Podcasts about Severity

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Differences in Severity and Prognosis Between Bicuspid and Tricuspid Severe Aortic Stenosis.

Hello folks, welcome to sans, episode 33. This is going to cover the newsletter for December 19th, which means we're pretty much caught up. Yeah!would you like to view the newsletter to see what might be of interest to you? Here's the newsletter for December 19, 2025. Here is what is in the top of the news and we've got to start with yet another maximum severity flaw. Cisco AsyncOS Unpatched Maximum-Severity Flaw Exploited SonicWall Addresses Actively Exploited Vulnerability in SMA 100 Series Appliances; CISA Adds Flaw to KEV with a One-Week Mitigation Deadline Known Critical Flaws in Fortinet Products are Being Actively Exploited Are you surprised about the fortinet stuff? Seems like they're in Sans practicly every newsletter it seems, even though we missed time due to illness.Here is what is in the rest of the week's news and we start again with a maximum severity bug but this time with an RCE. Patch HPE OneView to Fix Maximum-Severity RCE Flaw ASUS Live Update Vulnerability Added to KEV RAT Allegedly Discovered on Mediterranean Ferry NHS Technology Supplier Discloses Cybersecurity Incident Virginia Mental Health Authority Breach Follow-Up: French Ministry of the Interior Cyberattack Law Enforcement Dismantles Infrastructure for Alleged Ransomware Money Laundering Service I can't wait to see what the update on the French Ministry is. It sounded like the beginning of a particular investigation which was just getting started last podcast and newsletter for December 16. Please contact me through my web site or listen to the podcast to learn how to contact me. Thanks so much for listening, and make it a happy holiday season!

On episode #96 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 12/4/25 – 12/17/25. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Rabies Cluster Among Steer on a Dairy Farm — Minnesota, 2024 (CDC:MMWR) Incidence of community-acquired pneumonia and herpes zoster in people with HIV based on CD4-count and age in the current antiretroviral therapy era: a longitudinal cohort study (CID) Associations between antibiotic use and outcomes in patients hospitalized with community-acquired pneumonia and positive respiratory viral assays (CID) Bacterial Lactobacillus Bacteremia: A Challenging Condition for Pediatrician (Pediatric Infectious Disease Journal) Trial of High-Dose Oral Rifampin in Adults with Tuberculous Meningitis (NEJM) Zoliflodacin versus ceftriaxone plus azithromycin for treatment of uncomplicated urogenital gonorrhoea: an international, randomised, controlled, open-label, phase 3, non-inferiority clinical trial (LANCET) Fungal The Last of US Season 2 (YouTube) Compassionate Use of Olorofim for Invasive Mold Infections: A Nationwide Observational Study in France  (OFID) Parasitic Eliminating Guinea worm (LANCET: Infectious Disases) Balamuthia mandrillaris Encephalitis in a 12-Year-old Girl: Report of the First Case Diagnosed in Greece (Pediatric Infectious Disease Journal) A Prospective Cohort Longitudinal Study of Human Acute Babesiosis: Quality of Life and Severity of Symptoms Through 1-Year Follow-up (OFID) Body lice and scabies co-infestation among unsheltered migrants, refugees, and asylum seekers and the right to water and sanitation (PLoS Neglected Tropical Diseases) Miscellaneous H.U.S.T.L.E: A Consult Fitness Guide for Infectious Diseases Providers (CID) Seven alternatives to evidence based medical education: an exploration of how we actually teach (BMJ) What does a doctor look like?Asking AI (BMJ) The Receding Specialty of Infectious Diseases and Implications for U.S. Healthcare (OFID) Integrating a host biomarker with a large language model for diagnosis of lower respiratory tract infection (Nature Communications) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Modern dads are around their kids much more than men were a generation or two ago. We see their struggles more and have opportunities to fix them, but should we? In this episode of the All Pro Dad Podcast, host Ted Lowe is joined by BJ Foster and Bobby Lewis to talk about supporting our kids without fighting all their battles. Why This MattersOne of the best ways we can support our kids is to stand beside them as they fight their own battles. Key Takeaways·      Modern dads are more involved: Research shows dads now spend 3–4x more time with our kids than men did in the 1970s. ·      But more involved can become “too” involved: More time gave rise to helicopter, lawn mower, bulldozer, and drone parents. ·      Kids will always need support: It will change during every stage, but dads will always play a role in their kids' lives. Action Steps for Dads1. Know When To Step In2. Step In vs. Step Back3. Really Listen. 4. Helping Them Process.5. Be Their Biggest Fan.6. Letting Them Struggle.Important Episode Timestamps00:00 – 00:43 | Parenting Has Changed Drastically00:43 – 02:12 | Helicopter, Lawnmower & Bulldozer Parents02:12 – 03:38 | The Dawn of the “Drone Parent”03:38 – 07:03 | Tracking, Tech, and Emotional Helicoptering07:03 – 09:12 | Fixing vs. Helping: When Parents Do Too Much09:12 – 12:27 | The Big Question: Support or Interfere?12:27 – 16:40 | Knowing When to Step In: Safety, Severity & Seasons16:40 – 23:03 | Helping Kids Process Challenges Without Taking Over23:03 – 28:32 | Pro Move of the WeekThis week, when you are tempted to jump in, pause and see if your kid can do it on their own. More Resources:Episode 88 – Could Your Son Be Struggling in Silence?Episode 95 – What Challenges is Generation Alpha Facing? 3 Reasons Your Child Needs to Struggle5 Areas Where Your Teen Needs to StruggleWe love feedback, but can't reply without your email address. Message us your thoughts and contact info!Connect with Us: Ted Lowe on LinkedIn Bobby Lewis on LinkedIn BJ Foster on LinkedIn Subscribe on Apple Podcasts Get All Pro Dad merch! EXTRAS: Follow us: Instagram | Facebook | X (Twitter)Join 200,000+ other dads by subscribing to the All Pro Dad Play of the Day. Get daily fatherhood ideas, insight, and inspiration straight to your inbox.This episode's blog can also be viewed here on AllProDad.com. Like the All Pro Dad gear and mugs? Get your own in the All Pro Dad store.Get great content for moms at iMOM.com

