Podcasts about PEM

Though I am a Pediatric Emergency Provider, most of the time I don't treat true emergencies. Intensive care is a fairly small portion of what I do. That is why I invited Dr. Matt Goldstein, a PICU doctor from NY to come on the show and discuss the 5 things PICU docs want PEM docs to know…  Low threshold to call and communicate concerns regarding a decompensating patient. Identify high risk intubations Try and get as much history as possible (understanding how busy ED is) Reassess ICU level patients once they are admitted (every hospital is different) The power of airway clearance (especially in children with complex care needs, tracheostomy etc)

Women who have missed a cervical screening appointment in England are to be offered HPV self-testing kits by the NHS. Over the next year, nearly four million women will receive invites on the NHS App or via text message, email or letter to order a free kit to use at home. The aim is to encourage more women to complete their potentially lifesaving screening to detect HPV, which can increase the risk of cervical cancer. Figures show that around a third of women who are eligible for cervical cancer screening have not taken up the offer recently. Dr Sue Mann, National Clinical Director for Women's Health in England and a consultant in Sexual and Reproductive Health, joins Nuala McGovern to discuss.Chef Sally Abe, who owns the restaurant The Pem, and Kayla Lawrie, a producer with social media food influencers TopJaw, have launched a map of women-owned hospitality businesses. What began with 350 restaurants, pubs, cafés and bakeries has now grown to more than 1,000 venues across the UK. They explain to Nuala what they hope to achieve.Around 7,500 women are diagnosed with ovarian cancer every year, with the majority aged over 50. But around 120 of those women are between 15 and 24. Enlli Thompson was just 19 when a growth was found on one of her ovaries. Since then, she's undergone chemotherapy, egg freezing, a hysterectomy and medically induced menopause. Enlli joins Nuala, alongside GP Charlotte Badescu, who was also diagnosed with ovarian cancer in 2021 when she was 31.Stephanie Brown from the University of Hull has spent the past year as Woman's Hour's researcher in residence on the scheme that Radio 4 runs with the Arts and Humanities Research Council. She studies the history of crime and, as part of our summer series exploring some of the latest research into women's lives past and present, she shares new findings about the punishment of women in medieval England.Is your wardrobe a clutter-free haven of beautifully coordinated outfits? Or is it more a chaotic jumble of jumpers, jeans and everything in between? Could an app be the answer? Some apps allow users to catalogue what they own, visualise outfits and experiment with their style. Nuala is joined by Nicole Glennon, Deputy Editor of the Irish Examiner Weekend magazine, and Dion Terrelonge, fashion psychologist and practitioner.Presenter: Nuala McGovern Producer: Dianne McGregor

Deutschland kann E-Motoren – doch Perfektion, Kosten und Entwicklungstempo werden zunehmend zum Wettbewerbsfaktor. RWTH-Forscher David Drexler erklärt, was China anders macht, wie Toyota und Lucid ihre Motoren optimieren und ob Mercedes Axialflussmotor oder DeepDrives Doppelrotor-Radialflussmaschine das nächste große Antriebskonzept werden könnten.

Der E-Motor gilt als simpel und weitgehend ausentwickelt. RWTH-Forscher David Drexler widerspricht: Moderne Antriebe werden leichter, leistungsfähiger und komplexer. Wir sprechen über Tesla, BMW, Mercedes und VW, 30.000 U/min, Zweiganggetriebe und die Frage, welcher E-Motor wirklich der beste ist.

Der E-Motor gilt als simpel und weitgehend ausentwickelt. RWTH-Forscher David Drexler widerspricht: Moderne Antriebe werden leichter, leistungsfähiger und komplexer. Wir sprechen über Tesla, BMW, Mercedes und VW, 30.000 U/min, Zweiganggetriebe und die Frage, welcher E-Motor wirklich der beste ist.

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. In this episode, we are joined by Brad Goldberg, MD (Children's Hospital Los Angeles), Erika Cheung, RN (Children's Hospital Los Angeles), and Pooja Nawathe, MD (Cedars-Sinai)—leaders from the LA County Special Pathogens Program. Together, we discuss how emergency clinicians can recognize, isolate, and respond to patients with emerging infectious diseases using the practical Identify, Isolate, Inform (III) framework. From travel screening and PPE to isolation protocols and communication with public health, this episode is packed with practical pearls to help your team prepare before the next outbreak arrives.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play Send us Fan Mail

Jaume Segalés y su equipo analizan los temas de actualidad y comentan la agenda cultural.‘Alá! Iré' en el Teatro Calderón Entrevistamos al bailarín y coreógrafo Rafael Amargo, que vuelve a las tablas con un nuevo espectáculo titulado ‘Alá! Iré'. Se representará el lunes 27 y el miércoles 29 julio, en el Rooftop (azotea) del Teatro Calderón (c/ Atocha, 18). Un proyecto novedoso que reivindica y recopila su extensa y notable trayectoria artística y su profunda pasión por el flamenco, con un enfoque innovador, vanguardista e intensamente emocional. ‘Alá! Iré' fusiona la danza contemporánea, la urbana y el electro-flamenco con el flamenco más puro, tomando como hilo conductor el último trabajo discográfico de Rafael Amargo, Flamencograma, del cual se interpretan varios temas. El repertorio sonoro también incluye una canción inédita de Diego el Cigala; poemas de Federico García Lorca, José María Pemán y Rafael de León; y clásicos universales como ‘Ne me quitte pas' junto a composiciones inéditas del propio Rafael Amargo.Sección de cine clásico Es sesión continua Antolín de la Torre hoy nos habla sobre Evasión o victoria (Escape to Victory). Drama bélico estadounidense de 1981 dirigido por John Huston y protagonizada por Michael Caine, Sylvester Stallone y Max von Sydow, acompañados de estrellas del fútbol como Pelé, Osvaldo Ardiles, Bobby Moore, Paul van Himst y Kazimierz Deyna, entre otros. La trama, ubicada en la II Guerra Mundial, expone el plan de fuga de un grupo de prisioneros aliados que, retenidos un campo de prisioneros de guerra nazi, ven la oportunidad de escapar durante un partido de fútbol.

El programa de hoy nos lleva hasta el colegio José María Pemán, donde avanzan las actuaciones para climatizar el parvulario de cara a mejorar las condiciones en las aulas. Analizamos también las críticas del PSOE al borrador del presupuesto municipal de 2026 y repasamos el éxito de participación de la Ruta Nocturna al Castillo Anzur, junto a la donación solidaria que la academia de Miguel Ríos ha entregado a la asociación Pasito a Pasito. Además, nos asomamos a la agenda del fin de semana, que llega repleta de propuestas con zarzuela en el Teatro Circo, conciertos, actividades en Fuente Álamo y otras citas para disfrutar del verano en Puente Genil.

La actualidad de hoy viene marcada por la despedida a Francisco Berral, recordado maestro que desarrolló buena parte de su trayectoria docente en el colegio José María Pemán y cuya figura será homenajeada por el pueblo de Puente Genil. Repasamos además las novedades del Festival Flamenco Fosforito, cuyas entradas saldrán a la venta el próximo martes, y recorremos la agenda cultural y de ocio del fin de semana, con especial atención al Festival de Blues y al concierto que Curro Rumbao ofrecerá mañana en los Jardines de Santa Elena. Completamos el programa con la psicóloga Beatriz López, que nos ayudará a identificar los síntomas del síndrome del trabajador quemado y cómo afrontarlo.

In today's episode, Haylie Pomroy welcomes back Dr. Melanie Hoppers of the Bateman Horne Center for a deep dive into post-exertional malaise, or PEM, the defining feature of ME/CFS that turns the conventional wisdom about exercise completely upside down. Dr. Hoppers explains why pushing through fatigue can cause lasting and sometimes permanent damage in patients with ME/CFS and long COVID. She breaks down what PEM actually is at the physiological level, how mitochondrial exhaustion limits the body's ability to produce energy, and why willpower has nothing to do with it. She also shares practical, real-world pacing strategies, including resting heart rate tracking, scheduled rest breaks, and how to stay within what she calls the energy envelope to protect the body's potential for healing. If you or someone you love has been told to just push through it, this episode will change how you think about energy, healing, and what your body actually needs. Tune in to Fast Metabolism Matters. If your body feels like it's running on empty, overburdened, or just not responding the way it used to, Haylie's latest book, Toxic Overload, tells you exactly what to do. Download your free digital copy today and start understanding what your body is trying to tell you. Free Download: Get Your Copy of Toxic Overload

The GEL Jr. team is back to help you get hip to the latest evidence in pediatric point-of-care ultrasound! Russ, Lianne, and Delia dive into a multicenter study evaluating the diagnostic accuracy of PEM physicians performing POCUS for hip effusions. Does accurate diagnosis require extensive fellowship training, or can anyone master this scan with a little practice? Grab your linear probe and let's find out!

Episode 13 – Learn about ME and Multi MorbiditiesIn this thirteenth episode we discuss other health conditions that can occur alongside a diagnosis of Myalgic Encephalomyelitis (ME) or Long Covid. It's estimated that between 75% and 91% of people with ME also have another condition.[1]Common morbidities are Postural Orthostatic Tachycardia Syndrome (PoTS) and Mast Cell Activation Syndrome (MCAS). In this episode, our guests Dr Amy Small and Mary McGowan share their insights and experiences of the impact of the interaction of these health conditions with ME or Long Covid. Dr Small outlines an approach towards treating these conditions that highlights the importance of being curious about what is going on in that person's life and exploring how post exertional malaise (PEM) is affecting them. With PEM, the impact may show up days after an activity. So, giving information on pacing and how to conserve energy is key to supporting the person to manage their health and energy. Symptoms of PoTS can mimic anxiety, so GPs need to explore these types of symptoms. This may take more time than a standard appointment. We also discuss what adjustments could be offered by GPs to build a relationship with the patient over time, taking a light touch approach. Mary asks that GPs educate themselves about these conditions and to plan and review the care, taking a holistic view. Clinical cases on these conditions were added in the recent update to Learna's free continuing professional development (CPD) module on ME/CFS, which this podcast series was produced to complement. ResourcesLearna CPD module on ME: https://www.studyprn.com/p/chronic-fatigue-syndrome Learn about ME GP webinar: https://youtu.be/jGN_BBhSz7U?si=cOhz0SHq4uMdzFzv NICE Guideline on ME/CFS (current clinical guidance on ME/CFS in Scotland): https://www.nice.org.uk/guidance/ng206Learn about ME podcast series: https://mecfs.buzzsprout.com/ Action for ME professional development resource: https://www.actionforme.org.uk/resource/professional-development-for-me/ World ME Alliance Medical Education Hub: https://worldmealliance.org/medical-education-hub/ What is Pacing?: https://www.actionforme.org.uk/resource/what-is-pacing/ Pacing and energy management: https://www.actionforme.org.uk/supporting-you/pacing-and-energy-management/ Postural Orthostatic Tachycardia Syndrome (PoTS): https://www.potsuk.org/ Mast Cell Activation Syndrome (MCAS): https://www.mastcellaction.org/  [1] Jesús Castro-Marrero Ph.D. a, Mónica Faro M.D. a, Luisa Aliste Ph.D. a, Naia Sáez-Francàs M.D., Ph.D. b, Natalia Calvo Ph.D. c, Alba Martínez-Martínez M.Sc a, Tomás Fernández de Sevilla M.D., Ph.D. a, Jose Alegre M.D., Ph.D. a. (September–October 2017). Comorbidity in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Nationwide Population-Based Cohort Study. Psychosomatics Volume 58, (Issue 5), September–October 2017, Pages 533-543. Available at Doi: https://doi.org/10.1016/j.psym.2017.04.010  

Nieves Concostrina cuenta cómo Manuel de Falla se marchó a Argentina en 1939 huyendo de una España franquista opresiva y violenta para la cultura y las libertades. Pese a que rechazó regresar en vida y detestaba la pompa, tras su muerte en 1946 su cadáver fue repatriado por la dictadura y enterrado con grandes homenajes en la catedral de Cádiz, junto al franquista José María Pemán.

