxia, eye problems, downbeat nystagmus, other nystagmus, vertical, and diplopia. It appears to be a more common form of adult-onset ataxia, and probably more common than was originally thought. It may account for a substantial number of ataxias, like, a substantial percentage of ataxias that we didn't know about. So, this was really a amazing discovery on SCA 27B. Dr Grouse: Now a lot of us I think feel a little anxious when we think about genetic testing for ataxia simply because there's so many forms, things are changing quickly. Do you have a rule of thumb or a kind of a framework that we can think of as we approach how we should be thinking about getting genetic testing for the subset of patients? Dr Zesiewicz: Sure. And I think that this is where age comes into play a lot. So, if you have a child who's 10, 11, or 12 who's having balance problems in the schoolyard, does not have a history of ataxia in the family, the teachers are telling you that the child is not running correctly, they're having problems with physical education, that is someone who you would think about testing for Friedreich's ataxia. A preteen or a child, that would be one thing that would be important to test. When you talk to your patient, it's important to really take a detailed family history. Not just mom or dad, but ethnicity, grandparents, etc. And sometimes, once in a while, you come up with a known spinal cerebellar ataxia. Then you can just test for that. So, if a person is from Portugal or has Portugal background and they have ataxia and the parents had ataxia, you would think of spinal cerebellar ataxia type 3. Or if they're Brazilian, or if the person is from a certain area of Cuba and mom and dad had ataxia and that person has ataxia, you would think of spinal cerebellar ataxia type 2. Or if a person has ataxia and their parent had blindness or visual problems, you may be more likely to think of spinal cerebellar ataxia type 7, for example. If they have that---either they have a known genetic cause in in the family, first degree family, or they come from an area of the world in which we can pinpoint what type we think it is---you can go ahead and get those tests. If not, you can take an ataxia comprehensive panel. Many times now, if you take the panel and the panel is negative, it will reflex to the whole exome gene sequencing, where we're finding really unusual and more rare types of ataxia, which are very interesting. Spinal cerebellar ataxia type 32, spinal cerebellar ataxia type 36, I had a spinal cerebellar ataxia type 15. So, I think you should start with the age, then the family history, then where the person is from. And then, if none of those work out, you can get a comprehensive panel, and then go on to whole exome gene sequencing. Dr Grouse: That's really, really useful. Thank you so much for breaking that down in a really simple way that a lot of us can take with us. Pivoting a little bit now back towards different types of acquired ataxias, what are some typical lab tests that you recommend for that type of workup? Dr Zesiewicz: Again, if there's no genetic history and the person does not appear to have a neurodegenerative disease, we do test for acquired ataxias. Acquired ataxias can be complex. Many times, they are in the autoimmune family. So, what we start with are just basic labs like a CBC or a CMP, but then we tried to look at some of the other abnormalities that could cause ataxia. So, celiac disease, stiff person syndrome. So, you would look at anti-glutamic acid decarboxylase antibodies, Hashimoto's---so, antithyroglobulin antibodies or antithyroperoxidase antibodies would be helpful. You know, in a case of where the patients may have an underlying neoplasm, maybe even a paraneoplastic workup, such as an anti-Hu, anti-Yo, anti-Ri. A person has breast cancer, for example, you may want to take a paraneoplastic panel. I've been getting more of the anti-autoimmune encephalitis panels in some cases, that were- that are very interesting. And then, you know, things that sometimes we forget now like the syphilis test, thyroid-stimulating test, take a B12 and folate, for example. That would be important. Those are some of the labs. We just have on our electronic chart a group of acquired labs for ataxia. If we can't find any other reason, we just go ahead and try to get those. Dr Grouse: Now, I'm curious what you think is the most challenging aspect of diagnosing a patient with cerebellar ataxia? Dr Zesiewicz: So, for those of us who see many of these patients a day, some of the hardest patients are the ones that---regardless of the workup that we do, we've narrowed it down, it's not hereditary. You know, they've been through the whole exome gene sequencing and we've done the acquired ataxia workup. It doesn't appear to be that. And then we've looked for parkinsonism and neurodegenerative diseases, and it doesn't appear to be that either; like, the alpha-synuclein will be negative. Those are the toughest patients, where we think we've done everything and we still don't have the answer. So, I've had patients in whom I've taken care of family members years and years ago, they had a presumed diagnosis, and later on I've seen their children or other family members. And with the advent of the genetic tests that we have, like whole exome gene sequencing, we have now been able to give the patient and the family a definitive diagnosis that they didn't have 25 years ago. So, I would say don't give up hope. Retesting is important, and as science continues and we get more information and we make more landmark discoveries in genetics, you may be better able to diagnose the patient. Dr Grouse: I was wondering if you had any recommendations regarding either some tips and tricks, some pearls of wisdom you can impart to us regarding the work of ataxia, or conversely, any big pitfalls that you can help us avoid? I would love to hear about it. Dr Zesiewicz: Yeah, there's no easy way to treat or diagnose ataxia patients. I've always felt that the more patients you see- and sounds easy, but the more patients you see, the better you're going to become at it, and eventually things are going to fall into place. You'll begin to see similarities in patients, etc. I think it's important not only to make sure that a person has ataxia, but again, look at the other signs and symptoms that may point to ataxia that you'll see in a cerebellar syndrome. I think it's important to do a full neuroexam. If a person has spasticity, that may point you more towards a certain type of ataxia than if a person has no reflexes, for example, that we see in Friedreich's ataxia. Some of the ocular findings are very interesting as well. It's important to know if a person has a tremor. I've seen several Wilson's disease cases in my life with ataxia. They're very important. I think a full neuroexam and also a very detailed history would be very helpful. Dr Grouse: Tell us about some promising developments in the diagnosis and management of ataxia that we should be on the lookout for. Dr Zesiewicz: The first drug for Friedreich's ataxia was FDA-approved two years ago, which was an NRF2 activator, which was extremely exciting and promising. There are also several medications that are now in front of the FDA that may also be very promising and have gone through long clinical trials. There's a medication that's related to riluzole, which is a medication used for amyotrophic lateral sclerosis, that has been through about seven years of testing. That is before the FDA as well for spinal cerebellar ataxia. Friedreich's ataxia has now completed the first cardiac gene therapy program with AAV vectors, which- we're waiting for full results, but that's a cardiac test. But I would assume that in the future, neurological gene therapy is not far behind if we've already done cardiac gene therapy and Friedreich's ataxia. So, you know, some of these AAV vector-based genetic therapies may be very helpful, as well as ASO, antisense oligonucleotides, for example. And I think in the future, other things to think about are the CRISPR/Cas9 technology for potential treatment of ataxia. It is a very exciting time, and some major promising therapies have been realized in the past 2 to 3 years. Dr Grouse: Well, that's really exciting, and we'll all look forward to seeing these becoming more clinically applicable in the future. So, thank you so much for coming to talk with us today. Dr Zesiewicz: Thank you. Dr Grouse: Again, today I've been interviewing Dr Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Tom Carpenter from Pheasants Forever & Quail Forever joins the show to break down the 2025 prairie grouse primer presented by Sportsman's Guide.  We break down sharp-tailed grouse, sage grouse, Hungarian partridge, and prairie chicken hunting expectations by region, from Idaho to Minnesota and places in between.  We discuss factors that raised bird counts in some places, and lowered counts in others.  We share details that can make or break your next hunt on the prairie and throw in a few tricks to outsmart those wild birds.  It's a full prairie grouse primer, with even more information @pheasantsforever   Presented by: Walton's (waltons.com/) OnX Maps (onxmaps.com/) Aluma Trailers (alumaklm.com) GAIM Hunting & Shooting Simulator (https://alnk.to/74wKReb) Compeer Home (compeerhome.com) Federal Premium Ammunition (federalpremium.com/) Hunt North Dakota (helloND.com/) Lucky Duck Premium Decoys (luckyduck.com/) & Samaritan Tire (samaritantire.com/)