Morten Handberg, Principal Consultant at Wind Power LAB, returns to discuss blade damage categorization. From transverse cracks and leading edge erosion to carbon spar cap repairs, he explains what severity levels really mean for operators and why the industry still lacks a universal standard. Sign up now for Uptime Tech News, our weekly email update on all things wind technology. This episode is sponsored by Weather Guard Lightning Tech. Learn more about Weather Guard’s StrikeTape Wind Turbine LPS retrofit. Follow the show on Facebook, YouTube, Twitter, Linkedin and visit Weather Guard on the web. And subscribe to Rosemary Barnes’ YouTube channel here. Have a question we can answer on the show? Email us! Welcome to Uptime Spotlight, shining Light on Wind. Energy’s brightest innovators. This is the Progress Powering tomorrow. Morten, welcome back to the program. Thanks, Allen. It’s fantastic to be back again. Boy, we have a lot to discuss and today we’re gonna focus on categorization of damage, which is a super hot topic across the industry. What does a cat five mean? What does a category three mean? What does a category 5.9 I’ve I’ve seen that more recently. Why do these defect categories matter? Morten Handberg: Well, it matters a lot because it really tells you as, uh, either an OEM or as an operator, how should you respond to your current blade issue. So you need to have some kind of categorization about what the defect type is and what the severity is. The severity will tell you something about the repairability and [00:01:00] also something about the part of the blade that is affected. The type of the defect tells you something about what is the origin From an operational point of view, it doesn’t make as much sense in a way because you really just wanna know, can this be repaired or not? You know? And you know, what does it need to repair? That’s what you need, what you really need to focus on as an operator, whether it’s then del elimination, erosion, peeling. Uh, transverse cracks, it’ll all come down to repairs. It does matter for you because it will tell you an underlying, you know, are there reason why I’m keep seeing all these damages? So that’s why you need to know the category as well. But purely operational. You just need to know what is the severity side know, what does it take to repair it? Allen Hall: So as the operator, a lot of times they’re getting information from different service providers or even the OEM. They’re getting multiple inputs on what a damage is in terms of a category. Are we getting a lot of conflicting information about this? Because the complaint from [00:02:00] I hear from operators is the OE EMM says this is a category four. The ISP says is a category five. Who am I to believe right Morten Handberg: now? Well, there is a lot of, a bit different opinions of that. It almost becomes a religious issue question at some point, but it, it really dives down to that, you know, there is no real standardization in the wind industry. And we’ve been discussing this, uh, I wanna say decades, probably not that much, but at least for the past 11 years I’ve been, been hearing this discussion come up. Uh, so it’s, it’s something this was just been struggling with, but it also comes down to that. Each OEM have their own origin. Uh, so that also means that they have trended something from aeronautics, from ship building industry, from, you know, uh, from, from some other composite related industry, or maybe not even composite related. And that means that they are building their own, uh, their own truth about what the different defects are. There is a lot of correlation between them, but there is still a lot of, lot of tweaks [00:03:00] and definitions in between and different nomenclature. That does add a a lot of confusion. Allen Hall: Okay, Morten Handberg: so Allen Hall: that explains, I mean, because there isn’t an industry standard at the moment. There is talk of an industry standard, but it does seem like from watching from the outside, that Europe generally has one, or operators specifically have one. Uh, EPRI’s been working on one for a little while. Maybe the IEC is working on one, but there isn’t like a universal standard today. Morten Handberg: There is not a universal standard. I mean, a lot of, a lot of OEMs or service providers will, will, will claim that they have the standard, they have the definition in wind power lab. We have our own. That we have derived from the industry and in, in general. But there is not an, uh, an industry agreed standard that everyone adheres to. That much is true. You could say in Europe, a lot of owners have come together, uh, in the Blade Forum, and they have derived, there’s a standard within that. Um, uh, and with a lot of success, they’d written, the [00:04:00] Blade Hamburg I think was very helpful because it was operator driven, um, approach. Allen Hall: So there is a difference then between defects that are significant and maybe even classified as critical and other defects that may be in the same location on the blade. How are those determined? Morten Handberg: The way that I’ve always approached is that I will look at firstly what kind of blades type it is. So how is it structured? Where are the load carrying elements of the blade? That’s very important because you can’t really say on a business V 90 and a Siemens, uh, 3.6 that the defect in the same position will mean the same thing. That’s just not true because they are structured in very different ways. So you really need to look at the plate type just to start with. Then you need to look at, is it in a. In a loaded part of the blade, meaning is it over the, the load carrying part, um, uh, laminates? Is it in a, in a shell area? And you know, what is the approximate distance from the roof? Is that, that also tells you something [00:05:00] about the general loads in the area. So you know, you need to take that into consideration. Then you also need to look at how much of the blade is actually affected. Is it just surface layers? Is it just coating or is it something that goes, uh, through the entire laminate stack? And if that is on the, on the beam laminate, you’re in serious trouble. Then it will be a category five. If the beam laminate is vectored. And if you’re lucky enough that your blade is still sitting on the turbine, you should stop it, uh, to avoid a complete BA bait collapse. Uh, so, so you need, so, so that, you know, you can, that, that is very important when you’re doing defect categorizations. So that means that you need Allen Hall: internal inspections on top of external Morten Handberg: inspections. If you see something, uh, that is potentially critical, then yeah, you should do an internal inspection as well to verify whether it’s going through, um, the entire lemonade stack or not. That that’s a, that’s a good, good, good approach. Um, I would say often, you know, if you see something that is potentially critical, uh, but there is still a possibility that could be repaired. Then I might even also just send up a repair [00:06:00] team, uh, to see, you know, look from the outside how much of the area is actually affected, because that can also pretty quickly give you an indication, do we need to take this blade down or not? Sometimes you’ll just see it flat out that, okay, this crack is X meters long, it’s over sensitive area of the blade. You know, we need to remove this blade. Uh, maybe when, once it’s down we can determine whether it’s repairable or not, but. We, but it’s not something that’s going to be fixed up tower, so there’s not a lot of need for doing a lot of added, um, add added inspections to verify this, this point. Allen Hall: Let’s talk about cracks for a moment, because I’ve seen a lot of cracks over the last year on blades and some of them to me look scary because they, they are going transverse and then they take a 90 degree and start moving a different direction. Is there a, a rule of thumb about cracks that are visual on the outside of the blade? Like if it’s how, if they’re [00:07:00] closer to the root they’re more critical than they’re, if they’re happening further outers or is there not a rule of thumb? You have to understand what the design of the blade is. Morten Handberg: Well, I mean the general rule of thumb is transfers cracks is a major issue that’s really bad. That’s, uh, you know, it’s a clear sign, something. Severely structural is going on because the transverse crack does not develop or develop on its own. And more likely not once it starts, you know, then the, uh, the, the strain boundaries on the sides of the cr of the crack means that it requires very little for it to progress. So even if in a relatively low loaded area with low strain, once you have a, a transverse crack, uh, present there, then it will continue. Uh, and you mentioned that it’s good during a 90 degree. That’s just because it’s doing, it’s, it’s taking the least path of the path of least resistance, because it’ll have got caught through the entire shell. Then when it reaches the beam, the beam is healthy. It’s very stiff, very rigid laminate. So it’s easier for it to go longitudinal towards the [00:08:00] root because that’s, that, that, that’s how it can progress. That’s where it has the, uh, you know, the, the, the strain, uh, um, the, the strain high, high enough strain that it can actually, uh, develop. That that’s what it would do. So transverse cracks in general is really bad. Of course, closer to root means it’s more critical. Um, if there is a crack transverse crack, uh, very far out in the tip, I would usually say, you know, in the tip area, five, 10 meter from the tip, I would say, okay, there’s something else going on. Something non load related. Probably causes, could be a lightning strike, could be an impact damage. That changed the calculation a little bit because then, you know, it’s not a load driven issue. So that might give you some time to, you know, that you can operate with something at least. But again, I, I don’t want to make any general rules that people then didn’t go out and say, well, I did that, so, and, but my blade still broke. That’s not really how it works. You need to really, you need to, to, uh, look at cracks like that individually. You can’t make a a common rule. Allen Hall: Another [00:09:00] area, which is under discussion across the industry are surface defects and there are a variety of surface defects. We’re seeing a lot of hail damage this year. Uh, that’s getting categorized as lightning damage. And so there’s obviously a different kind of repair going on. Hail versus lightning. Are there some standards regarding surface defects? Uh, the visuals on them? Is there a guideline about Morten Handberg: it? Well, I mean, uh, some of the, uh, some of the, how do you say, omic couture, some of the, uh, some of the standards, they do provide some guideline to determine which surface kind of surface defect it is, you could say, on the operational points, as long as it’s surface related. Then the repair methodology is the same, whether it’s peeling, erosion, voids, chipping scratches, the repair is the same. So that in principle does not change anything. But in the reason why it matters is because we need to understand the [00:10:00] underlying issue. So if you have lot of peeling, for instance, it means you have a very low quoting quality, and that is something that is either post post repair related or it’s manufacturing related, depending on the blade, on the age of your blade. So that’s very important for you to know because if you have peeling somewhere, then more likely than not, you’ll also have have issues with it elsewhere because, you know, tend to, they tend to follow each other, you know, coding quality issues. So that’s a good thing to know for you as an operator that you, this is just one of many, erosion is important, but often gets miscategorized because erosion is a leading edge issue. Um, so we only see it on the, on the very edge of the leading edge. So approximately 40 millimeter band. That’s typically what we see, and it’s straight on the leading edge. So if someone’s claiming that they see lead, leading edge erosion on the, on the pressure side, shell or ide, shell, it’s miscategorizing because that’s what you, that’s not why they have to have the ring. Uh, impacts ring can still, still [00:11:00] hit the shells, but when it hits the, the, the shell areas, it will ricochet because it hits it at an angle. Leading edge gets straight on. So it gets the entire impact force and that’s why you get the erosion issue because of, of fatigue essentially. Uh, coding fatigue. So that’s very important. There is something that you know you can really utilize if you just know that simple fact that it’s always a leading edge, it’s always uniform. It, you can track that. And if you have leading edge erosion in one area, you will have it in the entire wind farm. So you don’t need to do that much inspection to determine your erosion levels, voids, pinholes. They are manufacturing driven because they are driven by either imperfections in the coating, meaning you have a sand, grain dust, or you had, uh, air inclusions underneath your coating. And they will weaken the structure. And that means that, um, rain effect or other effects causing strain on your coating will accelerate a lot faster. So they will develop and create these small, um, yeah, uh, how do you [00:12:00] say, small defined holes in your coating. So that’s why it’s important to know. But if you’re running a wind farm 15 years, 10 years down the line. Then it’s more important for you to know that it’s a surface defect and you need to fix it by doing coating repair. You don’t need to think so much about the, the underlying issue, I would say. Allen Hall: Okay. I think that’s been miscategorized a number of times. I’ve seen what I would consider to be some sort of paint adhesion issue because it’s sort of mid cord and not near the leading edge, but sometimes it just looks like there’s massive peeling going on and maybe, uh, it’s easy to assume that maybe is erosion. It’s just a weak adhesion of paint. That that’s what you’re saying? Morten Handberg: Yeah. If it’s, if it’s midspan, if it’s shell related, then it’s, it’s a, it’s a coating quality related issue. It doesn’t really have anything to do with erosion. Um, you could say erosion. We can, we can, we can, uh, we can look at in, in, in two areas. So you have the out or third of the leading edge. [00:13:00] That’s where you would have the theoretical leading edge erosion breakdown, because that’s where you have rain impact high enough that it will cause some kind of degradation, but that all of your leading edge will suffer in the same way because the tip speed of the outer four meters of your blade. Versus the re the other, you know, uh, 10, 12 meters depending on length of your blade. Sometimes it’s a lot longer, but they are getting degraded in a much different way. So the out of pew meters, they can get what’s called structural erosion. So that means that the erosion goes fast enough and it’s progressive enough that you can start to damage the laminate underneath. You won’t see that further in because the, the impact is just not that great and you will likely not see structural erosion over the lifetime, but the out a few meters, that’s important. And that’s where you need, need to focus your, that that’s where you need to pay attention on what kind of materials you add because that can save you a lot of repair, re, re repair. And, uh, down the line, how do you categorize Allen Hall: leading edge erosion? A lot of [00:14:00] times I see it, uh, from operators. Let’s say it’s, uh, category four because it’s into the fiber. But is it always a structural issue? Is there a lot of loading on the leading edges of these blades where you would have to come back with structural applies to repair it? Or is it just a aerodynamic shape and does it really depend upon who the OE Em is? Morten Handberg: Well, I mean, I’ve seen erosion category five as well, and I think it’s a mis misinterpretation. I think it’s, you know, people are trying it to raise awareness that, hey, there was a serious issue with erosion, but it’s a wrong way to use the severities. Because if we look at severity five, severity five, if you have a critical issue, your blade is about to come down if you don’t do anything. So category five means you need to stop your turbine. Maybe you can repair it, but that really depends on the, uh, on what is damaged by, on, on, on the blade. And you can determine that once you removed it and looked at it on, on, on the ground. But you need to stop. Category four is a severe structural damage. It’s not something that [00:15:00] is causing an immediate threat, but it’s something that will progress rapidly if you don’t do anything. So here you need to look at the damage itself. So how does it affect the structure and can you operate it curtailed, uh, or can you operate it, uh, or can you operate normally and repair it within a short time window? That’s what you can use because it’s something that is. Uh, that can, that can develop into an, into an imminent issue if you don’t react to it. Severity three is more for your, is more your annual maintenance schedule. So that is your, your minor structural damages and it’s your erosion issues. So that’s something that there is a severity Three, you need to look at it for next year’s budget. Severity two means that. Something that’s gradually degradating your coating on the blade, but it’s not something that means anything at this point in time. So one is your coating, is your surface damage or minor surface damage. Pinholes uh, contamination. It’s really light issue, so it’s not something you really need to consider. So. [00:16:00] Severity ones, you, you really mean that, that it’s, you don’t need to think about this anymore. You know, it’s, it’s not an issue. So erosion will fall typically within severity two to severity four. Severity four being you have a hole in your blade from erosion, basically. Uh, because you can still have structural degradation of deleting it and still being a severity three, because it does not really change your maintenance cycle in any, in any way. You don’t need to do anything immediate to fix it. Um, so that’s why I would put most of erosion defects in severity three and just say, okay, it’s something we need to plan a leading edge, a leading edge ERO repair campaign next year or the year after, depending on the severity of it. That’s why, how I, I would approach, Allen Hall: that’s good insight, because I do think a lot of operators, when they do see a hole in the leading edge, think I have to stop this turbine. But at the same token, I have seen other operators with holes. I could put my fist through. That are continuing to use those blades and they will say, it’s not structural, it’s not [00:17:00] great aerodynamically, but the, we’re still making power here. We’re still making rated power. Even with the hole and the leading edge, it’s not going to progress anymore. It’s a, it’s a, it’s a progression that we understand. That’s how they describe it. It will get worse, but it’s not gonna get catastrophic worse. Morten Handberg: I mean, if you run it long enough, at some point, something secondary will happen. Sure. But again, that’s also why we use the severity four category for erosion, where you have severe structural degradation because it does starting to mean something for the integrity of the blade. It will not mean that it’s coming down right away when you see a hole in the blade from erosion. That’s, that’s the entire purpose of it. But it does it, you use it to raise awareness that there is something you need to look at imminently or at least react to, uh, and make a plan for. You can’t just pull, you can’t just delay it until next year’s, uh, maintenance campaign. We have an active issue here, so that’s why I think severity four applies to erosion. That has penetrated all structural layers. Allen Hall: Are there some [00:18:00] blade damages that are just can’t be repaired or, or just have too much difficulty to repair them, that it’s not worth it? And how do you know? How do you understand? That blade is not repairable versus the one next to it which looks similar, which can be repaired. What goes into that assessment? Morten Handberg: So one is, is the, is the beam laminate damaged? If it is, then uh, either it comes down to a commercial decision. It’s simply not fixable and, and restoring it in, you know, restoring it back, uh, to original form ship. And there’s also the, the, uh, the, ever, ever, ever, ever, ever, uh, returning element of carbon fiber, because carbon fiber adds another level of complexity repairs, because you’re so dependent on the pristine quality of the carbon for it to, to, for, to utilize the, the, uh, mechanical strength of carbon. And if you, if you don’t apply it in the right way, then you can create some high stress zones. Where, you know, the [00:19:00] cure is as bad as the disease really. So that’s why you have to be extra careful with carbon repairs. But they can be done. But it, you know, it really comes down to a commercial decision then. So in principle, unless the blade is deformed, uh, or, or, or damaged in such a way that you have to remove a large part of the s shell lemonade in a loaded area, then most things they can, in principle, be repaired. It’s just a matter of is the, is the cost of the repair. Cheaper than the cost of a new blade. And that calculation might, you know, depend on are there any, any spare blades available? Is this blade, uh, still in production? And if I don’t repair this, then I don’t have any blade for my turbine and then I can’t operate anymore. That also changed the calculus right along quite a lot, so I think. For a lot of damages. It, it’s more of a, it’s often more of a commercial decision rather than a technical, because ca glass fiber is very forgiving. You can repair a lot, even if it’s really severe. I mean, I’ve seen blade repairs that took [00:20:00] 3000 hours, but it was deemed worthwhile because you couldn’t get a, a bare blade. And in most other cases, that would’ve been been scrapped, you know, without, you know, without blinking. Um, so, so, you know, if you really want to, you could repair it. In a lot of cases, Allen Hall: how difficult is it to repair carbon protrusions, because it does seem like when they manufacture those protrusions, there’s a lot of quality control going into it. The fibers have to be in the right direction all the time, and they’re really compacted in there. They’re tight, tight block of carbon that you’re purchasing and sliding into into this blade. Are they really repairable in sections or is it you have to take out the whole length of a pultrusion and replace it? I’m, I’m trying to understand the difficulty here because there’s a lot of operators in the United States now that have some portion of their fleet is carbon spar cap, not a lot of it, but some of it. How [00:21:00] difficult is that to repair? Morten Handberg: Well, it’s difficult enough that a lot of OEMs, they will say if you have a damage to the carbon, it’s a non-repairable defect. That is to a large extent the general rule. Um, there are, there are, uh, there are ways and some of it is replacement of the protrusion. Um, other, another method is, is to do a vacuum infusion lamination. I’ve also seen some repairs with success where, uh, glass fiber is utilized instead of carbon fiber. So you reply, so you, you, um, you calculate the mechanical strength of the carbon. And then replace that with an equal amount, you know, strength wise of glass fiber. The problem is you are to a degree playing with little bit with fire because you are then changing the structure of the blade. You are increasing the thickness and thereby you are changing the stiffness. So it’s, you have to be really [00:22:00] careful, uh, it’s possible. And uh, again. All if all other options are out and you want this blade really to get up and running again because it’s your only option. Maybe it’s worthwhile to, to investigate, but it requires a lot of insight in and also a little bit of, uh, how do you say, uh, you don’t, you shouldn’t be too risk adverse if you go down that that route, but, but again, it is possible. It is technically possible. But it’s something you do for the outer, uh, outer areas of the blade where you have less loads and you’re less sensitive. Allen Hall: Can those carbon repairs be done up tower or are they always done with the rotor set or the blade drop down to ground? Morten Handberg: I know some carbon repairs have been done up tower, but in general it’s down tower also, just because if you have damage to your carbon, it means you have a severe structural issue. So you wouldn’t generally try to do it that well, I would, not in general, but, but the, the, the cases I’ve seen that, that has been downturn repairs. Yeah. Allen Hall: Do you think about the categories differently? If it includes carbon [00:23:00] as a structural element? Morten Handberg: No, because carbon is part of the load carrying laminate. If you’re to the load carrying laminate, then it becomes a four or five immediately. Um, so, uh, so I would say the same rule applies because ag again, it’s a very rough scale, but it applied, but it gives you a sense of where, you know, what is the urgency, which is what I think we in generally need. And I like the more simple model because it’s more applicable to the general industry and it’s easier for, uh, you know, it’s easier to, to implement. Um. And it is easier to understand than if you have a too too gradual, uh, scale because it’s difficult for the people who are sitting and assessing to determine if, uh, you know, what, what category it is. And it’s difficult for the people who have to read the report afterwards. And it’s also about, you know, what is the purpose? And in general, I would say, well, this, the defect categorization, the severe categorization is to determine can this be repaired or not? That’s what we use it [00:24:00] for. So that, that, that’s how we, it should be applied. Allen Hall: Is the industry going to have a universal standard? Soon. Is that possible? Or is this really gonna be country by country, region by region? How we think about blade defects and blade repairs? Morten Handberg: I think that. Given the, uh, the, how do you say, the individual interests in having their own model from the different OEMs or service providers? I think the, when they’re choosing a pope, they have an easy task ahead of them, you know, deciding that. Then we have the agreeing on an on inte standard and on plate. Allen Hall: Pope is currently an American, so that tells you something. The world has shifted. There is still hope. Maybe there is still hope because it, it is a very difficult problem and I hear a lot of conflicting opinions about it and they’re not wrong. The opinions I hear when they’re explained to me, they have a rationale as to why. They’re calling something a cat four versus a cat three. [00:25:00] It all makes sense, but when you get two engineers in the room, they’re rarely are going to agree. So I’m just thinking maybe, maybe there isn’t a, a yeah, maybe there isn’t a time where we’re all gonna come together. Morten Handberg: I think that, you know, it’s, it’s also about what are you willing to accept and what are you willing to s. You know, as an OEM, as a blade engineer, as a service provider, in order to make common agreement. Because I think if we were willing to, you know, set aside differences, um, and then agree on, okay, what is the, what, what is that, what is the, the ma the industry needs and what, what fulfills the purpose? We could agree tomorrow, but that’s not where we are, uh, at the moment. So, so I don’t see that happening anytime soon. But yes, there, there was a way to do an in to make an international standard. Um, for blades and I, I would say maybe it’s, if the IC made, made, made one, then maybe that that could, uh, that could fix it. Uh, maybe if, uh, they’re starting to become more [00:26:00]focused from governments, uh, and you know, that it wind industry becomes recognized as critical infrastructure. That then there is a requirement for international standards on what are defects, to make it easier to determine what is critical or not, so that proper reaction can be made. That will also help it. But again, as long as it’s only about late experts having to agree with each other and that’s the only then, then we’re, then we will not get to a point where we’re going to agree on, on everything. No. Allen Hall: Wow. This is a continual discussion about blade defects and categorization and Morton. I really appreciate. You’re giving us your thoughts about it because I trust you one and two, you’re on the leading edge of what the industry is thinking. So it’s very good to get you in here and explain where categorization is and, and two operators that are listening to this podcast understand you’re probably getting a lot of different opinions about categorization. You need to sit down and figure it out for yourself, or reach out to Morton who can explain what you should be thinking and how you should be [00:27:00]thinking about this problem. Morton, how do people get ahold of you to learn more? Morten Handberg: Easiest way is to reach out to me on LinkedIn. Um, I have a very active profile there. You can always write me and I’ll always write, write, write it back. You can also write to me on my company email, m me h@windpowerapp.com. Um, those are the two easiest way to get, uh, get in, in, uh, get in touch me. And I would say, as an owner, what you need to know. Is it a structural issue or is a surface issue you have? And then plan your repairs from there. That is, that is the. Basic, yeah, that, that you need to have, and then forget about the others, the other side of it, you know, if it’s one defect type or another, that’s not necessarily what’s going to help you. It’s all about getting the blades repaired. And, uh, and the turbine up and running again. That should be the focus. Allen Hall: Absolutely. Morton, we love having you on the podcast. Thank you so much for joining us. It’s good to be here. See [00:28:00] you.