Nieves Concostrina cuenta cómo Manuel de Falla se marchó a Argentina en 1939 huyendo de una España franquista opresiva y violenta para la cultura y las libertades. Pese a que rechazó regresar en vida y detestaba la pompa, tras su muerte en 1946 su cadáver fue repatriado por la dictadura y enterrado con grandes homenajes en la catedral de Cádiz, junto al franquista José María Pemán.

Nieves Concostrina cuenta cómo Manuel de Falla se marchó a Argentina en 1939 huyendo de una España franquista opresiva y violenta para la cultura y las libertades. Pese a que rechazó regresar en vida y detestaba la pompa, tras su muerte en 1946 su cadáver fue repatriado por la dictadura y enterrado con grandes homenajes en la catedral de Cádiz, junto al franquista José María Pemán.

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long, MD (@long_brit), we cover pediatric intussusception.emDOCs.net Emergency Medicine (EM) Podcast To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle PlaySend us Fan Mail

El Parlamento de Andalucía ha evidenciado el escaso interes de Vox por formar parte de la cámara de representantes. El PP encomienda la presidencia del Parlamento nuevamente al veterano Jesús Aguirre en una mesa que controlará con la mayoría absoluta. Cinco de los siete puestos han quedado a manos del Partido Popular. Empieza el momento de la negociación y de la agenda de prioridad nacional y el PP en Andalucía actúa como lo ha hecho en otras comunidades, como por ejemplo: Extremadura, Aragón y Castilla y León. Los populares, como si hubiesen ganado la mayoría absoluta, no han negociado el reparto de las sillas. La justicia pone en libertad con medidas cautelares al cantante sevillano Benet, tras haber sido acusado en abril de una presunta agresión sexual.Detienen a un matrimonio británico por dejar a sus tres hijos pequeños en un Hotel de Benalmádena mientras se iban de fiesta y dar positivo en la prueba de cocaína en la sangre. Entre ellos se encontraba un bebé de seis meses.La mafia que circula por la costa andaluza vuelve a arremeter contra la justicia. De nuevo en Huelva, se pone en relieve la escalada de violencia de los narcotraficantes quienes han apuntado sus armas largas a la Guardia Civil como respuesta a la incautación de un alijo.El Servicio Andaluz de Salud contratará a 4.600 profesionales para cubrir los refuerzos de verano. Un 14% más que el año pasado.Los resultados de la Selectividad en la comunidad autónoma han salido. Un 90,63% de alumnos han sido aprobados. El plazo para pedir la revisión comienza, al igual que la inscripción a las universidades.En Mojácar, Almería, empieza la tradicional Fiesta de los Moros y Cristianos. Las celebraciones al aire libre durarán hasta el domingo.El Teatro de Verano en Cádiz ha regresado tras varios proyectos de reforma fallidos. Ha cambiado su nombre debido a la involucración propagandistica con el franquismo del escritor anterior y a partir de ahora pasa a llamarse José María Pemán.Marta Robles gana el premio de Novela Ateneo de Sevilla por su libro El Anillo de Eloísa. La historia de una saga familiar a lo largo de cien años.Se prevé el comienzo del levantamiento de la Verja que separa a Gibraltar y La Línea. Un paso más a la desaparición de la frontera como dicta el acuerdo entre la Unión Europea y Reino Unido.Escuchar audio

El puerto de Tarifa permanece cerrado por el temporal de levante que se recrudece hoy en la zona gaditana y campiña con aviso naranja, por rachas de 90 kilómetros. Marea Blanca alerta del cierre de centros de salud por la tarde en verano, mientras el SAS asegura que aumentará contratos. El 20 de agosto reabre el Teatro de verano de Cádiz que mantendrá el nombre de Pemán. Y el concurso del carnaval de Cádiz comenzará el 8 de enero en 2027. Y en "Se ha escrito un libro", el tiempo que dedicamos a nuestra literatura, el libro es hoy "Vientos de amura" de Manuel Bellido, con quien habla nuestro compañero Miguel Albandoz.Escuchar audio

Wenn wir in Europa einen Schritt machen, macht China drei: Kurz vor der Battery Show in Stuttgart analysiert Batterie-Experte Heiner Heimes vom PEM der RWTH Aachen in unserem Podcast, warum Europas Batteriezellproduktion im „Tal der Tränen“ steckt – und welche Kräfte dem Abwärtssog noch entgegenwirken können. Europa wollte beim Aufbau einer eigenen Batterieindustrie ganz vorne mitspielen. Doch nach Gigafactory-Ankündigungen, Milliardeninvestitionen und der Hoffnung auf technologische Souveränität ist die Lage deutlich ernüchternder geworden: Geplante Zellproduktionskapazitäten in Europa haben sich von angekündigten 2.000 auf unter 1.000 Gigawattstunden pro Jahr mehr als halbiert. Kurz vor der Battery Show Europe in Stuttgart spricht electrive-Chefredakteur Peter Schwierz in „eMobility Insights“ mit Professor Heiner Heimes vom Lehrstuhl Production Engineering of E-Mobility Components (PEM) der RWTH Aachen über die Frage, die über der europäischen Batteriebranche schwebt: Wird Europa bei der Batteriezellproduktion noch zu einem eigenständigen Industriestandort – oder verfestigt sich die Abhängigkeit von asiatischem Know-how? Heimes zeichnet ein bewusst differenziertes Bild: Neben der schwierigen Lage der Zellproduzenten entwickeln sich aus seiner Sicht Bereiche wie Recycling, Testinfrastruktur sowie Modul- und Packfertigung deutlich positiver. Besonders kritisch beurteilt er den Hochlauf der Zellfertigung: Nicht der Fabrikbau allein entscheidet über den Erfolg, sondern die Fähigkeit, dauerhaft hochwertige Zellen mit geringen Ausschussraten zu produzieren. Die Phase nach dem Start der Produktion nennt er das „Tal der Tränen“: Sie sei „maximal herausfordernd, maximal anspruchsvoll und […] unglaublich kapitalintensiv“. Am Beispiel Northvolt erläutert Heimes, warum technologische Schwierigkeiten beim Hochlauf nicht nur einzelne Unternehmen betreffen, sondern das Vertrauen von Investoren und Politik in die gesamte europäische Zellproduktion belasten können. Zugleich warnt er vor Selbstüberschätzung im globalen Wettbewerb: „Wird das noch was? Ja, ich wünsche es mir. Ich kämpfe dafür, wir alle kämpfen dafür, auf ganz unterschiedlichen Ebenen, in unterschiedlichen Bereichen. Wenn man das Ganze realistisch sieht, dann muss man das aber durchaus vorsichtig reflektieren.“ Dennoch ist das Gespräch kein Abgesang auf Europas Batterieindustrie. Heimes verweist auf Gegenkräfte: auf europäisches Forschungs- und Entwicklungswissen, auf Batterietesting, Recycling, Modul- und Packfertigung, auf Produktionsinnovationen und auf Unternehmen wie PowerCo. Für deren Rolle findet er klare Worte: „Wenn es Powerco mit Volkswagen nicht schafft, eine Batteriezellproduktion in Europa zu etablieren, wer soll es denn dann schaffen?“ Zugleich plädiert Heimes für ein stärker europäisch orchestriertes Vorgehen nach dem Vorbild von Airbus: Nicht jedes Land müsse alles selbst aufbauen; entscheidend sei eine arbeitsteilige, langfristig unterstützte europäische Wertschöpfungskette. Auch das neu gestartete Forschungsprojekt FastBat soll dazu beitragen, Produkt- und Prozessinnovationen sowie Start-ups zu fördern und Forschung in industrielle Wertschöpfung zu überführen. Wie also steht es um Europas Batteriezukunft? Die Antwort von Heiner Heimes ist weder Zweckoptimismus noch Untergangsszenario: „Ich bin da weder optimistisch noch pessimistisch. Ich bin realistisch.“ Eine Folge über industrielle Wahrheit, strategische Abhängigkeiten – und die Frage, welche positiven Kräfte Europa jetzt mobilisieren kann. Viel Spaß beim Hören!