Ecologist, guide, dog trainer, and taxidermist, Meadow Kouffeld, gives us a rundown on Ruffed Grouse biology and their habits. Knowing your quarry isn't just interesting, it will make you a better hunter. Quit grousing around and tune in for some great grouse info.As always, we want to hear your feedback! Let us know if there are any topics you'd like covered on the Vortex Nation™ podcast by asking us on Instagram @vortexnationpodcast

This week, Kevin talks with the owner of Aspen Thicket Grouse Dogs, Dennis Stachewicz. This episode focuseses on Dennis's background, including his military service and current role as Community Development Director in Michigan's Upper Peninsula, along with his experiences in hunting and breeding German shorthair pointers. Dennis shared detailed insights about his dog training and breeding program, hunting techniques, and experiences with grouse populations and habitat management in the region. The conversation concluded with discussions about wolf encounters, hunting experiences, and the importance of preserving hunting and fishing traditions for future generations. https://www.aspenthicketgrousedogs.com/ As always, THANK YOU for listening! Predator Thermal Optics code "ptothermal" for 10% off all Predator Thermal Optics brand Scopes and Monoculars www.predatorthermaloptics.com www.predatorhunteroutdoors.com code: tripod for 10% off tripods and mounts code: light for 20% off lighting products Predator Hunter Outdoors ATN Prym1 Wiebe Knives- code "OVERDRIVE15" for 15% off you entire order High Pressure Pneumatics Razor Broadheads- code "Overdrive10" for 10% off your order

Grouse, woodcock, training during the hunt, and a short history of Gordon Setters ... those are the topics in my conversation with Stephen Faust, pro grouse and woodcock guide, dog trainer and breeder, and avid hunter. We'll also cover a typical guide's day in the field, how we can be better guide clients, and dog training tips.  We'll track a woodcock's day - where it hangs, what it eats and even how professionals like Stephen tag chicks in the spring. We'll look at habitat and habits, and dog handling for these wily birds. Then, into the grouse woods for insights into some lesser-known prime food sources, cover types, and habitat needs from opening day to winter.  "Fix It" offers a useful web source for finding birds, and listeners (a lot of them) weigh in on "Do beeper collars scare birds?" You'll take something useful away from that discussion! And it's all brought to you by: HiVizSights.com, RuffLand Kennels, Mid Valley Clays and Shooting School, TrulockChokes, HiViz shooting systems, Pointer shotguns, Purina Pro Plan Sport and FindBirdHuntingSpots.com.

In this article, biologists Kyle Hedges and Frank Loncarich discuss grassland management techniques that landowners and managers can utilize to help bolster upland bird populations on their properties.Check out Duck Camp's gear at duckcamp.com. Read more at projectupland.com.

On our recent trip to Washington, we had two days to play with.  So we decided to go search out a lifer: Dusky Grouse.  Who knew we would find such a charming, interesting vacation destination, too!  Winthrop and the Methow Valley has a lot of great cascades birds to see and things to do.Adventure begins at: 12:15 Show notes Southeast Arizona Birding Festival Rio Grande Valley Birding Festival Spring ChirpeBird October Global Big DaySun Mountain LodgeWinthropeBird Trip Report Birds/Animals mentioned Kagu Dusky Grouse Lewis's Woodpecker Intro Bird Call: Vesper Sparrow (Recorded: June 2025, Washington)Outro Bird Call: Black-throated Gray Warbler (Recorded: June 2025, Washington) Support the showConnect with us at... IG: @Hannahgoesbirding and @ErikgoesbirdingFacebook: @HannahandErikGoBirdingEmail us at HannahandErikGoBirding@gmail.comWebsite: http://www.gobirdingpodcast.comVenmo: @hannahanderikgobirdingGet a discount at Buteo Books using code: BIRDNERDBOOKCLUB

In this article, biologists Kyle Hedges and Frank Loncarich discuss grassland management techniques landowners and managers can use to help bolster upland game bird populations on their properties.Read more at projectupland.com.

In this episode of the Birdshot Podcast, host Nick Larson welcomes Andy Wayment, a passionate upland bird hunter, fly fisherman, and bibliophile, to discuss some of the best books in the world of upland hunting and fly fishing. Their conversation spans timeless authors like Burton Spiller and Tom Davis, plus a special look at books like Irish Red and Big Red. Whether you're a bird hunter, fly fisherman, or just a lover of outdoor literature, this episode is sure to inspire your next reading list. Andy Wayment is an avid upland bird hunter, fly fisherman, and self-proclaimed book nerd. With years of experience in bird hunting and a deep appreciation for literature, Andy has curated an extensive collection of hunting and fishing books. He is particularly passionate about sharing his knowledge of the classic authors and hidden gems in the genre. Andy has also authored his own books on Idaho upland hunting, contributing to the literary world of bird hunting. Expect to Learn The best books on upland bird hunting, including Irish Red and Big Red. Insights into the connections between fly fishing and bird hunting literature. Hidden gems in bird hunting books, including works by Burton Spiller and Tom Davis. Why fly fishing books also attract hunters and how the two pursuits often intersect in literature. The upcoming release of Andy's own book, Idaho Grouse Fever, and what readers can expect. Episode Breakdown with Timestamps [00:00:00] - Introduction to Andy Wayment and His Love for Books [00:03:52] - Andy's Story as a fly fisherman [00:10:23] - The Connection Between Fly Fishing and Upland Hunting books [00:15:59] - Authors and their Qualifications [00:25:05] - Irish Red and Big Red by Jim Kjelgaard [00:36:47] - Best Birds by Worth Mathewson [00:42:55] - Andy's New Book [00:57:40] - No. 1 Book - Drummer in the Woods [01:03:58] - Hour+ of Book Recommendations and Closing Thoughts. Follow Andy Wayment  Instagram: https://www.instagram.com/andywayment/  Website: https://uplandways.com/ ANDY'S TOP FIVE FAVORITES:  1.  Drummer in the Woods, Burton Spiller  2.  Partridge Shortenin', Gorham Cross (Grampa Grouse) 3.  My Friend the Patridge, S.T. Hammond  4.  That's Ruff, George King 5.  Grouse Feathers, Again, Burton Spiller Runner's Up:  6.  Upland Days, William G. Tapply 7.  Upland Autumn, William G. Tapply  8.  A Passion for Grouse, anthology edited by Tom Pero ANDY'S PICKS FOR FAVORITE UPLAND FICTION 1.  A Millionaire's Dream, Brett Wannacott 2.  A High Lonesome Call, Robert Holthowzer 3.  Jenny Willow, Mike Gaddis  4.  Irish Red, Jim Kjelgaard 5.  The Dumbell of Brookfield, John Tainter Foote BOOKS WITH SOME BLUE GROUSE HUNTING 1.  Fool Hen Blues, E. Donnell Thomas, Jr.  2.  A Hunter's Road and The Sporting Road, Jim Fergus 3.  Plateaus of Destiny, Mike Gould 4.  Kicking Up Trouble, John Holt 5.  Grouse of North America: A Cross-Continental Hunting Guide, Tom Huggler 6.  Winston, Ben O. Williams 7.  Idaho Upland Days, Andrew Marshall Wayment  8.  Hunting Upland Birds, Charley Waterman  Follow Host Nick LinkedIn: https://www.linkedin.com/in/xnicklarsonx/ Website: www.birdshotpodcast.com Instagram: https://www.instagram.com/birdshot.podcast/?hl=en Listening Links: Spotify: https://open.spotify.com/show/17EVUDJPwR2iJggzhLYil7 Apple Podcasts: https://podcasts.apple.com/us/podcast/birdshot-podcast/id1288308609 YouTube: http://www.youtube.com/@birdshotpodcast8302 SUPPORT | http://www.patreon.com/birdshot Use Promo Code | BSP20 to save 20% on https://www.onxmaps.com/hunt/app Use Promo Code | BS10 to save 10% on https://trulockchokes.com/ The Birdshot Podcast is Presented By: https://www.onxmaps.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

