Podcasts about PSP

Progressive supranuclear palsy and corticobasal syndrome are closely related neurodegenerative disorders that present with progressive parkinsonism and multiple other features that overlap clinically and neuropathologically. Early recognition is critical to provide appropriate treatment and supportive care. In this episode, Teshamae Monteith, MD, FAAN speaks with Nikolaus R. McFarland, MD, PhD, FAAN, author of the article “Progressive Supranuclear Palsy and Corticobasal Syndrome” in the Continuum® August 2025 Movement Disorders issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. McFarland is an associate professor of neurology at the University of Florida College of Medicine at the Norman Fixel Institute for Neurological Diseases in Gainesville, Florida. Additional Resources  Read the article: Progressive Supranuclear Palsy and Corticobasal Syndrome Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD 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 Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Nikolaus McFarland about his article on progressive supranuclear palsy and cortical basilar syndrome, which appears in the August 2025 Continuum issue on movement disorders. Welcome, how are you? Dr Farland: I'm great. Thank you for inviting me to do this. This is a great opportunity. I had fun putting this article together, and it's part of my passion. Dr Monteith: Yes, I know that. You sit on the board with me in the Florida Society of Neurology and I've seen your lectures. You're very passionate about this. And so why don't you first start off with introducing yourself, and then tell us just a little bit about what got you interested in this field. Dr Farland: I'm Dr Nicholas McFarlane. I'm an associate professor at the University of Florida, and I work at the Norman Fixel Institute for Neurological Diseases. I am a director of a number of different centers. So, I actually direct the cure PSP Center of Care and the MSA Center of Excellence at the University of Florida; I also direct the Huntington's clinic there as well. But for many years my focus has been on atypical parkinsonisms. And, you know, I've treated these patients for years, and one of my focuses is actually these patients who suffer from progressive supranuclear palsy and corticobasal syndrome. So that's kind of what this review is all about. Dr Monteith: You probably were born excited, but I want to know what got you interested in this in particular? Dr Farland: So, what got me interested in this in particular was really the disease and the challenges that's involved in it. So, Parkinson's disease is pretty common, and we see a lot of that in our clinic. Yet many times, roughly about 10 to 15% of my patients present with these atypical disorders. And they're quite fascinating. They present in different ways. They're fairly uncommon. They're complex disorders that progress fairly rapidly, and they have multiple different features. They're sort of exciting to see clinically as a neurologist. I think they're really interesting from an academic standpoint, but also in the standpoint of really trying to bring together sort of a team. We have built a multidisciplinary team here at the University of Florida to take care of these patients. They require a number of folks on that team to take care of them. And so, what's exciting, really, is the challenge of treating these patients. There are very limited numbers of therapies that are available, and the current therapies that we have often really aren't great and over time they fail. And so, part of the challenge is actually doing research. And so, there's actually a lot of new research that's been going on in this field. Recently, there's been some revisions to the clinical criteria to help diagnose these disorders. So, that's really what's exciting. The field is really moving forward fairly rapidly with a number of new diagnostics, therapeutics coming out. And hopefully we can make a real difference for these patients. And so that's what really got me into this field, the challenge of trying to treat these patients, help them, advocate for them and make them better. Dr Monteith: And so, tell me what the essential points of this article. Dr Farland: So, the essential points, really, of this article is: number one, you know, just to recognize the new clinical criteria for both PSP and corticobasal syndrome, the diagnosis for these disorders or the phenotypic spectrum has really expanded over the years. So, we now recognize many different phenotypes of these disorders, and the diagnosis has gotten fairly complicated. And so, one of the goals of this article was to review those new diagnostic criteria and the different phenotypic ways these diseases present. I wanted to discuss, also, some of the neuropathology and clinicopathological overlap that's occurred in these diseases as well as some of the new diagnostic tests that are available. That's definitely growing. Some of the new studies that are out, in terms of research and clinical trials. And then wanted to review some of the approaches for treatment for neurologists. Particularly, we're hoping that, you know, this article educates folks. If you're a general neurologist, we're hoping that recognizing these diseases early on will prompt you to refer these patients to specialty clinics or movement disorder specialists early on so they can get appropriate care, confirm your diagnosis, as well as get them involved in trials if they are available. Dr Monteith: And how has the clinical criteria for PSP and cortical basilar syndrome changed? Dr Farland: I think I already mentioned there's been an evolution of the clinical criteria for PSP. There's new diagnostic criteria that were recently published, and it recognizes the multiple clinical phenotypes and the spectrum of the disease that's out there, which is much broader than we thought about. Corticobasal clinical criteria are the Dr Armstrong criteria from 2013. They have not been updated, but they are in the works of being updated. But it does recognize the classic presentation of corticobasal syndrome, plus a frontal executive predominant and then a variant that actually overlaps with PSP. So, there's a lot more overlap in these two diseases than we originally recognized. Dr Monteith: And so, you spoke a bit about FTD spectrum. So why don't you tell us a little bit about what that is? I know you mentioned multiple phenotypes. Dr Farland: What I really want to say is that both PSP and corticobasal syndrome, they're relatively rare, and what- sort of as to common features, they both are progressive Parkinson disorders, but they have variable features. While they're commonly associated with Parkinson's, they also fit within this frontotemporal lobar spectrum, having features that overlap both clinically and neuropathologically. I just want folks to understand that overlap. One of this pathological overlap here is the predominant Tau pathology in the brain, an increasing recognology- recognition of sort of the pathological heterogeneity within these disorders. So, there's an initial description, a classic of PSP, as Richardson syndrome. But now we recognize there are lots of different features to it and there are different ways it presents, and there's definitely a lot of clinical pathological overlap. Dr Monteith: Why don't we just talk about some red flags for PSP? Dr Farland: Yeah, sure. So, some of the red flags for PSP and even corticobasal syndrome are: number one is rapid progression with early onset of falls, gait difficulty, falling typically backwards, early speech and swallow problems that are more prominent than you see in Parkinson's disease, as well as eye gaze issues. So, ocular motor features, particularly vertical gaze palsy. In particular what we talk about is the supranuclear gaze palsy, and one of the most sensitive features that we've seen with these is downgaze limitation or slowed downgaze, and eventually a full vertical gaze palsy and followed supranuclear gaze palsy. So, there's some of the red flags that we see. So, while we think about the lack of response to levodopa frequently as something that's a red flag for Parkinson's, there are many times that we see Parkinson's patients, and about a quarter of them don't really respond. There's some features that don't respond to levodopa that may not be so specific, but also can be helpful in this disease. Dr Monteith: And what about the red flags for cortical basilar syndrome? Dr Farland: So, for cortical basilar syndrome, some of the red flags again are this rapidly depressive syndrome tends to be, at least in its classical present presentation, more asymmetric in its presentation of parkinsonism, with features including things like dystonic features, okay? For limb dystonia and apraxias---so, inability to do a learned behavior. One of those red flags is a patient who comes in and says, my hand doesn't work anymore, which is something extremely uncommon that you hear in Parkinson's disease. Most of those patients will present, say, I might have a tremor, but they very rarely will tell you that I can't use my hand. So look out for that sign. Dr Monteith: And let's talk a little bit about some of the advances in the fields you mentioned, evolving biomarker and imaging capacities. So, how are these advances useful in helping us understand these conditions, especially when there's so much heterogeneity? Dr Farland: I might start by talking a little bit about some of the clinical criteria that have advanced. Why don't we start there and just discuss some of the advances? I think in PSP, I think, originally we had both probable and possible diagnoses of PSP, and the diagnostic criteria were basically focused on what was what's called “classical PSP” or “Richardson syndrome”. But now we recognize that there are multiple phenotypes. There's an overlap with Parkinsonism that's slower in progression and morphs into PSP, the classical form. There's a frontal behavioral variant where patients present with that frontal behavioral kind of thing. There's a speech-language variant that can overlap with PSP. So they have prominent speech language, potentially even apraxia speech. So, recognition of these different phenotypes is sort of a new thing in this field. There's even overlap with cortical basal syndrome and PSP, and we note that the pathology can overlap as well. So, I think that's one of the things that have changed over time. And these were- recently came out in 2017 in a new publication in the Movement Disorders Society. So, in terms of diagnostic tests as well---and there's been quite a bit of evolution---really still to date, our best diagnostic test is imaging. MRI is really one of our best tests currently. Currently blood tests, spinal fluid, there's new biomarkers in terms of skin… they're still in the research phase and not necessarily very specific yet. So, we rely heavily on imaging still; and for PSP, what we're looking for largely are changes in the brain stem, and particularly focused on the midbrain. So disproportionate midbrain atrophy compared to the pons and the rest of the midbrain is a fairly specific intensive sign for PSP. Whereas in MSA we see more of a pontine atrophy compared to the midbrain. So that can be really helpful, and there are lots of different new measurements that can be done. PET scans are also being used as well. And there are new PET markers, but they still