Die Geschichten, die in diesem Podcast erzählt werden, handeln oft davon, wie Dinge besser werden. Insbesondere wie Genesung von einer Suchterkrankung dazu führt, dass Menschen stärker, gesünder und selbstbestimmter werden – Aber was ist mit Erkrankungen, die sich diesem »Recovery-Narrativ« verweigern? Wir wollen den ME/CFS-Awareness-Month dafür nutzen, über diese Fragen zu sprechen. Dafür haben wir die beiden Expertinnen Mirja Nicolas und Ronja Büchner eingeladen. Beide forschen zum Thema Stigmatisierung und Psychologisierung Betroffener.Falls ihr euch weiter informieren möchtet, hier findet ihr den frei verfügbaren Essay »Welche Rolle spielt „die Psyche“? Long COVID und ME/CFS als Prüfsteine für eine evidenzbasierte und patient*innenorientierte Psychiatrie und Psychotherapie«: https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-2866-9127.pdfPsychologisierung: Psychologisierung bedeutet zum einen, körperliche Erkrankungssymptome hauptsächlich oder ausschließlich als psychisch verursacht zu deuten, obwohl es klare Hinweise auf biologische Ursachen gibt. Es kann aber auch heißen, dass man psychische Faktoren überbewertet. Zum Beispiel wenn es um die Entstehung, Chronifizierung oder Aufrechterhaltung der körperlichen Symptome geht. Im Zusammenhang mit ME/CFS und Long Covid heißt das zum Beispiel, dass Beschwerden (subtil oder direkt) auf Stress, Angst, Depression, falsche Gedankenmustern oder Vermeidungsverhalten geschoben werden.Medical Gaslighting bedeutet, dass reale gesundheitliche Beschwerden von medizinischem Personal wiederholt als eingebildet, übertrieben oder rein psychisch dargestellt werden, sodass Betroffene an sich selbst zweifeln.PEM steht für Post-Exertional Malaise – bedeutet eine häufig zeitversetzt eintretende, unverhältnismäßige Verschlechterung des Zustands nach körperlicher oder kognitiver Aktivität, nach emotionaler Belastung oder durch zu viele Reize Es ist das Kernmerkmal von ME/CFS und kommt auch bei einem Teil der Long-Covid-Betroffenen vor.Pacing bedeutet, sich die eigene Energie sehr sorgsam einzuteilen, um auf jeden Fall unter der eigenen Belastungsgrenze zu bleiben. Ziel ist, auf diese Weise weitere Verschlechterungen (Crashes) zu vermeiden.SodaKlub auf Steady:https://steadyhq.com/de/sodaklub/Mia GatowMias Buch: »Rausch und Klarheit«Mias Newsletter: Romanzen und FinanzenMika DöringRecovery Deutschland e.V. Mikas Kunst Hosted on Acast. See acast.com/privacy for more information.

Arrancamos el programa de hoy con una amplia mirada a la actualidad local, en la que hablamos de las obras para mejorar la climatización del parvulario del colegio José María Pemán, repasamos la valoración que hace el secretario local del PSOE, José Antonio Gómez, tras los resultados electorales del pasado domingo y conocemos además los actos organizados por el Ayuntamiento con motivo del Día Internacional de la Salud de las Mujeres, junto a la presentación del encuentro empresarial sobre certificados de ahorro energético que se celebrará este jueves en el Hotel El Carmen; nos unimos también al camino de la Hermandad del Rocío de Puente Genil para conocer cómo avanza la peregrinación junto a su presidente, Daniel Jurado, y completamos el programa con Kike Urdiales y una nueva entrega de Más de Una Canción, esta semana con un guiño especial a los estudiantes que terminan el curso.

Advocate • Lived Experience with ME/CFS Join Anne Wilson, CEO of Emerge Australia, as she welcomes Carolyn Merritt, a remarkable advocate and retired physiotherapist, to the Imagine Podcast. In this insightful episode, Carolyn shares her personal journey with ME/CFS and dysautonomia, offering a unique perspective on the impact of post-exertional malaise (PEM). I don't think I really […]

Facilitator • Lived Experience ME/CFS • Advocate Join us for an insightful episode of the Emerge Australia Imagine Podcast as we delve further into the world of ME/CFS and the impacts of post-exertional malaise (PEM) with an expert guest, Louise De Pino. Louise, a trained social worker and experienced peer facilitator, brings a wealth of knowledge and personal […]

Educator • Advocate Join Anne Wilson, CEO of Emerge Australia, as she welcomes Kate Herbert, the organisation’s dedicated Nurse Educator, for an insightful conversation during ME/CFS Awareness Week. Kate, with her unique blend of professional expertise and personal experience, will delve into the often misunderstood and challenging aspects of post-exertional malaise (PEM) in ME/CFS. PEM is […]

For more information and support, join us at https://thecirsgroup.com Jacie and Barbara discuss chronic fatigue syndrome (ME/CFS), emphasizing it as a real, multisystem illness rather than “just being tired,” and describe hallmark symptoms like post-exertional malaise (PEM), unrefreshing sleep, brain fog/word-finding issues, orthostatic intolerance, sensory sensitivity, pain, headaches, and the push-crash cycle. They explain how ME/CFS is often hard to diagnose due to lack of a single definitive test, the use of exclusionary testing and symptom criteria, and how cardiopulmonary exercise testing can objectively demonstrate impaired recovery and reduced oxygen utilization, which is useful for disability or legal documentation. They argue the diagnosis is a label, not a root cause, and propose chronic inflammatory response syndrome (CIRS) from biotoxin exposure (often water-damaged buildings/mold) as a potential driver, citing Dr. Ming Dooley's review comparing ME/CFS research to CIRS treatment outcomes. They outline next steps: assess exposure history and symptom patterns, take symptom clusters and the VCS test, find a CIRS-literate practitioner, address current environments before protocols, and explore resources and their community membership. For more information and support, join us at https://thecirsgroup.com TIMESTAMPS 00:00 Intro to Chronic Fatigue / medical disclaimer 02:30 Chronic Fatigue Syndrome is real, let's ask WHY 04:26 What is ME/CFS? 06:40 The CFS lived experience 09:09 Getting a ME/CFS diagnosis 11:05 Labels vs root cause 12:08 What is actually happening when you have ME/CFS 13:01 How CIRS may cause ME/CFS: published research backed 15:29 Why doctors miss CIRS 17:14 Next steps if you want to seek treatment 20:10 Testing and find a practitioner that is Shoemaker Certified 21:04 Resources For more information and support, join us at https://thecirsgroup.com LINKS MENTIONED IN THIS EPISODE: Ming Dooley's published research connecting CFS and CIRS: https://pubmed.ncbi.nlm.nih.gov/40806417/ https://pmc.ncbi.nlm.nih.gov/articles/PMC11623837/ https://pubmed.ncbi.nlm.nih.gov/41265402/ VCS test and symptom questions for CIRS: https://www.survivingmold.com/store/online-vcs-screening Order Jacie's book! The 30 Day Carnivore Bootcamp: https://a.co/d/7MgHrRs The CIRS Group: Support Community: https://thecirsgroup.com Instagram: https://www.instagram.com/thecirsgroup/ Find Jacie for carnivore, lifestyle and limbic resources: Jacie's book on the Carnivore diet!  https://a.co/d/8ZKCqz0 Instagram: https://www.instagram.com/ladycarnivory YouTube: https://www.youtube.com/@LadyCarnivory Blog: https://www.ladycarnivory.com/ Find Barbara for business/finance tips and coaching: Website: https://www.actlikebarbara.com/ Instagram: https://www.instagram.com/actlikebarbara/ YouTube: https://www.youtube.com/@actlikebarbara Jacie is a Shoemaker certified Proficiency Partner, NASM certified nutrition coach, author, and carnivore recipe developer determined to share the life changing information of carnivore and CIRS to anyone who will listen. Barbara is a business and fitness coach, CIRS and ADHD advocate, writer, speaker, and a big fan of health and freedom. Together, they co-founded The CIRS Group, an online support community to help people that are struggling with their CIRS diagnosis and treatment.

In this new (not so new anymore) segment of PEM Rules Dr. Jay Fisher, who has been practicing PEM since 1992 came back to discuss an interesting case of something we don't see very often in the Peds ER and NEVER want to miss.   

Episode Notes Quite frankly, there is very little that this week's special guest hasn't dabbled in at some point . . .but, chances are you'll recognize the name, thanks to her nationally-syndicated radio program!! I'm delighted to welcome Pem Pfisterer Clark, host of "Wedding Planning with Pem", heard on Henderson's WSON Radio, and many other stations across the Commonwealth and beyond! Pem is also a licensed wedding officiant, who offers several scenic settings which are uniquely suited to accommodate intimate ceremonies. If that weren't enough, she is an excellent source of tuxedo and suit rentals for special occasions...and, she skillfully teaches art to children of all ages through her downtown Henderson studio of art instruction. Join me and Pem as we discuss the discovery of her artistic talents, her masterful works of art that have been sold both nationally and internationally, and the specifics of the classes she regularly teaches. We also detail her tuxedo/suit rental business, her splendid wedding venues, and the creation/evolution of her radio show (which is still going strong after 25 years!). Lastly, we touch on a podcast she co-hosts with long-time WSON News Director Bill Stephens Stark known as "Around Town with Stark and Clark". For inquiries regarding any and all aspects of my conversation with Pem, don't hesitate to call or text her at 270-454-8181. Additional information about "Wedding Planning with Pem" is readily available through the web page linked here: https://weddingplanningwithpem.com/. Be sure to click on the following link to find out more about Pem's engaging art classes for children: https://mspemsartforkids.com/. Details about her intimate wedding spaces are as close as the following website: https://marrymesimply.com/. And finally, listen and subscribe to the "Around Town with Stark and Clark" podcast by simply clicking here: https://aroundtownwithstarkandclark.com/. Find out more at https://blabbin-in-the-bluegrassblabbi.pinecast.co

Despite working in a very busy Pediatric Emergency Department, Urological emergencies are not too common and often those patients challenge us. That is why I invited Dr. Jessica Casey whom I sometimes consult from the Pediatric ER to talk about common urological emergencies. Here are two links Jessica recommends us PEM providers   Article on Priapism in children https://pubmed.ncbi.nlm.nih.gov/24135215/ The TWIST score calculator. https://www.mdcalc.com/calc/10440/testicular-workup-ischemia-suspected-torsion-twist   Please consider contributing to PEM Rules at https://ko-fi.com/pemrules And check out www.pemrules.com    Copyright PEM Rules LLC DISCLAIMER By listening to this podcast, you agree not to use these resources as medical advice to treat any medical conditions in either yourself or others, including, but not limited to, patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or website. Under no circumstances shall PEM Rules, the PEM Rules podcast or any guests or affiliated entities be responsible for damages arising from their use. This podcast should not be used in any legal capacity whatsoever, including, but not limited to, establishing "standard of care" in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the website or in the podcast.    

Discover some of the first collected objects in PEM's storied collection.