When Chrissy Streit met and later married an avid hunter she made it clear that she was never, ever going to hunt. As a very conscientious eater of animal protein, her opinions about hunting shifted over time. When the young couple began a family and the thought of both the origin and the content of the food they would feed their children came into play, Chrissy really began to experience a change of perspective. Now, a very accomplished hunter, gardener, forager and cook, Chrissy shares her journey with others online through her various "Forest and Farm" platforms. In this episode, Jesse Deubel and Chrissy Streit talk about Chrissy's transition from being accepting of hunting to becoming a hunter herself. She shares heartfelt stories about the experiences she's had and how it has helped shape her view of life, death and food. From hunting grouse to elk and growing and harvesting species from rabbits to lettuce this episode covers four natural food procurement options that minimize our dependence on the local grocery market. Hunting, fishing, gardening and foraging are all covered in this entertaining and educational conversation. At the root of it all is a reminder about the importance of understanding that all living organisms on this planet are connected. The consequences of humans becoming increasingly distanced from the natural world are real. Being in nature helps our minds and our souls and the [real] food it provides feeds our bodies. Hopefully when you finish listening to this one you'll want to get outside, get your hands dirty and touch grass. Until then, enjoy the listen!  For more info:Forest and Farm FBForest and Farm InstagramNMWF Website

Mike Amman is a Wisconsin forester and the Vice President of the Wisconsin Sharp-Tailed Grouse Society. Mike & Travis celebrate Wisconsin's decision to re-open a sharp-tailed grouse hunting season, the mission at the Wisconsin sharp-tailed grouse society, reversing a habitat loss trend & bouncing back bird numbers, logging practices that create ruffed grouse habitat across the Great Lakes region, hunting sharp-tailed grouse on the prairie vs Midwest, moving to find the right hunting covers, mentally and physically preparing for opening day, shot size and chokes for grouse, putting on miles, and a whole lot more... @wisharptails   Presented by: Walton's (waltons.com/) OnX Maps (onxmaps.com/) Aluma Trailers (alumaklm.com) GAIM Hunting & Shooting Simulator (https://alnk.to/74wKReb) Compeer Home (compeerhome.com) Federal Premium Ammunition (federalpremium.com/) Hunt North Dakota (helloND.com/) Lucky Duck Premium Decoys (luckyduck.com/) & Samaritan Tire (samaritantire.com/)

We talk with "The Grouse Guy", Jeremiah Psiropoulos about birding in Colorado, finding grouse, Colorado-style pizza, and more! Learn more about Jeremiah and his tours here: https://antigonewildlifetours.com/about

In this episode of The Birdshot Podcast, host Nick Larson is joined by Mike Amman, a County Forester in Wisconsin, to discuss the evolving landscapes of the state's upland habitats, with a particular focus on sharp-tailed grouse populations, habitat management, and conservation efforts. Mike shares his extensive experience working with county forests, overseeing land management practices that support both wildlife conservation and sustainable forestry. This episode also focuses on Mike's involvement and the exciting developments surrounding a limited hunting season for sharp-tailed grouse this fall. Mike Amman is a County Forester with over 22 years of experience working in forest management across Wisconsin's public and private lands. His expertise includes habitat restoration, wildlife management, and timber production, particularly within the context of county forest systems. Mike is also an active board member of the Wisconsin Sharp-tailed Grouse Society, a group dedicated to the conservation of sharp-tailed grouse populations and the unique barrens habitat of northwest Wisconsin. His commitment to preserving wildlife habitats while balancing sustainable forestry practices makes him an invaluable resource for land management in the region. Expect to Learn How Mike Amman manages and conserves county forest land in Wisconsin. The role of prescribed burns and mechanical treatments in restoring and maintaining sharp-tailed grouse habitat. Insights into the Wisconsin Sharp-tailed Grouse Society and its conservation efforts. The impact of forest fragmentation and land ownership changes on wildlife habitat. Why sharp-tailed grouse populations are thriving in some areas and the challenges involved in maintaining sustainable harvests for hunting seasons. Episode Breakdown with Timestamps [00:00:00] - Introduction [00:01:36] - A Day in the Life of a County Forester [00:05:46] - Major Differences in the Forest over time [00:18:00] - Fabric from Wood Fiber- Tencel [00:29:12] - 100+ Dancing Males on a Lek [00:38:11] - Give or Take Event [00:42:18] - Trips Out West Spur Mike's Interest in Sharp-tailed Grouse [00:48:46] - Considerations for Bird Dog Training [00:52:32] - Observation Tool For Sharp-tailed Grouse Sightings [00:56:56] - Learn More about the onX Hunt WI Game Bird Layer [00:03:18] - How to Connect with Mike Follow Guest Mike LinkedIn: https://www.linkedin.com/in/mike-amman-a361a62a/ Instagram: https://www.instagram.com/grouseweims/ Wisconsin Sharp-tailed Grouse Society: https://www.wisharptails.org/ Follow Host Nick LinkedIn: https://www.linkedin.com/in/xnicklarsonx/ Website: www.birdshotpodcast.com Instagram: https://www.instagram.com/birdshot.podcast/?hl=en Listening Links Spotify:https://open.spotify.com/show/17EVUDJPwR2iJggzhLYil7 Apple Podcasts:https://podcasts.apple.com/us/podcast/birdshot-podcast/id1288308609 YouTube:http://www.youtube.com/@birdshotpodcast8302 SUPPORT | http://www.patreon.com/birdshot Use Promo Code | BSP20 to save 20% on https://www.onxmaps.com/hunt/app Use Promo Code | BS10 to save 10% on https://trulockchokes.com/ The Birdshot Podcast is Presented By: https://www.onxmaps.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Top topics on Outdoor News Radio this week include a discussion with Managing Editor Rob Drieslein and Editor Tim Spielman on how swimmer's itch has created wrath toward common mergansers on some western Minnesota lakes. Then Charlotte Roy from the Minnesota DNR joins the program to break down the pretty good forecast for ruffed grouse […] The post Episode 550 – 2025 grouse forecast, swimmer's itch and mergansers, ICAST recap, corner crossings appeared first on Outdoor News.