remain kind of research-based, but are becoming more and more prevalent and may be available soon for potential use. Although there's some overlap with PET tracers with Alzheimer's disease and different Tau isoforms. So, something to be wary about, but we will be seeing some of these soon coming out as well. More kind of up-to-date things include things like the spinal fluid as well as even some of the skin biopsies. And I think we've heard some word of recent studies that have come out that potentially in the very near future we might actually have some Tau protein tests that we can look at Tau either in spinal fluid or even in a skin biopsy. But again, still remains research-based and, we still need more information as to whether these tests can be reproducible and how sensitive or specific they are. Dr Monteith: It sounds like, when really approaching these patients, still, it's a lot of back to the history, back to the clinical and some basic imaging that we should be able to identify to distinguish these types of patients, and we're not quite where we need to be yet for biomarker. Dr Farland: I totally agree with you. I think it starts, really, with the clinical exam and that's our main focus here; and understanding some of the new clinical criteria which are more sensitive, but also specific, too. And they're really useful to look at. So, I think reviewing those; patients do progress, following them over time can be really useful. And then for diagnosis, getting imaging if you suspect a patient has an atypical presentation of parkinsonism, to look for signs or features that might be specific for these different disorders. Dr Monteith: Why don't we take a typical case, a typical patient that you would see in clinic, and walk us through the thought process---especially, maybe they presented somewhat early---and the different treatment approaches to helping the patient, and of course their family. Dr Farland: Yeah, sure. So, a typical patient might be someone who comes in with, like, a three year history of progressive gait problems and falling. And let's say the patient says, I'm falling backwards frequently. They may have had, like, a rib fracture, or they hit their head once, and they're describing some speech issues as well. Now they're relying on a walker and family members saying they rarely let them be by themselves. And there may be some slowing of their cognitive function and maybe a bit of withdrawal. So that's a typical patient. So, the approach here is really, what are some of the red flags? I think already you hear a red flag of a rapidly progressive disease. So, Parkinson's disease patients rarely have frequent falls within the first five years. So, this is within three years or less. You're already hearing early onset of gait problems and falling, and particularly falling backwards rather than forwards as often Parkinson's disease patients do. You're hearing early speech problems and maybe a subtle hint of cognitive slowing and some withdrawal. So, a lot of things that sort of are red flags. So, our approach really would be examining this patient really closely. Okay? We'd be listening to the history, looking at the patient. One thing is that some of these patients come in, they may be in a wheelchair already. That's a red flag for us. If they're wearing sunglasses---sometimes we see that patients, they have photosensitivity and they're in a chair and they're wearing sunglasses---you take the glasses off and you look at their face and they have that sort of a facial stare to them---not just the masked face, but the stare---and their eyes really aren't moving. So, another kind of clue, maybe this is probably something atypical, particularly PSP is what I'm thinking about. So, the approach is really, do a thorough exam. I always recommend looking at eye movements and starting with volitional saccades, not giving them a target necessarily, but asking them to look up and then look down. And then particularly look at the speed of downgaze and whether they actually have full versions down, are able to do that. That's probably your most sensitive test for a patient who has PSP. Not the upgaze, which can be- upgaze impairment in older patients can be nonspecific. So, look for that down gaze. So, if I can get out one message, that's one thing that can be easily done and examined fairly quickly for diagnosis of these patients. And then just look for signs of rigidity, bradykinesia, maybe even some myelopraxia, and then look at their gait carefully so that there's a high suspicion. Again, if there's some atypical features, imaging is really important. So, my next step would be probably getting an MRI to evaluate whether- do they have brain somatrophy or other widespread atrophy or other signs? You need to think about your differential diagnosis for some of these patients as well. So, common things are common; vascular disease, you can't have vascular parkinsonism or even signs of NPH. Both of those can present with progressive gait difficulty and falls. So, the gait may look more like Parkinson's rather than ataxic gait that we see in classic PSP, but still they have early gait issues, and that can be a mimicker of PSP, So looking for both of those things in your imaging. Think about sort of autoimmune potentially causes. So, if they have a really rapid progressive cause, there are some rare autoimmune things. There have been recent reports of things like IgLON5, although there's limited cases, but we're doing more screening for some of those autoimmune causes. And then even some infectious causes like Whipples, that are rarely present like this. Okay? And have other signs and features. Dr Monteith: So, let's say you diagnose this patient with PSP and you're assessing the patients to see how you can improve their quality of life. So, what are some potential symptomatic managements that will help our patient? Dr Farland: I recommend for most all of these patients… while the literature indicates that many patients with PSP, and especially corticobasal syndrome, don't respond well to levodopa. So, the classic treatment for parkinsonism. However, we all recommend a trial of levodopa. These patients may respond partially to doses of levodopa, and we try to push the doses a bit higher. So, the recommended trial is usually a dose up to roughly 1000 milligrams of levodopa per day. And give it some time, at least two, if not actually three months of a trial. If not well-tolerated, you can back off. If there's no response at all or no improvement, then slowly back off and taper patients off and ask them to tell you whether they feel like they're actually worsening. So, many patients, sometimes, don't recognize the improvements, or family members don't recognize it until we actually taper them back off. And they may end up saying there are some other things that even recognize. Even some nonmotor benefits can be seen with levodopa. In some cases, we do keep them on levodopa, but levodopa's our best therapy for this. Dopamine agonists, MAO inhibitors, have all been sort of tried and they've been studied, but often don't really help or fail to help benefit these patients and could be fraught with some other side effects. I think many people do also turn to Amantadine as a treatment for Parkinson's, gait problems, freezing, if you see it in these disorders. Yet Amantadine is fraught with issues of side effects, including cognitive issues, and I think is not well-tolerated. But there are the rare patient who actually does respond to this or claims they respond to this. By and large, these patients relentlessly progress, unfortunately. So, beside treatment of other symptoms, I think it's really important to recognize that they require supportive cares and therapy. So, starting those early on and getting your allied healthcares kind of involved. So that includes people like physical, occupational therapy for the gait issues, the falls, occupational therapy for doing daily activities. Speech language pathology can be really a critical player for these because of the early speech and language issues, as well as swallow difficulties. Swallow is compared quickly in these patients. And so, we do recommend the screening evaluation, then often following patients either every six- or even annually, at least, with a swallow evaluation. And we recommend the fluoroscopic-guided kind of modified barium swallow for these patients.  Dr Monteith: And how does that differ if, let's say, the patient had cortical basilar syndrome? What are some of the symptomatic treatments that would be high on your consideration? Dr Farland: So actually, these patients also have a very similar approach, and they often have some overlapping features. Maybe a little bit of difference in terms of the level of apraxia and some dystonic features that you see in corticobasal syndrome. So, as I mentioned earlier that these patients have a more typ- when they present, typically have a more asymmetric presentation. And one of the biggest issues is this limb apraxia. They may have abnormal movements as well as, like, the alien limb-type phenomena as well. So, the focus of therapy, while similar in the sense we focus on the parkinsonism, I do always try levodopa and try to ramp up the doses to see if it benefits. It does often fail, but it's definitely worth trying. The other focus of these patients is trying to treat symptoms. Dystonia, those features… in some cases, we can help; if it's painful or uncomfortable, muscle relaxants can be used. If it's vocal, things like Botox can be really helpful. Often times it is more palliative than actually restorative in terms of function, but still can be really helpful for patients who ask about pain and discomfort and trying to treat. And then of course, again, the focus on our supportive care. We need to build that network and build that team of folks, the therapists, the physical, occupational, and the speech therapist to help them. If they have language problems---like either in PSP or corticobasal---I'll also include my request to a speech language pathologist to work on cognitive function. That's a special, additional thing you have to ask for and then specifically request when you make a referral to a speech language pathologist. Dr Monteith: That is so important. I think keeping the simulation, keeping the social support, and I would probably guess that you would also include screening for sleep and mood disorder. Dr Farland: Absolutely. Mood disorders are really big in these diseases. Patients are suffering terribly. You do hear about labile mood in both of these diseases, particularly PSP; and even what's called pseudobulbar palsy, where the mood is not always congruent with the affect. So they may laugh or cry inappropriately, and particularly the crying can be very disturbing to family and caregivers to see that. And so, treating those things can be really important. So always asking about the mood issues. Depression in particular is something that we're very sensitive about, and there is a higher incidence of suicidal ideations. Asking about that and feeling and making sure that they are in a safe environment can be really important. Dr Monteith: Thank you so much. Dr Farland: Thank you. Dr Monteith: Today I've been interviewing Dr Nikolaus McFarland about his article on progressive supranuclear palsy and cortical basilar syndrome, 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.