How to stop post-exertional malaise If you have M.E/CFS and keep experiencing post-exertional malaise, this video is for you.In this week's episode, I break down exactly why PEM happens, why the push-crash cycle keeps you stuck, and what actually helps you get out of it.If you're tired of doing too much, crashing, and feeling like you're going around in circles, I think this will really help. Here are 4 ways we can help. 1. Join our free community to meet others, be inspired, and get more recovery info - https://www.facebook.com/groups/cfshealthrecoveryhub 2. Watch the newly released past members "Guest Panel" Workshop where they share their top 5 recovery secrets - https://www.cfshealth.com/guestpanelreplay 3. Get our free most popular recovery trainings:- Find your baseline - Stop pushing and crashing - https://www.cfshealth.com/baseline - The 3 stages of recovery and what to do in each one - https://www.cfshealth.com/the3stages - The "9 do's and don'ts" PDF - to decrease symptoms and improve energy - https://www.Cfshealth.com/pdf 4. Want to help professionally with a step-by-step recovery plan specific to you? Fill out the application form and the team will send you the details - https://www.cfshealth.com/form

Gros zoom sur les skills et leurs usages dans les coding agents, sur les benchmarks de stacks techniques MCP, mais aussi du Java 26-27, du HttpClient, du NodeJS, des scenarios nucléaires pilotés par l'IA, de la méthodologie, bref on ne s'ennuie pas ! Enregistré le 15 mars 2026 Téléchargement de l'épisode LesCastCodeurs-Episode-338.mp3 ou en vidéo sur YouTube. News Langages Bruno Borges a créé un site, inspiré d'un site récent qui montrait comment CSS avait évolué, qui illustre justement comment Java a bien évolué au fil du temps, et est devenu un langage encore plus élégant https://javaevolved.github.io/ Code simplifié: main() allégé, var, blocs de texte, API String enrichie. Pattern Matching: switch sur types, instanceof amélioré, record patterns. Données: Records, collections immuables faciles à créer, méthodes de listes. Concurrence: Threads virtuels, CompletableFuture, StructuredTaskScope, ScopedValue. Erreurs & Sécurité: NPE précis, catch multiples, Optional amélioré, filtres de désérialisation. I/O & Réseau: HttpClient moderne, E/S fichiers/console simplifiées, transferTo. Dates & Heures: API modernisée, précise, immutables et thread-safe. Langage: Interfaces sealed/private, import de modules, Math.clamp Streams: Nouveaux opérateurs (takeWhile, mapMulti, Gatherers, teeing). Outils & Perf: jshell, exécution simplifiée, jwebserver, AOT, JFR, optimisation mémoire. 10+ raisons de ne pas utiliser le HttpClient du JDK, avec un article très détaillé de Brice Dutheil https://blog.arkey.fr/2026/02/08/ten-reasons-to-not-use-jdk-httpclient/ JDK HttpClient: intégré, non-upgradable. OkHttp: plus lourd (dépendance Kotlin). TLS/SSL: JDK: SSLContext limité, vérif hôte globale, épinglage manuel, SSLParameters rigides. OkHttp: contrôle fin (SSLSocketFactory/TrustManager), vérif hôte/épinglage dédiés, ConnectionSpec structuré. Connexions: JDK: pas de repli, fabrique socket custom impossible (pas UDS/Named Pipes direct), pool limité (propriétés système, contrôle pauvre avant JDK 20/21). OkHttp: repli automatique, fabrique custom, pool granulaire. Réseau: JDK: résolveur DNS par défaut, Authenticator unique. OkHttp: résolveur DNS custom, authentificateurs séparés (proxy/serveur). Cycle Requêtes: JDK: pas d'intercepteurs ni API événements intégrés. OkHttp: addInterceptor, EventListener pour événements granulaires. Ressources: JDK: pas d'arrêt propre avant JDK 21. OkHttp: arrêt granulaire (pool, exécuteur, cache). Timeout: JDK: désactivé après en-têtes; le transfert du corps peut dépasser le timeout initial. JDK 26 et JDK 27 : ce qui nous attend — https://www.infoq.com/news/2026/02/java-26-so-far/ JDK 26 est une version non-LTS prévue le 17 mars 2026, avec 10 nouvelles fonctionnalités réparties en 5 catégories Le support HTTP/3 arrive enfin dans l'API HTTP Client standard de Java (JEP 517) La Structured Concurrency (projet Loom) en est à sa 6e preview, avec l'ajout d'une méthode onTimeout() sur StructuredTaskScope.Joiner Les Lazy Constants passent en 2e preview : des constantes initialisées à la demande, utiles pour optimiser le démarrage Le G1 GC gagne en performance via une réduction des synchronisations entre threads applicatifs et threads GC (JEP 522) Le cache d'objets AOT (JEP 516) est étendu pour fonctionner avec n'importe quel GC, y compris ZGC L'API Applet est définitivement supprimée (JEP 504), fermant une page historique de Java L'encodage PEM des objets cryptographiques continue sa preview avec support de chiffrement/déchiffrement de KeyPair Pour JDK 27 (septembre 2026), l'échange de clés post-quantique hybride pour TLS 1.3 est déjà ciblé (JEP 527) Project Valhalla progresse avec une preview des Value Classes : objets sans identité, à champs final uniquement Librairies Une étude de performance montre que Java est un super choix pour développer des serveurs MCP https://www.tmdevlab.com/mcp-server-performance-benchmark.html Comparaison de performances de serveurs MCP (Model Context Protocol) en Java, Go, Node.js, Python. Méthodologie: 3,9 millions requêtes, environnement Docker (1 cœur CPU, 1 Go RAM/serveur). Fiabilité: 0% d'erreurs pour toutes les implémentations. Tiers de performance: 1 (Haute): Go & Java (latence < 1ms, ~1600 requêtes/s). ▪︎ Go: Efficacité mémoire exceptionnelle (18 Mo vs 220 Mo pour Java). ▪︎ Java: Latence marginalement meilleure, mais 12x plus de mémoire. 2 (Moyenne): Node.js (latence ~10,7 ms, ~560 requêtes/s). Surcharge par instanciation. 3 (Faible): Python (latence ~26,5 ms, ~290 requêtes/s). Limité par GIL. Recommandations production: Go: Optimal forte charge, cloud-native, optimisation coûts. Java: Latence très basse critique, infrastructure Java existante. Node.js & Python: Adaptés charges modérées/faibles, développement/test. Node.js et Python peuvent être optimisés pour améliorer leurs performances en production. Et encore, en Java, le benchmark n'a pas utilisé GraalVM pour une compilation native, ce qui aurait donné des chiffres côté mémoire qui aurait concurrencé Go Qui a la meilleure perf entre Quarkus et Spring pour faire des serveurs MCP ? https://medium.com/@egekaraosmanoglu/spring-boot-vs-quarkus-which-java-runtime-wins-the-ai-mcp-tools-performance-battle-4da9d6a248d5 Quarkus JVM: Débit et latence les plus élevés (jusqu'à 16 381 req/s, 65% plus rapide que Spring Boot), surpasse Spring Boot même avec Apache Camel. Quarkus Native: Consommation mémoire la plus faible (118 MB), démarrage instantané, performance prédictible. Spring Boot MVC: Bonnes performances, écosystème mature, nécessite un "warm-up" important (jusqu'à 44% de gain). Spring Boot WebFlux: Légèrement meilleur débit et latence que MVC (~5%), mais plus de mémoire et complexité réactive. Coût architectural: MapStruct: Impact négligeable (< ±5%). Apache Camel: Réduction de débit de 8-21%, mais valeur ajoutée significative; Quarkus JVM + Camel reste > Spring Boot baseline. Protocole MCP: Sur Quarkus JVM (avec Camel), surpasse gRPC. Recommandations: Débit max: Quarkus JVM. Coût/Serverless: Quarkus Native. Intégration d'entreprise: Quarkus JVM + Camel + MapStruct. Meilleur choix Spring: Spring Boot WebFlux + MapStruct. Benchmark des stacks qui implémentent MCP https://www.tmdevlab.com/mcp-server-performance-benchmark-v2.html MCP (Model Context Protocol) est le protocole d'Anthropic pour connecter les LLMs à des outils et sources de données externes ; ce benchmark compare 15 implémentations serveur. 39,9 millions de requêtes traitées avec zéro erreur, sur des charges I/O réalistes (Redis + HTTP API) plutôt que des tâches CPU synthétiques. Rust atteint 4 845 RPS avec seulement 10,9 Mo de RAM ; Quarkus obtient 4 739 RPS avec la meilleure latence (4,04 ms en moyenne, 8,13 ms au P95). Go (3 616 RPS) et Spring MVC (3 540 RPS) constituent un second groupe solide. Node.js plafonne à 423 RPS ; Bun est 2,2x plus rapide sur un code identique (876 RPS) ; Python atteint 259 RPS avec 4 workers et uvloop. Découverte notable : un bug dans le SDK Rust rmcp v0.16 ajoutait ~40 ms de latence à toutes les réponses HTTP, limitant le débit à 1 283 RPS ; corrigé en v0.17 via la PR #683. Les images natives GraalVM réduisent la mémoire de 27 à 81 % mais dégradent le débit de 20 à 36 % ; Quarkus-native est l'exception avec 36 Mo RAM et 3 449 RPS. Spring MVC (bloquant) surpasse WebFlux (réactif) à 50 utilisateurs simultanés, rappelant que le modèle réactif n'est pas toujours gagnant. Recommandations : Rust ou Quarkus pour la production haute charge, Go pour le cloud-native, Bun plutôt que Node.js en JavaScript. Jakarta EE 12 Milestone 2 : données, cohérence et configuration https://www.infoq.com/articles/jakartaee-12-milestone-2/ Jakarta EE est la plateforme Java entreprise open-source, socle de frameworks comme Quarkus et Spring, qui standardise les APIs pour la persistance, les transactions, la sécurité, etc. Jakarta EE 12 adopte Java 21 comme baseline (avec support Java 25) et supprime définitivement le SecurityManager déprécié. La nouvelle spec Jakarta Query unifie JPQL (SQL/relationnel) et JDQL (NoSQL) en un seul langage avec deux profils : Core Language (portable) et Persistence Language (relationnel). Jakarta Data 1.1 introduit les requêtes dynamiques via une API fluente avec Restriction et l'annotation @Is pour des conditions plus expressives. Jakarta Data supporte désormais les repositories stateful, permettant la gestion du cycle de vie des entités (persist, merge, detach, refresh) comme en JPA classique. Jakarta NoSQL 1.1 intègre Jakarta Query via une nouvelle interface Query et supporte les projections avec des Java records. Jakarta Persistence 4.0 supporte SequencedCollection (Java 21) comme type de collection dans les entités. Une nouvelle spec Jakarta Agentic AI est en cours, visant des APIs vendor-neutral pour construire des agents IA sur les runtimes Jakarta EE, avec intégration prévue de LangChain4j et Spring AI. Cette release est encore un milestone (pas pour la prod) — l'adoption large dépendra de la maturité des outils (IDE, validation de requêtes, diagnostics). Nouveaux benchmarks Quarkus vs Spring Boot : performance complète et transparente https://quarkus.io/blog/new-benchmarks/ Quarkus est un framework Java optimisé pour les conteneurs, connu pour son faible usage mémoire et son démarrage rapide, concurrent principal de Spring Boot. Les anciens graphiques de performance sur quarkus.io étaient obsolètes, sans date, sans source, et ne montraient pas le débit (throughput). L'absence de données sur le throughput faisait croire à tort que Quarkus avait de mauvaises performances à ce niveau. Un nouveau benchmark open source a été créé, transparent et reproductible, disponible sur GitHub. Résultats : Quarkus gère 2,7x plus de transactions par seconde que Spring Boot, démarre 2,3x plus vite, avec deux fois moins de mémoire. Des experts Spring Boot externes ont contribué à rendre la comparaison plus équitable, notamment sur la configuration des pools de connexions. Les threads virtuels améliorent le débit d'environ 6000 tps supplémentaires pour tous les frameworks testés. Spring Boot 4 offre un meilleur débit que Spring Boot 3, mais au prix d'un démarrage plus lent et d'une empreinte mémoire plus élevée. En mode natif (GraalVM), le démarrage est ultra-rapide mais le throughput est divisé par deux, pour Quarkus comme pour Spring Boot. Le mode natif n'est recommandé que pour les applis démarrées/arrêtées très fréquemment ou à faible charge. Quarkus 3.32 : fondations pour la prochaine LTS https://quarkus.io/blog/quarkus-3-32-released/ Quarkus est un framework Java cloud-natif optimisé pour GraalVM et HotSpot, conçu pour les microservices et les environnements conteneurisés. Cette version marque le feature freeze pour la prochaine version LTS 3.33. Intégration de Project Leyden (AOT JVM) : le démarrage d'une application REST minimale passe de 370ms à 80ms. L'entraînement Leyden peut se déclencher au build ou via les tests d'intégration. Amélioration du graceful shutdown HTTP, avec des contributions de l'équipe Keycloak. Enregistrement automatique dans Consul via l'extension Stork pour la découverte de services. Nouvelles fonctionnalités de sécurité : DPoP nonce providers personnalisés, support de rich authorization pour OIDC. Possibilité de personnaliser l'ordre des mécanismes d'authentification et ajout de OIDCAuthenticationCompletionAction. Mise à jour du framework Google Cloud Functions en version 2.0, ainsi que