Grouse hunting on moors is likely one of the most heated hunting topics in the United Kingdom. Every year the industry comes under attack, and they have to stand up and fight to highlight the benefits that come from Grouse shooting on moors. In Part 1 of a series on "Fighting for the Moorlands", Robbie connects with two key individuals in the "Why Moorlands Matter" movement - Emily Graham and Ian Coghill (or commonly referred to as Coggers). If you have ever been interested in learning more about the fight against hunting in the United Kingdom, have heard about grouse shooting, or may have just heard about moors, this is the podcast to learn more about all of those subjects. Get to know the guest: https://www.scribehound.com/countryside/shooting-talk/s/shooting-debates/why-moorland-matters-my-interview-with-ian-coghill  Do you have questions we can answer? Send it via DM on IG or through email at info@bloodorigins.com Support our Conservation Club Members! Kayuga Broadheads: https://www.kayugabroadheads.com.au/  Lanthrop & Sons: https://lathropandsons.com/  Silent Pursuits: https://www.silentpursuits.com/  See more from Blood Origins: https://bit.ly/BloodOrigins_Subscribe Music: Migration by Ian Post (Winter Solstice), licensed through artlist.io This podcast is brought to you by Bushnell, who believes in providing the highest quality, most reliable & affordable outdoor products on the market. Your performance is their passion. https://www.bushnell.com  This podcast is also brought to you by Silencer Central, who believes in making buying a silencer simple and they handle the paperwork for you. Shop the largest silencer dealer in the world. Get started today! https://www.silencercentral.com  This podcast is brought to you by Safari Specialty Importers. Why do serious hunters use Safari Specialty Importers? Because getting your trophies home to you is all they do. Find our more at: https://safarispecialtyimporters.com  Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of NDO Podcast, we visit with Jesse Kolar, Department upland game management supervisor, and RJ Gross, Department upland game management biologist, about this year's high pheasant crowing counts, historical comparisons to the glory days and how deer don't have wings.

