tri Neuroimaging Correlates with Clinical Severity in Wilson Disease: A Multiparametric Quantitative Brain MRI [RESEARCH] By www.ajnr.org Published On :: 2024-11-07T15:14:12-08:00 BACKGROUND AND PURPOSE: Previous studies have reported metal accumulation and microstructure changes in deep gray nuclei (DGN) in Wilson disease (WD). However, there are limited studies that investigate whether there is metal accumulation and microstructure changes in DGN of patients with WD with normal-appearing routine MRI. This study aimed to evaluate multiparametric changes in DGN of WD and whether the findings correlate with clinical severity in patients with WD. MATERIALS AND METHODS: The study enrolled 28 patients with WD (19 with neurologic symptoms) and 25 controls. Fractional anisotropy (FA), mean diffusivity (MD), and magnetic susceptibility in globus pallidus, pontine tegmentum, dentate nucleus, red nucleus, head of caudate nucleus, putamen, substantia nigra, and thalamus were extracted. Correlations between imaging data and the Unified Wilson’s Disease Rating Scale (UWDRS) neurologic subitems were explored. RESULTS: FA, MD, and susceptibility values were higher in multiple DGN of patients with WD than controls (P < .05). Patients with WD without abnormal signals in DGN on routine MRI also had higher FA, MD, and susceptibility values than controls (P < .017). We found that UWDRS neurologic subscores correlated with FA and susceptibility values of DGN (P < .05). In addition, we also found that FA and susceptibility values in specific structures correlated with specific neurologic symptoms of WD (ie, tremor, parkinsonism, dysarthria, dystonia, and ataxia) (P < .05). CONCLUSIONS: Patients with WD have increased FA, MD, and susceptibility values even before the lesion is morphologically apparent on routine MRI. The increased FA and susceptibility values correlate with clinical severity of WD. Full Article
tri Automated Volumetric Software in Dementia: Help or Hindrance to the Neuroradiologist? [RESEARCH] By www.ajnr.org Published On :: 2024-11-07T15:14:12-08:00 BACKGROUND AND PURPOSE: Brain atrophy occurs in the late stage of dementia, yet structural MRI is widely used in the work-up. Atrophy patterns can suggest a diagnosis of Alzheimer disease (AD) or frontotemporal dementia (FTD) but are difficult to assess visually. We hypothesized that the availability of a quantitative volumetric brain MRI report would increase neuroradiologists’ accuracy in diagnosing AD, FTD, or healthy controls compared with visual assessment. MATERIALS AND METHODS: Twenty-two patients with AD, 17 with FTD, and 21 cognitively healthy patients were identified from the electronic health systems record and a behavioral neurology clinic. Four neuroradiologists evaluated T1-weighted anatomic MRI studies with and without a volumetric report. Outcome measures were the proportion of correct diagnoses of neurodegenerative disease versus normal aging ("rough accuracy") and AD versus FTD ("exact accuracy"). Generalized linear mixed models were fit to assess whether the use of a volumetric report was associated with higher accuracy, accounting for random effects of within-rater and within-subject variability. Post hoc within-group analysis was performed with multiple comparisons correction. Residualized volumes were tested for an association with the diagnosis using ANOVA. RESULTS: There was no statistically significant effect of the report on overall correct diagnoses. The proportion of "exact" correct diagnoses was higher with the report versus without the report for AD (0.52 versus 0.38) and FTD (0.49 versus 0.32) and lower for cognitively healthy (0.75 versus 0.89). The proportion of "rough" correct diagnoses of neurodegenerative disease was higher with the report than without the report within the AD group (0.59 versus 0.41), and it was similar within the FTD group (0.66 versus 0.63). Post hoc within-group analysis suggested that the report increased the accuracy in AD (OR = 2.77) and decreased the accuracy in cognitively healthy (OR = 0.25). Residualized hippocampal volumes were smaller in AD (mean difference –1.8; multiple comparisons correction, –2.8 to –0.8; P < .001) and FTD (mean difference –1.2; multiple comparisons correction, –2.2 to –0.1; P = .02) compared with cognitively healthy. CONCLUSIONS: The availability of a brain volumetric report did not improve neuroradiologists’ accuracy over visual assessment in diagnosing AD or FTD in this limited sample. Post hoc analysis suggested that the report may have biased readers incorrectly toward a diagnosis of neurodegeneration in cognitively healthy adults. Full Article
tri Stent Retriever AssIsted Lysis Technique with Tirofiban: A Potential Bailout Alternative to Angioplasty and Stenting [CLINICAL PRACTICE] By www.ajnr.org Published On :: 2024-11-07T15:14:12-08:00 BACKGROUND AND PURPOSE: Angioplasty and stent placement have been described as a bailout technique in individuals with failed thrombectomy. We aimed to investigate Stent retriever AssIsted Lysis (SAIL) with tirofiban before angioplasty and stent placement. MATERIALS AND METHODS: Patients from 2 comprehensive stroke centers were reviewed (2020–2023). We included patients with failed thrombectomy and/or underlying intracranial stenosis who received SAIL with tirofiban before the intended angioplasty and stent placement. SAIL consisted of deploying a stent retriever through the occluding lesion to create a bypass channel and infuse 10 mL of tirofiban for 10 minutes either intra-arterially or IV. The stent retriever was re-sheathed before retrieval. The primary end points were successful reperfusion (expanded TICI 2b–3) and symptomatic intracerebral hemorrhage. Additional end points included 90-day mRS 0–2 and mortality. RESULTS: After a median of 3 (interquartile range, 2–4) passes, 44 patients received the SAIL bridging protocol with tirofiban, and later they were considered potential candidates for angioplasty and stent placement bailout (43.2%, intra-arterial SAIL). Post-SAIL successful reperfusion was obtained in 79.5%. A notable residual stenosis (>50%) after successful SAIL was observed in 45.7%. No significant differences were detected according to post-SAIL: successful reperfusion (intra-arterial SAIL, 80.0% versus IV-SAIL, 78.9%; P = .932), significant stenosis (33.3% versus 55.0%; P = .203), early symptomatic re-occlusion (0% versus 8.0%; P = .207), or symptomatic intracerebral hemorrhage (5.3% versus 8.0%; P = .721). Rescue angioplasty and stent placement were finally performed in 15 (34.1%) patients (intra-arterial SAIL 21.0% versus IV-SAIL 44%; P = .112). At 90 days, mRS 0–2 (intra-arterial SAIL 50.0% versus IV-SAIL 43.5%; P = .086) and mortality (26.3% versus 12.0%; P = .223) were also similar. CONCLUSIONS: In patients with stroke in which angioplasty and stent placement are considered, SAIL with tirofiban, either intra-arterial or IV, seems to safely induce sustained recanalization, offering a potential alternative to definitive angioplasty and stent placement. Full Article
