333 Matching Annotations
  1. Oct 2024
    1. Disease: Von Willebrand Disease (VWD) Type 2A

      Patient: 31 yo, Female

      Variant1: VWF NC_000012.12: c.875-5T>Gdel, p.(Ser292_Glu333delinsLys) Causes complete exon 8 skipping

      Variant2: VWF NM_000552.5: c.813C>G, p.(Tyr271*)

      Phenotypes: History of bleeding (epistaxis, uncontrollable by conventional hemostatic treatment), Easy bruising, gum bleeding, excessive menstrual bleeding, mild decrease in plasma VWF:Ag, severe impairment in VWF function, VWF:Ab/VWF:Ag ratio decreased, VWF:CB/VWF:Ag ratio decreased, FVIII:C lvs slighly below normal range

      Family: Son had bleeding diathesis and spontaneous epistaxis (less severe than proband), normal parents

      In silico data available: SpliceAI delta score of 0.51 for loss of splice acceptor caused by variant 1

      Alamut showed small to moderate effects of the variant on normal splicing of VWF

      NetGene2 showed weak strength of 3' splice sites in exon 8

      SpliceAid2 showed TIA-1 and TIAL 1, which bind to U-rich motifs and facilitate 5' splice site recognition where destroyed in the mutated sequence

  2. Jul 2024
    1. 26:30 Brings up progress traps of this new technology

      26:48

      question How do we shift our (human being's) relationship with the rest of nature

      27:00

      metaphor - interspecies communications - AI can be compared to a new scientific instrument that extends our ability to see - We may discover that humanity is not the center of the universe

      32:54

      Question - Dr Doolittle question - Will we be able to talk to the animals? - Wittgenstein said no - Human Umwelt is different from others - but it may very well happen

      34:54

      species have culture - Marine mammals enact behavior similar to humans

      • Unknown unknowns will likely move to known unknowns and to some known knowns

      36:29

      citizen science bioacoustic projects - audio moth - sound invisible to humans - ultrasonic sound - intrasonic sound - example - Amazonian river turtles have been found to have hundreds of unique vocalizations to call their baby turtles to safety out in the ocean

      41:56

      ocean habitat for whales - they can communicate across the entire ocean of the earth - They tell of a story of a whale in Bermuda can communicate with a whale in Ireland

      43:00

      progress trap - AI for interspecies communications - examples - examples - poachers or eco tourism can misuse

      44:08

      progress trap - AI for interspecies communications - policy

      45:16

      whale protection technology - Kim Davies - University of New Brunswick - aquatic drones - drones triangulate whales - ships must not get near 1,000 km of whales to avoid collision - Canadian government fines are up to 250,000 dollars for violating

      50:35

      environmental regulation - overhaul for the next century - instead of - treatment, we now have the data tools for - prevention

      56:40 - ecological relationship - pollinators and plants have co-evolved

      1:00:26

      AI for interspecies communication - example - human cultural evolution controlling evolution of life on earth

  3. Apr 2024
  4. Feb 2024
    1. impaired cognitive functioning following cancer diagnosis and treatment may be the result of a preexisting vulnerability due to exposure to childhood trauma (Lupien et al., 2009; Miller, Chen, & Zhou, 2007). In that regard, trauma should be considered, among other factors, in treatments aiming to address difficulties with cognitive functioning
    1. Crizanlizumab is a monoclonal antibody against P-selectin.[30] which has now been approved by Novartis on November 15, 2019 for the indication of vaso-occlusive crisis in sickle cell patients.
    1. Antagonizing PTGDR-1 and -2 in human lupus could be quickly accessible and safe since Laropiprant was approved by the FDA to inhibit the flushing induced by niacin to treat dyslipidemias55, and Ramatroban, a dual Thromboxane A2 receptor/PTGDR-2 antagonist can be used in allergic rhinitis56
  5. Jan 2024
    1. Leukotriene receptor antagonists (anti-leukotriene agents such as montelukast and zafirlukast) may
  6. Nov 2023
    1. hypoglossal nerve stimulator
      • for: sleep apnea - treatment - surgical implant