 Normal pressure hydrocephalus (NPH) is a clinical syndrome of gait abnormality, cognitive impairment, and urinary incontinence. Evaluation of CSF dynamics, patterns of fludeoxyglucose (FDG) uptake, and patterns of brain stiffness may aid in the evaluation of challenging cases that lack typical clinical and structural radiographic features. In this episode, Katie Grouse, MD, FAAN, speaks with Aaron Switzer, MD, MSc, author of the article “Radiographic Evaluation of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Switzer is a clinical assistant professor of neurology in the department of clinical neurosciences at the University of Calgary in Calgary, Alberta, Canada. Additional Resources Read the article: Radiographic Evaluation of Normal Pressure Hydrocephalus Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr. Switzer: Thanks so much for having me, Katie. I'm a neurologist that's working up in Calgary, Alberta, Canada, and I have a special interest in normal pressure hydrocephalus. So, I'm very happy to be here today to talk about the radiographic evaluation of NPH. Dr Grouse: I'm so excited to have you here today. It was really wonderful to read your article. I learned a lot on a topic that is not something that I frequently evaluate in my clinic. So, it's really just a pleasure to have you here to talk about this topic. So, I'd love to start by asking, what is the key message that you hope for neurologists who read your article to take away from it? Dr. Switzer: The diagnosis of NPH can be very difficult, just given the clinical heterogeneity in terms of how people present and what their images look like. And so, I'd like readers to know that detailed review of the patient's imaging can be very helpful to identify those that will clinically improve with shunt surgery. Dr Grouse: There's another really great article in this edition of Continuum that does a really great job delving into the clinical history and exam findings of NPH. So, I don't want to get into that topic necessarily today. However, I'd love to hear how you approach a case of a hypothetical patient, say, where you're suspicious of NPH based on the history and exam. I'd love to talk over how you approach the imaging findings when you obtain an MRI of the brain, as well as any follow-up imaging or testing that you generally recommend. Dr. Switzer: So, I break my approach down into three parts. First, I want to try to identify ventriculomegaly and any signs that would support that, and specifically those that are found in NPH. Secondly, I want to look for any alternative pathology or evidence of alternative pathology to explain the patient's symptoms. And then also evaluate any contraindications for shunt surgery. For the first one, usually I start with measuring Evans index to make sure that it's elevated, but then I want to measure one of the other four measurements that are described in the article, such as posterior colossal angle zed-Evans index---or z-Evans index for the American listeners---to see if there's any other features that can support normal pressure hydrocephalus. It's very important to identify whether there are features of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, which can help identify patients who may respond to shunt surgery. And then if it's really a cloudy clinical picture, it's complicated, it's difficult to know, I would usually go through the full evaluation of the iNPH radscale to calculate a score in order to determine the likelihood that this patient has NPH. So, the second part of my evaluation is to rule out evidence of any alternative pathology to suggest another cause for the patient's symptoms, such as neurodegeneration or cerebrovascular disease. And then the third part of my evaluation is to look for any potential contraindications for shunt surgery, the main one being cerebral microbleed count, as a very high count has been associated with the hemorrhagic complications following shunt surgery. Dr Grouse: You mentioned about your use of the various scales to calculate for NPH, and your article does a great job laying them out and where they can be helpful. Are there any of these scales that can be reasonably relied on to predict the presence of NPH and responsiveness to shunt placement? Dr. Switzer: I think the first thing to acknowledge is that predicting shunt response is still a big problem that is not fully solved in NPH. So, there is not one single imaging feature, or even combination of imaging features, that can reliably predict shunt response. But in my view and in my practice, it's identifying DESH, I think, is really important---so, the disproportionately enlarged subarachnoid space hydrocephalus---as well as measuring the posterior colossal angle. I find those two features to be the most specific. Dr Grouse: Now you mentioned the concept of the NPH subtypes, and while this may be something that many of our listeners are familiar with, I suspect that, like myself when I was reading this article, there are many who maybe have not been keeping up to date on these various subtypes. Could you briefly tell us more about these NPH subtypes? Dr. Switzer: Sure. The Japanese guidelines for NPH have subdivided NPH into three different main categories. So that would be idiopathic, delayed onset congenital, and secondary normal pressure hydrocephalus. And so, I think the first to talk about would be the secondary NPH. We're probably all more familiar with that. That's any sort of pathology that could lead to disruption in CSF dynamics. These are things like, you know, a slow-growing tumor that is obstructing CSF flow or a widespread meningeal process that's reducing absorption of CSF, for instance. So, identifying these can be important because it may offer an alternative treatment for what you're seeing in the patient. The second important one is delayed onset congenital. And when you see an image of one of these subtypes, it's going to be pretty different than the NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. Clinically, you may see that the patients have a higher head circumference. So, the second subtype to know about would be the delayed onset congenital normal pressure hydrocephalus. And when you see an image of one of these subtypes, it's going to be a little different than the imaging of NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. And there are two specific subtypes that I'd like you to know about. The first would be long-standing overt ventriculomegaly of adulthood, or LOVA. And the second would be panventriculomegaly with a wide foramen of magendie and large discernomagna, which is quite a mouthful, so we just call it PAVUM. The importance of identifying these subtypes is that they may be amenable to different types of treatment. For instance, LOVA can be associated with aqueductal stenosis. So, these patients can get better when you treat them with an endoscopic third ventriculostomy, and then you don't need to move ahead with a shunt surgery. And then finally with idiopathic, that's mainly what we're talking about in this article with all of the imaging features. I think the important part about this is that you can have the features of DESH, or you can not have the features of DESH. The way to really define that would be how the patient would respond to a large-volume tap or a lumbar drain in order to define whether they have this idiopathic NPH. Dr Grouse: That's really helpful. And for those of our listeners who are so inclined, there is a wonderful diagram that lays out all these subtypes that you can take a look at. I encourage you to familiarize yourself with these different subtypes. Now it was really interesting to read in your article about some of the older techniques that we used quite some time ago for diagnosing normal pressure hydrocephalus that thankfully we're no longer using, including isotope encephalography and radionuclide cisternography. It certainly made me grateful for how we've come in our diagnostic tools for NPH. What do you think the biggest breakthrough in diagnostic tools that are now clinically available are? Dr. Switzer: You know, definitely the advent of structural imaging was very important for the evaluation of NPH, and specifically the identification of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, in the late nineties has been very helpful for increasing the specificity of diagnosis in NPH. But some of the newer technologies that have become available would be phase-contrast MRI to measure the CSF flow rate through the aqueduct has been very helpful, as well as high spatial resolution T2 imaging to actually image the ventricular system and look for any evidence of expansion of the ventricles or obstruction of CSF flow. Dr Grouse: Regarding the scales that you had referenced earlier, do you think that we can look forward to more of these scales being automatically calculated and reported by various software techniques and radiographic interpretation techniques that are available or going to be available? Dr. Switzer: Definitely yes. And some of these techniques are already in development and used in research settings, and most of them are directed towards automatically detecting the features of DESH. So, that's the high convexity tight sulci, the focally enlarged sulci, and the enlarged Sylvian fissures. And separating the CSF from the brain tissue can help you determine where CSF flow is abnormal throughout the brain and give you a more accurate picture of CSF dynamics. And this, of course, is all automated. So, I do think that's something to keep an eye out for in the future. Dr Grouse: I wanted to ask a little more about the CSF flow dynamics, which I think may be new to a lot of our listeners, or certainly something that we've only more recently become familiar with. Can you tell us more about these advances and how we can apply this information to our evaluations for NPH? Dr. Switzer: So currently, only the two-dimensional phase contrast MRI technique is available on a clinical basis in most centers. This will measure the actual flow rate through the cerebral aqueduct. And so, in NPH, this can be elevated. So that can be a good supporting marker for NPH. In the future, we can look forward to other techniques that will actually look at three-dimensional or volume changes over time and this could give us a more accurate picture of aberrations and CSF dynamics. Dr Grouse: Well, definitely something to look forward to. And on the topic of other sort of more cutting-edge or, I think, less commonly-used technologies, you also mentioned some other imaging modalities, including diffusion imaging, intrathecal gadolinium imaging, nuclear medicine studies, MR elastography, for example. Are any of these modalities particularly promising for NPH evaluations, in your opinion? Do you think any of these will become more popularly used? Dr. Switzer: Yes, I think that diffusion tract imaging and MR elastography are probably the ones to keep your eye out for. They're a little more widely applicable because you just need an MR scanner to acquire the images. It's not invasive like the other techniques mentioned. So, I think it's going to be a lot easier to implement into clinical practice on a wide scale. So, those would be the ones that I would look out for in the future. Dr Grouse: Well, that's really exciting to hear about some of these techniques that are coming that may help us even more with our evaluation. Now on that note, I want to talk a little bit more about how we approach the evaluation and, in your opinion, some of the biggest pitfalls in the evaluation of NPH that you've found in your career. Dr. Switzer: I think there are three of note that I'd like to mention. The first would be overinterpreting the Evans index. So, just because an image shows that there's an elevated Evans index does not necessarily mean that NPH is present. So that's where looking for other corroborating evidence and looking for the clinical features is really important in the evaluation. Second would be misidentifying the focally enlarged sulci as atrophy because when you're looking at a brain with these blebs of CSF space in different parts of the brain, you may want to associate that to neurodegeneration, but that's not necessarily the case. And there are ways to distinguish between the two, and I think that's another common pitfall. And then third would be in regards to the CSF flow rate through the aqueduct. And so, an elevated CSF flow is suggestive of NPH, but the absence of that does not necessarily rule NPH out. So that's another one to be mindful of. Dr Grouse: That's really helpful. And then on the flip side, any tips or tricks or clinical pearls you can share with us that you found to be really helpful for the evaluation of NPH? Dr. Switzer: One thing that I found really helpful is to look for previous imaging, to look if there were features of NPH at that time, and if so, have they evolved over time; because we know that in idiopathic normal pressure hydrocephalus, especially in the dash phenotype, the ventricles can become larger and the effacement of the sulci at the convexity can become more striking over time. And this could be a helpful tool to identify how long that's been there and if it fits with the clinical history. So that's something that I find very helpful. Dr Grouse: Absolutely. When I read that point in your article, I thought that was really helpful and, in fact, I'm guessing something that a lot of us probably aren't doing. And yet many of our patients for one reason or other, probably have had imaging five, ten years prior to their time of evaluation that could be really helpful to look back at to see that evolution. Dr. Switzer: Yes, absolutely. Dr Grouse: It's been such a pleasure to read your article and talk with you about this today. Certainly a very important and helpful topic for, I'm sure, many of our listeners. Dr. Switzer: Thank you so much for having me. Dr Grouse: Again, today I've been interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

WXPR News for July 7, 2025

In this LIVE episode of the Steamboat Comedy Podcast, Kyle Ruff and Matt Newland are joined by fellow comedians Mike Stanley and Aaron 'Mad Dog' Graham! The show takes place at Dusky Grouse Coffee shop here in Steamboat Springs, and we get a special coffee tasting with resident expert Collie! Topics also include Mike's commercial gig with Bell Tire, Aaron's bologna knees, and Sydney Sweeney at Jeff Bezos's $57,000,000 wedding

Before we hit the microphone I asked Zach to walk my property to see what has happened in three the years since we logged our woods. I learned a lot! RGS/AWS is the shining star in the heavens we call home. Projects are popping up all over and the future is brite!!