Podcasting 2.0 August 22nd 2025 Episode 231: "Keep Publishing" Adam & Dave are joined by John Spurlock to discuss HLS, OP3, PSP and many more acronyms! ShowNotes We are LIT John Spurlock op3.dev HLS Podcast Radar HLS Costs - Google Sheets Standard Podcast Consumption (SPC) HLS VIDEO etc What Will Apple Do? This week in Vibe Coding - TWIV ------------------------------------- MKUltra chat Transcript Search What is Value4Value? - Read all about it at Value4Value.info V4V Stats Last Modified 08/22/2025 14:18:27 by Freedom Controller

Multiple system atrophy is a rare, sporadic, adult-onset, progressive, and fatal neurodegenerative disease. Accurate and early diagnosis remains challenging because it presents with a variable combination of symptoms across the autonomic, extrapyramidal, cerebellar, and pyramidal systems. Advances in brain imaging, molecular biomarker research, and efforts to develop disease-modifying agents have shown promise to improve diagnosis and treatment. In this episode, Casey Albin, MD speaks with Tao Xie, MD, PhD, author of the article “Multiple System Atrophy” in the Continuum® August 2025 Movement Disorders issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Xie is director of the Movement Disorder Program, chief of the Neurodegenerative Disease Section in the department of neurology at the University of Chicago Medicine in Chicago, Illinois. Additional Resources Read the article: Multiple System Atrophy Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin 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 Albin: Hello everyone, this is Dr Casey Albin. Today I'm interviewing Dr Tao Xie about his article on diagnosis and management of multiple system atrophy, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, and please introduce yourself to our audience. Dr Xie: Thank you so much, Dr Albin. My name is Tao Xie, and sometimes people also call me Tao Z. I'm a mood disorder neurologist, professor of neurology at the University of Chicago. I'm also in charge of the mood disorder program here, and I'm the section chief in the neurodegenerative disease in the Department of Neurology at the University of Chicago Medicine. Thank you for having me, Dr Albin and Dr Okun and the American Academy of Neurology. This is a great honor and pleasure to be involved in this education session. Dr Albin: We are delighted to have you, and thank you so much for the thoughtful approach to the diagnosis and management. I really want to encourage our listeners to check out this article. You know, one of the things that you emphasize is multiple system atrophy is a fairly rare condition. And I suspect that clinicians and trainees who even have a fair amount of exposure to movement disorders may not have encountered that many cases. And so, I was hoping that you could just start us off and walk us through what defines multiple system atrophy, and then maybe a little bit about how it's different from some of the more commonly encountered movement disorders. Dr Xie: This is a really good question, Dr Albin. Indeed, MSA---multisystem atrophy----is a rare disease. It is sporadic, adult-onset, progressive, fatal neurodegenerative disease. By the name MSA, multisystem atrophy. Clinically, it will present with multiple symptoms and signs involving multiple systems, including symptoms of autonomic dysfunction and symptoms of parkinsonism, which is polyresponsive to the levodopa treatment; and the symptom of cerebellar ataxia, and symptom of spasticity and other motor and nonmotor symptoms. And you may be wondering, what is the cause- underlying cause of these symptoms? Anatomically, we can find the area in the basal ganglia striatonigral system, particularly in the putamen and also in the cerebellar pontine inferior, all of the nuclear area and the specific area involved in the autonomic system in the brain stem and spinal cord: all become smaller. We call it atrophy. Because of the atrophy in this area, they are responsible for the symptom of parkinsonism if it is involved in the putamen and the cerebral ataxia, if it's involved in the pons and cerebral peduncle and the cerebellum. And all other area, if it's involved in the autonomic system can cause autonomic symptoms as well. So that's why we call it multisystem atrophy. And then what's the underlying cellular and subcellular pathological, a hallmark that is in fact caused by misfolded alpha-synuclein aggregate in the oligodontia site known as GCI---glial cytoplasmic increasing bodies---in the cells, and sometimes it can also be found in the neuronal cell as well in those areas, as mentioned, which causes the symptom. But clinically, the patient may not present all the symptoms at the same time. So, based on the predominant clinical symptom, if it's mainly levodopa, polyresponsive parkinsonism, then we call it MSAP. If it's mainly cerebellar ataxia, then we call it MSAC. But whether we call it MSP or MSC, they all got to have autonomic dysfunction. And also as the disease progresses, they can also present both phenotypes together. We call that mixed cerebellar ataxia and parkinsonism in the advanced stage of the disease. So, it is really a complicated disease. The complexity and the similarity to other mood disorders, including parkinsonism and the cerebellar ataxia, make it really difficult sometimes, particularly at the early stages of disease, to differentiate one from the other. So, that was challenging not only for other professionals, general neurologists and even for some movement disorder specialists, that could be difficult particularly if you aim to make an accurate and early diagnosis. Dr Albin: Absolutely. That is such a wealth of knowledge here. And I'm going to distill it just a little bit just to make sure that I understand this right. There is alpha-synuclein depositions, and it's really more widespread than one would see maybe in just Parkinson's disease. And with this, you are having patients present with maybe one of two subtypes of their clinical manifestations, either with a Parkinson's-predominant movement disorder pattern or a cerebellar ataxia type movement disorder pattern. Or maybe even mixed, which really, you know, we have to make things quite complicated, but they are all unified and having this shared importance of autonomic features to the diagnosis. Have I got that all sort of correct? Dr Xie: Correct. You really summarize well. Dr Albin: Fantastic. I mean, this is quite a complicated disease. I would pose to you sort of a case, and I imagine this is quite common to what you see in your clinic. And let's say, you know, a seventy-year-old woman comes to your clinic because she has had rigidity and poor balance. And she's had several falls already, almost always from ground level. And her family tells you she's quite woozy whenever she gets up from the chair and she tends to kind of fall over. But they noticed that she's been stiff,and they've actually brought her to their primary care doctor and he thought that she had Parkinson's disease. So, she started levodopa, but they're coming to you because they think that she probably needs a higher dose. It's just not working out very well for her. So how would you sort of take that history and sort of comb through some of the features that might make you more concerned that the patient actually has undiagnosed multiple systems atrophy? Dr Xie: This is a great case, because we oftentimes can encounter similar cases like this in the clinic. First of all, based on the history you described, it sounds like an atypical parkinsonism based on the slowness, rigidity, stiffness; and particularly the early onset of falls, which is very unusual for typical Parkinson disease. It occurs too early. If its loss of balance, postural instability, and fall occurred within three years of disease onset---usually the motor symptom onset---then it raises a red flag to suspect this must be some atypical Parkinson disorders, including multiple system atrophy. Particularly, pou also mentioned that the patient is poorly responsive to their levodopa therapy, which is very unusual because for Parkinson disease, idiopathic Parkinson disease, we typically expect patients would have a great response to the levodopa, particularly in the first 5 to 7 years. So to put it all together, this could be atypical parkinsonism, and I could not rule out the possibility of MSA. Then I need to check more about other symptoms including autonomic dysfunction, such as orthostatic hypertension, which is a blood pressure drop when the patient stands up from a lying-down position, or other autonomic dysfunctions such as urinary incontinence or severe urinary retention. So, in the meantime, I also have to put the other atypical Parkinson disorder on the differential diagnosis, such as PSP---progressive supranuclear palsy---and the DLBD---dementia with Lewy body disease.---Bear this in mind. So, I want to get more history and more thorough bedside assessment to rule in or rule out my diagnosis and differential diagnosis. Dr Albin: That's super helpful. So, looking for early falls, the prominence of autonomic dysfunction, and then that poor levodopa responsiveness while continuing to sort of keep a very broad differential diagnosis? Dr Xie: Correct. Dr Albin: One of the things that I just have to ask, because I so taken by this, is that you say in the article that some of these patients actually have preservation of smell. In medical school, we always learn that our Parkinson's disease patients kind of had that early loss of smell. Do you find that to be clinically relevant? Is that- does that anecdotally help? Dr Xie: This is a very interesting point because we know that the loss of smelling function is a risk effect, a prodromal effect, for the future development of Parkinson disease. But it is not the case for MSA. Strange enough, based on the literature and the studies, it is not common for the patient with MSA to present with anosmia. Some of the patients may have mild to moderate hyposmia, but not to the degree of anosmia. So, this is why even in the more recent diagnosis criteria, the MDS criteria published 2022, it even put the presence of anosmia in the exclusion criteria. So, highlight the importance of the smell function, which is well-preserved for the majority in MSA, into that category. So, this is a really interesting point and very important for us, particularly clinicians, to know the difference in the hyposmia, anosmia between the- we call it the PD, and the dementia Lewy bodies versus MSA. Dr Albin: Fascinating. And just such a cool little tidbit to take with us. So, the family, you know, you're talking to them and they say, oh yes, she has had several fainting episodes and we keep taking her to the primary care doctor because she's had urinary incontinence, and they thought maybe she had urinary tract infections. We've been dealing with that. And you're sort of thinking, hm, this is all kind of coming together, but I imagine it is still quite difficult to make this diagnosis based on history and physical alone. Walk our listeners through sort of how you're using MRI and DAT scan and maybe even some other biomarkers to help sort of solidify that diagnosis. Dr Xie: Yeah, that's a wonderful question. Yeah. First of all, UTI is very common for patients with MSA because of urinary retention, which puts them into a high risk of developing frequent UTI. That, for some patients, could be the very initial presentation of symptoms. In this case, if we check, we say UTI is not present or UTI is present but we treat it, then we check the blood pressure and we do find also hypertension---according to new diagnosis criteria, starting drop is 20mm mercury, but that's- the blood pressure drop is ten within three minutes. And also, in the meantime the patients present persistent urinary incontinence even after UTI was treated. And then the suspicion for MS is really high right at this point. But if you want increased certainty and a comfortable level on your diagnosis, then we also need to look at the brain MRI mark. This is a required according to the most recent MDS diagnosis criteria. The presence of the MRI marker typical for MSA is needed for the diagnosis of clinically established MSA, which holds the highest specificity in the clinical diagnosis. So then, we have- we're back to your question. We do need to look at the brain MRI to see whether evidence suggestive of atrophy around the putamen area, around the cerebellar pontine inferior olive area, is present or not. Dr Albin: Absolutely. That's super helpful. And I think clinicians will really take that to sort of helping to build a case and maybe recognizing some of this atypical Parkinson's disease as a different disease entity. Are there any other biomarkers in the pipeline that you're excited about that may give us even more clarity on this diagnosis? Dr Xie: Oh, yeah. This is a very exciting area. In terms of biomarker for the brain imaging, particularly brain MRI, in fact, today there's a landmark paper just published in the Java Neurology using AI, artificial intelligence or machine learning aid, diagnoses a patient with parkinsonism including Parkinson's disease, MSA, and PSP, with very high diagnostic accuracy ranging from 96% to 98%. And some of the cases even were standard for autopsy, with pathological verification at a very high accurate rate of 93.9%. This is quite amazing and can really open new diagnosis tools for us to diagnose this difficult disease; not only in an area with a bunch of mood disorder experts, but also in the rural area, in the area really in need of mood disorder experts. They can provide tremendous help to provide accurate, early diagnosis. Dr Albin: That's fantastic and I love that, increasing the access to this accurate diagnosis. What can't artificial intelligence do for us? That's just incredible. Dr Xie: And also, you know, this is just one example of how the brain biomarker can help us. Theres other---a fluid biomarker, molecular diagnostic tools, is also available. Just to give you an example, one thing we know over the past couple years is skin biopsy. Through the immunofluorescent reaction, we can detect whether the hallmark of abnormally folded, misfolded, and the phosphorate, the alpha-synuclein aggregate can be found just by this little pinch of skin biopsy. Even more advanced, there's another diagnosis tool we call the SAA, we call the seizure amplification assay, that can even help us to differentiate MSA from other alpha-synucleinopathy, including Parkinson disease and dementia with Lewy bodies. If we get a little sample from CSF, spinal cerebral fluids, even though this is probably still at the early stage, a lot of developments still ongoing, but this, this really shows you how exciting this area is now. We're really in a fast forward-moving path now. Dr Albin: It's really incredible. So, lots coming down the track in, sort of, MRI, but also with CSF diagnosis and skin biopsies. Really hoping that we can hone in some of those tools as they become more and more validated to make this diagnosis. Is that right? Dr Xie: Correct. Dr Albin: Amazing. We can talk all day about how you manage these in the clinic, and I really am going to direct our listeners to go and read your fantastic article, because you do such an elegant job talking about how this takes place in a multidisciplinary setting, if at all possible. But as a neurointensivist, I was telling you, we have so much trouble in the hospital. We have A-lines, and we have the ability to get rapid KUBs to look at Ilias, and we can have many people as lots of diagnosis, and we still have a lot of trouble treating autonomiclike symptoms. Really, really difficult. And so, I just wanted to kind of pick your brain, and I'll start with just the one of orthostatic hypotension. What are some of the tips that you have for, you know, clinicians that are dealing with this? Because I imagine that this is quite difficult to do without patients. Dr Xie: Exactly. This is indeed a very difficult symptom to deal with, particularly at an outpatient setting. But nowadays with the availability of more medication---to give an example, to treat patients with orthostatic hypertension, we have not only midodrine for the cortisol, we also have droxidopa and several others as well. And so, we have more tools at hand to treat the patient with orthostatic hypertension. But I think the key thing here, particularly for us to the patient at the outpatient setting: we need to educate the patient's family well about the natural history of the disease course. And we also need to tell them what's the indication and the potential side effect profile of any medication we prescribe to them so that they can understand what to expect and what to watch for. And in the meantime, we also need to keep really effective and timely communication channels, make sure that the treating physician and our team can be reached at any time when the patient and family need us so that we can be closely monitoring, their response, and also monitoring potential side effects as well to keep up the quality of care in that way. Dr Albin: Yeah, I imagine that that open communication plays a huge role in just making sure that patients are adapting to their symptoms, understanding that they can reach out if they have refractory symptoms, and that- I imagine this takes a lot of fine tuning over time. Dr Xie: Correct. Dr Albin: Well, this has just been such a delight to get to talk to you. I really feel like we could dive even deeper, but I know for the sake of time we have to kind of close out. Are there any final points that you wanted to share with our listeners before we end the interview? Dr Xie: I think for the patients, I want them to know that nowadays with advances in science and technology, particularly given a sample of rapid development in the diagnostic tools and the multidisciplinary and multisystemic approach to treatment, nowadays we can make an early and accurate diagnosis of the MSA, and also, we can provide better treatment. Even though so far it is still symptomatically, mainly, but in the near future we hope we can also discover disease-modifying treatment which can slow down, even pause or prevent the disease from happening. And for the treating physician and care team professionals, I just want them to know that you can make a difference and greatly help the patient and the family through your dedicated care and also through your active learning and innovative research. You can make a difference. Dr Albin: That's amazing and lots of hope for these patients. Right now, you can provide really great care to take care of them, make an early and accurate diagnosis; but on the horizon, there are really several things that are going to move the field forward, which is just so exciting. Again today, I've been really greatly honored and privileged to be able to talk to Dr Tao Xie about his article on diagnosis and management of multiple system atrophy, which appears in the August 2025 Continuum issue on movement disorders. Be sure to check out Continuum Audio episodes for this and other issues. And thank you again to our listeners for joining us today. Dr Xie: Thank you so much for having me. 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.