      • treatment: sleep apnea

        • surgical implant
        • for moderate to severe cases
        • hypoglossal nerve stimulator
    2. two Dental devices
      • for: sleep apnea - treatment - dental devices

      • treatment: sleep apnea

        • dental devices
        • for moderate sleep apnea
          • mandibular advancement splint
          • tongue retaining device
    3. CPAP
      • for: sleep apnea - treatment - CPAP air pressure machine
    1. every person who got apnea got to be on vitamin d vitamin d makes a tremendous change for so many different 00:24:20 chemical changes in our entire body uh it affects you not only our immune system because you know we look at covet they you know they found like eight over eighty percent of every covert case had deficiency of vitamin d so you think about if your immune system 00:24:33 is weakened that means other systems are weakened which what does the immune system do it keeps away inflammation you see it's all tied together it's so important so now you say why do i need vitamin d well how much are you in the 00:24:46 sun as we get older we're just not in the sun all that much and oh i eat healthy you're not getting it from you're not from your food you need to supplement
      • for: sleep apnea - treatment - vitamin D
    2. for people who have this sleep apnea you may want to start taking a little more magnesium because magnesium what does it do it relaxes it causes the vessel to relax cause the muscles to relax causes all the tissues 00:21:22 to relax and basically when you're getting that apnea things are closing okay so magnesium has been a huge huge change in the research right now so uh you know my favorite magnesiums you know 00:21:34 you have the citrate you have you have the the glycinates those are the best that absorb so i would it was me that's what i would get on uh and try the magnesium because you know sometimes when we just make a little bitty change 00:21:47 it can go a long way because you know unfortunately in the medical field they're not really tuned into nutrition
      • for: sleep apnea - treatment - magnesium, magnesium citrate, magnesium glycinate
    3. for those people who have sleep apnea try gargling with salt water before you 00:14:31 go to bed you may be amazed 40 50 percent of you may say the next morning i don't know what the heck happened but guess what salt water 00:14:42 reduces inflammation so gargling with salt water can be a cure for many of those conditions
      • for: sleep apnea - potential treatment - gargling salt water to reduce inflammation, sleep apnea - potential treatment - eliminate sugar
  7. Oct 2023
  8. Sep 2023
    1. Dr. Childress Second Opinion ConsultationThis handout describes various options for incorporating the second-opinionconsultation of Dr. Childress on an assessment, diagnosis, and treatment plan for court-involved family conflict. I am able to provide second opinion consultation to the involvedmental health professionals if they or the court believe this would be helpful in theresolution of the family conflict through my HIPAA compliant online telehealth office atdoxy.me/drchildress.
  9. Jun 2023
    1. In a similar study design but with a longer follow up (3 months from diagnosis of COVID-19) 16 young adults were investigated for brachial FMD, cerebral vasodilator function and arterial stiffness. Out of these 16 participants, eight were still symptomatic while the others did no longer display signs of COVID-19
    2. shedding of thrombin from endothelial cells may play a role in modulating the loss of normal endothelial cell quiescence
    3. D-Dimer levels
    4. statin treatment, which is the gold standard therapy to lower cholesterol levels in CVD patients to limit hyperlipidemia, was shown to reduce in-hospital mortality in patients with diabetes mellitus and COVID-19 (Saeed et al., 2020) and its use was also independently associated with lower intensive care unit admissio
  10. Apr 2023
    1. A secure attachment is now seen asanchored in both the emotional closeness within the parent–child relationship, as well as in thechild’s comfort venturing beyond that realm to explore the larger world, as facilitated by the parentwho supports and encourages separation-individuation (for discussions of attachment theory andresearch, see Main, Hesse, & Hesse, 2011; Marvin, Cooper, Hoffman, & Powell, 2002

      REMINDER TO ME......Remember this. For now, and later.