Before we hit the microphone I asked Zach to walk my property to see what has happened in three the years since we logged our woods. I learned a lot! RGS/AWS is the shining star in the heavens we call home. Projects are popping up all over and the future is brite!!

Before we hit the microphone I asked Zach to walk my property to see what has happened in three the years since we logged our woods. I learned a lot! RGS/AWS is the shining star in the heavens we call home. Projects are popping up all over and the future is brite!!

Before we hit the microphone I asked Zach to walk my property to see what has happened in three the years since we logged our woods. I learned a lot! RGS/AWS is the shining star in the heavens we call home. Projects are popping up all over and the future is brite!! 

Hindu Janajagruti Samiti has submitted a memorandum to Amit Shah, Devendra Fadnavis and CP Deven Bharti, warning of a public agitation if they refused to meet its demand.

Recently, sophisticated myelographic techniques to precisely subtype and localize CSF leaks have been developed and refined. These techniques improve the detection of various types of CSF leaks thereby enabling targeted therapies. In this episode, Katie Grouse, MD, FAAN, speaks with Ajay A. Madhavan, MD, author of the article “Radiographic Evaluation of Spontaneous Intracranial Hypotension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Madhavan is assistant professor of radiology at the Mayo Clinic in Rochester, Minnesota. Additional Resources Read the article: Radiographic Evaluation of Spontaneous Intracranial Hypotension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Jones:  This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse:  This is Dr Katie Grouse. Today I'm interviewing Dr Ajay Madhavan about his article on Radiographic Evaluation of Spontaneous Intracranial Hypotension, which he wrote with Dr Levi Chazen. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr Madhavan:  Hi, thanks a lot, Katie. Yeah, so I'm Ajay Madhaven. I'm a neuroradiologist at the Mayo Clinic in Rochester, Minnesota. I did all my training here, so, I've been here for a long time. And I have a lot of interest in spinal CSF leaks, and I do a lot of that work. And so I'm really excited to be talking about this article with you. Dr Grouse:  I'm really excited too. And in fact, it's such a pleasure to have you here talking today on this topic. I know a lot's changed in this field, and I'm sure many of our listeners are really interested in learning about the developments and imaging techniques to improve detection and treatment of CSF leaks, especially since maybe we've learned about this in training. I want to start by asking you what you think is the most important takeaway from your article. Dr Madhavan:  Yeah, that's a great question. I think---and you kind of already alluded to it---I think the main thing is, I hope people recognize that this field has really changed a lot in the last five to ten years, through a lot of multi-institutional collaboration and also collaboration between different specialties. We've learned a lot about different types of spinal CSF leaks, how we can recognize the disease, particularly the types of myelography that we need to be using to accurately localize and treat these leaks. Those are the things that have really evolved in the last five to ten years, and they've really helped us improve these patients' lives. Dr Grouse:  Can you remind us of the different common types of spinal leaks that can cause spontaneous intracranial hypotension? Dr Madhavan:  Yeah, so there are a number of different spinal CSF leaks, types, and I would say the three most common ones that really most people should try to be aware of and cognizant of are: first, ventral dural tears. So those are, like, just physical holes in the dura. And they're usually caused by little bone spurs that come from the vertebral columns. So, they're often patients who have some degenerative changes in their spine. And those are really very common. Another type of spinal CSF leak that we commonly see is a lateral dural tear. So that's like the same thing in a slightly different location. So instead of being in the front, it's off to the side of the dura laterally. And so, it's also just a hole in the dura. And then the third and most recently discovered type of spinal CSF leak is a CSF-venous fistula. So those are direct connections between the subarachnoid space and little paraspinal vein. And it took us a long time to even realize that this was a real pathology. But now that it's been recognized, we've found that this is actually quite common. So those three types of leaks are probably the three most common that we see. And there's certainly others out there, but I would say over 90% of them fall into one of those three categories. Dr Grouse:  That's a great review, thank you. Just as another quick review, as we talk more about this topic, can you remind us of some of the most common or typical brain imaging findings that you'll see in cases of spontaneous intracranial hypotension? Dr Madhavan:  Yeah, absolutely. So, when you do a brain MRI in a patient who has spontaneous intracranial hypotension, you will usually, though not always, see typical brain MRI abnormalities. And I kind of think of those as falling into three different categories. So, the first one I think of is dural enhancement or thickening. So that's enlargement or engorgement of the dura, the pachymeninges, and enhancement on postgadolinium imaging. So, that's kind of the first category. The second is that, when you lose spinal fluid volume, other things often expand to take up the space. So, for example, you can get distension or enlargement of the dural venous sinuses, and sometimes you can also get subdural food collections or hematomas. They can arise spontaneously. And I kind of think of those as, you know, you, you've lost the cerebrospinal fluid volume and something else is kind of filling up the space. And then the third category is called brain sagging. And that's a constellation of findings where the posterior fossa structures and the pituitary gland in the cell have become abnormal because you've lost the fluid that normally cushions those structures and causes them to float up. For example, the brain stem will sag down, the distance between the mammillary body and the ponds may become reduced. The suprasellar cistern space may be reduced such that the optic chiasm becomes very close to the pituitary gland, and the prepontine cistern may also become reduced in size. And there are various measurements that can be used to determine whether something is subtly abnormal. But just generally speaking, those are really the three categories of brain MRI abnormalities you'll see. Dr Grouse:  That was a great review. And of course, I think in many times when we are thinking about or suspecting this diagnosis, we may be lucky to find those imaging findings to reinforce a diagnosis. Because as it turns out, after reading your article, I was really surprised to find out that in as many as 19% of cases we actually see normal brain imaging, which really was a surprise to me, I have to say. And I think that this really encompasses why spontaneous intercranial hypotension is such a difficult diagnosis to make. I think a lot of us struggle with how far to take the workup when, you know, spontaneous intercranial hypotension is clinically suspected, but multiple imaging studies are normal. Do you have any guidance on how to approach these more difficult cases? Dr Madhavan:  So, that's a really good question. And you know, it's- as you can imagine, that's a topic that comes up in most meetings where people discuss this, and it's been a continued challenge. And so, like you said, about 19 or 20% of patients who have this disease can have a, a normal brain MRI. And we've tried to do some work to figure out why that is and how we can identify patients who still have the disease. And I can just provide, I guess, some tips that have helped me in my clinical practice. One thing is, if I ever see a patient with a normal brain MRI where this disease is clinically suspected---for example, maybe they have orthostatic headaches or other very typical symptoms and we don't know why, but their brain MRI is normal---the first thing I do is I try to look back at their old imaging. So many times, these patients who present to us at Mayo, who, when we do their MRI scan here, their brain MRI looks normal… if you really look back at imaging that they've had done elsewhere---maybe even two to three years prior---at the time their symptoms started, they actually had some abnormalities. So, I might see that a patient, two years ago, had dural enhancement that spontaneously resolved; but now they still have symptoms of SIH and they may still have a CSF leak that we can find and treat, but their brain MRI has, for whatever reason, normalized. So, I always start by looking back at old imaging, and I found that to be very helpful. The other thing is, if you see a patient with a normal brain MRI, it's also important to look at their spine MRI because that can provide clues that might suggest that they could still have a spinal CSF leak. And the two things I look for on the spine MRI: one, if there's any extradural CSF. So, spinal fluid outside of where it's supposed to be within the confines of the subarachnoid space. And you know, really, if you see extradural CSF, you know they probably have a spinal fluid leak somewhere. Even if their brain MRI is normal, that just gives you the information that there is a dural tear probably somewhere. And so, in those patients we'll definitely still proceed to myelography or other testing, even if they have a normal brain MRI. And then the last thing I look for is whether or not they have prominent meningeal diverticula. Patients with CSF venous fistulas almost always have one or more prominent diverticula on their spine along the nerve root sleeves. And that's probably because most of these fistulas come from nerve root sleeve diverticula. We don't completely understand the pathogenesis of CSF venous fistulas, but they're clearly associated with meningeal diverticula. So, if I see a patient who has a normal brain MRI, but I see on their spine MRI that they have many meningeal diverticula that are relatively prominent, that makes me more inclined to be a little bit more aggressive in doing myelography to find a CSF leak. And then I look at other demographic features, too. So, for example, elevated BMI and older age are associated with CSF venous fistulas. So, that can help you determine whether or not it's warranted to go on to more advanced imaging, too. So those are all just a variety of different things that we've used to help us. Dr Grouse:  Thank you for sharing that. I wanted to go on to say that, you know, reading your article, of course, as you mentioned, you alluded to the fact