tri High-Resolution MRA Cerebrovascular Findings in a Tri-Ethnic Population [CLINICAL PRACTICE] By www.ajnr.org Published On :: 2024-11-07T15:14:12-08:00 BACKGROUND AND PURPOSE: Incidental findings on brain MRI and variations of the circle of Willis (CoW) are relatively common among the general population. Ethnic differences have been described before, but few studies have explored the prevalence of incidental intracranial cerebrovascular findings and CoW variants in the setting of a single multiethnic cohort. The purpose of this investigation was to describe both incidental cerebrovascular findings and the morphology of the CoW on high-resolution 3T TOF-MRA in a UK tri-ethnic population-based cohort and to present updated prevalence estimates and morphologic reference values. MATERIALS AND METHODS: We studied participants from the UK Southall and Brent REvisited study who underwent 3T brain MRI between 2014 and 2018. TOF-MRA images were assessed for the presence of incidental cerebrovascular findings and used to determine CoW anatomy. RESULTS: Seven hundred fifty participants (mean age, 71.28 [SD, 6.46] years; range, 46–90 years; 337 women), 322 White Europeans, 253 South Asians, and 175 African Caribbeans were included. Incidental cerebrovascular findings were observed in 84 subjects (11.2%, 95% CI, 9.0%–13.7%; 36 women; 42.86%, 95% CI, 32.11%–54.12%), with cerebral aneurysms being the most frequent followed by intracranial arterial stenoses with the highest prevalence among South Asians compared with White European (OR: 2.72; 95% CI, 1.22–6.08; P = .015) and African Caribbean subjects (OR: 2.79; 95% CI, 1.00–7.82; P = .051). Other findings included arteriovenous malformations and infundibula. The CoW was found to be more often complete in women than in men (25.22% compared with 18.41%, P = .024) and in African Caribbean (34.86%) compared with White European (19.19%) and South Asian (14.23%) subjects (P < .001 each). CONCLUSIONS: Intracranial arterial stenoses were independently associated with ethnicity after adjusting for vascular risk factors, having the highest prevalence among South Asians. The prevalence of aneurysms was higher than that in previous population-based studies. We observed anatomic differences in the CoW configuration among women, men, and ethnicities. Full Article
tri Artificial Intelligence Efficacy as a Function of Trainee Interpreter Proficiency: Lessons from a Randomized Controlled Trial [RESEARCH] By www.ajnr.org Published On :: 2024-11-07T15:14:12-08:00 BACKGROUND AND PURPOSE: Recently, artificial intelligence tools have been deployed with increasing speed in educational and clinical settings. However, the use of artificial intelligence by trainees across different levels of experience has not been well-studied. This study investigates the impact of artificial intelligence assistance on the diagnostic accuracy for intracranial hemorrhage and large-vessel occlusion by medical students and resident trainees. MATERIALS AND METHODS: This prospective study was conducted between March 2023 and October 2023. Medical students and resident trainees were asked to identify intracranial hemorrhage and large-vessel occlusion in 100 noncontrast head CTs and 100 head CTAs, respectively. One group received diagnostic aid simulating artificial intelligence for intracranial hemorrhage only (n = 26); the other, for large-vessel occlusion only (n = 28). Primary outcomes included accuracy, sensitivity, and specificity for intracranial hemorrhage/large-vessel occlusion detection without and with aid. Study interpretation time was a secondary outcome. Individual responses were pooled and analyzed with the t test; differences in continuous variables were assessed with ANOVA. RESULTS: Forty-eight participants completed the study, generating 10,779 intracranial hemorrhage or large-vessel occlusion interpretations. With diagnostic aid, medical student accuracy improved 11.0 points (P < .001) and resident trainee accuracy showed no significant change. Intracranial hemorrhage interpretation time increased with diagnostic aid for both groups (P < .001), while large-vessel occlusion interpretation time decreased for medical students (P < .001). Despite worse performance in the detection of the smallest-versus-largest hemorrhages at baseline, medical students were not more likely to accept a true-positive artificial intelligence result for these more difficult tasks. Both groups were considerably less accurate when disagreeing with the artificial intelligence or when supplied with an incorrect artificial intelligence result. CONCLUSIONS: This study demonstrated greater improvement in diagnostic accuracy with artificial intelligence for medical students compared with resident trainees. However, medical students were less likely than resident trainees to overrule incorrect artificial intelligence interpretations and were less accurate, even with diagnostic aid, than the artificial intelligence was by itself. Full Article