    2. WHEN A CHILD REJECTS A PARENT: WORKING WITHTHE INTRACTABLE RESIST/REFUSE DYNAMICMarjorie Gans Walters and Steven Friedlander
    1. Team consists of:• Judge• Attorneys• Therapists• Family Member• Optional• Alternative decision-maker (PC or Case Manager?)• Guardian ad Litem• Counsel for MinorsMixing roles.............blurred boundaries.........multiple hats forone person may cause problems
    2. Evidence-InformedInterventions (EIIs) to address parent–child contact problems

      "evidenced informed" - mandate of FFPSA

    3. Conventional wisdom passed down from judge to judge may work in“average parenting case,” but not here
      • yes, because "conventional wisdom" means conduct when a judge assumes she has sufficient depth of expertise that takes a qualified provider 2 decades to attain and, with false logic, believes she can get "close enough" and inexplicably doesn't just say "I don't know, and I don't want to waste my time and pain trying to figure it out when we have people prescribed and accessible to do just that; and I'm not going to jeopardize my license/job/morals or applying the best available care and effort to save the lives of a child and family."
    4. Don’t necessarily trust your gut

      i.e. DO NOT OPERATE OUTSIDE YOUR COMPETENCE AREAS OF TRAINING AND EXPERIENCE For starters: - If you are an attorney or social worker....full stop. YOU ARE NOT QUALIFIED. STOP ALL STATEMENTS. The only thing to say is, "I DON'T KNOW, WE NEED QUALIFIED HELP" - IF YOU ARE ANYTHING OTHER THAN A PSYCHIATRIST OR CLINICAL PSYCHOLOGIST WHO IS ALSO TRAINED AND EXPERIENCED SPECIFICALLY IN THESE SYSTEMS AND PATHOLOGIES....YOU ARE NOT QUALIFIED, SEE ABOVE. If you are an LCSW, etc; you perhaps may be one of the few who are exceptionally knowledgable, and you may be very effective as part of the care team, BUT YOU ARE NOT QUALIFIED TO DIAGNOSE AND DIRECT CARE AND TREAT OUTSIDE OF THE DIRECTION AND SUPERVISION OF ABOVE SAID QUALIFIED PROVIDERS.

    5. Swift decisions on little evidence – too often gut responses are basedupon personal experience and maybe clouded by emotions

      THIS INFECTION is running rampant

    6. he Perfect StormSuch cases often involve personality disorders, high parentalconflict, and complex systems involvement, in what [Drs.Abigail Judge and Peggie Ward] call ‘the perfect storm.’In these circumstances, clinicians, attorneys, and judgesfrequently become players in the family drama, so it isimportant for all professionals to assess whether they arebeing manipulated by one or both parents and actuallymaking a bad situation worse.Because systems-based perspective and a teamapproach are essential in working with families in highconflict, scrupulous attention to inter-team dynamics iscritical to preventing parallel divisive dynamics amongprofessionals.From OVERCOMING PARENT-CHILD CONTACT PROBLEMS edited by Abigail Judge andRobin Deutsch; Oxford (2017); Introduction page 3. Introduction by Drozd and Bala
    7. Collaboration among all treating professionals is called fo
    8. Well intentioned professionals may need to get out of the way

      see above

    9. A Child’s Voice is critical to hear (and not necessarily is a child havingchoice in their best interest

      Court and State and add-on therapists MUST understand or get out.

    10. Parents need to be willing to change

      Blame does not exist here. It does not matter if I did nothing to cause this, did a lot to cause, or "deserve" to or not to have to change. What matters is understanding what happened, what things I could have done better if I'd known then what I know now and will now and about the entire situation and dynamic and what my daughter was feeling/thinking/going thru; and then what I need to do to achieve the goal ....and the goal is my daughter becomes ridiculously enabled and empowered to seek/understand/find/attain a deeply joyful fulfilling heart-beating life and is provided all things that are TRULY in her best interest, including the ridiculously wonderful father she was given and owed, til the end of time, and then beyond.