Camel Quarkus et Quarkus CXF. Les utilisateurs sur LTS 3.27 sont encouragés à tester la migration vers 3.33 pour faire remonter des retours. NodeJS change sa cadence de releases https://nodejs.org/en/blog/announcements/evolving-the-nodejs-release-schedule Node.js est le runtime JavaScript côté serveur le plus utilisé, géré par la OpenJS Foundation avec un cycle de releases actif depuis la fusion avec io.js il y a dix ans. À partir de Node.js 27 (octobre 2026), le projet passe d'une release majeure tous les six mois à une seule par an. Chaque release deviendra LTS, supprimant la distinction entre versions paires (LTS) et impaires (non-LTS). Un nouveau canal Alpha est introduit, permettant les changements semver-major pendant la phase de test précoce. Les phases deviennent : Alpha (6 mois, oct. à mars), Current (6 mois, avr. à oct.), LTS (30 mois), puis EOL. La durée totale de support reste de 36 mois, identique au modèle actuel. La numérotation des versions s'aligne sur l'année calendaire de la release Current (ex : 27.0.0 en 2027). La version Alpha est signée, taguée et testée via CITGM, mais n'est pas destinée à la production. La motivation principale : les versions impaires étaient peu adoptées, la distinction pair/impair perturbait les débutants, et réduire les lignes de release parallèles allège la charge des bénévoles. Les auteurs de bibliothèques sont encouragés à intégrer les releases Alpha dans leur CI dès que possible pour détecter les régressions en amont. Web jQuery v4 est sorti https://www.infoq.com/news/2026/02/jquery-4-release/?utm_source=twitter&utm_medium=link&utm_campaign=calendar jQuery est une bibliothèque JavaScript historique qui simplifie la manipulation du DOM, la gestion des événements et les requêtes AJAX, encore très présente dans de nombreuses bases de code. Cette version majeure sort pour les 20 ans de la bibliothèque, après presque une décennie sans version majeure. Suppression du support d'Internet Explorer 10 et antérieur, Edge Legacy et les anciennes versions iOS/Android. IE11 reste encore supporté dans jQuery 4, mais sa suppression est prévue pour jQuery 5. Le code source migre d'AMD vers les ES modules, pour une meilleure compatibilité avec les outils de build modernes. Le bundler passe de RequireJS à Rollup. Suppression des fonctions dépréciées comme jQuery.isArray, jQuery.parseJSON et jQuery.trim, désormais disponibles nativement en JavaScript. Le fichier gzippé gagne plus de 3 000 octets ; le build slim descend à environ 19,5 ko. Ajout du support des Trusted Types pour faciliter la compatibilité avec les Content Security Policy strictes. jQuery reste pertinent pour la maintenance de bases de code existantes et les projets nécessitant une faible dépendance aux frameworks. La réactivité en frontend : concepts et approches https://www.sfeir.dev/front/quest-ce-que-la-reactivite-en-frontend/ Un article qui resume comment la reactivite est implementee en front web La réactivité en frontend désigne le mécanisme qui permet de mettre à jour automatiquement l'UI quand les données changent, sans manipulation directe du DOM. Sans réactivité, les développeurs doivent mettre à jour manuellement chaque élément de l'interface, ce qui est fastidieux et source d'erreurs. Le data binding unidirectionnel (React) distingue le flux de données des callbacks d'interaction utilisateur. Le data binding bidirectionnel (Angular) synchronise automatiquement données et UI dans les deux sens. Le Virtual DOM (React, Vue) compare une représentation en mémoire avec le DOM réel avant d'appliquer uniquement les changements nécessaires. Les observables via RxJS (Angular) permettent de gérer des flux de données asynchrones et des événements complexes. Les signaux (SolidJS, Angular récent, Svelte) offrent des mises à jour granulaires et de meilleures performances que les approches précédentes. Les signaux proposent une API plus simple que les observables tout en restant très performants. La réactivité abstrait la manipulation du DOM et permet aux développeurs de se concentrer sur l'état de l'application. Data et Intelligence Artificielle Gunnar Morling a annoncé la sortie de Hardwood, un nouveau parseur Java pour les fichiers Apache Parquet, grâce aux leçons apprises par le 1BRC challenge https://www.morling.dev/blog/hardwood-new-parser-for-apache-parquet/ Hardwood : Nouveau parseur Apache Parquet open-source (Java 21+). But : Dépasser parquet-java (dépendances lourdes, lecteur mono-threadé). Points clés : Dépendances minimes, pipeline de décodage multi-threadé. APIs : RowReader (ligne) et ColumnReader (colonne, haute perf.). Optimisations : Parallélisme pages, préchargement adaptatif, moins d'allocations. Développement : Assisté par IA (Claude Code), révision humaine. Futur : "Predicate push-down", compatibilité parquet-java, écriture, CLI, intégration Iceberg. Apicurio Registry passe AI-Native — https://www.apicur.io/blog/2026/02/05/apicurio-registry-ai-natural-evolution Apicurio Registry est un registre open-source de schemas (OpenAPI, AsyncAPI, Avro, Protobuf…) gérant versioning, validation et gouvernance des APIs. Le projet étend ses capacités pour devenir une plateforme native AI, en appliquant les mêmes principes de gouvernance aux agents IA. Support du protocole A2A (Agent-to-Agent) : les agents s'enregistrent via des "Agent Cards" et se découvrent mutuellement via des endpoints standardisés. Un serveur MCP intégré permet aux LLMs d'interagir directement avec le registre (découverte de schémas, validation, création). L'intégration avec Claude Desktop est déjà documentée, permettant de gérer les artefacts en langage naturel. Deux nouveaux types d'artefacts : PROMPT_TEMPLATE (templates de prompts versionnés avec variables) et MODEL_SCHEMA (validation des entrées/sorties des agents). Les SDKs Java (LangChain4j, Quarkus) et Python (LangChain, LlamaIndex) sont disponibles. Une démo multi-agents illustre le "context chaining" : chaque agent reçoit les sorties des agents précédents dans la pipeline. La roadmap prévoit : gestion du cycle de vie des agents, recherche sémantique, intégration dans les pipelines de déploiement. L'Histoire du Deep Learning : quand les machines ont commencé à apprendre https://blog.ippon.fr/2026/02/20/lhistoire-du-deep-learning-quand-les-machines-ont-commence-a-apprendre/ un article qui retrace les avancées clées du machine learning Le deep learning est un sous-domaine du ML basé sur des réseaux de neurones empilés en couches, aujourd'hui omniprésent dans la vision, le langage et la recommandation. Le Perceptron (1957) est le premier modèle formel d'apprentissage supervisé, mais il échoue sur des problèmes non linéaires comme le XOR : une limite structurelle, pas algorithmique. La rétropropagation du gradient (années 80) permet d'entraîner des réseaux multi-couches, mais souffre du problème de "vanishing gradient" qui bloque l'apprentissage en profondeur. L'essor du deep learning dans les années 2000 est autant une révolution matérielle qu'algorithmique : les GPU, conçus pour le jeu vidéo, se révèlent parfaitement adaptés aux calculs matriciels. AlexNet (2012) marque une rupture industrielle en démontrant qu'un CNN profond entraîné sur GPU surpasse largement les méthodes classiques en reconnaissance d'images. Les LSTM (1997) résolvent les problèmes de mémoire à long terme des RNN, mais leur nature séquentielle limite fortement la parallélisation. Les Transformers ("Attention Is All You Need", 2017) révolutionnent le domaine en remplaçant la récursion par un mécanisme d'attention parallélisable, adaptable aux GPU et TPU. L'IA générative introduit une rupture conceptuelle : les modèles apprennent la distribution des données pour en produire de nouveaux exemples, et non plus simplement classifier. Les LLM offrent un socle généraliste réutilisable pour de nombreuses tâches, là où l'IA prédictive nécessitait un modèle spécifique par problème. La question de l'AGI reste ouverte et très incertaine, mais l'IA devient déjà un "acteur logiciel" capable de raisonner et d'agir de manière autonome via les agents. Ca y est, Agent to Agent Protocol (A2A) est sorti en version 1.0 https://a2a-protocol.org/latest/announcing-1.0/ Prêt pour la prod Support multi-version ( multi-protocoles (gRPC, HTTP+JSON…) Multi-tenancy : un même endpoint peut supporter et exposer plusieurs agents distincts Agent Cards signées et vérifiables cryptographiquement pour vérifier l'identité des agents Flexibilité : les clients peuvent choisir de consommer les résultats par polling, streaming, ou également webhooks Outillage Le guide complet pour créer des skills pour vos agents, par Anthropic https://resources.anthropic.com/hubfs/The-Complete-Guide-to-Building-Skill-for-Claude.pdf Définition et structure : Les skills sont des dossiers contenant des instructions (fichier SKILL.md obligatoire) et des scripts qui enseignent aux agents comment exécuter des tâches spécifiques ou utiliser des outils MCP de manière fiable. Fonctionnement technique : Le système repose sur la "divulgation progressive" via un en-tête YAML critique, permettant à Claude de charger le contexte de la compétence uniquement lorsque la demande de l'utilisateur le nécessite. Cycle de vie : Le guide couvre toutes les étapes de développement, de la définition des cas d'usage (automatisation, création de documents) aux protocoles de test et de distribution. il couvre aussi comment tester (brievement) et des patterns communs Apprendre a utiliser les skills pour structurer son code ia https://philippart-s.github.io/blog/2026-02-18-anthropic-skills/ Les Skills Claude sont des packages d'instructions dans un dossier enseignant à Claude comment gérer des tâches spécifiques de façon cohérente. Un skill se compose au minimum d'un fichier SKILL.md avec un frontmatter YAML et des instructions en Markdown. Le frontmatter YAML impose deux champs obligatoires : name (en kebab-case) et description (max 1024 caractères expliquant quoi faire et quand le déclencher). Les skills fonctionnent de façon identique sur Claude.ai, Claude Code et l'API sans modification. Trois catégories principales : création de documents/assets, automatisation de workflows multi-étapes, et amélioration d'intégrations MCP. Les skills s'appuient sur le principe de divulgation progressive : frontmatter toujours chargé, corps du SKILL.md si pertinent, fichiers liés à la demande. Cinq patterns courants : orchestration séquentielle, coordination multi-MCP, raffinement itératif, sélection d'outils contextuelle, intelligence métier embarquée. Les tests doivent couvrir le déclenchement (90% des requêtes pertinentes), le fonctionnel et la comparaison avec la baseline sans skill. Pour la distribution, héberger sur GitHub avec un README séparé du dossier du skill (pas de README.md dans le dossier lui-même). Un skill-creator officiel permet de générer un premier SKILL.md en 15-30 minutes à partir d'une description en langage naturel. Les skills pour les agents, c'est une façon d'automatiser des tâches répétitives https://glaforge.dev/posts/2026/02/21/easily-build-a-local-mcp-server-in-java-with-a-skill-in-gemini-cli/ Construction facile de serveurs MCP Java locaux pour Gemini CLI et autres agents. Solution au code Java répétitif : JBang + LangChain4j + un "skill" utilisé par Gemini CLI. Idée clée : Une "skill" pour Gemini CLI automatise génération et installation des serveurs. La "skill" génère un fichier Java, le compile et l'enregistre dans les paramètres de Gemini CLI. Avantages : Élimine le boilerplate, enregistrement automatique, développement rapide. Conclusion : Les "skills" d'agent automatisent les tâches répétitives et systématisent l'expérimentation. Un SKILL.md par Julien Dubois pour permettre aux agents IA de créer des projets Spring en suivant les bonnes pratiques à la JHipster https://github.com/jdubois/dr-jskill/blob/main/SKILL.md Dr JSkill est une "Agent Skill" conçue pour aider les IA (GitHub Copilot CLI, Claude Code) à générer des applications Spring Boot 4.x selon les meilleures pratiques de Julien Dubois. Permet de créer des projets full-stack modernes utilisant Java 25, PostgreSQL et Docker, avec un choix de frameworks front-end (Vue.js par défaut, React, Angular ou Vanilla JS). Intègre des scripts Node.js multiplateformes pour automatiser la génération de projets via start.spring.io sans dépendances npm externes. Préconise des choix technologiques stricts : Maven uniquement, pas de Lombok, et utilisation de Hibernate ddl-auto pour la gestion du schéma (pas de Flyway/Liquibase). Supporte nativement la compilation GraalVM (images natives) pour des démarrages ultra-rapides (