Description: Psoriatic disease affects far more than just the skin. Hear leading dermatologist Dr. April Armstrong and Dr. Benoît Guérrette discuss this and more with Jensen, a patient advocate. Psoriatic disease affects not only the skin but it can impact confidence, emotional and social well-being, and daily life. In this episode, join moderator Dr. Guy Eakin, Chief Scientific and Medical Officer at NPF, as we explore the disconnect between clinical classifications of psoriasis and what patients experience in real-life with leading dermatologist Dr. April Armstrong, Dr. Benoît Guérrette, Vice President of Dermatology & Rheumatology at Takeda, and Jensen, a NPF patient advocate and former Lead Youth Ambassador. Listen as we address the need for a more nuanced approach to classifying disease severity that accounts for the holistic needs of psoriatic disease, as well as share insights into how advocacy and awareness can drive change in treatment access and care standards.  The intent of this episode is to identify how clinical severity classifications of psoriasis are evolving to meet the needs of those who live with the disease and how that change impacts overall management. This episode is sponsored by Takeda. Timestamps: (0:00) Intro to Psoriasis Uncovered and guest welcome to dermatologist Dr. April Armstrong, Vice President of Takeda, Dr. Benoît Guérette, and patient advocate Jensen, who discuss the unmet needs of people with moderate psoriasis and how as a community we can better serve those living with the disease. 2:22 How health care providers and the biopharmaceutical industry are coming together to address systemic eligibility and the unmet needs of people living with psoriasis. 4:25 Quality of life should be included when assessing clinical severity in psoriasis and identification of appropriate treatment choices. 6:52 The impact of misdiagnosis, inappropriate treatment, and effect on high impact sites can be life- altering. 8:30 How appropriate treatment and knowledge can make all the difference when diagnosed with plaque psoriasis.  9:40 Views on the psoriasis disease classification system and how it's evolving to include real life impact from physical and emotional needs, to more personalized care for those living with psoriasis, even when small body surface areas are involved. Severity isn't defined by skin coverage alone. 12:38 What's needed to prioritize the care and outcomes of people living with psoriasis. 14:18  The future of management and care for psoriatic disease. 15:53  "My skin tells a story." Wisdom from what I wish I had known previously. 16:52  Moving closer to care that truly reflects the lives and needs of those who live with psoriasis. Key Takeaways: ·       Severity of psoriasis isn't defined by skin coverage or body surface area (BSA) alone. The impact on quality of life should also be considered in the assessment, selection of treatment, and management of the disease.  ·       The psoriasis disease classification system is evolving to be more of a patient centered approach.  Many clinicians are now using the International Psoriasis Council (IPC) or 2 bucket approach to identify whether someone should receive a topical or systemic treatment based on location and response to treatment, as well as impact on quality of life.  ·       With continued research and  development, the next 5 to 10 years could see a shift in effective treatment options while also treating sooner to initiate better outcomes for people living with psoriasis and psoriatic arthritis. Guest Bios:   April Armstrong, M.D., M.P.H. is an internationally renowned dermatologist and clinical researcher who is a Professor and Chief of Dermatology at the University of California Los Angeles (UCLA) where she specializes in inflammatory skin diseases such as psoriasis, atopic dermatitis, and hidradenitis suppurativa (HS). Dr. Armstrong is also the Co-Director for Network Resources at the UCLA Clinical and Translational Research Institute. She has conducted over 150 clinical trials and published over 350 high impact articles in scientific journals. Dr. Armstrong holds multiple leadership positions including the immediate Past Chair of the National Psoriasis Foundation Medical Board, Co-President of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), councilor for the International Psoriasis Council, and board member for the International Dermatology Outcome Measures and the American Academy of Dermatology.  Benoît Guérette, Ph.D. is an accomplished leader in medical affairs with extensive experience across academia and the pharmaceutical industry. Since March 2025, Dr. Guérette has served as Vice President of Dermatology and Rheumatology US Medical Affairs at Takeda Pharmaceutical. Prior to joining Takeda, he held several strategic and leadership roles at various pharmaceutical companies, including overseeing clinical development, global and U.S. medical affairs, global access & pricing, translational sciences and more. Before transitioning to the industry, Dr. Guérette was an Associate Professor of Immunology at Laval University, leading research in cancer immunology. He holds a Ph.D. in Medicine, Microbiology, and Immunology from Laval University and completed postdoctoral studies in Inflammation and Immunology at  Harvard Medical School.  Jensen is a volunteer and former Lead Youth Ambassador for the National Psoriasis Foundation. Jensen developed psoriasis at age 7 but wasn't formally diagnosed until age 14 being misdiagnosed along the way, trying different management approaches that were ineffective. She was a competitive swimmer from elementary through high school and in the last 2 years of high school played lacrosse. Upon finishing high school she attended college becoming a registered nurse in an intensive care unit. Jensen wants "youth living with psoriatic disease to feel a  community that is behind them and with them every step of the way. I really want to be able to make a difference in a way that would've helped me as a child when I was diagnosed." Resources: Ø  "Reassessing Psoriasis Severity" Advance Online, National Psoriasis Foundation. H. Onorati. January 16, 2024,  https://www.psoriasis.org/advance/psoriasis-severity-high-impact-sites/   Ø  "Psoriasis Involving Special Areas is Associated with Worse Quality of Life, Depression, and Limitations in the Ability to Participate in Social Roles and Activities". Blauvelt, A., Strober, B., Gondo, G., Journal of Psoriasis and Psoriatic Arthritis Volume 8, Issue 3.  https://journals.sagepub.com/doi/full/10.1177/24755303231160683