    11. “Don’t Treat the Trauma without (a finding of) Trauma:Treatment without a finding of trauma perpetuatesdysfunction.• Evidence-based or evidence-informed trauma treatment isthe treatment of choice
    12. Therapist reporting back to court when there isnoncompliance with parenting plan, orders ortreatment agreement
    13. Keys to the Castle in RRD Work• Treating only the child and treating the rejected parent and child doNOT work.• The Favored Parent holds at least one of the keys. They must buy in.• Catching the family as early as possible is another key. Entrenchedpatterns are very very difficult (not going to say impossible) to break.• Known measures of success or even small steps of progress arecritical.• Transparency, modified confidentiality, & accountability are keys.• “Contact” (between each parent and the child) involves more thanphysical custody.• The greatest potential (& often the most challenging work) rests in thecoparent relationship
    14. SOLUTIONS:The Whole Family must be Involved•Treatment of choice is SYSTEMIC FAMILYTHERAPY

      All members of family involved • Focus on estranged relationship • Child likely to resist • Working with rejected/resisted parent and child only, without aligned parent, recipe for failure

    15. The Solution, continuedWhat failsTime is the enemy and thus..........Therapists, attorneys, and the court may be part of the problem in RRDwork.BiasesConstructive advocacy vs. zealous advocacyMixing up clinical and forensic rolesBeing too helpful: Dual rolesCaution: The voice of the child
    16. What worksEarly and earlier interventions.The Team Approach: When therapists, attorneys, and the court are on ateamAccountability.Keeping costs down.Tools in the Toolbox.One Size Really Does Not Fit All: The Importance of Incorporating CulturallyRelevant Adaptations in Reunification Therapy (April Harris-Britt, DianePaces-Wiles, Noa Wax, 17 September 2021, Family Court Review.Reunification Therapy research is significantly limited as it pertains to thechallenges of treating and assisting such families from diverse culturalbackgrounds.Suggestions are offered for enhancing Evidence-Informed Interventions(EIIs) to address parent–child contact problems within diversepopulations by incorporating culturally specific interventions to increaseparenting skills, reduce parent and child distress, and repair attachmentsthrough therapeutic experiences66
    1. The therapies that will be coming here once we get them here will be DBT first, “informed” by EFT.
    1. Parents will want Dialectic Behavior Therapy (DBT; Linehan) adapted to the family courts, informed by Emotionally Focused Therapy (EFT; Johnson).
    1. When the child is hostile to a parent, what are the parent's immediate response options? The Baker and Fine article referenced above offers much wisdom.
    2. do not dare to allow themselves to enjoy the targeted parent.
    3. essential in severe alienation in order to free children from loyalty conflicts that would prevent a successful reunification.
    4. Treatment of severe alienation Pioneering alienation therapist Linda Gottlieb emphasizes that severe alienation—when an alienator blocks designated parenting-plan time, withholds school or medical information—requires court orders:
    5. treatment of severe cases
    1. How alienation is best treated psychologically.  Individual therapy alone for the alienated child not only will be unlikely to resolve the alienation; it is likely to reinforce the pattern. Alienated children must be treated in joint sessions with the targeted parent.  The alienating parent must be in treatment as well to learn to recognize and stop his/her alienating behaviors.  Treatment addressed toward helping the parents resolve the issues that motivate the alienation also can help. Court intervention is generally essential in more severe alienation cases where time allotted to the targeted parent in the court-approved parenting plan is being blocked. In the case of severe alienation, urgency is an issue.  Earlier intervention prevents worsening and increases the likelihood of successful treatment for all cases.
    1. an attractive woman

      Every young inexperienced confused lonely horny sexually frustrated heterosexual male understands the powerful reality of vulnerability and susceptibility to manipulation in this scenario

    2. Patience is a necessity

      Disagree. Sometimes, more often than not this is a convenient crutch lacking logic and what it really means is you don't know what to do. ....it's justified if you understand it's going to take 20 steps and each step takes x amount of time, and there's no way around it

    3. traumatized

      Aka...abused

    4. unable to find one he believed understood his experience well enough

      The need: to be understood, to really believe they understand and feel it as you do, and that they agree with you.