tri Distribution and Disparities of Industry Payments to Neuroradiologists [CLINICAL PRACTICE] By www.ajnr.org Published On :: 2024-11-07T15:14:12-08:00 BACKGROUND AND PURPOSE: Physician-industry relationships can be useful for driving innovation and technologic progress, though little is known about the scale or impact of industry involvement in neuroradiology. The purpose of this study was to assess the trends and distributions of industry payments to neuroradiologists. MATERIALS AND METHODS: Neuroradiologists were identified using a previously-validated method based on Work Relative Value Units and Neiman Imaging Types of Service classification. Data on payments from industry were obtained from the Open Payments database from the Centers for Medicare & Medicaid Services, from 2016 to 2021. Payments were grouped into 7 categories, including consulting fees, education, gifts, medical supplies, research, royalties/ownership, and speaker fees. Descriptive statistics were calculated. RESULTS: A total of 3019 neuroradiologists were identified in this study. Between 2016 and 2021, 48% (1440/3019) received at least 1 payment from industry, amounting to a total number of 21,967 payments. Each year, among those receiving payments from industry, each unique neuroradiologist received between a mean of 5.49–7.42 payments and a median of 2 payments, indicating a strong rightward skew to the distribution of payments. Gifts were the most frequent payment type made (60%, 13,285/21,967) but accounted for only 4.1% ($689,859/$17,010,546) of payment value. The greatest aggregate payment value came from speaker fees, which made up 36% ($6,127,484/$17,010,546) of the total payment value. The top 5% highest paid neuroradiologists received 42% (9133/21,967) of payments, which accounted for 84% ($14,284,120/$17,010,546) of the total dollar value. Since the start of the coronavirus 2019 (COVID-19) pandemic, the number of neuroradiologists receiving industry payments decreased from a mean of 671 neuroradiologists per year prepandemic (2016–2019) to 411 in the postpandemic (2020–2021) era (P = .030). The total number of payments to neuroradiologists decreased from 4177 per year prepandemic versus 2631 per year postpandemic (P = .011). CONCLUSIONS: Industry payments to neuroradiologists are highly concentrated among top earners, particularly among the top 5% of payment recipients. The number of payments decreased during the COVID-19 pandemic, though the dollar value of payments was offset by coincidental increases in royalty payments. Further investigation is needed in subsequent years to determine if the postpandemic changes in industry payment trends continue. Full Article
tri Deep molecular tracking over the 12-yr development of endometrial cancer from hyperplasia in a single patient [RESEARCH REPORT] By molecularcasestudies.cshlp.org Published On :: 2024-01-10T08:13:38-08:00 Although the progressive histologic steps leading to endometrial cancer (EndoCA), the most common female reproductive tract malignancy, from endometrial hyperplasia are well-established, the molecular changes accompanying this malignant transformation in a single patient have never been described. We had the unique opportunity to investigate the paired histologic and molecular features associated with the 12-yr development of EndoCA in a postmenopausal female who could not undergo hysterectomy and instead underwent progesterone treatment. Using a specially designed 58-gene next-generation sequencing panel, we analyzed a total of 10 sequential biopsy samples collected over this time frame. A total of eight pathogenic/likely pathogenic mutations in seven genes, APC, ARID1A, CTNNB1, CDKN2A, KRAS, PTEN, and TP53, were identified. A PTEN nonsense mutation p.W111* was present in all samples analyzed except histologically normal endometrium. Apart from this PTEN mutation, the only other recurrent mutation was KRAS G12D, which was present in six biopsy samplings, including histologically normal tissue obtained at the patient's first visit but not detectable in the cancer. The PTEN p.W111* mutant allele fractions were lowest in benign, inactive endometrial glands (0.7%), highest in adenocarcinoma (36.9%), and, notably, were always markedly reduced following progesterone treatment. To our knowledge, this report provides the first molecular characterization of EndoCA development in a single patient. A single PTEN mutation was present throughout the 12 years of cancer development. Importantly, and with potential significance toward medical and nonsurgical management of EndoCA, progesterone treatments were consistently noted to markedly decrease PTEN mutant allele fractions to precancerous levels. Full Article
tri The importance of escalating molecular diagnostics in patients with low-grade pediatric brain cancer [PRECISION MEDICINE IN PRACTICE] By molecularcasestudies.cshlp.org Published On :: 2024-01-10T08:13:38-08:00 Pilocytic astrocytomas are the most common pediatric brain tumors, typically presenting as low-grade neoplasms. We report two cases of pilocytic astrocytoma with atypical tumor progression. Case 1 involves a 12-yr-old boy with an unresectable suprasellar tumor, negative for BRAF rearrangement but harboring a BRAF p.V600E mutation. He experienced tumor size reduction and stable disease following dabrafenib treatment. Case 2 describes a 6-yr-old boy with a thalamic tumor that underwent multiple resections, with no actionable driver detected using targeted next-generation sequencing. Whole-genome and RNA-seq analysis identified an internal tandem duplication in FGFR1 and RAS pathway activation. Future management options include FGFR1 inhibitors. These cases demonstrate the importance of escalating molecular diagnostics for pediatric brain cancer, advocating for early reflexing to integrative whole-genome sequencing and transcriptomic profiling when targeted panels are uninformative. Identifying molecular drivers can significantly impact treatment decisions and improve patient outcomes. Full Article
tri Information needs for GPs on type 2 diabetes in Western countries: a systematic review By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 BackgroundMost people with type 2 diabetes receive treatment in primary care by GPs who are not specialised in diabetes. Thus, it is important to uncover the most essential information needs regarding type 2 diabetes in general practice.AimTo identify information needs related to type 2 diabetes for GPs.Design and settingSystematic review focused on literature relating to Western countries.MethodMEDLINE, Embase, PsycInfo and CINAHL were searched from inception to January 2024. Two researchers conducted the selection process, and citation searches were performed to identify any relevant articles missed by the database search. Quality appraisal was conducted with the Mixed Methods Appraisal Tool. Meaning units were coded individually, grouped into categories, and then studies were summarised within the context of these categories using narrative synthesis. An evidence map was created to highlight research gaps.ResultsThirty-nine included studies revealed eight main categories and 36 subcategories of information needs. Categories were organised into a comprehensive hierarchical model of information needs, suggesting ‘Knowledge of guidelines’ and ‘Reasons for referral’ as general information needs alongside more specific needs on ‘Medication’, ‘Management’, ‘Complications’, ‘Diagnosis’, ‘Risk factors’, and ‘Screening for diabetes’. The evidence map provides readers with the opportunity to explore the characteristics of the included studies in detail.ConclusionThis systematic review provides GPs, policymakers, and researchers with a hierarchical model of information and educational needs for GPs, and an evidence map showing gaps in the current literature. Information needs about clinical guidelines and reasons for referral to specialised care overlapped with needs for more specific information. Full Article