The Radical Neurodivergent Act of Stopping Before You're Exhausted Patricia (she/her) shares what it's like when life is actuall calm. Without drama or big stories to tell, she reflects on learning to honor her energy limits. Patricia talks about pacing physical activity, noticing the urge to push past fatigue, and practicing self-compassion when her body needs rest. She also shares everyday moments—from kayaking at sunrise to navigating workouts and dog walks—while exploring what it means for autistic and neurodivergent people to find the "sweet spot" between doing enough and doing too much. WHAT YOU'LL HEAR IN THIS EPISODE ·       Sometimes life is peaceful and stable—and that can make content creation surprisingly hard. ·       Many creatives and neurodivergent people are used to generating insight during moments of stress or conflict. ·       Learning to honor calm periods can be a form of nervous system healing. ·       Patricia reflects on getting back into kayaking and being on the water, which brings joy and grounding. ·       Physical energy levels can change over time, especially with chronic illness or post-exertional malaise. ·       Pacing physical activity is an ongoing learning process. ·       The urge to "do just one more thing" can push the body past its limits. ·       Choosing to stop while still feeling okay can prevent a crash later. ·       Post-exertional malaise (PEM) can cause significant fatigue after physical or cognitive exertion. ·       Some autistic and neurodivergent people experience PEM, especially with hypermobile Ehlers-Danlos syndrome (hEDS) or related conditions. ·       Finding the sweet spot between movement and rest is an ongoing experiment. ·       Overexertion can lead to days of fatigue that disrupt daily functioning. ·       Practicing restraint—doing less than your maximum—can actually support long-term wellbeing. ·       Asking for help, like getting assistance with moving a kayak, is part of sustainable energy management. ·       Even small tasks can become energy-intensive when managing chronic fatigue. ·       Devices and metrics (like watches and headphones) can sometimes create frustration rather than helpful feedback. ·       Everyday moments—like figuring out how to climb out of a pool—can become humorous reflections on aging and energy limits. ·       Patricia shares updates about family, travel plans, and caring for pets while balancing energy. ·       OCD thoughts still pop up, but she practices noticing and naming them rather than getting pulled into them. ·       Life doesn't always need drama to be meaningful—sometimes calm and connection are enough. SOUND BITES · "I create my best content when there's drama—but I don't actually want any drama." · "Everything is going really well right now… and I just don't have a lot to talk about." · "I'm really practicing holding back a little so there's something left in the tank." · "It's that balance—enough stimulation but not too much, enough movement but not too much."   SENSITIVITY IS NOTHING TO APOLOGIZE FOR; IT'S HOW YOUR BRAIN IS WIRED You are not broken. You were shaped by systems that weren't built for you. You deserve rest, joy, and support exactly as you are. PODCAST HOST Patricia Young (she/her) was a Licensed Clinical Social Worker for over 17 years, but she is now exclusively providing coaching. She knows what it's like to feel like an outcast, misfit, and truthteller.  Learning about the trait of being a Highly Sensitive Person (HSP), then learning she is AuDHD with a PDA profile, OCD and RSD, helped Patricia rewrite her history with a deeper understanding, appreciation, and a sense of self-compassion.  She created the podcasts Unapologetically Sensitive and Unapologetically AuDHD to help other neurodivergent folks know that they aren't alone, and that having a brain that is wired differently comes with amazing gifts, and some challenges.  Patricia works online globally working individually with people, and she teaches Online Courses for neurodivergent folks that focus on understanding what it means to be a sensitive neurodivergent. Topics covered include: self-care, self-compassion, boundaries, perfectionism, mindfulness, communication, and creating a lifestyle that honors you Patricia's website, podcast episodes and more: www.unapologeticallysensitive.com   LINKS   To write a review in itunes: click on this link https://itunes.apple.com/us/podcast/unapologetically-sensitive/id1440433481?mt=2 select "listen on Apple Podcasts" chose "open in itunes" choose "ratings and reviews" click to rate the number of starts click "write a review"   Website--www.unapologeticallysensitive.com Facebook-- https://www.facebook.com/Unapologetically-Sensitive-2296688923985657/ Closed/Private Facebook group Unapologetically Sensitive-- https://www.facebook.com/groups/2099705880047619/ Instagram-- https://www.instagram.com/unapologeticallysensitive/ Youtube-- https://www.youtube.com/channel/UCOE6fodj7RBdO3Iw0NrAllg/videos?view_as=subscriber Tik Tok--https://www.tiktok.com/@unapologeticallysensitiv Unapologetically AuDHD Podcast-- https://unapologeticallysensitive.com/unapologeticallyaudhd/ e-mail-- unapologeticallysensitive@gmail.com Show hashtag--#unapologeticallysensitive Music-- Gravel Dance by Andy Robinson www.andyrobinson.com  

Welcome to Episode 65 of This Is Not Happening. An Album of the Month podcast. In Part 1, we review our Album of the Month. This month Nolan brings a big chunk of country (or is Heartland Rock?) with Zach Bryan's latest release 'With Heaven On Top'.In Part 2, we play Spin It or Bin It, we pick a theme and all pick songs that represent that theme. This month the theme is 'New Music', tracks released since January 1st.__________Part 1 | Album of the Month | Zach Bryan | With Heave On Top ____________Zach Bryan is a relatively divisive, country artist who is HUGE in the states but can his latest album help him become (even more of) a global superstar? At 25 tracks and 1hr 18 mins he's giving the album every chance of making an impact.This album has genuine, authentic heart. It's length is a big talking point, so is it's genre, is it country? Americana? Something else?Listen to the original album here.Listen to the acoustic version released 3 days after the original here.Watch an interesting conversation with Bryan and Springsteen here.       ___________________Part 2 | Spin It or Bin It | New Music _____________________Every 3 months we pick the theme 'New Music' and each pick 4 tracks that have been released in the last 2 month. Listen to our 16 track play list that we created for the New Music theme.We then each pick select 1 track and ask the simple question 'Spin It Or Bin It'?Joey chose 'Aperture' by Harry Styles.David chose 'Miami' by Pigeon.Nolan chose 'Milk, Blue' by Pem.Guy chose 'Out of Phase' by Alexis Taylor and Lola KirkeWe've been writing the blog for years come and have a look - https://thisisnothappening.net/

In this episode, Evan H. Hirsch, MD, unpacks one of the most frustrating and misunderstood symptoms of Long Covid and ME/CFS: post-exertional malaise (PEM). If you feel worse after physical or mental activity (even simple things like doing the dishes or going for a short walk) you might be experiencing PEM. In this episode, you'll learn: What PEM is and how it impacts people with Long Covid and Chronic Fatigue   Why traditional exercise recommendations can make things worse   The role of mitochondria, adrenals, and hormone dysfunction in energy crashes   The "Toxic 5" root causes behind PEM: heavy metals, chemicals, mold, infections, and nervous system dysfunction   A powerful new study showing the biological damage exercise causes in Long Covid patients   How to identify your baseline and pace activity to reduce symptom flares  If you've ever been told to "just push through it," this episode will show you why that advice fails, and what actually works. . We help you resolve your Long Covid and Chronic Fatigue (ME/CFS) by finding and fixing the REAL root causes that 95% of providers miss. Learn about these causes and how we help people like you, Click Here. Do you have fatigue, brain fog, shortness of breath, muscle pain, or other strange symptoms? You might have Long Covid. Take our free quiz to find out if Long Covid is behind the mystery symptoms you're experiencing, Click Here. For more information about Evan and his program, Click Here.   Prefer to watch on Youtube? Click Here.   Please note that any information in this episode is for educational purposes only and does not constitute medical advice.