there's lots of new imaging modalities out there. It was very illuminating and just an excellent resource for the options that exist and when they're useful. You did a great job summarizing it. And I encourage our readers to check out your article, to refresh themselves, update themselves on what's happened in this space. And of course, we can't summarize them all today, but I was wondering if you could possibly walk us through a hypothetical case of a patient who comes in with a history very suspicious for SIH? How would you approach this patient? Say you have gotten imaging that suggested that there is a spinal fluid leak and now you have to figure out where it is. Dr Madhavan:  Yeah. So, you know, I think the most typical scenario it'll be a patient who has been seen by one of my excellent neurology colleagues and they've done a brain MRI and they've made the diagnosis through a combination of clinical information and brain MRI finding. And then the next thing we'll do always is, we'll obtain a spine MRI. So, I think of the purpose of the spine MRI as to determine what type of spinal fluid leak they have. On the spine MRI, if you see extradural CSF, those patients essentially always will have a dural tear. And it may be a ventral dural tear or a lateral dural tear. But if you see extradural CSF, that is pretty much what they have. And conversely, if you don't see extradural CSF---if you just see, for example, many meningeal diverticula, but you don't see anything else particularly abnormal---most of those patients have a CSF venous fistula, just common things being common. So I use the spine MRI to determine what type of leak they have. And then the next thing I think about is, okay, I'm going to do a myelogram on this patient. How do I want to position them? Because it turns out that positioning is probably the most important factor for finding these spinal fluid leaks. You have to have the patient positioned correctly to find the leak that you're trying to localize. And so, if I suspect they have a ventral dural tear, I will always position those patients prone for their myelogram. And I might do one of many different types of myelograms. And, you know, the article talks about things like digital subtraction myelography and dynamic CT myelography. And you can find any of these leaks with any of those techniques, but you just have to have the patient positioned correctly. So, if I think I have a ventral dural tear, I'll put them prone for the myelogram. If I think they have a lateral dural tear, I'll put them in the cubitus position for the myelogram. And also, if they- if I think they have a CSF-venous fistula, I'll also put them in the decubitus position. Obviously if you're putting them in the decubitus position, you have to decide whether it's going to be left or right side down. So that may require a two-day exam. Sometimes you don't have to; in many cases, we're able to just do everything in one day. But those are all the different factors I think about when I'm trying to determine how I'm going to work those patients up further. So, I really use the spine MRI chiefly to think about what type of leak they're going to have and how I'm going to plan the myelogram. Dr Grouse:  That's really great. And it's, I think, really nice to emphasize how much the positioning matters in all this, which I think is not something we've been classically taught as far as the diagnosis of spinal leaks. Another thing I'm really interested in your opinion on is, you talked a lot about how to optimize and what can make you successful at diagnosis. I'm curious what you think one of the easiest mistakes to make or, you know, that we should hopefully avoid when treating patients with this disease. Dr Madhavan:  Yeah. And I think, you know, one other thing that's been discussed a lot in this topic… you know, we've talked about the patients with a normal brain MRI. Another barrier or challenge particularly with CSF-venous fistulas is, sometimes they can be very subtle on imaging. So, it's not always you see it very definitive CSF-venous fistula where you can say, like, there's no question, that's a fistula. There are many times where we do a good-quality myelogram and we see something that looks, like, possible for a CSF venous fistula, or probable. If I had to put a number on it, maybe there's a 50 to 70% chance of real. So, in those cases, we end up wondering, like, should we treat this suspected leak? And I think one common mistake  or one thing that needs to be looked at further is, how do we handle these patients where we don't know whether the fistula is real or not? That's usually something where I will have a discussion with the patient, and I'm usually just very upfront with him about my interpretation of the imaging. I'll just tell them, we did a good-quality myelogram. You did a great job. We got good images. I don't see anything definitive, but I see this thing that I think has maybe a 60% chance of being real. And then I'll confer with one of my neurology colleagues and we'll decide whether it's worth treating that or not. And we'll just be very upfront with a patient about whether- about the likelihood of its success and what their long-term prognosis is. And oftentimes we let them make the decision. But I think that remains to be one of the big challenges is, how do we treat these patients who have suspected leaks that are not definitive on imaging. Dr Grouse:  That sounds absolutely like an important area where there can be problems, so I appreciate that insight. I'm interested what you think in your article would come as the biggest surprise to our listeners who may not have kept up as much with all of the changes that have happened in recent years? Dr Madhavan:  One of the things that was certainly, at least, a surprise to me as I was going through my training and learning about this topic is how diverse myelography has really become. You know, when I was a radiology resident, I learned about myelography as this thing that we've been doing for 30 to 40 years. And historically we've used myelograms just to look for degenerative changes: disc bulges, you know, disc herniations and things like that. Now that MRI is more prevalent, we don't use it as much, but it has turned out that it has a very big role in patients with spinal fluid leaks. Furthermore, something that I've learned is just how diverse these different types of myelograms have become. It used to kind of be just that a myelogram is a myelogram is a myelogram, but now we have different types of positioning, different types of equipment that we use. We vary the timing between contrast injection and imaging to optimize success for finding spinal fluid leaks. So, I think many times I talk to people who may not be as familiar with this field and they're surprised at just how diverse that has become and how sophisticated some of the various myelographic techniques have become and how much that really makes a difference in being able to accurately diagnose these patients. Dr Grouse:  Well, I can say it was a surprise to me. Even as someone who does treat quite a few patients with this condition, I was surprised to see the breadth of different options that have become available. And then kind of a follow-up to that, what do you think the current area of controversy is in this area of diagnosis and treatment? Dr Madhavan:  The biggest ones are ones you've sort of already alluded to. So, one big one is, how far do we go in patients who have a normal brain MRI who still have a clinical suspicion of the disease? And sometimes it's really hard, because sometimes you will find patients who clinically have a very strong case for having spontaneous intracranial hypotension. You look at them, they have very acute-onset orthostatic headaches. There's no better explanation for their symptoms that we know of. And it's hard to know what to do with those patients, because some of them want to continue to undergo diagnostic workup, but you can only do so many myelograms and you can only do so much with this diagnostic workup that requires some radiation dose before it becomes very challenging. That's a major point of just, I guess, ongoing research as to what can we do better for that subset of patients. Fortunately, it's not all of them, it's a subset of them, but I think we could help those patients better in the future as we learn more about the disease. So that's one. And the other one is treating these equivocal findings, like I discussed.  And where should our threshold be to treat a patient, and what type of treatment should we do in patients where we don't know whether a leak is real? Should we just do a very noninvasive- relatively noninvasive blood patch? Do we do an embolization where we're leaving a foreign body there? Is it worth sending those patients to surgery? Those are all unanswered questions and things that continue to spark ongoing debate. Dr Grouse:  Do you think that there's going to be any new big breakthroughs, or even, do you know of any big developments on the horizon that we should be keeping our eyes out for? Dr Madhavan:  You know, I think for me the biggest thing is, imaging is dramatically improving. We talked a little bit about photon counting detector CT in our article, and that's one of the newest and best techniques for imaging these patients because it has very, very high resolution, it has a lower radiation dose, it has allowed us to find leaks that we were not able to find before. And there are other high-resolution modalities that are emerging and becoming more accessible to things like cone beam CT which we do in addition to digital subtraction myelography. And on top of that, we've started to use AI-based tools to make images look a lot better. So, there are various AI algorithms that have come out that allow us to remove artifacts from imaging. They help us image patients with a bigger body habitus better without running into a lot of imaging artifacts. They help us reduce noise in imaging. They can just give us better-quality images and aid us in the diagnosis. For me as a radiologist, those are some of the most exciting things. We're finding less invasive ways with less radiation to better diagnose these patients with just better-quality imaging. Dr Grouse:  Well, that is definitely something to be excited about. So, I just want to thank you so much for talking with us today. It's been such an interesting, informative discussion and a real privilege to talk with you about this important topic. Dr Madhavan:  Yeah, thanks so much. I really appreciate the time to talk with you, and I look forward to seeing the article out there and hopefully getting some interesting questions. Dr Grouse:  Again, today I've been interviewing Dr Ajay Madhavan about his article on Radiographic Evaluation of Spontaneous Intracranial Hypotension, which he wrote with Dr Levi Chasen. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