tri Collaborative discussions between GPs and pharmacists to optimise patient medication: a qualitative study within a UK primary care clinical trial By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 BackgroundThere has been significant investment in pharmacists working in UK general practice to improve the effective and safe use of medicines. However, evidence of how to optimise collaboration between GPs and pharmacists in the context of polypharmacy (multiple medication) is lacking.AimTo explore GP and pharmacist views and experiences of in-person, interprofessional collaborative discussions (IPCDs) as part of a complex intervention to optimise medication use for patients with polypharmacy in general practice.Design and settingA mixed-method process evaluation embedded within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) trial conducted in Bristol and the West Midlands, between February 2021 and September 2023.MethodAudio-recordings of IPCDs between GPs and pharmacists, along with individual semi-structured interviews to explore their reflections on these discussions, were used. All recordings were transcribed verbatim and analysed thematically.ResultsA total of 14 practices took part in the process evaluation from February 2022 to September 2023; 17 IPCD meetings were audio-recorded, discussing 30 patients (range 1–6 patients per meeting). In all, six GPs and 13 pharmacists were interviewed. The IPCD was highly valued by GPs and pharmacists who described benefits, including: strengthening their working relationship; gaining in confidence to manage more complex patients; and learning from each other. It was often challenging, however, to find time for the IPCDs.ConclusionThe model of IPCD used in this study provided protected time for GPs and pharmacists to work together to deliver whole-patient care, with both professions finding this beneficial. Protected time for interprofessional liaison and collaboration, and structured interventions may facilitate improved patient care. Full Article
tri Lack of Knowledge of Antibiotic Risks Contributes to Primary Care Patients Expectations of Antibiotics for Common Symptoms [Research Briefs] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use. We conducted a survey (n = 564) between January 2020 to June 2021 in public and private primary care clinics in Texas to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses. We surveyed Black patients (33%) and Hispanic/Latine patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses. Public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than private clinic patients. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4). Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications. Full Article
tri Family Medicine Obstetrics: Answering the Call [Editorials] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 Full Article
tri [Evolutionary Biology] How Important Is Variation in Extrinsic Reproductive Isolation to the Process of Speciation? By cshperspectives.cshlp.org Published On :: 2024-11-01T06:50:52-07:00 The strength of reproductive isolation (RI) between two or more lineages during the process of speciation can vary by the ecological conditions. However, most speciation research has been limited to studying how ecologically dependent RI varies among a handful of broadly categorized environments. Very few studies consider the variability of RI and its effects on speciation at finer scales—that is, within each environment due to spatial or temporal environmental heterogeneity. Such variation in RI across time and/or space may inhibit speciation through leaky reproductive barriers or promote speciation by facilitating reinforcement. To investigate this overlooked aspect of speciation research, we conducted a literature review of existing studies of variation in RI in the field and then conducted individual-based simulations to examine how variation in hybrid fitness across time and space affects the degree of gene flow. Our simulations indicate that the presence of variation in hybrid fitness across space and time often leads to an increase in gene flow compared to scenarios where hybrid fitness remains static. This observation can be attributed to the convex relationship between the degree of gene flow and the strength of selection on hybrids. Our simulations also show that the effect of variation in RI on facilitating gene flow is most pronounced when RI, on average, is relatively low. This finding suggests that it could serve as an important mechanism to explain why the completion of speciation is often challenging. While direct empirical evidence documenting variation in extrinsic RI is limited, we contend that it is a prevalent yet underexplored phenomenon. We support this argument by proposing common scenarios in which RI is likely to exhibit variability and thus influence the process of speciation. Full Article
tri The CheckMate 816 trial: a milestone in neoadjuvant chemoimmunotherapy of nonsmall cell lung cancer By breathe.ersjournals.com Published On :: 2024-11-12T00:25:08-08:00 Advancements in immunotherapy in the perioperative setting have revolutionised the treatment of resectable nonsmall cell lung cancer (NSCLC). Here we present the methodology and results of the clinical trial CheckMate 816 demonstrating the benefit of neoadjuvant therapy with nivolumab plus chemotherapy compared with chemotherapy alone. Furthermore, this article discusses the implications for future practice in resectable NSCLC and the need for future research. Full Article