Series - Romans: Guilt Grace & Gratitude pt. 81 Text: 11:21-24 by Nick Neves, pastor | Lord's Day Morning | 11.30.25

Last Decades, Persistent Pain, and Final Rest — Ronald White — In his later years, the severity of Chamberlain's Civil War wound, which he largely concealed, became public through a newspaper account of his surgery. He attempted business ventures without success, realizing his true calling lay in service to others. Remaining active into his 80s, he traveled extensively, impressively reading the Quran in Arabic and the Bible in Greek. Chamberlain died in 1914, essentially becoming the last casualty of the Civil War due to his Petersburgwound. Share

Erie County Executive Mark Poloncarz introduces a new website for winter storm severity full 1715 Fri, 21 Nov 2025 19:20:44 +0000 FDjPtumbHypp2cS2IiREOZVFISYnHOrb news & politics,news WBEN Extras news & politics,news Erie County Executive Mark Poloncarz introduces a new website for winter storm severity Archive of various reports and news events 2024 © 2021 Audacy, Inc. News & Politics News False https

Main Theme: The message continues the study of Joshua chapters 10–11, exploring how God led Israel to fully conquer their enemies. Pastor emphasized that these natural battles symbolize our spiritual warfare—the believer's call to finish battles of faith, destroy sin's influence, and walk in victory through obedience. Opening and Global Prayer The service began with intercession for Christians under persecution in Nigeria and Sudan, highlighting that while Western believers face spiritual battles, others face literal physical danger for their faith. Pastor led prayer for God's mercy, protection, and bold witness among the persecuted church. Israel's Battle and Spiritual Parallels (Joshua 10:16–43) Joshua commanded the army to seal the five kings in the cave at Makkedah, pursue the enemy, and finish the battle. After victory, Joshua had his captains place their feet on the necks of the kings—a prophetic act of dominion. This became a picture of spiritual warfare: “Sometimes we don't finish the battle. We let things live that God told us to destroy.” Believers must pursue sin and temptation until they are “dust under our feet.” Partial obedience leads to future bondage. Lesson: Don't leave sin alive. Whatever is not put to death will eventually come back to destroy. Just as Joshua completed every battle, we must close every spiritual door and cut off access to the enemy. God's Ways and the Danger of Presumption Pastor reminded the congregation that God moves in diverse ways: “Sometimes He fights supernaturally; other times He works through natural means or people—but it's always His hand.” He warned against putting God in a box or expecting Him to act the same way every time, which leads to a Pharisaical mindset. True faith trusts His sovereignty regardless of method. The Severity of Sin Joshua's command to destroy the Canaanite nations often troubles modern readers, but Pastor explained: God owns everything; He is perfectly just in judgment. Israel's destruction of wicked nations demonstrates the seriousness of sin, not cruelty. “We don't see how wicked sin really is… we've redefined it as conditions or sickness instead of rebellion against God.” Sin caused death, chaos, and even required the crucifixion of God's Son to be redeemed. God's judgment isn't biased—He later judged Israel the same way when they turned to idolatry. “He's long-suffering, but He's also holy.” God the Redeemer Pastor used the analogy of the pawn shop and Hosea's marriage: Humanity belonged to God but sold itself to sin. Yet God, though rightful owner, paid again with the blood of Christ to buy us back. “He walked into the spiritual pawn shop and paid for the whole store.” This is the picture of grace: redemption at a cost God didn't owe. Spiritual Warfare and Finishing the Fight (Joshua 11) The northern kings united against Israel, but God reassured Joshua: “Do not be afraid. I will deliver them into your hand.” God again fought for Israel, proving that obedience keeps God's presence active. Joshua's faithfulness to continue Moses' commands showed continuity—obedience to divine instruction brings sustained victory. Application: Romans 6 and the War Within Pastor connected Joshua's battles to Romans 6, explaining how believers must fight sin with the same intensity: “Shall we continue in sin that grace may abound? God forbid.” Through baptism, we are united with Christ's death and resurrection. Therefore, sin has no dominion over believers: “Even when you fail, your position in Christ overrides your condition.” Victory comes by renewing the mind with the Word, speaking God's truth over ourselves, and closing every door to sin. Believers must “cut off options” that lead back to bondage—relationships, habits, or influences that tempt the flesh. Becoming a Bondservant Paul called himself a bondslave of Christ—one who chooses to stay out of love, not compulsion. Pastor contrasted this with modern Christians who seek convenience: “Christianity isn't weakness—it's surrender. The greatest opportunity isn't success, it's becoming a man or woman of God.” Closing Exhortation God desires full victory for His people—no compromise, no partial obedience. The Christian walk is discipleship as a journey, not a destination. Every battle is an opportunity to grow stronger in faith and obedience. “Cut off what tempts you. Pursue your enemies until they're dust under your feet. You are dead to sin and alive to God. Finish the fight.” Core Message Don't leave sin alive—finish the battle. God's justice reveals the true horror of sin. You are redeemed at great cost—live as one who's been bought back. Renew your mind, close every door to the enemy, and walk in your position in Christ. The greatest victory is not survival—it's surrender.

Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Evan S. Dellon, MD, and Elizabeth T. Jensen, PhD, about a paper they published on predictors of patients receiving no medication for treatment of eosinophilic esophagitis. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:52] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:14] Holly introduces today's topic, predictors of not using medication for EoE, and today's guests, Dr. Evan Dellon and Dr. Elizabeth Jensen.   [1:29] Dr. Dellon is an Adjunct Professor of Epidemiology at the University of North Carolina School of Medicine in Chapel Hill. He is also the Director of the UNC Center for Esophageal Diseases and Swallowing.   [1:42] Dr. Dellon's main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and eosinophilic GI diseases (EGIDs).   [1:55] Dr. Jensen is a Professor of Epidemiology with a specific expertise in reproductive, perinatal, and pediatric epidemiology. She has appointments at both Wake Forest University School of Medicine and the University of North Carolina at Chapel Hill.   [2:07] Her research primarily focuses on etiologic factors in the development of pediatric immune-mediated chronic diseases, including understanding factors contributing to disparities in health outcomes.   [2:19] Both Dr. Dellon and Dr. Jensen also serve on the Steering Committee for EGID Partners Registry.   [2:24] Ryan thanks Dr. Dellon and Dr. Jensen for joining the podcast today.   [2:29] Dr. Dellon was the first guest on this podcast. It is wonderful to have him back for the 50th episode! Dr. Dellon is one of Ryan's GI specialists. Ryan recently went to North Carolina to get a scope with him.   [3:03] Dr. Dellon is an adult gastroenterologist at the University of North Carolina at Chapel Hill. He directs the Center for Esophageal Diseases and Swallowing. Clinically and research-wise, he is focused on EoE and other eosinophilic GI diseases.   [3:19] His research interests span the entire field, from epidemiology, diagnosis, biomarkers, risk factors, outcomes, and a lot of work, more recently, on treatments.   [3:33] Dr. Jensen has been on the podcast before, on Episode 27. Holly invites Dr. Jensen to tell the listeners more about herself and her work with eosinophilic diseases.   [3:46] Dr. Jensen has been working on eosinophilic gastrointestinal diseases for about 15 years. She started some of the early work around understanding possible risk factors for the development of disease.   [4:04] She has gone on to support lots of other research projects, including some with Dr. Dellon, where they're looking at gene-environment interactions in relation to developing EoE.   [4:15] She is also looking at reproductive factors as they relate to EoE, disparities in diagnosis, and more. It's been an exciting research trajectory, starting with what we knew very little about and building to an increasing understanding of why EoE develops.   [5:00] Dr. Dellon explains that EoE stands for eosinophilic esophagitis, a chronic allergic condition of the esophagus.   [5:08] You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have EoE, it is a long-term condition.   [5:24] Eosinophils are a type of white blood cell, specializing in allergy responses. Normally, they are not in the esophagus. When we see them there, we worry about an allergic process. When that happens, that's EoE.   [5:40] Over time, the inflammation seen in EoE and other allergic cell activity causes swelling and irritation in the esophagus. Early on, this often leads to a range of upper GI symptoms — including poor growth or failure to thrive in young children, abdominal pain, nausea, and symptoms that can mimic reflux.   [5:58] In older kids, symptoms are more about trouble swallowing. That's because the swelling that happens initially, over time, may turn into scar tissue. So the esophagus can narrow and cause swallowing symptoms like food impaction.   [6:16] Ryan speaks of living with EoE for decades and trying the full range of treatment options: food elimination, PPIs, steroids, and, more recently, biologics.   [6:36] Dr. Dellon says Ryan's history is a good overview of how EoE is treated. There are two general approaches to treating the underlying condition: using medicines and/or eliminating foods that we think may trigger EoE from the diet.   [6:57] For a lot of people, EoE is a food-triggered allergic condition.   [7:01] The other thing that has to happen in parallel is surveying for scar tissue in the esophagus. If that's present and people have trouble swallowing, sometimes stretching the esophagus is needed through esophageal dilation.   [7:14] There are three categories of medicines used for treatment. Proton pump inhibitors are reflux meds, but they also have an anti-allergy effect in the esophagus.   [7:29] Topical steroids are used to coat the esophagus and produce an anti-inflammatory effect. The FDA has approved a budesonide oral suspension for that.   [7:39] Biologics, which are generally systemic medications, often injectable, can target different allergic factors. Dupilumab is approved now, and there are other biologics that are being researched as potential treatments.   [7:51] Even though EoE is considered an allergic condition, we don't have a test to tell people what they are allergic to. If it's a food allergy, we do an empiric elimination diet because allergy tests aren't accurate enough to tell us what the EoE triggers are.   [8:10] People will eliminate foods that we know are the most common triggers, like milk protein, dairy, wheat, egg, soy, and other top allergens. You can create a diet like that and then have a response to the diet elimination.   [8:31] Dr. Jensen and Dr. Dellon recently published an abstract in the American Journal of Gastroenterology about people with EoE who are not taking any medicine for it. Dr. Jensen calls it a real-world data study, leveraging electronic health record patient data.   [8:51] It gives you an impression of what is actually happening, in terms of treatments for patients, as opposed to a randomized control trial, which is a fairly selected patient population. This is everybody who has been diagnosed, and then what happens with them.   [9:10] Because of that, it gives you a wide spectrum of patients. Some patients are going to be relatively asymptomatic. It may be that we arrived at their diagnosis while working them up for other potential diagnoses.   [9:28] Other patients are going to have rather significant impacts from the disease. We wanted to get an idea of what is actually happening out there with the full breadth of the patient population that is getting diagnosed with EoE.   [9:45] Dr. Jensen was not surprised to learn that there are patients who had no pharmacologic treatment.   [9:58] Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are early in their disease process and still exploring dietary treatment options.   [10:28] Holly sees patients from infancy to geriatrics, and if they're not having symptoms, they wonder why bother treating it.   [10:42] Dr. Jensen says it's a point of debate on the implications of somebody who has the disease and goes untreated. What does that look like long-term? Are they going to develop more of that fibrostenotic pattern in their esophagus without treatment?   [11:07] This is a question we're still trying to answer. There is some suggestion that for some patients who don't manage their disease, we very well may be looking at a food impaction in the future.   [11:19] Dr. Dellon says we know overall for the population of EoE patients, but it's hard to know for a specific patient. We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range.   [11:39] Some people get symptoms and get diagnosed right away. Others might have symptoms for 20 or 30 years that they ignore, or don't have access to healthcare, or the diagnosis is missed.   [11:51] What we see consistently is that people who may be diagnosed within a year or two may only have a 10 or 20% chance of having that stricture and scar tissue in the esophagus, whereas people who go 20 years, it might be 80% or more.   [12:06] It's not everybody who has EoE who might end up with that scar tissue, but certainly, it's suggested that it's a large majority.   [12:16] That's before diagnosis. We have data that shows that after diagnosis, if people go a long time without treatment or without being seen in care, they also have an increasing rate of developing strictures.    [12:29] In general, the idea is yes, you should treat EoE, because on average, people are going to develop scar tissue and more symptoms. For the patient in front of you with EoE but no symptoms, what are the chances it's going to get worse? You don't know.   [13:04] There are two caveats with that. The first is what we mean by symptoms. Kids may have vomiting and growth problems. Adults can eat carefully, avoiding foods that hang up in the esophagus, like breads and overcooked meats, sticky rice, and other foods.   [13:24] Adults can eat slowly, drink a lot of liquid, and not perceive they have symptoms. When someone tells Dr. Dellon they don't have symptoms, he will quiz them about that. He'll even ask about swallowing pills.    [13:40] Often, you can pick up symptoms that maybe the person didn't even realize they were having. In that case, that can give you some impetus to treat.   [13:48] If there really are no symptoms, Dr. Dellon thinks we're at a point where we don't really know what to do.   [13:54] Dr. Dellon just saw a patient who had a lot of eosinophils in their small bowel with absolutely no GI symptoms. He said, "I can't diagnose you with eosinophilic enteritis, but you may develop symptoms." People like that, he will monitor in the clinic.   [14:14] Dr. Dellon will discuss it with them each time they come back for a clinic visit.   [14:19] Holly is a speech pathologist, but also sees people for feeding and swallowing. The local gastroenterologist refers patients who choose not to treat their EoE to her. Holly teaches them things they should be looking out for.   [14:39] If your pills get stuck or if you're downing 18 ounces during a mealtime, maybe it's time to treat it. People don't see these coping mechanisms they use that are impacting their quality of life. They've normalized it.   [15:30] Dr. Dellon says, of these people who aren't treated, there's probably a subset who appropriately are being observed and don't have a medicine treatment or are on a diet elimination.   [15:43] There's also probably a subset who are inappropriately not on treatment. It especially can happen with students who were under good control with their pediatric provider, but moved away to college and didn't transfer to adult care.   [16:08] They ultimately come back with a lot of symptoms that have progressed over six to eight years.   [16:18] Ryan meets newly diagnosed adult patients at APFED's conferences, who say they have no symptoms, but chicken gets caught in their throat. They got diagnosed when they went to the ER with a food impaction.   [16:38] Ryan says you have to wonder at what point that starts to get reflected in patient charts. Are those cases documented where someone is untreated and now has EoE?   [16:49] Ryan asks in the study, "What is the target EGID Cohort and why was it selected to study EoE? What sort of patients were captured as part of that data set?"   [16:58] Dr. Jensen said they identified patients with the ICD-10 code for a diagnosis of EoE. Then they looked to see if there was evidence of symptoms or complications in relation to EoE. This was hard; some of these are relatively non-specific symptoms.   [17:23] These patients may have been seeking care and may have been experiencing some symptoms that may or may not have made it into the chart. That's one of the challenges with real-world data analyses.   [17:38] Dr. Jensen says they are using data that was collected for documenting clinical care and for billing for clinical care, not for research, so it comes with some caveats when doing research with this data.   [18:08] Research using electronic health records gives a real-world perspective on patients who are seeking care or have a diagnosis of EoE, as opposed to a study trying to enroll a patient population that potentially isn't representative of the breadth of individuals living with EoE.   [18:39] Dr. Dellon says another advantage of real-world data is the number of patients. The largest randomized controlled trials in EoE might have 400 patients, and they are incredibly expensive to do.   [18:52] A study of electronic health records (EHR) is reporting on the analysis of just under 1,000. The cohort, combined from three different centers, has more than 1,400 people, a more representative, larger population.    [19:16] Dr. Dellon says when you read the results, understand the limitations and strengths of a study of health records, to help contextualize the information.   [19:41] Dr. Dellon says it's always easier to recognize the typical presentations. Materials about EoE and studies he has done that led to medicine approvals have focused on trouble swallowing. That can be relatively easily measured.   [20:01] Patients often come to receive care with a food impaction, which can be impactful on life, and somewhat public, if in a restaurant or at work. Typical symptoms are also the ones that get you diagnosed and may be easier to treat.   [20:26] Dr. Dellon wonders if maybe people don't treat some of the atypical symptoms because it's not appreciated that they can be related to EoE.   [20:42] Holly was diagnosed as an adult. Ryan was diagnosed as a toddler. Holly asks what are some of the challenges people face in getting an EoE diagnosis.   [20:56] Dr. Jensen says symptoms can sometimes be fairly non-specific. There's some ongoing work by the CEGIR Consortium trying to understand what happens when patients come into the emergency department with a food bolus impaction.   [21:28] Dr. Jensen explains that we see there's quite a bit of variation in how that gets managed, and if they get a biopsy. You have to have a biopsy of the esophagus to get a diagnosis of EoE.   [21:45] If you think about the steps that need to happen to get a diagnosis of EoE, that can present barriers for some groups to ultimately get that diagnosis.   [21:56] There's also been some literature around a potential assumption about which patients are more likely to be at risk. Some of that is still ongoing. We know that EoE occurs more commonly in males in roughly a two-to-one ratio. Not exclusively in males, obviously, but a little more often in males.   [22:20] We don't know anything about other groups of patients that may be at higher risk. That's ongoing work that we're still trying to understand. That in itself can also be a barrier when there are assumptions about who is or isn't likely to have EoE.   [23:02] Dr. Dellon says that in adolescents and adults, the typical symptoms are trouble swallowing and food sticking, which have many causes besides EoE, some of which are more common.   [23:18] In that population, heartburn is common. Patients may report terrible reflux that, on questioning, sounds more like trouble swallowing than GERD. Sometimes, with EoE, you may have reflux that doesn't improve. Is it EoE, reflux, or both?   [24:05] Some people will have chest discomfort. There are some reports of worsening symptoms with exercise, which brings up cardiac questions that have to be ruled out first.   [24:19] Dr. Dellon mentions some more atypical symptoms. An adult having pain in the upper abdomen could have EoE. In children, the symptoms could be anything in the GI tract. Some women might have atypical symptoms with less trouble swallowing.   [24:58] Some racial minorities may have those kinds of symptoms, as well. If you're not thinking of the condition, it's hard to make the diagnosis.   [25:08] Dr. Jensen notes that there are different cultural norms around expressing symptoms and dietary patterns, which may make it difficult to parse out a diagnosis.   [25:27] Ryan cites a past episode where access to a GI specialist played a role in diagnosing patients with EoE. Do white males have more EoE, or are their concerns just listened to more seriously?   [25:57] Ryan's parents were told when he was two that he was throwing up for attention. He believes that these days, he'd have a much easier time convincing a doctor to listen to him. From speaking to physicians, Ryan believes access is a wide issue in the field.   [26:23] Dr. Dellon tells of working with researchers at Mayo in Arizona and the Children's Hospital of Phoenix. They have a large population of Hispanic children with EoE, much larger than has been reported elsewhere. They're working on characterizing that.   [26:49] Dr. Dellon describes an experience with a visiting trainee from Mexico City, where there was not a lot of EoE reported. The trainee went back and looked at the biopsies there, and it turned out they were not performing biopsies on patients with dysphagia in Mexico City.   [27:13] When he looked at the patients who ended up getting biopsies, they found EoE in 10% of patients. That's similar to what's reported out of centers in the developed world. As people are thinking about it more, we will see more detection of it.   [27:30] Dr. Dellon believes those kinds of papers will be out in the next couple of months, to a year.   [27:36] Holly has had licensure in Arizona for about 11 years. She has had nine referrals recently of children with EoE from Arizona. Normally, it's been one or two that she met at a conference.   [28:00] Ryan asks about the research on patients not having their EoE treated pharmacologically. Some treat it with food avoidance and dietary therapy. Ryan notes that he can't have applesauce, as it is a trigger for his EoE.   [28:54] Dr. Jensen says that's one of the challenges in using the EHR data. That kind of information is only available to the researchers through free text. That's a limitation of the study, assessing the use of dietary elimination approaches.   [29:11] Holly says some of her patients have things listed as allergies that are food sensitivities. Ryan says it's helpful for the patients to have their food sensitivities listed along with their food allergies, but it makes records more difficult to parse for research.   [30:14] Dr. Dellon says they identify EoE by billing code, but the codes are not always used accurately. Natural Language Processing can train a computer system to find important phrases. Their collaborators working on the real-world data are using it.   [30:59] Dr. Dellon hopes that this will be a future direction for this research to find anything in the text related to diet elimination.   [31:32] Dr. Jensen says that older patients were less likely to seek medication therapy. She says it's probably for a couple of reasons. First, older patients may have been living with the disease for a long time and have had compensatory mechanisms in place.   [32:03] The other reason may be senescence or burnout of the disease, long-term. Patients may be less symptomatic as they get older. That's a question that remains to be answered for EoE. It has been seen in some other disease processes.   [32:32] Dr. Dellon says there's not much data specifically looking at EoE in the older population. Dr. Dellon did work years ago with another doctor, and they found that older patients had a better response to some treatments, particularly topical steroids.   [32:54] It wasn't clear whether it was a milder aspect of the disease, easier to treat, or because they were older and more responsible, taking their medicines as prescribed, and having a better response rate. It's the flip side of work in the pediatric population.   [33:16] There is an increasingly aging population with EoE. Young EoE patients will someday be over 65. Dr. Dellon hopes there will be a cure by that point, but it's an expanding population now.   [33:38] Dr. Jensen says only a few sites are contributing data, so they hope to add additional sites to the study. For some of the less common outcomes, they need a pretty large patient sample to ask some of those kinds of questions.   [33:55] They will continue to follow up on some of the work that this abstract touched on and try to understand some of these issues more deeply.   [34:06] Dr. Dellon mentions other work within the cohort. Using Natural Language Processing, they are looking at characterizing endoscopy information and reporting it without a manual review of reports and codes. You can't get that from billing data.   [34:29] Similarly, they are trying to classify patient severity by the Index of Severity with EoE, and layer that on looking at treatments and outcomes based on disease severity. Those are a couple of other directions where this cohort is going.   [34:43] Holly mentions that this is one of many research projects Dr. Jensen and Dr. Dellon have collaborated on together. They also collaborate through EGID Partners. Holly asks them to share a little bit about that.   [34:53] Dr. Jensen says EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join.   [35:07] EGID Partners also needs people who don't live with an EGID to join, as controls. That gives the ability to compare those who are experiencing an EGID relative to those who aren't.   [35:22] When you join EGID Partners, they provide you with a set of questionnaires to complete. Periodically, they push out a few more questionnaires.   [35:33] EGID Partners has provided some really great information about patient experience and answered questions that patients want to know about, like joint pain and symptoms outside the GI tract.   [36:04] To date, there are close to 900 participants in the registry from all over the world. As it continues to grow, it will give the ability to look at the patient experience in different geographical areas.   [36:26] Dr. Dellon says we try to have it be interactive, because it is a collaboration with patients. The Steering Committee works with APFED and other patient advocacy groups from around the world.    [36:41] The EGID Partners website shows general patient locations anonymously. It shows the breakdown of adults with the condition and caregivers of children with the condition, the symptom distribution, and the treatment distribution.   [37:03] As papers get published and abstracts are presented, EGID Partners puts them on the website. Once someone joins, they can suggest a research idea. Many of the studies they have done have come from patient suggestions.   [37:20] If there's an interesting idea for a survey, EGID Partners can push out a survey to everybody in the group and answer questions relatively quickly.   [37:57] Dr. Dellon says a paper came out recently about telehealth. EoE care, in particular, is a good model for telehealth because it can expand access for patients who don't have providers in their area.   [38:22] EoE is a condition where care involves a lot of discussion but not a lot of need for physical exams and direct contact, so telehealth can make things very efficient.    [38:52] EGID Partners surveyed patients about telehealth. They thought it was efficient and saved time, and they had the same kind of interactions as in person. In general, in-state insurance covered it. Patients were happy to do those kinds of visits again.   [39:27] Holly says Dr. Furuta, herself, and others were published in the Gastroenterology journal in 2019 about starting to do telehealth because patients coming to the Children's Hospital of Colorado from out of state had no local access to feeding therapy.   [39:50] Holly went to the board, and they allowed her to get licensure in different states. She started with some of the most impacted patients in Texas and Florida in 2011 and 2012. They collected data. They published in 2019 about telehealth's positive impact.   [40:13] When 2020 rolled around, Holly had trained a bunch of people on how to do feeding therapy via telehealth. You have to do all kinds of things, like make yourself disappear, to keep the kids engaged and in their chairs!   [40:25] Now it is Holly's primary practice. She has licenses in nine states. She sees people all over the country. With her diagnosis, her physicians at Mass General have telehealth licensure in Maine. She gets to do telehealth with them instead of driving two hours.   [40:53] Dr. Jensen tells of two of the things they hope to do at EGID Partners. One is trying to understand more about reproductive health for patients with an EGID diagnosis. Only a few studies have looked at this question, and with very small samples.   [41:15] As more people register for EGID Partners, Dr. Jensen is hoping to be able to ask some questions related to reproductive health outcomes.   [41:27] The second goal is a survey suggested by the Student Advisory Committee, asking questions related to the burden of disease specific to the teen population.   [41:48] This diagnosis can hit that population particularly hard, at a time when they are trying to build and sustain friendships and are transitioning to adult care and moving away from home. This patient population has a unique perspective we wanted to hear.   [42:11] Dr. Jensen and Dr. Dellon work on all kinds of other projects, too.   [42:22] Dr. Dellon says they have done a lot of work on the early-life factors that may predispose to EoE. They are working on a large epidemiologic study to get some insight into early-life factors, including factors that can be measured in baby teeth.   [42:42] That's outside of EGID Partners. It's been ongoing, and they're getting close, maybe over the next couple of years, to having some results.   [43:03] Ryan says all of those projects sound so interesting. We need to have you guys back to dive into those results when you have something finalized.   [43:15] For our listeners who want to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes below.   [43:22] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist.   [43:31] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections.   [43:41] Ryan thanks Dr. Dellon and Dr. Jensen for joining us today. This was a fantastic conversation. Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Evan S. Dellon, MD, MPH, Academic Gastroenterologist, University of North Carolina School of Medicine   Elizabeth T. Jensen, MPH, PhD, Epidemiologist, Wake Forest University School of Medicine, University of North Carolina at Chapel Hill   Predictors of Patients Receiving No Medication for Treatment of Eosinophilic Esophagitis in the United States: Data from the TARGET-EGIDS Cohort   Episode 15: Access to Specialty Care for Eosinophilic Esophagitis (EoE)   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "I've been working on eosinophilic gastrointestinal diseases for about 15 years. I started some of the early work around understanding possible risk factors for the development of disease. I've gone on to support lots of other research projects." — Elizabeth T. Jensen, MPH, PhD   "You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have it, it really is a long-term condition." — Evan S. Dellon, MD, MPH   "There are two general approaches to treating the underlying condition, … using medicines and/or eliminating foods from the diet that we think may trigger EoE. I should say, for a lot of people, EoE is a food-triggered allergic condition." — Evan S. Dellon, MD, MPH   "I didn't find it that surprising [that there are patients who had no treatment]. Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are … still exploring dietary treatment options." — Elizabeth T. Jensen, MPH, PhD   "We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range. Some people get symptoms and are diagnosed right away. Other people might have symptoms for 20 or 30 years." — Evan S. Dellon, MD, MPH   "EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join. EGID Partners also needs people who don't live with an EGID to join, as controls." — Elizabeth T. Jensen, MPH, PhD