#145Uncover "The Secret to Thriving as a Homeschool Parent

Welcome to the eighth season of Into the Aether! For this season premiere, we will be discussing our favorite games for the Sony PlayStation Portable. The PSP was a very special console and is still a joy to play. Some might say it's the "Walkman of the 21st Century." As always, thank you all so much for listening to and supporting the show. Whether this is your first time joining us or you've been here since 2018, we're so happy you decided to give us a listen. Here's to friendship, summer, portability, and the rest of season eight!Find us everywhere: https://intothecast.onlineBuy some merch if you'd like: https://shop.intothecast.onlineJoin the Patreon: https://www.patreon.com/intothecast---Follow Stephen Hilger: https://bsky.app/profile/stephenhilger.bsky.social Follow Brendon Bigley: https://bsky.app/profile/bb.wavelengths.onlineProduced by AJ Fillari: https://bsky.app/profile/ajfillari.bsky.social---Season 8 cover art by Scout Wilkinson: https://scoutwilkinson.myportfolio.com/Theme song by Will LaPorte: https://ghostdown.online/---Timecodes:(00:00) - Intro (00:58) - Imagine if you could take a console with you (02:42) - Welcome to the Aether! (07:10) - Changes to the Patreon (GOOD!) (17:57) - Basic recap (18:56) - New merch! (21:46) - How we prepared for the episode (57:53) - Taking the podcast out of sleep mode (59:10) - The symbol criteria (01:00:59) - 2005 (01:01:17) - Lumines (01:08:04) - Burnout Legends (01:16:03) - Tony Hawk's Underground 2: Remix (01:21:59) - Me & My Katamari (01:28:05) - Meadowtron by Hideki Tobeta | Me & My Katamari OST (01:28:39) - PSP's proof of concept (01:30:45) - Star Wars Battlefront II (01:37:26) - Wipeout Pure (01:43:44) - SHININ' by Mondo Gross | Lumines OST (01:44:21) - 2006 (01:44:52) - Megaman Powered Up (01:52:03) - Daxter (01:59:22) - Ridge Racer 2 (02:14:21) - Tsui Tsui by Yu Miyake | Ridge Racer 2 OST (02:14:57) - Gitaroo Man Lives! (02:23:35) - Soft Machine by COIL | Gitaroo Man Lives! OST (02:24:04) - Tales of Eternia (02:31:25) - Tekken 5: Dark Resurrection (02:37:33) - Pulse Phaze by Yu Miyake | Ridge Racer 2 OST (02:37:58) - 2007 (02:38:20) - Puzzle Quest: Challenge of the Warlords (02:49:21) - Map by Steve Fawkner | Puzzle Quest: Challenge of the Warlords OST (02:49:51) - Jeanne d'Arc (03:04:31) - Synthesis Frog by Takeshi Inoue | Jeanne d'Arc OST (03:05:03) - AJ wants to know about the frog (03:06:27) - Main Theme by Takeshi Inoue | Jeanne d'Arc OST (03:06:59) - 2008 (03:07:02) - Hot Shots Golf: Open Tee 2 (03:12:02) - Main Menu by Gon Ohtsuji | Hot Shots Golf: Open Tee 2 OST (03:12:30) - 2009 (03:15:02) - Patapon 2 (03:20:57) - Half-Minute Hero (03:25:50) - Issuing apologies and corrections!!! (03:27:42) - Rock Band Unplugged (03:33:06) - Monster Hunter Freedom Unite (03:51:35) - Armored Core 3 Portable (04:00:51) - Gathering Hall Theme by Akihiko Narita | Monster Hunter Freedom Unite OST (04:01:21) - 2010 (04:02:24) - Persona 3 Portable (04:16:15) - Way of Life by Shoji Meguro | Persona 3 Portable OST (04:16:47) - God of War: Ghost of Sparta (04:23:14) - Metal Gear Solid: Peace Walker (04:31:42) - Kingdom Hearts Birth by Sleep (04:40:52) - Dearly Beloved by Yoko Shimomura, Tsuyoshi Sekito, Takeharu Ishimoto | Kingdom Hearts Birth by Sleep OST (04:41:26) - Valkyria Chronicles 2 (04:49:15) - Ys Seven AND Ys: The Oath in Felghana (04:59:16) - Extensive Forest Green by Hayato Sonoda, Takahiro Unisuga, Saki Momiyama, Masanori Osaki | Ys Seven OST (04:59:48) - 2011 (05:00:39) - Dissidia 012 Final Fantasy (05:06:21) - 15 seconds of Kingdom Hearts III spoilers (05:06:36) - How do you say 012? (05:07:40) - The Legend of Heroes: Trails in the Sky (05:22:15) - The Byway of Departure by Hayato Sonoda, Wataru Ishibashi | Trails in the Sky OST (05:22:40) - Tactics Ogre: Let Us Cling Together (05:33:16) - Tactics Ogre: Let Us Cling Together - Overture by Hitoshi Sakimoto, Masaharu Iwata | Tactics Ogre: Let Us Cling Together OST (05:33:45) - Honorable Mentions (05:34:04) - Street Fighter Alpha 3 MAX (05:35:28) - Soulcalibur: Broken Destiny (05:37:16) - LocoRoco (05:39:01) - Crisis Core: Final Fantasy VII (05:44:38) - Valkyrie Profile: Lenneth (05:47:09) - The 3rd Birthday (05:52:16) - Persona 2: Innocent Sin (05:55:27) - Brave Story: New Traveler (05:59:26) - Final Fantasy Tactics: The War of the Lions (06:05:25) - Every Extend Extra (06:08:30) - Water, Banana Bread, and Math (06:10:09) - Deciding the top 5 of the Aether (06:25:27) - Standing up (06:25:37) - The Into the Aether Top 5 Video Games for the Sony Playstation Portable (06:27:05) - Thank you so much for being here! (06:32:32) - Wrapping up ---Thanks to all of our amazing patrons including our Eternal Gratitude members:Zachary DIanfaceMcGeeMatt HClayton MChris Yw0nderbradShawn LCody RZach RFederico VLogan HAlan RSlinkmattjanzz DeaconGrokCorey ZDirectional JoySusan HOlivia KDan SIsaac SWill CJim WEvan BDavid Hmin2Aaron GVErik MBrady HJoshua JTony LDanny KSeth MAdam BJustin KAndy HDemoParker EMaxwell LSpiritofthunderJason WJason TCorey TMinnow Eats WhaleCaleb WfingerbellyJesse WMike TCodesWesleyErik BmebezacSergio LninjadeathdogRory BA42PoundMooseAndrewJustin MPeterStellar.BeesBrendan KScott RwreckxNoah OMichael GArcturusChris RhepaheCory FChase ALoveDiesNick QWes KChris MRBMichaela WAdam FScott HAlexander SPTherese KjgprintersJessica BMurrayDavid PJason KBede RKamrin HKyle SPhilip  ★ Support this podcast on Patreon ★

Medverkande i detta somriga avsnitt är: Fredrik, Mattias, Victoria, Poki och Jesper.Då var det dags igen! Våra poddare ska ge ytterst kvalificerade gissningar (yeah right ha ha) – nästan orakelmässiga sianden kring för vad våra kära Nördlivs-kollegor kommer ha för topp 10-listor när året 2025 är över!Hur långt når Kingdom Come: Deliverance II, Clair Obscur: Expedition 33, Bionic Bay eller Death Stranding 2: On the Beach egentligen? Och vilka spel tror vi når våra vänners topplistor – av de spel som dessutom inte släppts ännu? Många frågor, många gissningar och mycket knasigt snack!Detta och mängder av sidospår, spaningar och allehanda spekulationer i ett avsnitt vars mål är att skapa diskussion.Har ni några tankar kring detta ämne? Skriv till oss på info@nordlivpodcast.se alternativt skriv inne på vår Discord.Kom med i vår Discord här! – Nördliv på iTunes – Nördliv på Spotify

This week on Thumb Cramps, playing video games on the bus is back as they continue to celebrate Handhelgust this time joined by Scaredy Boys' very own Tom Reed to look at God of War: Chains of Olympus for the PSP, Mario Paint for the SNES for the Nintendo Switch 2 and Caravan Sandwitch for the Nintendo Switch. Plus, a pitch for a legacy sequel to Mad Men, news of uploading photos in a brand new way and a special guest appearance from one of the greatest songwriters of all time.Buy tickets to Thumb Cramps live from Cheerful Earful hereThumb Cramps+ has launched! Ad-free podcasts and a bonus monthly episode of Speedrunning Television; a brand new podcast that innovates how to watch television as gamers. Subscribe now on Sanspants Plus OR Apple Podcasts! Email us at ThumbCrampsPod@gmail.com Find us on Instagram;Jackson | Duscher | Thumb Cramps | Tom | Scaredy BoysWatch us on Twitch;Jackson | Duscher | Sanspants RadioYou can physically send us stuff to PO BOX 7127, Reservoir East, Victoria, 3073.Join our facebook group here or join our Discord here.Theme music by Benny Davis! You can find all his stuff at his website or check out his YouTube channel. Hosted on Acast. See acast.com/privacy for more information.