tri ExpressVPN Has Never Been This Cheap: This Trick Can Save You 61% on This VPN By gizmodo.com Published On :: Tue, 12 Nov 2024 23:00:41 +0000 This is not a joke, the subscription to ExpressVPN is at an unprecedented price. We'll tell you everything you need to know so you don't miss out on its Black Friday offer. Full Article Deals
tri Hundreds of thousands of Quebec public sector workers vow further strike action By rabble.ca Published On :: Mon, 06 Nov 2023 21:23:15 +0000 With 420,000 Quebec public sector workers on strike on Monday, and with little progress in negotiations, the Front Commun promises further strike action. The post Hundreds of thousands of Quebec public sector workers vow further strike action appeared first on rabble.ca. Full Article Labour Front Commun
tri Hundreds dead after massive truck bomb strikes Mogadishu By www.pbs.org Published On :: Sun, 15 Oct 2017 16:27:49 +0000 Civilians evacuate from the scene of an explosion in KM4 street in the Hodan district of Mogadishu, Somalia October 14, 2017. Photo By Feisal Omar/Reuters At least 231 people were killed and hundreds more wounded after a massive truck bomb on Saturday struck Somalia’s capital city of Mogadishu. The Somali government has blamed the al-Qaida-linked militant group al-Shabab for the attack, and called it the deadliest ever to hit the nation. The blast took place outside the Safari Hotel, where rescue workers dug through the rubble of collapsed buildings overnight in search of survivors. Witnesses described a devastating scene with large-scale carnage, as doctors worked feverishly to attend to the dead and injured, many badly burned. “The hospital is overwhelmed by both dead and wounded,” Dr. Mohamed Yusuf, the director of Medina hospital located near the blast, told the Associated Press. “We also received people whose limbs were cut away by the bomb. This is really horrendous, unlike any other time in the past.” Photos and videos of the bombing, which took place on a busy street near a section of the city housing foreign embassies, showed collapsed walls, twisted metal, and sporadic fires spewing smoke. The Qatari government said its embassy was “severely damaged” in the strike. There should be an embedded item here. Please visit the original post to view it. Family members searched through the wreckage and waited at local hospitals with the hopes of finding relatives who survived the bombing. Somali President Mohamed Abdullahi Mohamed announced three days of mourning. The attacks received international condemnation, including from the United States. The post Hundreds dead after massive truck bomb strikes Mogadishu appeared first on PBS NewsHour. Full Article al-Shabab Mogadishu NewsHour Weekend
tri Nordic-style Open Kindergarten to be trialled in Scotland ahead of potential roll-out By www.heraldscotland.com Published On :: Tue, 12 Nov 2024 00:01:00 +0000 A new Nordic-style Open Kindergarten will be trialled in part of Scotland ahead of a potential roll-out across the country. Full Article
tri Limogate: Neil Gray to address use of ministerial car for football trips By www.heraldscotland.com Published On :: Tue, 12 Nov 2024 16:02:34 +0000 Health Secretary Neil Gray will address concerns around his use of a ministerial car to attend football games at Hampden. Full Article
tri Libraries recognised for community contributions in annual award ceremony By www.heraldscotland.com Published On :: Tue, 12 Nov 2024 16:00:00 +0000 Shetland Library and the National Library of Scotland have been praised for "providing optimist for the future." Full Article
tri RPG Cast – Episode 571: “Hospital Hat Trick” By rpgamer.com Published On :: Sat, 30 Jan 2021 20:18:07 +0000 Anna Marie practices equal opportunity violence. Kelley fawns over Sidon Shark (do do do do). Robert is the destroyer of Vitas. Josh is stress. Chris does some Neo Vision shaming. And Alex wonders why he allows this podcast on the site. The post RPG Cast – Episode 571: “Hospital Hat Trick” appeared first on RPGamer. Full Article News Podcasts RPG Cast Atelier Ryza Dandy Dungeon Dragon Quest Tact Final Fantasy Brave Exvius Hyrule Warriors: Age of Calamity Super Robot Wars T The Legend of Heroes: Trails of Cold Steel IV Vampyr Woodsalt Ys IX
tri RPG Cast – Episode 705: “Trip the Gold Digger” By rpgamer.com Published On :: Sat, 30 Dec 2023 21:07:14 +0000 Kelley's cat decided Christmas was over. Chris is scared to return to Vana'diel and hates Norrath, but is strangely interested in hanging out with river hobbits in Middle Earth. Meanwhile, Phil tries to recruit everyone into his multilevel Monster Hunter scheme. The post RPG Cast – Episode 705: “Trip the Gold Digger” appeared first on RPGamer. Full Article News Podcasts RPG Cast Lord of the Rings Monster Hunter: World Path of Exile Super Mario RPG Remake World of Warcraft
tri Spyro Reignited Trilogy Headed to Xbox Game Pass Tomorrow, November 12 By www.vgchartz.com Published On :: Mon, 11 Nov 2024 16:26:38 GMT Following a tease, Microsoft and Activision Blizzard have announced Spyro Reignited Trilogy will release for Xbox Game Pass tomorrow, November 12. VGChartz staff gave Spyro Reignited Trilogy an 8 out of 10 and stated, "it was wise to steer away from marketing the collection as a remaster because that label undercuts the developers’ level of dedication and investment in revitalizing these games." Read details on the trilogy below: Remade from the ground up, the Spyro Reignited Trilogy features all three of the original games that started it all – Spyro the Dragon, Spyro 2: Ripto’s Rage, and Spyro: Year of the Dragon, amazing for the original fans and new players alike. Spyro the Dragon Our new favorite little purple dragon starts on a quest to rescue his dragon friends who have been turned into crystal by the villain Gnasty Gnorc (what an unfortunate and yet apt name!). Spyro explores vibrant Dragon Realms, collects gems, and flambés his enemies, all while learning to how breathe fire and glide. Spyro 2: Ripto’s Rage! Spyro finds himself in the magical land of Avalar where he is trying to save the realm from the evil sorcerer Ripto and his minions. Along the way, he befriends new entirely new allies, overcomes challenges, complete tasks, and unlocks even more powers to take down Ripto and restore peace. Spyro: Year of the Dragon In Spyro: Year of the Dragon, Spyro finds out that the Dragon Eggs have been stolen by the devious Sorceress, sending him on a new mission to recover the eggs and save the dragon population. Our favorite purple dragon meets new friends, learns new abilities, all while exploring more vibrant realms with challenges (and treasures!). Xbox players have been able to explore the Dragon Realms with Spyro since 2018 with the release of the Reignited Trilogy, and now we’re excited to invite our community to jump into these incredible adventures once again and relive the fun and nostalgia that only Spyro can bring. Available on Game Pass Standard, Game Pass Ultimate, and PC Game Pass, for cloud, console and PC, it’s sure to ignite some serious fun. Let’s go save the Dragon Realms! A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.Full Article - https://www.vgchartz.com/article/463034/spyro-reignited-trilogy-headed-to-xbox-game-pass-tomorrow-november-12/ Full Article Analysis Charts Industry