Worship with us live online at ExploreGracePoint.com/church-onlineGracePoint Church2351 Rice Creek RdNew Brighton, MN 55112

Covid vaccines boosted the immune response in people being treated for cancer and improved their survival, a recent study concludes. mRNA expert Jeff Coller at Johns Hopkins says as more evidence mounts establishing the benefits of mRNA vaccines, we need … Many vaccines are intended to reduce disease severity, Elizabeth Tracey reports Read More »

Welcome to GamePlan with the Sports Docs. On each of these mini episodes, we chat about a new article or new surgical technique in the field of sports medicine. We'll give you our quick take on the most recent data and how this data will be impacting our practice.Today, we're talking about hamstring injuries in the NFL. And if your fantasy team is anything like my fantasy team, it currently looks like an infirmary. So, you'll probably want to listen in to this episode.Now, we've covered hamstring injuries in the NFL before.  Last year we did an entire Game Plan episode dedicated to this topic.  That is episode #52 if you want to check it out. Today, we are actually reviewing a new study just published this month in AJSM that focused on how player characteristics, injury severity and imaging findings can impact the amount of time missed as well as risk of recurrent injury. The article is titled “Correlation of Player and Imaging Characteristics with Severity and Missed Time in the National Football League Professional Athletes with Hamstring Strain Injury.” Molly Day, Scott Rodeo and team at HSS published this retrospective cross-sectional study that aimed to identify certain player characteristics, clinical examination findings and MRI  results that were associated with injury severity and missed playing time. As always, links to all of the papers that we discuss on this show can be found on our podcast website – www.thesportsdocspod.com

What will this fall and winter season bring? Will it be ducky? Or are we in another lull until January, find out today in the first of two Long-term Weather Severity Forecasts! DrMike digs deep into data that predicts or winter weather, that and your weekly duck migration forecast.