On this episode we continue our species specific series. Mountian Grouse in Montana is this weeks focus.  Primarily we talk about Blue Grouse but we do talk about both Spruce and Ruffed grouse also. George hasnt hunted them before but is very interested in them, so he asked Wess and Myself the questions that he was curious about and Wess and I did our best to answer.

In this episode of the Birdshot podcast, host Nick Larson welcomes Lars Jacob, a seasoned hunter and shotgun fitting expert. They discuss hunting conditions in Vermont, the impacts of weather on grouse populations, and the challenges of grouse hunting. They also delve into the intricacies of shotgun fitting, the importance of practice for instinctive shooting, and the allure of vintage guns, particularly British and American models. The conversation rounds off with Lars sharing his experiences and insights into gun fitting, techniques, and some exciting upcoming events. 00:00 Introduction and Weather Update 03:01 Grouse Population and Habitat Challenges 04:15 Impact of West Nile Virus on Grouse 07:30 Cyclical Nature of Grouse Populations 08:20 Changes in Vermont's Habitat and Logging Practices 12:05 Public Land Grouse Hunting Tips 12:36 Grouse Diet and Seasonal Behavior 19:11 Historical Changes in Vermont's Landscape 22:19 Turkey Hunting Legacy and Techniques 41:25 Understanding Turkey Behavior and Hunting Techniques 42:53 The Evolution of Turkey Hunting Methods 43:33 The Importance of Patience in Turkey Hunting 45:04 Introduction to the Northeast Side by Side Classic Event 46:17 Highlights of the Northeast Side by Side Classic 47:25 The Art of Gun Fitting 51:41 The Process of Gun Fitting 01:01:52 Challenges and Techniques in Wing Shooting 01:08:47 The Value of Vintage Guns 01:19:06 Conclusion and Contact Information FOLLOW | @larsjacobwingshooting CONTACT | Lars Jacob at 802-289-2002 LISTEN | to Episode #167 and #277 with Lars Jacob SUPPORT | patreon.com/birdshot Follow us | @birdshot.podcast Use Promo Code | BSP20 to save 20% with onX Hunt Use Promo Code | BS10 to save 10% on Trulock Chokes The Birdshot Podcast is Presented By: onX Hunt, Final Rise and Upland Gun Company Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Birdshot Podcast, host Nick Larson talks with Logan Clark, a graduate researcher, about his extensive study on dusky grouse migrations and behavior. They discuss the challenges and innovations in monitoring wildlife, including the use of autonomous recording units (ARUs) and GPS tracking. Logan shares insights from his fieldwork, the modeling techniques applied for abundance estimation, and the future directions for dusky grouse research. 02:08 Pheasant Fest Experience 02:45 Poster Session and Networking 09:02 Research and Monitoring Techniques 37:40 Microphone vs. Human Detection 39:26 Challenges in Grouse Detection 40:07 Occupancy and Abundance Estimates 42:33 Machine Learning in Bird Detection 44:44 Developing Detection Models 52:50 Unexpected Discoveries 55:47 GPS Tracking and Grouse Movements 01:03:44 Future Research Directions 01:12:12 Career Aspirations and Challenges SUPPORT | patreon.com/birdshot Follow us | @birdshot.podcast Use Promo Code | BSP20 to save 20% with onX Hunt Use Promo Code | BS10 to save 10% on Trulock Chokes The Birdshot Podcast is Presented By: onX Hunt, Final Rise and Upland Gun Company Learn more about your ad choices. Visit megaphone.fm/adchoices

In This Hour:--  Family stories continue around a Montgomery Ward pump action 22.--  Hunting grouse and quail --  Make sure you check the expiration date on your pepper sprayGun Talk 03.23.25 After Show