This episode is all about Contra: Rogue Corps, a Contra game that doesn't know what it means to be a Contra game. Anyway and as always, thank you for watching or listening, I hope you enjoy this here episode, and I hope you have a wonderful wonderful rest of your day. (And if you haven't already, or are a listener and not a watcher, please like, subscribe, hit the bell, and all that jazz; it may not seem like much, but it goes a long way in helping support the show and site in general. I would appreciate it greatly.)

108 dias depois de Issam Sartawi ser assassinado em Albufeira, por ordem da organização palestiniana Abu Nidal, Portugal volta a ser palco de um novo atentado terrorista internacional. A embaixada da Turquia, em Lisboa, vai ser invadida por um grupo de homens armados. Um jovem agente da PSP, no seu terceiro dia de trabalho, vai estar à hora errada, no sítio errado. E vai ser a primeira vítima dos terroristas, que vão conseguir entrar e fazer reféns. "1983: Portugal à Queima-Roupa" é o novo Podcast Plus do Observador. É narrado por Victoria Guerra e tem banda sonora original dos Linda Martini. Pode ouvir semanalmente os episódios de "1983: Portugal à Queima-Roupa" na playlist própria do podcast na Apple Podcasts, Spotify, Youtube ou outras plataformas de podcast. Os assinantes standard e premium do Observador tem acesso exclusivo e antecipado a todos os episódios em observador.pt.See omnystudio.com/listener for privacy information.

108 dias depois de Issam Sartawi ser assassinado em Albufeira, por ordem da organização palestiniana Abu Nidal, Portugal volta a ser palco de um novo atentado terrorista internacional. A embaixada da Turquia, em Lisboa, vai ser invadida por um grupo de homens armados. Um jovem agente da PSP, no seu terceiro dia de trabalho, vai estar à hora errada, no sítio errado. E vai ser a primeira vítima dos terroristas, que vão conseguir entrar e fazer reféns. "1983: Portugal à Queima-Roupa" é o novo Podcast Plus do Observador. É narrado por Victoria Guerra e tem banda sonora original dos Linda Martini. Pode ouvir semanalmente os episódios de "1983: Portugal à Queima-Roupa" na playlist própria do podcast na Apple Podcasts, Spotify, Youtube ou outras plataformas de podcast. Os assinantes standard e premium do Observador tem acesso exclusivo e antecipado a todos os episódios em observador.pt.See omnystudio.com/listener for privacy information.

108 dias depois de Issam Sartawi ser assassinado em Albufeira, por ordem da organização palestiniana Abu Nidal, Portugal volta a ser palco de um novo atentado terrorista internacional. A embaixada da Turquia, em Lisboa, vai ser invadida por um grupo de homens armados. Um jovem agente da PSP, no seu terceiro dia de trabalho, vai estar à hora errada, no sítio errado. E vai ser a primeira vítima dos terroristas, que vão conseguir entrar e fazer reféns. "1983: Portugal à Queima-Roupa" é o novo Podcast Plus do Observador. É narrado por Victoria Guerra e tem banda sonora original dos Linda Martini. Pode ouvir semanalmente os episódios de "1983: Portugal à Queima-Roupa" na playlist própria do podcast na Apple Podcasts, Spotify, Youtube ou outras plataformas de podcast. Os assinantes standard e premium do Observador tem acesso exclusivo e antecipado a todos os episódios em observador.pt.See omnystudio.com/listener for privacy information.

Medverkande i detta somriga avsnitt är: Fredrik, Poki och Mattias.I detta sommaravsnitt får ni ett avsnitt som påminner om de ordinarie avsnittten. Det blir snack om film och spel vi tagit itu med under sommaren. Men även spel vi trodde vi skulle spela men aldrig hann.Vi reflekterar helt enkelt över vad vi hunnit spela hittills och vad som faktiskt stått ut, Följ med oss på detta orerande sommaravsnitt när vi pratar om följande saker:SPELDeath Stranding 2,Donkey Kong Bananza,The King is Watching,The Midnight Walk,Karma: The Dark World,Tainted Grail: The Fall of Avalon,WUCHANG: Fallen Feathers,Clair Obscur: Expedition 33, FILM & TVSuperman,Sleepers,The Batman (2022),Fantastic Four: The First Steps,Reacher,Godzilla Minus One,Stort tack till alla som lyssnar! Hoppas er sommar varit fantastisk! Kram!

This week on Thumb Cramps, it's finally safe to play video games on the bus as they celebrate Handhelgust, a month dedicated to handheld gaming. To celebrate the start of such a wonderful event, they're joined by Humdinger's' very own Bec Petraitis to look at Patapon for the Nintendo Switch 2 but originally the PSP, Batman: Arkham Knight for the Steam Deck so it counts and Nintendo Switch 2 Welcome Tour for the Nintendo Switch 2. Also they lose their minds.Check out Space Murder! A TTRPG hereBuy tickets to Thumb Cramps live from Cheerful Earful hereThumb Cramps+ has launched! Ad-free podcasts and a bonus monthly episode of Speedrunning Television; a brand new podcast that innovates how to watch television as gamers. Subscribe now on Sanspants Plus OR Apple Podcasts! Email us at ThumbCrampsPod@gmail.com Find us on Instagram;Jackson | Duscher | Thumb Cramps | Bec | HumdingerWatch us on Twitch;Jackson | Duscher | Sanspants Radio | BecYou can physically send us stuff to PO BOX 7127, Reservoir East, Victoria, 3073.Join our facebook group here or join our Discord here.Theme music by Benny Davis! You can find all his stuff at his website or check out his YouTube channel. Hosted on Acast. See acast.com/privacy for more information.

This episode is all about Wreckfest, a racing game where wrecking is the name and wrecking is the game, so get your friend Ralph and wreck it with a pal. Anyway and as always, thank you for watching or listening, I hope you enjoy this here episode, and I hope you have a wonderful wonderful rest of your day. (And if you haven't already, or are a listener and not a watcher, please like, subscribe, hit the bell, and all that jazz; it may not seem like much, but it goes a long way in helping support the show and site in general. I would appreciate it greatly.)

Fredrik och Poki ger forna år en match, när de ska samsas om dåtidens bästa spel. Detta ÄR "Retro GOTY!".Dags för retrospel - eller vad nu 2000-talets spel är?! Upplägget är som vanligt; Vi lyfter först våra personliga topp tio spel för året i fråga - denna gång spelåret 2003! Därefter gör vi den titulära RETRO GOTY:n.Vilka är spelen som hamnar i vår gemensamma "Game of the Year" á 2003? Lyssna och lär kära lyssnare!Exempel på spel som tas upp:Ikaruga,Prince of Persia: The Sands of Time,Colin McRae Rally 3,SimCity 4,Zone of the Enders: The 2nd Runner,Halo: Combat Evolved,Grand Theft Auto: Vice City ,Star Wars Jedi Knight: Jedi Academy,Max Payne 2: The Fall of Max Payne,Freelancer,The Legend of Zelda: The Wind Waker,Resident Evil Zero,Need for Speed: Underground,Star Wars: Knights of the Old Republic,Command & Conquer: Generals,Lionheart: Legacy of the Crusader,BloodRayne,Silent Hill 3,I.G.I.-2: Covert Strike,Lost Kingdoms II ,Mario Kart: Double Dash,Metroid Prime,Castlevania: Aria of Sorrow,Devil May Cry 2,Primal,Skies of Arcadia,Dessa och många många fler (obs! Vi spoilar inte de som ligger i våra personliga topplistor ovan!

Lex chats with Harish Natarajan - Practice Manager, Financial Inclusion and Infrastructure, Finance, Competitiveness & Innovation at the World Bank, and Carlos Brandt - The Senior Advisor for Pix at the Central Bank of Brazil. Together they discuss the remarkable success of Pix, Brazil's real-time payment system, which now sees over 6 billion transactions per month and is used by more than 90% of the adult population and 80% of companies. Lex explores how Pix was created by the Central Bank of Brazil with strong public-private collaboration, backed by regulatory authority and supported by a co-creation model with stakeholders. Key to its adoption were a low-cost centralized infrastructure, clear branding, mandatory participation by large banks, and a robust national communication strategy. Globally, Pix is seen as a leading example of fast payment system deployment, driven by the central bank acting as a neutral coordinator and scheme owner. Lex also examines the technical architecture, built in-house by a surprisingly small team of 55–65 people, and how scalable infrastructure and extensibility have enabled rapid growth and innovation. NOTABLE DISCUSSION POINTS: 1. Pix achieved mass adoption through public-private co-creation and legal mandate:Pix now processes over 6 billion transactions per month, with 90% of Brazil's adult population and 80% of businesses actively using it. Its success stems from a strategic legal mandate in 2013 granting the Central Bank regulatory and operational authority over retail payments. The Central Bank then led a co-creation process involving both public and private stakeholders through the Pix Forum, fostering alignment, inclusivity, and strong network effects.2. A lean but powerful team built a nation-scale real-time payments system:The Pix infrastructure was built entirely in-house by a relatively small team, 30-40 people for the technical infrastructure layer and around 25 for the payment scheme layer. It operates 24/7 with real-time settlement and uses centralized infrastructure separate from Brazil's traditional large-value payment rails. This centralized, purpose-built architecture dramatically lowered costs and enabled rapid rollout.3. Strategic communication and mandated participation drove adoption at scale:The Central Bank led a national communication campaign to build trust, establish a strong brand identity, and educate the public. Simultaneously, it mandated major banks (with over 500,000 active accounts) to join Pix, triggering widespread voluntary adoption from smaller PSPs. The rollout included a restricted pilot phase and emphasized user-friendly features like QR codes and aliases to boost convenience and usage from day one. TOPICS Pix, Central Bank of Brazil, World Bank, Visa, Citibank, M-Pesa, Alipay, SPI, fintech, payments, PSP, API, Fast Payments, Payments Infrastructure, PayTech ABOUT THE FINTECH BLUEPRINT 