How dangerous and quite simply, how bad is sin…how severe it is, but how thankful we are for God’s provisions to address sin through Jesus.

This week, Pastor Abraham leads us back into our series on the minor prophets with Nahum. Take a deeper look with us at this short, but often neglected book.

Aquí San Pablo está asegurando nos de que en el futuro, los judíos en gran números van a regresar a la fe verdadera. Esto aun no ha pasado, pero cuando pasa, será una ayuda tremenda para la causa de Cristo.

The conversation delves into the concept of deterrence in crime prevention, emphasizing that the likelihood of being caught and punished is a more significant factor than the severity of the punishment itself. It highlights that longer sentences do not effectively deter crime if offenders believe they can evade capture.In the intricate world of criminal law, understanding the principles of punishment and sentencing is crucial. This post delves into the philosophical debates and practical applications that shape the justice system today. From historical shifts to modern challenges, we explore the core tensions and evolving standards that define this field.The Evolution of Punishment: Historically, punishment has transformed from physical and public sanctions to more regulated and humane approaches. This shift reflects changing societal values and the evolving standards of decency that courts use today. The question remains: why do we punish at all? This leads us to the two major philosophies in sentencing—utilitarianism and retribution.Retribution vs. Utilitarianism: Retribution focuses on the past act, advocating for punishment as a moral necessity. In contrast, utilitarianism looks forward, weighing the societal benefits against the costs of punishment. This philosophical divide influences every sentencing decision, from deterrence to rehabilitation.The Role of Deterrence: Deterrence is a key goal in utilitarian sentencing, aiming to prevent future crimes. However, the effectiveness of deterrence is debated, with studies showing that the certainty of punishment is more impactful than its severity. This insight challenges the traditional reliance on harsh sentences as a deterrent.Constitutional Limits and the Eighth Amendment: The Eighth Amendment serves as a constitutional check against excessive punishment. Its interpretation has led to significant legal precedents, particularly in capital cases. The amendment's role in non-capital cases, however, remains a topic of debate, with courts often deferring to legislative policy choices.The landscape of punishment and sentencing is complex, shaped by historical, philosophical, and legal factors. As we navigate these challenges, the balance between retribution and utilitarian goals continues to evolve. Understanding these dynamics is essential for anyone studying or practicing criminal law.Subscribe Now: Stay informed on the latest developments in criminal law by subscribing.TakeawaysThe deterrent effect of certainty is much stronger than severity.Longer sentences are ineffective if offenders think they can escape punishment.Severity deters only when the certainty of being caught is high.Offenders' calculations are influenced more by perceived chances of getting caught than by potential penalties.Understanding offender behavior is crucial for effective crime prevention strategies.Policies should focus on increasing the likelihood of apprehension rather than just increasing penalties.The relationship between certainty and severity is complex and requires careful consideration.Effective deterrence strategies must address the mindset of potential offenders.Crime prevention efforts should prioritize certainty over severity in their approaches.Research consistently supports the importance of certainty in deterrence.deterrence, crime prevention, certainty, punishment, severity, offender behavior

In this episode of Fire Ecology Chats, Fire Ecology editor Bob Keane speaks with Elijah Orland about using thermal imagery to better understand what leads to burn severity and how quickly we can get that information to others.Full journal article can be found at https://fireecology.springeropen.com/articles/10.1186/s42408-025-00407-x

Send us comments, suggestions and ideas here! In this week's show we explore the first thirteen lines from Liber ARARITA and explore each one's corresponding sephirah on the Tree of Life, discussing its corresponding planetary god from the Greek and Roman tradition along with a profile of the angelic archangel who rules over each station. This chapter corresponds to the “Good” side of the Tree of Life and explains it in fairly classical, straight-forward terms. On the free side of the show we make it all the way from Kether to Gevurah but discover that we've run out of time and resume our discussion of Tiphareth through Malkuth during the paid section of the show which includes a rousing discussion about Jacob and his battle with the angel we suspect to be Kamael. Tune in next week to hear about how the Tree of Life from this week matches up with the Tree of Death and its corresponding orders of demons. Thank you and enjoy the show!for more great content by Tim Hacker make sure to check out CryticChronicles.comOn this week's show we discuss:Surah 112The Ain Soph AuirKether, The CrownMetatronThe Vault of HeavenThe Flaming Star and the Sixfold StarBinah, UnderstandingZadkiel, Archangel of Mercy Chesed, MercyDaddy JupiterGevurah, Severity vs. Pachad, FearOn the extended side of the show available at www.patreon.com/TheWholeRabbit we finish discussing the tree and talk about:Tiphareth, BeautyThe Beloved Gods of the SunRaphael, Physician of GodVenus, Goddess of EXTREME LOVEJacob's Thigh and NetzachHaniel, the Romantic Angel. Yesod, The FoundationGabriel, God's Strength! Michael, God's BonkerSandalphon, Metatron's TwinThis episode was prepared by Luke Madrid and Heka Astra with angel commentaries included by Tim Hacker, Blue sections read by Mari Sama.Where to find The Whole Rabbit:Spotify: https://open.spotify.com/show/0AnJZhmPzaby04afmEWOAVInstagram: https://www.instagram.com/the_whole_rabbitTwitter: https://twitter.com/1WholeRabbitOrder Stickers: https://www.stickermule.com/thewholerabbitOther Merchandise: https://thewholerabbit.myspreadshop.com/Music By Spirit Travel Plaza:https://open.spotify.com/artist/30dW3WB1sYofnow7y3V0YoSources:Liber ARARITA / IAO 131https://iao131.com/commentaries/liber-dcccxiii-vel-ararita-sub-figura-dlxx/Book of Thoth:https://dn710008.ca.archive.org/0/items/out-of-print-and-rare-books-collection/BookOfThoth.pdfAbrahadabra:http://www.thelemapedia.org/index.php/ABRAHADABRABook of the Law:https://sacred-texts.com/oto/engccxx.htmTHE GEMATRIA NOTEBOOKS OF PAUL FOSTER CASEDion Fortune, Mystical KabbalahVision and the Voice:Support the show

In hour 1, the WIP Midday Show are discussing the AJ Brown post game comments and whole situation in more details. Particularly Hugh who claims he knows people close to the Eagles that have sad the situation is "bad, bad"

High-severity wildfires that burn communities are obviously bad. But what about high-severity fire that burns in the backcountry? Guest Dr. Dick Hutto, Emeritus Professor of biology and wildlife biology at the University of Montana and author of the recently published book A Beautifully Burned Forest: Learning to Celebrate Severe Forest Fire, makes the case that high-severity fire has been unfairly demonized and this fire forms an important and transitory habitat type. Rethinking high-severity fire has policy consequences. Do we invest as heavily in fire risk reduction for wildlands or is funding better spent in and near communities? Do we invest as heavily in fire suppression where fires are burning far from human habitations? And what do we do after fires burn—do we log and replant or leave it be? Listen to hear Dr. Hutto's prescriptions.Want to learn more? Check out Dr. Hutto's website on fire ecology. Support the show

In this episode of Fire Ecology Chats, Fire Ecology editor Bob Keane speaks with Astrid Sanna, Alina Cansler, and Craig Bienz about evaluating fuel treatments of fire suppression operations through the 2021 Bootleg Fire of South-Central Oregon.Full journal article can be found at https://fireecology.springeropen.com/articles/10.1186/s42408-025-00387-y

நரகமும் அதன் கடுமையும் [Surah Al-Kahf: 51 to 53] மவ்லவி அலி அக்பர் உமரி | Ali Akbar Umari 14-09-2025 Taqwa Masjid, Trichy

நரகமும் அதன் கடுமையும் [Surah Al-Kahf: 51 to 53] - கேள்வி பதில் அமர்வுமவ்லவி அலி அக்பர் உமரி | Ali Akbar Umari14-09-2025Taqwa Masjid, Trichy

Severity of common cold symptoms fell 41% in the fittest and 31% in the most active.https://bjsm.bmj.com/content/45/12/987.abstractFlu shots in children: 5× higher risk of noninfluenza respiratory infections (incl. coronaviruses).https://pubmed.ncbi.nlm.nih.gov/22423139/Glyphosate damages gut health.https://www.mdpi.com/1099-4300/15/4/1416Adults sleeping ≤6 h/night were ~4× more likely to develop a cold after rhinovirus exposure; similar with ≤7 h + low sleep efficiency.https://pmc.ncbi.nlm.nih.gov/articles/PMC4531403/Vitamin D deficiency was common in COVID patients—41.9% overall, 80% in severe cases.https://pubmed.ncbi.nlm.nih.gov/33048028/Sea lion study:https://www.frontiersin.org/journals/marine-science/articles/10.3389/fmars.2020.602565/fullNFL player's story:https://bleacherreport.com/articles/1859740-random-things-most-nfl-fans-never-knew-football-players-almost-never-get-sickCowling 2012: Flu shots in children increased risk of noninfluenza infections 5×.https://pubmed.ncbi.nlm.nih.gov/22423139/Wolff study: Vaccinated servicemen had higher odds of coronavirus (+36%), metapneumovirus (+51%), and other noninfluenza viruses (+15%).https://www.sciencedirect.com/science/article/pii/S0264410X19313647Vaccinated kids ≤4 yrs: 4.8× higher hazard of noninfluenza infection (CI 2.88–7.99). Ages 5–17: 1.61× higher hazard (CI 0.98–2.66).https://pubmed.ncbi.nlm.nih.gov/29525279/Chris Kresser (2021): Vitamin D deficiency raised SARS-CoV-2 infection risk by 80%. Deficient patients had 1.77× higher infection risk, 2.57× more severe, 2.35× higher mortality.https://vimeo.com/530879066/e9b314a0beTom Jefferson review of 259 BMJ studies: Flu vaccines had little effect on outcomes like absences, days lost, illness, or death.https://pmc.ncbi.nlm.nih.gov/articles/PMC1626345/Pesticide research (http://ndl.ethernet.edu.et/bitstream/123456789/54884/1/Jonathan%20J.%20Li_2008.pdf#page=399):• Women with reproductive cancers had 4–6× higher pesticide levels (8.7–10.9 mg/L vs 1.9 mg/L).• Living ≤1 mile from a golf course → 126% higher Parkinson's risk; risk drops 13% per mile after 3 mi.• Shared water with golf course → nearly 2× PD risk.• Vulnerable groundwater regions → 82% higher PD risk.“These chemicals can be carcinogenic, mutagenic, teratogenic, and estrogenic (disrupting hormones).”If you need other studies, ask AI or email shortlifeadvice@gmail.com