Emily Pilbeam presents a mixtape of her personal selection of tracks from BBC Introducing, including music from Lime Garden, Pigeon, Tom Emlyn, Midding, Pem, comfort, Hot Face, Group A.D., Praise Lubangu, Coach Party, Panda Swim, AtticOmatic, Melanie Baker, Champion Trees, Bung, Clara Pople and a Track of the Week from comfort.Produced in Manchester by BBC Audio for BBC Radio 6 Music.

Grave accidente ferroviario: 44 fallecidos. La investigación apunta a un fallo en la vía, con muescas en vagones y trenes previos, pese a su reciente renovación. El ministro de Fomento niega falta de mantenimiento, aunque Adif ejecutó solo el 55% de su presupuesto y los descarrilamientos subieron un 200% en siete años. La caja negra sugiere que el maquinista no fue consciente. Clave la recuperación del bogie. Funeral de Estado el 31 de enero. Debate sobre responsabilidad política en infraestructuras y "colonización" de empresas públicas. Otras noticias: Lluvias intensas en Cataluña (N), Baleares, Cantábrico y Galicia, con alerta roja por olas de más de 9 metros. El PIB per cápita español, estancado desde 2019, está un 25% por debajo de la eurozona debido a la baja productividad y empleos de bajo valor. Un ataque de EE.UU. en Venezuela causó 100-120 muertos. El TSJA anuló la retirada del título de hijo predilecto a José María Pemán en Cádiz.

Listen to the discussion I had with EM physician Dr. Patricia Capone and PEM physician Delia Gold from Nationwide children's Hospital about the field of Pediatric EM and what advice we, PEM specialists, have for the medical students, residents and anyone who is "scared" of children

Emily Pilbeam presents a mixtape of her personal selection of tracks from BBC Introducing, including Chalk, Mandy, Indiana, TTSSFU, Ellur, Cardinals, Hank Bee, TURNSPIT, KuleeAngee, ladylike, Ultimate Thunder feat. Robyn Rocket, a new Track of the Week from Pem, and vegas water taxi are our Featured Artist.Produced in Salford by BBC Audio for BBC Radio 6 Music.

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Dr. Sing-Yi Feng from UT Southwestern joins us for environmental toxins.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play 

Probably one of the most important (and most challenging) situation in PEM is how do we identify the child with none accidental trauma among the see of true / innocent accidental injuries. That is why I asked Toni Laskey, a child abuse physician in Utah to come and talk about this very important topic. 

Send us a textDr. Aimee Nefcy shares how myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) affected her career as an emergency physician and how validation, pacing, and targeted sleep therapy changed her trajectory. We explore misdiagnosis, harmful advice, and practical steps that may help.• Post-exertional malaise (PEM) as the defining feature of ME/CFS• Dysautonomia management with salt, fluids, compression, fludrocortisone• Why GET and simplistic “just exercise” advice can harm• Wearables as trend tools alongside formal testing• Incremental gains with low‑dose trials and supplements• Validation over dismissal in clinical encounters• Potential overlaps between Long COVID with POTS, hypermobility, MCAS• Using IOM 2015 criteria and Bateman Horne clinic resources• Pacing strategies for physical and cognitive loadPlease go ahead and share this episode with someone you think might benefit from itSupport the show Check out our website at www.theneurotransmitters.com to sign up for emails, classes, and quizzes! Would you like to be a guest or suggest a topic? Email us at contact@theneurotransmitters.com Follow our podcast channel on

Send us a textCoach Matiash joins the show to talk PEM wrestling, the Christmas Tournament, and of course: a stray Bill McDonald mention. Support the showFollow on Twitter & Instagram @JV_Takes & Website - JVTakes.com

Welcome back to Beautifully Broken, where healing meets high performance. Today I'm joined by my friend and returning guest George Wiseman, who last appeared in Episode 141 sharing his extraordinary origin story. This time, we take a more advanced dive into hydrogen medicine—specifically the differences between molecular hydrogen (H₂) and Brown's Gas, a unique blend containing hydrogen, oxygen, water vapor, and an electron-rich plasma known as EEW (electronically expanded water).George breaks down how Brown's Gas delivers not only molecular hydrogen but also bioavailable electrons—fuel your body uses to stop oxidative cascades, rebuild tissue, and restore cellular communication. We talk about why H₂ alone doesn't always create a perceptible effect, why Brown's Gas often does, and how these modalities play distinct roles in the ecosystem of healing tools. He shares incredible user stories—from carpal tunnel relief in minutes to a young woman who beat metastasized cancer using Brown's Gas as part of an integrative healing plan.We also explore the new micro-bubbler attachment that infuses bathwater with micro- and nano-bubbles, dramatically increasing gas absorption and accelerating skin repair. Then George reveals the next frontier: a forthcoming AquaCure add-on that allows users to make their own deuterium-depleted water, a therapy shown to support mitochondrial function and metabolic repair.This conversation is equal parts science, innovation, and lived experience—another perspective-shifting journey with one of the most generous inventors in wellness tech. Episode Highlights [00:00] – Hydrogen research overview: inflammation, oxidative stress, and why H₂ is having a moment[02:22] – The AquaCure's unheard-of one-year money-back guarantee[03:38] – Welcoming George back + reflections on the “Beautifully Broken” ethos[05:26] – No device is a panacea: hydrogen as one tool in a larger healing ecosystem[07:53] – A remarkable cancer remission case and how Brown's Gas supported the process[09:16] – Why hydrogen helps nearly every condition studied (and why side effects are positive)[10:27] – What is Brown's Gas? The six constituent gases and how they're formed[11:56] – Discovery of electrically expanded water (EEW): a third gas with unique properties[14:22] – The role of electrons: inflammation reduction, oxidative damage repair, and immune support[16:47] – Brown's Gas during the pandemic: oxygenation, cytokine storms & rapid recovery[19:14] – Why you must stay below a 2% inhalation threshold for safety[21:40] – Hydrogen's role in regeneration: scars, immune restoration, and organ repair[24:08] – External applications: bags, gloves, spot treatments, and rapid nerve relief[26:10] – Hydrogen vs. methane: how microbiome differences shape individual outcomes[28:27] – Why Brown's Gas feels different than H₂—tingles, energy, and nerve activation[30:32] – EZ water (Pollack): how Brown's Gas increases structured water up to 300%[34:42] – Solving medical mysteries: capillary flow, blood pressure, and nutrient transport[39:12] – The problem with “flagged words” in health conversations (structured water, silver, etc.)[45:17] – Dreaming of an NFL-wide recovery experiment (Buffalo Bills, call us!)[47:13] – The new micro-bubbler: micro/nano bubbles, skin repair, and whole-body absorption[52:24] – Scar regeneration, tingling, and my own early bathtub experiment[53:18] – Comparing Brown's Gas to oxygen, CO₂, and other recovery tools[55:44] – Why hydrogen research has shifted to PEM systems—and their limitations[59:42] – Worldwide accessibility: yes, AquaCure ships to New Zealand (and everywhere else)[01:01:47] – Upcoming release: AquaCure's deuterium-depleted water system[01:04:08] – Why DDW matters for metabolism and mitochondrial repair[01:05:28] – Holiday discount: 25% off until December 15, 2025 + upcoming price increase[01:06:51] – Closing gratitude and reminder to support the showGet the AquaCureGeorge Wiseman's AquaCure: https://eagle-research.com/product/ac50-v2/— Code: BEAUTIFULLYBROKENLinks & ResourcesThe Biological Blueprint Program: https://www.beautifullybroken.world/Beam Minerals: http://beamminerals.com/beautifullybroken— Code: BEAUTIFULLYBROKENSilver Biotics: bit.ly/3JnxyDD— 30% off with Code: BEAUTIFULLYBROKENLightPathLED: https://lightpathled.pxf.io/c/3438432/2059835/25794— Code: beautifullybrokenCathcBio https://www.catchbio.com/beautifullybroken— Code: beautifullybrokenStemRegn: https://www.stemregen.co/products/release?_ef_transaction_id=&affid=52&oid=1— Code: beautifullybroken     CONNECT WITH FREDDIEWork with Me: https://www.beautifullybroken.world/biological-blueprintWebsite and Store: (http://www.beautifullybroken.world) Instagram: (https://www.instagram.com/beautifullybroken.world/) YouTube: https://www.youtube.com/@freddiekimmel Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