Viper checks out K-ON! HO-KAGO LIVE!!, a PSP rhythm game based on a franchise he knows nothing about. What could go wrong? TRACKLISTING: 00:00:00 K-ON! HO-KAGO LIVE!! - Cagayake! GIRLS 00:02:38 K-ON! HO-KAGO LIVE!! - My Love is a Stapler 00:04:23 K-ON! HO-KAGO LIVE!! - Girly Storm Sprint Stick 00:06:36 Let's Get into the Mix! 00:12:30 Code Breakers - Round 1 00:14:30 K-ON! HO-KAGO LIVE!! - Have some tea? 00:15:45 K-ON! HO-KAGO LIVE!! - Polka Dot Chiffon 00:17:07 K-ON! HO-KAGO LIVE!! - Humming Bird 00:19:36 K-ON! HO-KAGO LIVE!! - Hello Little Girl 00:22:26 Changing the Tune to Your Friday Night! 00:37:31 Code Breakers - Round 2 00:38:14 K-ON! HO-KAGO LIVE!! - Fude Pen ~Ballpoint Pen~ 00:40:43 K-ON! HO-KAGO LIVE!! - Curry, Then Rice 00:42:21 K-ON! HO-KAGO LIVE!! - Fluffy Time 00:44:08 Requester Monarchy 00:47:10 Code Breakers - Round 3 00:49:24 Wonderland Wars: Nanatsu Iro no Romance - Hearts Of Wonderland [Requester Monarchy #3] 00:56:42 Musica e WCCF ~World Club Champion Football Seria A 2001-2003~ - The Winners [Requester Monarchy #2] 01:02:03 Pachinko CR Puyo Puyo - One-Two has Three! [Requester Monarchy #1] 01:07:52 Code Breakers - Results 01:12:02 K-ON! HO-KAGO LIVE!! - Sweet Bitter Beauty Song 01:14:03 K-ON! HO-KAGO LIVE!! - Head Over Heels for Guitar 01:16:55 K-ON! HO-KAGO LIVE!! - I Go My Own Road 01:19:09 Thanks for Listening! 01:22:48 K-ON! HO-KAGO LIVE!! - Don't say "lazy"

Support the show Patreon: https://www.patreon.com/PSTrophyroom Discord: https://discord.gg/wPNp3kC  BSYK: https://tinyurl.com/3e24bn7y  Store: https://tinyurl.com/ktbsdw3s  This week on The Trophy Room:  A PlayStation Podcast hosts Teegan, Kyle, and Joe talk about the news straight from the PlayStation blog that the PS5 latest software beta that helps Dualsense controller link to various Bluetooth devices such as a PC, Table, Smartphone, iphone, and PlayStation 5 via Bluetooth sync. It alos has an energy saver that lowers the performance of the PS5 to save energy could this also lead to a device thats a future and acual PSP or PSVita mobile device akin to a Nintendo Switch 2? Maybe a gaming handheld at the start of the next generation of video game consoles with a PlayStation 6 and PS6 Handheld or even a PS5 handheld device that native without the need to stream. Its also a sign of PlayStation's push to publish more games on PC and Steam. Also Battlefield 6 may launch at a premium price of over $80 this after Microsoft Gaming and Xbox announced that The Outer Worlds 2 has lowered its price from $80 toa more reasonable 70 us dollar price tag. If Electronic Arts revealed the price to be 80 dollars along the likes Mario Kart World and Grand Theft Auto 6 might very well launch at that price. Is BF4 really having the backing the way of Call of Duty Black Ops 7 or GTA 6? Also our Wuchang Fallen Feathers Review in Progress as it already is breaking records on steam concurrent player count? 

In this episode Gino, Chris "ZombiePie" -REDACTED-, and Jedd Rud discuss the back half of Final Fantasy Type-0! We cover everything after chapter 2, marvel at how poorly the game plays, and wonder how much better the experience could have been if we were playing on PSP on a bullet train instead of on a TV. We then rank the game in our difinitive Ranking of Fantasies! Check out the current ranking of Fantasies here: bit.ly/deepfinal Please consider donating to the National Network of Abortion Funds: abortionfunds.org/donate If you've been enjoying the podcast, please consider supporting us at https://www.patreon.com/DeepListens If you like our new art and want to commission some of your own, reach out to Tyler at tylerorbin.net

The third and final part of my Attack the Backlog playthrough of Kingdom Come: Deliverance, a game that wasn't what I expected. I thought the game was going to be more open, where you create your own character and find your own story within its world. I was wrong. While you can shape the character you play to an extent, you are playing a specific character--Henry in this case--who has his own story and there's little room for deviations. This isn't a bad thing, but when you're expecting salt and get sugar instead, it's impossible to not be at least a little disappointed and disappointed I was.

Graveyard duck, give me the bag. Inside of this bag you can find us feeling the magic, repeatedly getting lost in the forest, spriting a tree differently, receiving PSP-exclusive Nash backstory, dreaming bloody murder, parting bushes like the red sea, debating the existence of god with children, learning of the nomadic lifestyle, spreading disease, stacking up powerful rugs, violating gift customs, passing out, deleting a joke about Kyle's massive penis, worshipping goat satan, and spreading black power to every corner of the world. Rest well, my ignorant knight. 00:00:00 Chili Powder Fun Dip 00:02:13 Intro 00:03:32 Illusion Forest 00:08:56 Illusion Forest - Night 00:12:53 Illusion Forest - Morning 00:17:49 Pao 00:26:52 Pao Buildings 00:33:15 Tempest 00:40:56 Pao Post Plague 00:44:50 Black Dragon Cave 00:54:53 Real Net 00:57:38 Outro Patreon: patreon.com/retroam Bluesky: @retrogradeamnesia.bsky.social YouTube: www.youtube.com/@RetrogradeAmnesia E-Mail: podcast@retrogradeamnesia.com Website: www.retrogradeamnesia.com  

Medverkande i detta somriga avsnitt är: Poki, Fredrik, Mattias, Emil och Jesper.I detta sommaravsnitt får ni en XL-version av leken "Speltråden". Vår värd Poki styr upp genom att ge ett antal påståenden/ledtrådar, som sedan våra två lag ska försöka utröna vad tusan han är ute efter. Poängjakt, huvudkli och skratt utlovas!Stort tack till alla som lyssnar! Hoppas er sommar varit fantastisk! Hörs igen om en vecka när ordinarie avsnitt är tillbaka! Kram!

Earlier this year we did God of War 2, and i been itching for more.  For this Mini we take a look at God of War Chains of Olympus.  The first of the 2 psp titles.  Does this game hold up? How does it do as a prequel from Before God of War 1?  Come listen to what we thought about Kratos first outing on the PSP. Starring Mike Albertin, Joe Butler, Nate and Sierra. 

Part one of my Attack the Backlog playthrough of Kingdom Come: Deliverance, a game that wasn't what I expected. I thought the game was going to be more open, where you create your own character and find your own story within its world. I was wrong. While you can shape the character you play to an extent, you are playing a specific character--Henry in this case--who has his own story and there's little room for deviations. This isn't a bad thing, but when you're expecting salt and get sugar instead, it's impossible to not be at least a little disappointed and disappointed I was.

Medverkande i detta somriga avsnitt är: Fredrik, Mattias, Emil, 'Poki' och Jesper.I detta sommaravsnitt får ni ett tv-seriemusikquiz! Vår värd Fredrik styr upp ett gäng låtar som våra två lag ska gissa friskt kring - eller genuint kunna!Ett avsnitt med både gamla godingar, moderna klassiker och ett och annat jämmer från gubbarna! Precis som det ska vara!Stort tack till alla som lyssnar! Hoppas er sommar varit fantastisk! Hörs igen om en vecka när ordinarie avsnitt är tillbaka! Kram!Kom med i vår Discord här! - Nördliv på iTunes – Nördliv på Spotify

Quer se goste ou não, a TAP vai ser vendida a metade. Quem vai dar uma moedinha para ajudar a causa? PSP está a ser investigada por tortura, ainda não estão óbvios os limites da autoridade?See omnystudio.com/listener for privacy information.