      ....therapy, making a deal, apologies and getting past one person hurting another, creating friendship, falling in love

    5. education

      We need the alienators ordered into therapy, into declaring that were wrong and why, we need them sanctioned so it sends a message that will pierce the denial and cause the lightbulb of the gut to turn on.

    6. drive doubt away.

      AKA, full circle to the whole root cause of presentation if severe parental alienation..... ADAMANT REFUSAL TO CONTACT, NO JUSTIFIABLE REASON IS PROVIDED

    7. report any doubts or negative thoughts to Jacob

      Whether intentional or not, this is what happened by default. Even suicide crises started happening, Rhyanna became uncommunicative to school, refused to see me, and would only leave with Kate

    8. Put forth a closed sense of logic; allow no real input or criticism.

      Not directly, but indirectly in that (Kate and others) I was telling the scare story was likely and but telling you the other realities; and that if you brought anything up to question it I didn't understand and didn't want to entertain it because I was convinced my scare story was accurate.

    9. metaphorically snap.

      The spontaneous thing that has to happen once you're older then 18 for a chance to ever come back to your family. And these takes at best years, and often, never happens.

    10. six years

      11 years abandoning his family and church

    11. Five years

      Had abandoned his church and family for 5 years

    12. was more concerned about

      what brother Jacob had influenced him to be concerned about

    13. I’m not a stupid man. I’m not, really. And I just can’t seem to figure out what went wrong.”
    14. neither seemed to understand what he’d gone through.
    15. I hoped to explain to him how cults operate. Once he understood the powerful techniques of persuasion that were used against him, perhaps at least some of the guilt and foolishness he might be feeling over his cultic involvement would decrease.
    1. dies showthat when courts remove severely alienated children from the influence ofthe alienating parent and order an appropriate intervention, at least 90%of the children are restored to a satisfactory relationship with bothparents

      Studies show that when courts remove severely alienated children from the influence of the alienating parent and order an appropriate intervention, at least 90%of the children are restored to a satisfactory relationship with both parents

    1. “What’s happening in outpatient reunification therapy is not only not helping [but] it’s making things far worse,” Baker stresses. “One major problem in general is that clinicians often let these cases go on and on with middle-of-the-road treatments without getting to the underlying cause. Many therapists let these cases go for years without saying, ‘Gee, I’m not really doing anything good here.’” “There’s this false belief that it’s impossible to tell what’s really going on,” she continues. But “it’s not impossible to tell if clinicians were trained specifically in this subspecialization.”
    1. Family Therapy. Functional family therapy (FFT) is a family-based prevention and intervention program for high-risk youths ages 11–18. It concentrates on decreasing risk factors and increasing protective factors that directly affect adolescents who are at risk for delinquency, violence, substance use, or behavioral problems such as conduct disorder or oppositional defiant disorder. FFT is conducted over 8–12, 1-hour sessions for mild cases; it includes up to 30 sessions of direct service for families in more difficult situations. Sessions generally occur over a 3-month period and can be held in clinical settings as an outpatient therapy model or as a home-based model. In one large-scale study on FFT, which was delivered by community-based therapists, Sexton and Turner (2010) found that when adherence to the FFT model was high, FFT resulted in a significant reduction in felony crimes and violent crimesand a nonsignificant decrease in misdemeanor crimes. In addition, a study by Celinska and colleagues (2013) foundthat FFT had a positive effect on youths in the areas of reducing risk behavior, increasing strengths, and improving functioning across key

      "Functional Family Therapy"

  11. Sep 2022
    1. Diabetes is a condition where the body does not make enough insulin or use the insulin it creates the way it should. As a result, the body isn’t processing food properly to produce energy. Instead, sugars build up in the blood leading to health complications.