tri ‘Anora’: The Screwball Stripper Odyssey That Should Win All the Oscars By www.thedailybeast.com Published On :: Thu, 17 Oct 2024 09:00:00 GMT NEONMovies can’t, by definition, be all things to all people, and yet Anora—winner of the Cannes Film Festival’s highest honor, the Palme d’Or—manages to vacillate between assorted registers with stunning, and ultimately affecting, aplomb.Another of The Florida Project and Red Rocket writer/director Sean Baker’s tales of marginalized individuals struggling to survive and find themselves in an often-unforgiving world, the film is a character study, romance, crime saga, screwball comedy, and vérité drama all wrapped into one unique and dexterous package. More impressive than its nimbleness, however, is its poise and empathy, the latter of which is chiefly bestowed upon its protagonist, whose life is thrown for a rollercoaster-grade loop-di-loop thanks to a chance introduction.Ani (Mikey Madison, in a star-making turn) is a Brighton Beach 23-year-old who lives with her sister and earns a living stripping at a local club. Anora, which hits theaters Oct. 18, introduces her at the end of a long pan along a bench where men are receiving lap dances from erotic professionals. Fixating on Ani’s face as she flashes the fake smile that her customers crave and her superiors demand, Baker’s camera creates immediate, intimate engagement with the young woman, and that continues as it presents snapshots of her daily (or, rather, nightly) routine at her place of employment.Read more at The Daily Beast. Full Article
tri The trick to Dragon Age's lore is that the lore is lying, says original "uber-plot" writer David Gaider By www.rockpapershotgun.com Published On :: Thu, 31 Oct 2024 16:48:59 +0000 Part of the fun of Dragon Age's fantasy is that it's inconsistent - or at least, inconsistent by the standards of fantasy RPGs, which often break down into a million neatly organised and interlocking codex entries. It all rides on who you speak to. The humans believe one thing about the origins and workings of Thedas, the elves another, the qunari something else entirely. These differences are the basis for many factional disagreements and thus, many core series plot developments. According to former lead writer David Gaider, however, there's an "uber-plot" behind it all that may one day be resolved and bring the series to a close, assuming BioWare continue to refer to his original (and closely guarded) narrative documents. Read more Full Article Strategy Electronic Arts RPG Dragon Age: The Veilguard Action Adventure Single Player Bioware
tri I am deeply enamoured by Dragon Age: The Veilguard's intricate and ridiculous fashion design By www.rockpapershotgun.com Published On :: Fri, 01 Nov 2024 11:53:53 +0000 Some extremely fresh vintage workwear that I bought for entirely practical reasons aside, I’m not exactly a fashion person. I have nobody to impress most days but my cat, and the only item of clothing she appears to have an opinion on is my Oodie, which is very comfortable for both of us and also smells like a chicken shop, which I imagine is more pleasant for her than me. This aside, I found myself taking a whole bunch of Dragon Age: The Veilguard screenshots as I played just to capture the RPG’s various outfits. They are ridiculous. Incredibly intricate and detailed, as well as being obscenely impractical for the most part. I do not like any of them in the sense I would wear them, but I like all of them in the sense that they display artists allowed to run free like caffeinated weasels and indulge their every whim. Read more Full Article Strategy Electronic Arts RPG Dragon Age: The Veilguard Action Adventure Single Player Bioware
tri Grand Theft Auto: The Definitive Edition trilogy on PC gets a classic lighting update from the mobile version By www.rockpapershotgun.com Published On :: Tue, 12 Nov 2024 13:44:27 +0000 My strongest and most enduring memory of Grand Theft Auto will always be creasing into complete hysterics watching my mate pile into a crumpled police officer with a wooden baseball bat in GTA 3 after school one time. Young’uns these days just don’t appreciate how revolutionary it was to be able to hit a cop with a thing after he’d already fallen over. Suffice it to say I’ve got good memories of the open world series’ nascent forays into 3D, though never enough to tempt me into revisiting them, especially given the poor reception to Grand Theft Auto: The Trilogy - The Definitive Edition. I can sympathise. I’m annoyed just having to type a semicolon and a dash in the same game name. If you’re in a similarly non-fussed position (I will never not be annoyed that ‘nonplussed’ doesn’t mean what it sounds like it should mean) I can’t imagine a lighting update that’s been available on the mobile versions for a while is enough to tempt you back. But what is a reporter's job if not pathetically treading water between chunklets of Grand Theft Auto news, upon the publishing of which Graham presses the button to release the nutritious pellets on which we all wholly subsist? I hope he doesn’t read that last sentence. I don’t get my pellet if the syntax becomes too convoluted. Moving swiftly on. Read more Full Article iOS Android Grand Theft Auto: The Trilogy - The Definitive Edition Nintendo Switch Rockstar Games Third person PS5 PC Simulation RPG Shooter Action Adventure Xbox Series X/S Single Player Xbox One Racing PS4