Synopsis: Join Natasha Ann Zachariah at The Usual Place as she unpacks the latest current affairs with guests. Two months after its dismal showing at the 2025 General Election, Progress Singapore Party (PSP) has shaken up its leadership team. On July 5, it announced that its founder and chairman Tan Cheng Bock, and vice-chair Hazel Poa had stepped down from their roles in the central executive committee (CEC), the party’s highest decision-making body. Party treasurer S. Nallakaruppan also relinquished his position. All three will remain members of the party. Dr Tan has been designated party adviser. Ms Poa was a Non-Constituency MP (NCMP) in the last term of Parliament, along with party chief Leong Mun Wai. At a press conference at the party’s headquarters in Bukit Timah Shopping Centre on July 5, Mr Leong announced a renewal plan, and introduced three new members who were co-opted into the CEC. The first is Ms Stephanie Tan, a full-time homemaker and former lawyer, who was the PSP candidate for Pioneer SMC. The other two are Mr Sani Ismail, an in-house legal counsel who contested West Coast-Jurong West GRC, and Mr Lawrence Pek, a former secretary-general of the Singapore Manufacturing Federation, who contested Chua Chu Kang GRC. Ms Tan joins me in this podcast to talk about being part of PSP’s refreshed leadership team, the insights she gleaned from walking the ground as a first-time candidate, and the challenges of a political party without a presence in Parliament. The Usual Place podcast is livestreamed at noon on YouTube on Thursdays. Subscribe to the YouTube channel to catch the podcast when it airs on July 10. Highlights (click/tap above): 2:54 Taking feedback from voters during the election 6:08 How PSP will aim to change public perception going forward 13:08 With no presence in Parliament, how will PSP stand out online? 17:10 Rejigging the game plan after being hit hard from the GE2025 results 24:16 “It’s about your heart to serve.” - Lessons Ms Tan learnt from Dr Tan Cheng Bock about longevity in politics 29:37 What is one thing Ms Tan would change if she were to become an MP? 34:15 Her take on young, middle-income couples who face financial barriers when having children Host: Natasha Ann Zachariah (natashaz@sph.com.sg) Read Natasha’s articles: https://str.sg/iSXm Follow Natasha on her IG account and DM her your thoughts on this topic: https://www.instagram.com/theusualplacepodcast Follow Natasha on LinkedIn: https://str.sg/v6DN Filmed by: Studio+65 Edited by: Teo Tong Kai, Eden Soh & Natasha Liew Executive producers: Ernest Luis & Lynda HongFollow The Usual Place Podcast and get notified for new episode drops every Thursday:Channel: https://str.sg/5nfmApple Podcasts: https://str.sg/9ijXSpotify: https://str.sg/cd2PYouTube: https://str.sg/theusualplacepodcastFeedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 Get more updates: http://str.sg/stpodcasts The Usual Place Podcast YouTube: https://str.sg/4Vwsa --- Get The Straits Times app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #tup #tuptrSee omnystudio.com/listener for privacy information.

Part one of my Attack the Backlog playthrough of Kingdom Come: Deliverance, a game that wasn't what I expected. I thought the game was going to be more open, where you create your own character and find your own story within its world. I was wrong. While you can shape the character you play to an extent, you are playing a specific character--Henry in this case--who has his own story and there's little room for deviations. This isn't a bad thing, but when you're expecting salt and get sugar instead, it's impossible to not be at least a little disappointed and disappointed I am.

Fredrik och Poki ger forna år en match, när de ska samsas om dåtidens bästa spel. Detta ÄR "Retro GOTY!".Dags för retrospel - eller vad nu 2000-talets spel är?! Upplägget är som vanligt; Vi lyfter först våra personliga topp tio spel för året i fråga - denna gång spelåret 2002! Efter det blir det allmänna minnen från året i fråga. Därefter gör vi den titulära RETRO GOTY:n.Vilka är spelen som hamnar i vår gemensamma "Game of the Year" á 2002? Lyssna och lär kära lyssnare!Exempel på spel som tas upp:Grandia II,Grand Theft Auto III,Need for Speed: Hot Pursuit 2,Warcraft III: Reign of Chaos,Conflict: Desert Storm,Halo: Combat Evolved,No One Lives Forever 2: A Spy in H.A.R.M.'s Way,Civilization III,Aliens Versus Predator 2,Blood Omen 2Enclave,Project Gotham Racing,Soldier of Fortune II: Double Helix,Command & Conquer: Renegade,Super Mario Sunshine,The Elder Scrolls III: Morrowind,Icewind Dale II,Civilization III,Azurik: Rise of Perathia,Neverwinter Nights,Age of Mythology,Heroes of Might and Magic IV,Mafia,Dungeon Siege,Battlefield 1942,RalliSport Challenge,Metal Gear Solid 2: Sons of Liberty,Dessa och många många fler (obs! Vi spoilar inte de som ligger i våra personliga topplistor ovan!

In this episode, Avery & Smoia take a huge deep dive of what our feelings as we are half way through this chaotic season, while also going over Warren's first ever Love Island watch party experience. We also go over B.Simone's crazy statement & her treatment on friends, A gentleman using a PSP as a GPS, 3 kids being arrested for a very serious crime, New music & so much more!!!WELCOME TO THE FOUNTAIN!!!!Follow the Pod's IG: @bythefountainpodFollow the Host's IG: @averyfluker, @sna.z_don, @aiomspsi

I needed something chill and relaxing after the nightmare that was Kingdom Come Deliverance--expect those episodes after this one. I thought about many games, but ultimately landed on DREDGE, a relatively simple game about boating and fishing, wrapped in a mysterious Lovecraftian bow. It was exactly what the doctor ordered. If the idea of boating around and fishing doesn't sound like a bore to you, I'm sure you'll have a wonderful time too. Just remember sleep in important, very very important.

Hey everyone! We have some big changes coming to Into the Aether in the near future and we wanted to talk through them a bit.To avoid burying the lede here: We're leaving the Pickaxe podcast network and returning to complete independence. This has actually been in the works for a little while, but we wanted to only share the news when all of the boxes were checked.This is not a decision we made lightly, but we're confident it is the right decision for us and for all of you.To be clear, we have no ill-will with Pickaxe and there are no hard feelings either way. This was entirely our decision. As breezy as the process of joining was, the process of offboarding has been equally breezy. We want to extend a huge thanks to the team over there for taking a chance on us and being so cool over the last few months. It's not often you're given as much creative control as we were in situations like this.Immediate Changes:1) No more programmatic ads The first and most obvious change will be the removal of programmatic advertising in the podcast. We hugely appreciate the feedback from you all regarding the inclusion of these ads. While we're happy to have tried this method out — it clearly didn't work for us, the vibe of the show, or the values of Aether as an entity.This change will affect the entire backlog of the podcast as well, so all episodes will return to being ad-free – with the exception of our host-read ads from before the Pickaxe era.We'll share more about our plans for returning to host-read ads at a later date, but for now: If you're currently backing the show at the $10 tier, we completely understand if you'd like to downgrade or cancel your membership for the time being. While we will be returning to an advertising model that feels better to us and focuses on lifting up bands and games and projects we can get behind, the reality is that those ads won't be present in the show until August at the earliest. We hope to have you back, but also understand if you need to pull your support for the time being. 2) Chapters are back!Another welcome change (cue the applause sfx) is that chapter markers are back on the menu. The move to Pickaxe unfortunately wiped the chapter markers from all episodes of the show, meaning you all needed to rely on the written timecodes in the episode descriptions. While this wasn't the end of the world, it also wasn't intentional or desirable on our part. We're happy to say that chapter markers should be working in the entire backlog, including the episodes which were produced during the Pickaxe era.The Future:We have some other big changes and ideas in the works that we'll be announcing on the PSP retrospective episode (which we will be recording on August 2nd). These changes are all positive and double down on our desire to keep the show independent for the foreseeable future. We're excited to share them with you!We're immensely proud of what Into the Aether has become over the past seven years (!!) and want to make sure its future is sustainable and bright as an indie show on TWG. The reason we are able to try all the things we do and push ourselves further is entirely due to all of your support. So just another huge thank you to everyone for listening and giving us the confidence to try and make this show in our own way.If you have any questions, feel free to post them here in Discord or email us at intotheaetherpodcast@gmail.com.Thanks again,BB + SH ★ Support this podcast on Patreon ★

Medverkande i detta avsnitt är: Fredrik, Poki och Ice (igen!)I detta säsongavslutningsavsnitt bjuder på samtal om spel, anime och lite annat smått och gott - allt i ett trevligt sällskap! Denna gång med extra många lekar! Något som passar väl in så här inför sommaravsnitten som kommer snart!Spel som tas upp:Tainted Grail: The Fall of Avalon,Symphonia,Medieval Dynasty,Minecraft: Spellägen i Hypixel - Build battle, Disaster SurvivalFilm/TV som tas upp:The Beginning After the End,Övrigt som tas upp:I detta avsnitt betar vi av ett antal lekar utöver de ordinarie speldiskussionerna! Vi går även igenom "Månadens spel" för både juli och augusti. Utöver detta kör vi även lekarna "Vad betyder ordet?" och "Kan hen spelen?". Ett chill avsnitt, med både rizz och drip!Kom med i vår Discord här! - Nördliv på iTunes – Nördliv på Spotify

Starting off with some Switch 2 news this month, the same month the Switch 2 released! We discuss a Day 1 Userland ROP Chain demonstrated on the Switch 2, the bans using MiG Flash cartridges, the beginnings of a microSD Express adapter, and get clarification on how far SciresM will support the Switch 2's homebrew scene. In Xbox centric news, rumors regarding an Xbox Classics program are clarified, along with a program similar to Cheat Engine being ported to the Xbox 360, and some awesome patches are shown to run the original Xbox's Dashboard at native 720p! Every model of the PS2 can now officially take on a Memory Card based entrypoint thanks to the release of ProtoPwn. PSP users get some love with BatterySteve to help with some aging and misleading batteries out there.

This was a frustrating experience. My first thought after booting up Evil Dead: The Game was, "Wow, this is prettier than I was expecting," followed immediately by, "Damn, I wish this was just a normal-ass single-player game. As I played the tutorials and eventually a handful of games, my disappointment and sadness only grew as the tutorial did a poor job of preparing me for a real match. Even once I started to "get it," I still wished Evil Dead: The Game was a single-player game instead of a live-service game; however, a live-service game it is (or was) and as many do, like the name of the game, this one is dead.

I've played many a Need for Speed game, but not one has frustrated me as much as Need for Speed Unbound. It may have a great sense of style and take place in a fictionalized version of my hometown--a not-so-great take on Chicago--but that's not enough to make up for its annoying structure, frustrating race design, and cheap AI. It also shouldn't come as a surprise that the story is shit, but I doubt anyone was expecting a great story in their racing game. Long story short, the fun was unfound in Need for Speed Unbound.

Pelo menos mais três agentes das forças de segurança, além do polícia da PSP que foi detido essa semana, estão numa lista com cerca de duas dezenas de pessoas sinalizadas pela Polícia Judiciária (PJ) no desmantelamento da milícia neonazi Movimento Armilar Lusitano (MAL).