      Our team of pediatric experts offers diabetes diagnosis for children and adolescents. If we discover pediatric diabetes, we partner with the right specialists to give your child the best possible treatment. We offer compassionate and trustworthy care that puts both the physical and emotional needs of our pediatric patients at the forefront.

  12. Aug 2022
  13. Apr 2022
    1. Prof. Shane Crotty. (2021, December 8). 3 studies today on antibodies & Omicron. 🔵 There may be a large drop in neutralization of Omicron 🔵 Antibodies stop Omicron well in hybrid immunity (infected+vax) 🔵 Sotrovimab is active versus Omicron Take home: Get vaccinated. Get boosted. Immune system is clever. 🧵 1/n [Tweet]. @profshanecrotty. https://twitter.com/profshanecrotty/status/1468390479280574472

  14. Mar 2022
    1. ReconfigBehSci on Twitter: ‘@STWorg @ProfColinDavis @rpancost @chrisdc77 @syrpis this is the most in depth treatment of the impact of equalities law on pandemic policy that I’ve been able to find- it would seem to underscore that there is a legal need for impact assessments that ask (some) of these questions https://t.co/auiApVC0TW’ / Twitter. (n.d.). Retrieved 22 March 2022, from https://twitter.com/SciBeh/status/1485927221449613314

  15. Feb 2022
    1. Agarwal, A., Rochwerg, B., Lamontagne, F., Siemieniuk, R. A., Agoritsas, T., Askie, L., Lytvyn, L., Leo, Y.-S., Macdonald, H., Zeng, L., Amin, W., Barragan, F. A., Bausch, F. J., Burhan, E., Calfee, C. S., Cecconi, M., Chanda, D., Dat, V. Q., Sutter, A. D., … Vandvik, P. O. (2020). A living WHO guideline on drugs for covid-19. BMJ, 370, m3379. https://doi.org/10.1136/bmj.m3379

    1. Heesakkers, H., van der Hoeven, J. G., Corsten, S., Janssen, I., Ewalds, E., Simons, K. S., Westerhof, B., Rettig, T. C. D., Jacobs, C., van Santen, S., Slooter, A. J. C., van der Woude, M. C. E., van den Boogaard, M., & Zegers, M. (2022). Clinical Outcomes Among Patients With 1-Year Survival Following Intensive Care Unit Treatment for COVID-19. JAMA, 327(6), 559–565. https://doi.org/10.1001/jama.2022.0040

    1. Jonathan Li on Twitter: “There’s a lineage of Omicron that’s gained the R346K mutation (BA.1.1). This one could spell some trouble for the AZ mAb (tixagevimab/cilgavimab, Evusheld) that’s being used for pre-exposure prophylaxis. If you want to learn about tix/cil vs Omicron, read on 1/7” / Twitter. (n.d.). Retrieved February 6, 2022, from https://twitter.com/DrJLi/status/1487479972293853188

  16. Jan 2022
    1. There is currently no role for methylxanthines or chest physical therapy (PT). NIV is the preferred method of ventilatory support and has been shown to improve outcomes in COPD exacerbations

      Methylxanthines and chest PT have no role in COPD exacerbation.

  17. Dec 2021
  18. Nov 2021
  19. Oct 2021
    1. Idea: May be the installation of some permanent implants with micro holes to relieve the pressure(liquid) would help? Does Spray (Oxymetazoline makers, multi-billion business) preventing human to achieve this? Must be as small as possible and multiple implants!

      annotation from my blog on nose congestion treatment.

    1. ICMR drops Ivermectin, Hydroxychloroquine drugs from Covid treatment. (2021, September 24). The Times of India.