🧭 REBEL Rundown 📝 Introduction Welcome to the Rebel Core Content Blog, where we delve into crucial knowledge for emergency medicine. Today, we share insightful tips from PEM specialist Dr. Elise Perelman, shedding light on respiratory challenges in infants, toddlers, and young children during the viral season. Understanding that most cases involve typical viruses, we aim to equip you with diagnostic pearls to identify more serious pathologies. Click here for Direct Download of the Podcast. 🔍 Recognizing Respiratory Patterns Pearl #1: Look at Your PatientBegin exams from the doorway. Observing patterns such as accessory muscle usage can reveal a patient’s respiratory effort. Specify whether the work of breathing occurs during inspiration, expiration, or both. Inspiratory work indicates difficulty getting air in, while expiratory work suggests trouble pushing air out. Silent tachypnea may point to other issues, like acidemia or pneumothorax. 🩺 Localizing Sounds for Accurate Diagnosis Pearl #2: Localize the SoundBreathing noises signal varied respiratory issues. Stridor, often heard on inspiration, results from obstructions above the thoracic inlet. Conversely, wheezing, generally linked to exhalation, indicates obstructions in the lower airways. Watch for signs like ‘silent chest’—a dangerous, severe obstruction, and distinguish grunting as a bodily mechanism to prevent alveolar collapse. Correctly identifying the sound assists in determining the appropriate intervention. 💉 Tailoring Treatment for Effective Results Once a sound is localized, treatments vary. We explore Soder from nasal congestion, typically needing supportive care and suctioning. Stridor from conditions like croup is eased with interventions to reduce airway swelling, such as steroids or inhaled epinephrine. Conversely, wheezing in infants is often due to bronchiolitis—not bronchospasms—and over-treatment is to be avoided. Supportive measures including suction, hydration, and oxygen are preferred unless improvement warrants bronchodilators. 🌬️ Intervening with Severe Asthma In severe cases of asthma or bronchiolitis, where standard at-home treatments fail, immediate adjunct therapies like intramuscular epinephrine become essential. Administering this quickly can alleviate obstruction when inhalants aren’t effective due to low air movement. 🦓 Navigating the Zebras of Respiratory Cases When recognizing Zebras—uncommon cases overshadowed by routine diagnoses—remain vigilant for histories or presentations that don’t conform. Conditions like pneumonia, bacterial tracheitis, and even myocarditis may mimic more common issues. 📌 Conclusion As attending physicians, our role extends beyond conventional treatment—it’s about discerning the atypical from the typical. Dr. Perelman urges continual reassessment, emphasizing reliance on observational skills as much as technological aid. Keeping keen on respiratory nuances ensures we catch those outlier cases, paving the way for adept medical care despite the overwhelming prevalence of viral infections.Stay tuned for more pearls and insights in our future posts, as Dr. Perelman shares further strategies for effective pediatric emergency care. For more resources, continue exploring our faculty’s valuable contributions on our site. Until then, stay safe and perceptive in your practice. Post Peer Reviewed By: Mark Ramzy, DO (X: @MRamzyDO), and Marco Propersi, DO (X: @Marco_Propersi) 👤 Guest Elise Perlman MD Pediatric Emergency Medicine​ Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Meet The Team 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley Host Dr. Mark Ramzy shines a spotlight on three distinguished ... Resuscitation Read More REBEL Core Cast 145.0: Understanding QTc Prolongation: Causes, Risks, and Management The QT interval is a vital part of ECG interpretation, ... Procedures and Skills Read More REBEL Core Cast 144.0: Tourniquet Tips In this episode of the Rebel Core Content podcast, Swami ... Procedures and Skills Read More REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy 🧭 REBEL Rundown 📝Introduction In this exciting episode of REBEL ... Endocrine, Metabolic, Fluid, and Electrolytes Read More REBEL Core Cast – DKA: Beyond the Basics Part 2 – SCOPE DKA-Trial Managing diabetic ketoacidosis (DKA) requires careful consideration of fluid therapy, ... Endocrine, Metabolic, Fluid, and Electrolytes Read More The post REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season appeared first on REBEL EM - Emergency Medicine Blog.

As a PEM physician I am fairly good (and confident) about intubating children and passing that ET tube beyond the vocal cords. Managing the vent, however is a whole different ballgame. That is why I asked Jared to come and teach us some basic vent setting for our children.

In this episode of The Hydrogen Podcast, we unpack three pivotal stories shaping hydrogen's next chapter—from major logistics partnerships and cost-slashing tech breakthroughs to a data-driven look at plant safety and reliability.

¡Vótame en los Premios iVoox 2025! El comité Nobel noruego acaba de otorgar el Premio Nobel de la Paz a la opositora venezolana María Corina Machado en reconocimiento por su lucha de muchos años para devolver la democracia en Venezuela y combatir la dictadura de Nicolás Maduro. Machado, una caraqueña de 58 años, es una figura muy conocida en su país y goza de un amplio apoyo, pero el chavismo no puede con ella. Su trayectoria política comenzó hace quince años como diputada, pero antes había presidido ya una ONG, Súmate, dedicada a exigir transparencia electoral, algo muy necesario en un régimen como el chavista que manipula las elecciones de forma rutinaria. Uno de sus primeros logros fue en 2004 cuando consiguió las firmas necesarias para celebrar un referéndum revocatorio contra Hugo Chávez, que, aunque se perdió, mostró un apoyo significativo a la oposición. Como diputada de 2011 a 2014, se significó por su confrontación directa con el régimen y eso le hizo ganar cierta notoriedad internacional. A diferencia de otros opositores que tratan de negociar e incluso encontrar acomodo dentro del chavismo, Machado mantiene una postura firme de oposición a la dictadura. Machado hace una enmienda a la totalidad del régimen chavista, un sistema político que ha convertido Venezuela en una brutal dictadura. La erosión de las libertades y el Estado de derecho comenzó en los primeros años de Chávez, se fue consolidando después y, con la llegada de Maduro, terminaron quitándose definitivamente la careta. El resultado es una crisis múltiple: económica, política y social que ha empujado a más de 8 millones de venezolanos al exilio, un éxodo sin precedentes en tiempos de paz. Este colapso contrasta con la época en la que Venezuela era un país al que acudían inmigrantes de todo el mundo. El Nobel a Machado es, en definitiva, un golpe al régimen de Maduro y a sus aliados de extrema izquierda, que ven en ella una amenaza por su popularidad y resistencia. El año pasado no pudo presentarse a las elecciones porque Maduro ordenó su inhabilitación, prestó apoyo entonces a Edmundo González, cuya victoria fue certificada por observadores independientes, lo que no fue obstáculo para que Maduro perpetrase un grosero fraude electoral. Tras ello González se tuvo que marchar a España y Machado pasó a la clandestinidad, desde donde lidera la oposición, pero sin salir de Venezuela. El premio llega en un momento de presión internacional contra el régimen chavista. EEUU ha emprendido una operación naval en el Caribe para luchar contra el narcotráfico vinculado al régimen. Su Gobierno también ofrece una elevada recompensa de 50 millones de dólares por la captura de Maduro. Aunque una invasión parece improbable, la tensión se ha incrementado en los dos últimos meses. El Nobel va en esa dirección. Visibiliza la lucha de Machado y complica cualquier acción del régimen contra ella ya que eso tendría un gran impacto internacional. Con o sin premio, María Corina Machado representa una esperanza para la transición democrática en un país donde el chavismo, hoy reducido a una simple maquinaria de represión y saqueo, ha aplastado a la sociedad civil. Su mensaje, que cala entre las clases populares, es que los problemas de Venezuela no son errores puntuales de la revolución, sino consecuencia directa de esa revolución. Su valentía y elocuencia la posicionan como persona a tener en cuenta para cuando en Venezuela vuelva a amanecer tras la larga noche del chavismo. En La ContraRéplica: 0:00 Introducción 3:55 Maria Corina y la larga noche del chavismo 33:30 Axa - Axa.es 35:08 El señalamiento en redes 41:20 Influencers con título 45:02 El himno de Pemán “Este episodio cuenta con la colaboración de AXA”. · Canal de Telegram: https://t.me/lacontracronica · “Contra el pesimismo”… https://amzn.to/4m1RX2R · “Hispanos. Breve historia de los pueblos de habla hispana”… https://amzn.to/428js1G · “La ContraHistoria del comunismo”… https://amzn.to/39QP2KE · “La ContraHistoria de España. Auge, caída y vuelta a empezar de un país en 28 episodios”… https://amzn.to/3kXcZ6i · “Contra la Revolución Francesa”… https://amzn.to/4aF0LpZ · “Lutero, Calvino y Trento, la Reforma que no fue”… https://amzn.to/3shKOlK Apoya La Contra en: · Patreon... https://www.patreon.com/diazvillanueva · iVoox... https://www.ivoox.com/podcast-contracronica_sq_f1267769_1.html · Paypal... https://www.paypal.me/diazvillanueva Sígueme en: · Web... https://diazvillanueva.com · Twitter... https://twitter.com/diazvillanueva · Facebook... https://www.facebook.com/fernandodiazvillanueva1/ · Instagram... https://www.instagram.com/diazvillanueva · Linkedin… https://www.linkedin.com/in/fernando-d%C3%ADaz-villanueva-7303865/ · Flickr... https://www.flickr.com/photos/147276463@N05/?/ · Pinterest... https://www.pinterest.com/fernandodiazvillanueva Encuentra mis libros en: · Amazon... https://www.amazon.es/Fernando-Diaz-Villanueva/e/B00J2ASBXM #FernandoDiazVillanueva #venezuela #mariacorina Escucha el episodio completo en la app de iVoox, o descubre todo el catálogo de iVoox Originals

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:    Leah: Hi, I was wondering if you know about how to deal with constipation and stuck poop due to tortuous colon. Thank you!                                                                                                                                                                                 Bettina: Dear Dr. Cabral, I'm reaching out regarding my husband, who is 47 years old and experiencing a range of symptoms that we're hoping to better understand. He has sensitive gums that are gradually receding, and he produces an excessive amount of earwax. He blows his nose daily and often feels tightness and tension in his neck, throat, and upper body. He is gluten intolerant and also reacts to milk sugar and lactose. Additionally, he frequently struggles to fall asleep. While these symptoms may not be directly related, I'd greatly appreciate your insight into any potential underlying connections or contributing factors and ideas to what my husband can do to change this. Thank you very much for your time and expertise.                                                                                                                                                                        Ellen: I have a question about high serum vitamin B12 levels. The normal range on the lab is 232 - 946. I am more than double the high end of the range at 1945. I take a daily multivitamin with with 400 mcg of B12, and take no other B12 supplement. Why is my number so high?                                                                                           Diana: Hi Dr. Cabral, My liver is stressed. Found out I have fatty liver in May, but am already doing everything I should to help reverse it. I'm wondering what you would do in my situation. For background, I have Ehlers Danlos & ME/CFS for 30 years (I'm 42). Have horrible PEM (can't walk for 5 mins, have to carefully plan all exertion), so can't exercise. Hypometabolic & blood glucose constantly elevated & spikes with exertion (walking to my kitchen, etc.), but eat healthy & no spikes with food. EBV reactivated 5 years ago & won't go away. Did Big 5 last year, nothing with liver came up. Have mold toxicity & SIBO, took binders to help. Did CBO protocol, but SIBO & mold won't go away. Do 21-day detox regularly, take DNS powder 2x per day + almost all supplements suggested in NAFLD podcast.                                                                                                   Allen: I am new to your podcast but saw you are offering the First Labs Program for 50% off labs. Is this all labs like the Big 5, or only certain ones. Can I run all of them? Thanks for all your help and work you are putting out!     Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3508 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!    

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Dr. Chris Buresh from Seattle Children's Hospital joins us to discuss addressing Substance Use Disorder in children and adolescents and he impactful role of the Emergency Department.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

GBH executive arts editor Jared Bowen discusses the Labubu craze and 200 years of American Art on display at the PEM.Harvard national security expert Juliette Kayyem discusses Israel's expanded attacks in central Gaza, the growing daily deaths at food and humanitarian sites operated by the IDF, and France's media organization calling for the removal of its freelancers who remain in Gaza, citing starvation.Market Basket employees -- Joe Schmidt and Tom Gordon -- were fired hours after Schmidt appeared on our show yesterday. We check back in with them on the latest in the Market Basket family feud. Ariel Foxman is the VP of brand and experience for the Boston Seaport and Brandon Cardet-Hernandez is a Boston School Committee and member of the Mass council for Latino Empowerment. They are married, and join for our "How Do You Two Know Each Other?" segment.Soheil Fathi and Sarah Moridpour of La Saison Bakery join to discuss their journey from Tehran to Boston.