Choosing the Best Payment Processor for Your Online Business in 2025Wondering which payment processor is right for your online store? In this episode, Maria Sparagis (CEO of DirectPayNet) explains the crucial differences between popular PSPs like Stripe, PayPal, Braintree, and getting your own dedicated merchant account.What you'll learn:- How Stripe and PayPal work for startups vs. scaling businesses- Hidden fees you might be ignoring- Why your business might outgrow Stripe sooner than you think- How a merchant account can increase your approval rates and protect you from sudden shutdowns- Easy integration tips that debunk the “merchant accounts are hard” mythWhether you sell digital products, subscriptions, coaching, or physical goods, this guide will help you pick the best payment processor in 2025 to maximize your revenue and keep your business stable.Many small businesses get lulled into Stripe's convenience — until it bites them later with freezes, zero human support, or hidden fees. Graduating to a merchant account is not only about saving money but protecting your cash flow from algorithmic shutdownsSubscribe for more payment processing secrets, fraud prevention tips, and e-commerce success strategies!0:00 into0:53 2 Types of Processors2:00 Why Not Choose a PSP5:42 Scaling Your Business10:45 Plug-and-Play12:48 Application Process14:07 PSP vs Merchant Account21:31 OutroNeed a merchant account? Get in touch! ➡️ directpaynet.com/contact-us

"Use Duality to control two bodies in real-time, letting you defend two sites at once, cover your own cross, or even trade yourself." Sounds pretty cool, right? Sadly, as cool as Spectre Divide sounded in concept, it never quite reached those levels in practice. Part of that comes down to the shooting--which was just okay--but the whole "Duality" system never felt like more than in gimmick in what little time I put into the game. Maybe its intricacies needed time to be discovered, but with it shutting down only a few weeks after its console release (and six months after its PC release), it never really got the chance.

This week ARG Presents 316, we'll take a long overdue look at the Sony PSP PlayStation Portable handheld! First we'll talk about the PSP and it's successes and failures, and then we'll look at a few of these "MOBILE" games to review. Kick back and and relax as we look at Bancho: Badass Rumble! and Work Time Fun!Email: theretrorotation@gmailFacebook: Amigos Retro GamingTwitch: amigosretrogaming#argpresents #Retrorotation#Retrocomputing

This week ARG Presents 316, we'll take a long overdue look at the Sony PSP PlayStation Portable handheld! First we'll talk about the PSP and it's successes and failures, and then we'll look at a few of these "MOBILE" games to review. Kick back and and relax as we look at Bancho: Badass Rumble! and Work Time Fun!Email: theretrorotation@gmailFacebook: Amigos Retro GamingTwitch: amigosretrogaming#argpresents #Retrorotation#Retrocomputing

Behold the second and final episode of my Attack the Backlog review of Grounded. While I really liked the game overall, one mission almost made me rage quit the game. I managed to get through it in the end, but it did leave a sour taste in my mouth and somewhat tarnished what is a mostly great game.

Understanding the ins and outs of driver testing and background checks can make all the difference in a trucking career. For Marc Bourne and Grady Phillips, supporting drivers means building trust through transparency and clear communication around testing and background screening.  In this episode, Chelsea Faulkner sits down with Marc Bourne, Vice President of Background Screening, Training, and Compliance Services at Workforce QA, and Grady Phillips, CRO at Workforce QA, who both bring a unique background to trucking, to explore how testing processes can be fair, straightforward, and driver-friendly. They discuss how companies can move beyond just ticking boxes to fostering honest, respectful relationships. You'll hear them bust common myths about drug and background testing, explain why drivers should take charge of their own records, and share how ongoing education and advocacy help create a safer, better-informed trucking community. Marc and Grady stress the importance of treating drivers like people and giving them clarity about what's tested and why it matters. In this episode, you'll hear about: Why trust is the foundation of driver testing and records How to advocate for yourself with MVR, PSP, and background checks How digitization can improve the hiring process Resources: Grady Phillips on LinkedIn Marc Bourne on LinkedIn HandledNow Website HandledNow on Facebook Chelsea on LinkedIn Episode highlights: (00:00) Intro and background of Marc Bourne and Grady Phillips (00:07:00) Why trust matters between drivers and companies (00:14:00) The power of clear communication and candidate experience (00:16:00) Debunking common myths about background checks (00:22:30) Understanding MVR, PSP, and clearinghouse records (00:32:00) Keeping up with policy changes and regulations (00:37:00) How digital tools are changing testing and record keeping (00:39:00) Rapid fire: driver questions and redesigning testing (00:43:00) Making drivers feel supported, not singled out (00:44:30) How to connect with Marc and Grady

It doesn't matter if you're first to an idea, if you don't execute it well enough, someone else can swoop in and steal your thunder before you even manage to throw your lightning. That's the case with Stampede: Racing, a battle royale kart racer where you start with 60 players and gradually whittle it down to one after reaching select checkpoints during a race. Sound familiar? It should, because it's basically Mario Kart World's Knockout Tour mode (and also way more similar to something like Fall Guys than Fortnite). Now, I don't know if Stampede was actually first to this idea, but I think we can all agree Knockout Tour refined the idea and made it into something that's tons of fun and will last in a way Stampede never was and will never get a chance to be.

Behold the first part of my review of Grounded. It's been a long time coming. I tried playing and streaming the game once before, but got so annoyed with the chat that I rage quit both the game and streaming for years. Fast-forward to now and things are very different, not only did chat never bother me when I streamed the game--you can check out the archive for my entire playthrough if you want--I also had a great time with the game and look forward to playing and seeing more (even though I will never not be scared whenever a spider shows up).

In this episode of the Brain & Life Podcast, co-host Dr. Daniel Correa is joined by dedicated public servant and former U.S. Representative for Virginia's 10th congressional district Jennifer Wexton. She shares about her journey with progressive supranuclear palsy (PSP) and what she has learned from the PSP community. She also discusses the importance of advocacy and the use of assistive technology, including the AI-generated voice she uses during this episode. Dr. Correa is then joined by Dr. Janis Miyasaki, a movement disorders specialist who practices at the University of Alberta in Canada where she is the head of the department of clinical neuroscience and co-directs the Neuropalliative Care Clinic. Dr. Miyasaki explains PSP and discusses what the care experience may look like for someone living with PSP and their loved ones as they search for comfort and peace. Interested in getting involved with advocacy? Learn more here: https://www.brainandlife.org/get-involved/advocate/     Additional Resources Former Representative Jennifer Wexton Breaks Barriers with AI-Generated Voice Amid PSP Battle The Research Pipeline for Progressive Supranuclear Palsy CurePSP   Other Brain & Life Podcast Episodes on Similar Topics Family Stories: Diagnosing a Neurodegenerative Condition The Future of Caregiving with Kat McGowan Still Standing with Staff Sergeant John Kriesel   We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? Record a voicemail at 612-928-6206 Email us at BLpodcast@brainandlife.org   Social Media: Guests: Jennifer Wexton @repwexton; Dr. Janis Miyasaki @ualberta Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD

On this powerful episode of The Manchester Living Podcast, host Brian Levy is joined by Janice Bloom and Ileen McFarland to discuss Progressive Supranuclear Palsy (PSP)—a rare, often misdiagnosed neurodegenerative disease similar to Parkinson's but far more aggressive.Janice and Ileen share deeply personal stories of navigating their husbands' PSP diagnoses, including the physical, emotional, and logistical challenges of caregiving. From misdiagnosis and finding proper care to emotional shifts, brain donation, anticipatory grief, and finding balance in caregiving, this episode is a must-watch for anyone affected by rare diseases or caring for a loved one.Their insights offer not just education, but inspiration—and a powerful reminder that while the body may decline, the human connection remains.http://www.ManchesterLivingPodcast.com

Giga Bytes Podcast #365: Hoy hablamos de rebajas a PS5, Switch 2, Harry Potter y mucho más!!! Days of Play: PS5 reduce precios hasta 11 de junio Cyberpunk 2 en desarrollo (nombre temporero), Phantom Liberty vende 10m The Witcher 3: Wild Hunt alcanza 60m de unidades vendidas Switch 2 video/photo upload directo al app EA Cancela juego de Black Panther, cierra Cliffhanger Games Sideshow a lanzar línea de HBO Last of Us The Last of us Part 2 vende 2m adicionales durante temporada 2 Pokemon Presents julio 22, 2025, Pokemon Z to A, lanza Oct 16 ($60 SW, $70 SW2) Clair Obscur Expedition 33 vende 3.3m de unidades en 33 dias en tiendas Nioh: franquicia alcanza 8 millones Rumor: Apple a lanzar app dedicado a Gaming Se report que Doom the Dark Ages solo ha vendido 800k unidades en PS5, Xbox y PC, resto de jugadores en Gamepass Switch 2 tendra midnight en PR, require update para usarse, Rumor: juegos classicos (PS1-PS3 y PSP) podrán utilizar PSSR en futuro update Live action Elden Ring con A24, Alex Garland en camino Cast Harry Potter HBO Max anunciado: Dominic McLaughlin como Harry Potter Alastair Stout como Ron Weasley Arabella Stanton como Hermione Granger       Sigueme y Suscribete: Facebook.com/elgiga Youtube.com/elgiga947 Instagram.com/elgiga947                                                                                                                                    Twitch.tv/elgiga947 Twitter.com/elgiga947 Giga Bytes Podcast   #monsterenergypr @monsterenergy @Stephreyesmarketing @caribbeanxsports @eriberto213 #gigabytespodcast #NintendoSwitch2 PS5 #TLOU #Max #DeathStranding2 #DareDevil #Starwars #Switch #AssassinsCreedShadows #PSSR #PS5Pro #Max #Xbox #Switch2 #Review #Playstation #Dualsense #TLOU

In this episode Gino, Chris "ZombiePie" -REDACTED-, and Jeff Rud discuss Final Fantasy Type-0! We discuss all of the trials and tribulations that led to this game coming out on the PSP in Japan and then not coming to the US until the PS4 remaster. We also discuss how sick the camera makes us and how unpleasant the game is in general. Check out the current ranking of Fantasies here: bit.ly/deepfinal Please consider donating to the National Network of Abortion Funds: abortionfunds.org/donate If you've been enjoying the podcast, please consider supporting us at https://www.patreon.com/DeepListens If you like our new art and want to commission some of your own, reach out to Tyler at tylerorbin.net

From the company driver per diem to overtime pay for truckers and more, OOIDA has some real concerns about the contents of the budget reconciliation bill. Also, because of all the ways it's tracked, your history in previous jobs could give you some real problems when you're searching for a new one. 0:00 – Newscast 10:05 – The ghost of jobs past could haunt your future 39:32 – Provisions in reconciliation bill could hit truckers