tri California wine country tries to get back to business despite wildfire destruction By www.pbs.org Published On :: Mon, 16 Oct 2017 22:35:59 +0000 Watch Video | Listen to the AudioJUDY WOODRUFF: Firefighters say they are making some progress battling the wildfires in Northern California. In all, the fires have consumed more than 220,000 acres, an area larger than New York City. More than 5,700 structures have been destroyed. And at least 41 people have died, making it the deadliest wildfire in the state’s history. The wine industry and the tourism business connected with it are trying to take stock. More than $50 billion in California’s economy comes from the wine business. And nearly 24 million people visit the region for that reason every year. Special correspondent Joanne Jennings reports from Napa County. JOANNE JENNINGS, Special Correspondent: The Mayacamas mountain range creates a natural barrier between Sonoma and Napa Counties. And it is here where the massive Nuns fire is posing a tough challenge for some 11,000 firefighters who are taming the blaze with aircraft and units on the ground. CAPT. MARK BRENNERMAN, Viejas fire Department: We’re going around and making sure none of these fires that are still smoldering and smoking, we’re not going to get another big fire out of them. JOANNE JENNINGS: Even as firefighters are battling shifting winds, owners and workers in Wine Country are trying to determine just how much damage has been done. The tony Highlands gated community was among the first to be consumed by flames when the Atlas fire raced through this canyon, leaving several mansions in rubble. Down the hill, at the Silverado resort, charred remnants of the Safeway PGA Tour remain. The major golf event had just wrapped up last Sunday afternoon, a few hours before flames engulfed tents and grandstands, forcing spectators and athletes to evacuate. MAN: Do you see how it burned right up to the retaining wall here? JOANNE JENNINGS: Silverado resident Steve Messina stayed behind and shot video of fire crews containing the flames, which consumed some condos. Within minutes, flames raced three miles down Silverado Trail, home to several storied hillside vineyards. Most wineries in the region have been spared the worst. But hundreds suffered some damage. And at least eight vineyards have been significantly damaged or destroyed. Pierre Birebent, who has been making wines for the family-owned Signorello estate for 20 years, rushed to his winery as quickly as he could. PIERRE BIREBENT, Signorello Estate Vineyards: I jumped right in my truck, came down, and then when I was riding down, I saw the hill all flaming. JOANNE JENNINGS: Two vineyard workers joined him to help save the estate’s tasting room. PIERRE BIREBENT: But the smoke was getting very thick, and the wind was very strong. And after an hour, we couldn’t breathe anymore. At the moment, I was so upset. It was rage to see that I couldn’t do anything. But it was like fighting a giant. JOANNE JENNINGS: The tasting room, which also housed the winery’s office and a dining room, burned to the ground. But Birebent says he wants to focused on what survived. Fortunately, he said, the fire stopped short of reaching the vineyard, the crush pad, or any of the barrels of wine stored on site; 95 percent of this year’s grapes were already picked. But, to be on the safe side, Birebent is taking these samples to a lab to make sure the juice is not too acidic for winemaking. If the crops are OK, a staff of 25 employees will have jobs to return to. As the fires begin to recede and the smoke clears, people here are beginning to wonder when the tourists, who fuel much of the economy, will return. It’s a serious concern for Andrew and Jeni (ph) Schluter, who are self-employed and are raising a young family. ANDREW SCHLUTER, Andrew’s Tours and Transportation: I do wine tours and transportation for people. And my business started to do really, really well. I was on track to have the best month ever. JOANNE JENNINGS: Andrew just bought this new SUV, which has been idle in his driveway collecting ash. Jeni is a personal trainer and has family who lost their homes in the fires. She’s just not sure how they’re going to make ends meet. WOMAN: I think we’re just overwhelmed, you know? And uncertainty is kind of scary. ANDREW SCHLUTER: We will hopefully get by for awhile, but we might make — have to make some hard decisions shortly. JOANNE JENNINGS: While fires burn nearby, some vineyards are already open to tourists. At the Raymond Vineyard, workers are crushing grapes at a feverish pitch. The tasting room is open for the first time since the fires started. Jeremy and Erika Moore arrived from Tennessee yesterday. They considered canceling their trip, but decided the best way they could help people here is to give them their business. JEREMY MOORE, Tourist: On the one hand, a few hundred yards from here, you can see them shuttling up with the helicopters fighting fires, but then here it’s beautiful. They are doing some great tastings, and they are working outside on the crops. So, it’s a weird combination of tragedy, but then at the same time business must go on, too. JOANNE JENNINGS: Proprietor Jean-Charles Boisset owns several wineries in California, France and Canada, but like many other people here, he and his family had to evacuate their home when the flames came dangerously close. Still, he is bullish about the future of the wine industry in this region. JEAN-CHARLES BOISSET, Boisset Collection: Napa has been one of the most amazing agricultural places in California for a long time, so it will survive those fires. What I love, as a Frenchman here in California, is that amazing American positive attitude. We will recover. We will walk again, run again, and we will welcome all our guests and give them the dreams of fine wine. JOANNE JENNINGS: For the PBS NewsHour, I’m Joanne Jennings in Napa Valley, California. The post California wine country tries to get back to business despite wildfire destruction appeared first on PBS NewsHour. Full Article california wildfires napa county wildfires
tri What preparing for an asteroid strike teaches us about climate change By www.newscientist.com Published On :: Wed, 06 Nov 2024 18:00:00 +0000 Averting an asteroid strike will need many of the same skills we must hone to tackle climate change and future pandemics Full Article
tri A simple driving trick could make a big dent in cars' carbon emissions By www.newscientist.com Published On :: Mon, 26 Aug 2024 20:41:29 +0100 An AI-powered model found that approaching intersections more slowly could lower yearly US carbon emissions by up to around 123 million tonnes Full Article