When we are experiencing a lot of stress or recovering from trauma or addiction, we can find ourselves living in a fight-flight-freeze state, where we feel either disconnected from or unsafe in our bodies. This practice is designed to gently cultivate a sense of safety and then create a kinesthetic anchor (rooted in awareness of how our body is moving) to start building a felt sense of security that your body can remember. Emily Jane is a mindfulness teacher, certified Embodied Processing (EP) practitioner, and recovery coach with a background in social work. She's been in recovery for over eight years, following two decades of active addiction, and her lived experience now fuels her passion for helping others heal. Emily is also the author of Beyond Addiction: A Mindful Guide to Recovery, where she shares her trauma-informed, compassionate approach to healing. Her work integrates mindfulness, coaching, trauma therapy, and somatic tools to help people reconnect with their bodies and find safety, peace, and empowerment on their recovery journey. The transcription of this guided meditation will be online at Mindful.org next week.  Stay curious, stay inspired. Join our community by signing up for our free newsletter:  mindful.org/signup Show Notes Find more from Emily Jane here. You can order your copy of Beyond Addiction here.  Go Deeper If you want to learn more about embodied practice and how mindfulness can aid in addiction recovery, check out these articles: Make It Personal: How Mindfulness Can Support Highly Stressed People A Simple Inquiry Practice to Unwind from Stress Could Mindfulness Decrease the Severity of Opioid Cravings?  Constant Craving  For more practice, here's another meditation to try: HALT Practice to Tune In to What Your Body Needs  And more from Mindful here: More episodes of 12 Minute Meditation Let us know what you thought of this episode of 12 Minute Meditation by leaving a review or by emailing yourwords@mindful.org.

In this episode of Fire Ecology Chats, Fire Ecology editor Bob Keane speaks with Jonathan Batchelor about exploring how drone-based photogrammetrictry could provide a more complete picture of fire impacts on the forest floor.Full journal article can be found at https://fireecology.springeropen.com/articles/10.1186/s42408-025-00375-2

Bruce and Gaydos recap the biggest dust storm since 2011!

Association between housing status and mental health and substance use severity among individuals with opioid use disorder and co-occurring depression and/or PTSD  BMC Primary Care  This is a cross-sectional analysis of associations between housing status and mental health and substance use severity among primary care patients with co-occurring disorders. The study is a sub-analysis using data from the Collaboration Leading to Addiction Treatment and Recovery from other Stresses randomized controlled trial, which tested the Collaborative Care Model for primary care patients with OUD and co-occurring depression and/or PTSD. Of 797 patients in the study, 13% were currently unhoused, 24% were unstably housed, and 63% were stably housed. Those who were unhoused were on average younger and had not used prescribed MOUD in the past 30 days. The analysis found that being unhoused or unstably housed was significantly associated with higher PTSD symptom severity, depression symptom severity, opioid use severity, and opioid overdose risk behaviors compared to those who were stably housed.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Federal agencies scrambled over the past several days to address a severe vulnerability in widely used Microsoft collaboration products. The software bug in Microsoft Exchange could be used by hackers to take over much of an organization's network, federal news networks. Justin Doubleday is Here with more on the latest cyber news. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In part two of this two-part series, Dr. Stacey Clardy and Casey R. Vanderlip discuss the changes that neurologists should implement in their clinics based on the findings from this study regarding APOE genotype.  Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000213853  

In part one of this two part series, Dr. Stacey Clardy and Casey R. Vanderlip discuss what neurologists need to know about how APOE4 and amyloid interact to impact cognitive function.  Show reference:  https://www.neurology.org/doi/10.1212/WNL.0000000000213853 

Dr. Stacey Clardy talks with Casey R. Vanderlip about whether the accelerated decline in episodic memory among APOE4 carriers is due to increased Aβ deposition or heightened susceptibility to Aβ-related effects.  Read the related article in Neurology®.  Disclosures can be found at Neurology.org. 

Bro. Chris Seagle preaching live from Still Water Baptist Church on 7.27.25 am

Did MetroHealth's $1 billion expansion put the hospital system into financial distress? Learn more about your ad choices. Visit megaphone.fm/adchoices

Many look upon God like an old faithful grandfather. But the Bible speaks of His goodness AND His severity. We return to the book of Romans for this study and to choose the God and Father we should serve.

Sermon from Exodus 4 in St. Charles, IL

In this episode of Command Control Power, hosts welcome Adam Burg from CALSO Technologies to share his harrowing experience with the Eaton Fire in Altadena, California. Adam recounts the events leading up to the evacuation of his family, the destruction of their home, and their subsequent journey to recovery. He highlights the overwhelming support from the community, the importance of preparedness, and offers advice for ensuring business continuity in the face of natural disasters. The episode provides a detailed and emotional account of resilience and the power of community. https://www.gofundme.com/f/support-the-burg-family-after-the-eaton-fire-in-altadena   00:00 Introduction and Welcome 00:23 Adam's Tragic Experience in LA 01:22 Evacuation and Immediate Aftermath 03:10 Community Support and Personal Reflections 04:14 The Fire's Impact on Daily Life 05:07 Realization of the Fire's Severity 06:32 Evacuation Orders and Family Preparations 08:25 The Night of the Evacuation 10:27 Returning to the Devastation 18:58 Cleanup and Recovery Efforts 30:20 Architectural Heritage and Rebuilding 31:45 Life at the Hotel: Initial Experiences 32:56 Community and Support Among Families 34:26 Interactions with Firefighters 35:36 Challenges of Hotel Living 36:43 Emotional Impact on the Family 38:01 Reflections on Community and Support 39:28 Environmental Refugees and Climate Change 41:34 Insurance and Preparedness 47:10 Rebuilding and Client Support 55:00 Lessons Learned and Final Thoughts Meet the community trying to save Altadena's history after the L.A. fires

Welcome to episode 183 of Growers Daily! We cover: garlic rust and what to do about it, how to tell if your soil is healthy, and it's feedback friday! We are a Non-Profit! 

In this episode, Kimberly and Alex discuss his extensive background in working with children on the Autism Spectrum Disorder (ASD). He spent much of those years taking a non-traditional approach from just behavioral to prioritizing fun and community. This work led him to keenly understanding the importance of local agriculture, nutrition, and the gut-brain connection, and eventually he began working as an animal butcher and supporting his wife's work, The Wild Nutritionist. Aspects of their discussion are connected through the thread of the importance of holistic care for ASD individuals as well as local farming, nutrition, and the gut-brain connection.   Bio Alex Johnson is a father, butcher, former autism specialist, husband of Kate Pope, The Wild Nutritionist, and long-term friend of Kimberly's. His background in theater studies, and then psychology, led him to working with children on the Autism Spectrum Disorder for over a decade. Understanding the needs of this population then helped him transition to regenerative agriculture and animal butchery.    What He Shares: –Working with children on the Autism Spectrum Disorder –How and why ASD has changed in recent years –Harms and limitations of diagnoses and labels –Transitioning to regenerative agriculture and butchery –Prioritizing community through local farming   What You'll Hear: –How Alex began working with kids –Studied theater and psychology –Role play and autism in 2010 –How insurance changed autism  –In home and in community teaching to kids with ASD –Bringing families together with potlucks –DSM-5 refining definition of ASD –Disproportionately diagnosed in boys versus girls –Severity ratings (1, 2, 3) of ASD –Issues with self-diagnoses –Performative vulnerability –Challenges in diagnosing ASD –Social, Communication, and Behavior  –Familial approaches to ASD and community –Neurodivergence and ASD labels –Limitations of checklists of diagnoses –Gut issues and ASD –Behavioral versus holistic and community care –Regenerative agriculture, nutrition, and ASD –Transitioning to animal butchery –Small-scale, mobile harvest operation  –Mobile Harvest Truck –Art of animal butchery and carrying traditions –Politics and farming –Community care in farming and rural areas –Nutritional needs for families –Getting kids involved in family nutrition –Importance of local farmers markets –Talking to local farmers –Buying seasonal produce –Harms of individual priorities versus community –Returning to community care   Resources Website: https://regenerativecookingschool.com/ IG: @wildnutrionist  

A big, deep dive into CTA and fractional flow reserve CT, and a sobering report on the new EVOQUE valve are discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback and Correction CRAAFT HF https://clinicaltrials.gov/study/NCT06505798 II Imaging and Behavior Change SCOT HEART 1 https://www.nejm.org/doi/full/10.1056/NEJMoa1805971 Five Reasons I Don't Believe an Imaging Test Improves Outcomes https://www.medscape.com/viewarticle/901204 SCOT HEART 2 https://www.jacc.org/doi/10.1016/j.jcmg.2024.05.016 III. More on Imaging and CT FFR Symptoms Don't Always Indicate the Severity of Coronary Artery Disease https://www.medscape.com/viewarticle/symptoms-dont-always-indicate-severity-coronary-artery-2025a1000ge6 ADVANCE Registry Protocol https://www.journalofcardiovascularct.com/article/S1934-5925(16)30288-X/abstract Research Letter JACC CV Imaging  https://doi.org/10.1016/j.jcmg.2025.05.002 ADVANCE Registry Paper 2018 https://doi.org/10.1093/eurheartj/ehy530 Cook et al JAMA Card https://jamanetwork.com/journals/jamacardiology/fullarticle/2629072 Low diagnostic yield Patel paper NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa0907272 Venk Murthy thread https://x.com/venkmurthy/status/1033379922679660544 IV EVOQUE Real World Data JACC has published a sobering research letter on the Transcatheter Tricuspid Valve Replacement called EVOQUE valve. Lupu et al JACC IV https://doi.org/10.1016/j.jcin.2025.03.019 TRISCEND II https://www.nejm.org/doi/full/10.1056/NEJMoa2401918 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net