tri Electric vehicles race combustion cars in 'battle of technologies' By www.newscientist.com Published On :: Thu, 12 Sep 2024 09:00:23 +0100 ‘Battle of Technologies’ sees electric vehicles and combustion cars compete at the highest level. Who will win? Full Article
tri Terminator is back, in a striking but flawed anime version By www.newscientist.com Published On :: Wed, 18 Sep 2024 19:00:00 +0100 We're trying to avert Judgment Day yet again – this time in an anime series for Netflix. But striking visuals can't make up for shortcomings in narrative and character development Full Article
tri Writing backwards can trick an AI into providing a bomb recipe By www.newscientist.com Published On :: Fri, 18 Oct 2024 16:22:57 +0100 AI models have safeguards in place to prevent them creating dangerous or illegal output, but a range of jailbreaks have been found to evade them. Now researchers show that writing backwards can trick AI models into revealing bomb-making instructions. Full Article
tri AI helps driverless cars predict how unseen pedestrians may move By www.newscientist.com Published On :: Tue, 29 Oct 2024 14:00:19 +0000 A specialised algorithm could help autonomous vehicles track hidden objects, such as a pedestrian, a bicycle or another vehicle concealed behind a parked car Full Article
tri Slick trick separates oil and water with 99.9 per cent purity By www.newscientist.com Published On :: Thu, 07 Nov 2024 19:00:11 +0000 Oil and water can be separated efficiently by pumping the mixture through thin channels between two semipermeable membranes Full Article
tri Gary Lineker 'strikes new BBC agreement' after Match of the Day exit confirmed By www.express.co.uk Published On :: Tue, 12 Nov 2024 20:21:00 +0000 Match of the Day presenter Gary Lineker has sealed a new agreement with the BBC just hours after his exit was confirmed. Full Article Football
tri Rockstar finally patches GTA Trilogy with fixes after a little help from Netflix By www.dailystar.co.uk Published On :: Tue, 12 Nov 2024 17:21:07 +0000 If you wanted to return to GTA Trilogy, now might be the best time as the game has finally got an update after three years which makes it closer to the much better mobile version Full Article Gaming
tri Electric vehicles could save thousands of lives by reducing pollution, new study finds By www.cbc.ca Published On :: Fri, 15 Sep 2023 15:24:33 EDT Researchers calculated that if 30 per cent of vehicles in Chicago currently running on combustion engines were converted to electric, the reduction in pollution would save billions in health care costs every year. Full Article Radio/Quirks & Quarks
tri This pediatrician has a stark warning about the risks of 'anti-science' By www.cbc.ca Published On :: Tue, 19 Sep 2023 04:00:00 EDT A pediatrician, author and co-inventor of a low-cost COVID-19 vaccine warns that the anti-vaccine movement has morphed into a political force that threatens the world's gains against deadly childhood infections like measles. Full Article News/Health
tri Trump eyes major Day One moves on the border, energy production, electric vehicles and more By www.washingtontimes.com Published On :: Tue, 12 Nov 2024 16:08:12 -0500 President-elect Donald Trump vowed on his first day in office to sign an executive order that seeks to end birthright citizenship for the children of illegal immigrants and kick-start the largest deportation effort in the nation's history. Full Article
tri Republican Rep. David Valadao wins reelection in heavily Democratic California district By www.washingtontimes.com Published On :: Tue, 12 Nov 2024 21:39:04 -0500 Republican Rep. David Valadao has won reelection in California's 22nd Congressional District, defeating Democrat Rudy Salas for the second time. Full Article
tri Harry Kane: England World Cup hero favourite to win Golden Boot after Panama hat-trick By www.sport.co.uk Published On :: Sun, 24 Jun 2018 11:25:00 +0000 HARRY KANE is now the clear favourite to win the World Cup Golden Boot after his hat-trick against Panama.. Full Article
tri Rules covering sport's 'crown jewels' poised for revamp to protect BBC and terrestrial TV channels By www.telegraph.co.uk Published On :: Wed, 27 Apr 2022 21:30:00 GMT Full Article topics:organisations/bbc topics:organisations/itv topics:organisations/channel-4 topics:organisations/channel-5 topics:events/qatar-world-cup-2022 structure:sport storytype:standard
tri Contrite Adam Peaty fights back to win Commonwealth Games gold after ‘disrespect’ controversy By www.telegraph.co.uk Published On :: Tue, 02 Aug 2022 21:09:17 GMT Adam Peaty is right about Commonwealths not being the pinnacle Peaty accused of disrespecting Games after roaring into 50m final British Cycling ‘confident’ they can replace Kenny if she retires Englishman Jake Jarman wins fourth gymnastics gold medal Daily Games schedule – plus key events to watch out for ]]> Full Article topics:events/commonwealth-games structure:sport topics:events/birmingham-commonwealth-games-2022 topics:people/adam-peaty
tri England women stripped of relay title after men’s 4x100 metres team land Commonwealth Games gold By www.telegraph.co.uk Published On :: Sun, 07 Aug 2022 15:45:42 GMT England 'swing' brings Commonwealth hockey gold home Laura Muir bounces back to win 1,500m on a golden night Delicious Orie hopes to follow in Anthony Johsua's footsteps Geraint Thomas unable to regain title in final Wales outing ]]> Full Article topics:events/commonwealth-games structure:sport topics:events/birmingham-commonwealth-games-2022 topics:places/birmingham storytype:standard
tri Hashtag Trending Mar.1- HP debacle; Humanoid robots closer to hitting our workplaces; Apple blew $10 billion on the electric car before pulling the plug By www.itbusiness.ca Published On :: Fri, 01 Mar 2024 12:47:41 +0000 If rumours are true and this one should be, I started it, we have a special edition of the Weekend show where we talk about the evolution of the role of the CIO with two incredible CIOs as the CIO Association of Canada turns 20. Don’t miss it. MUSIC UP Can HP make you love […] The post Hashtag Trending Mar.1- HP debacle; Humanoid robots closer to hitting our workplaces; Apple blew $10 billion on the electric car before pulling the plug first appeared on ITBusiness.ca. Full Article Podcasts AI Apple hashtag trending HP humanoid robots podcasts
tri Mum-of-four who died in Manchester house fire named as heartbreaking tributes pour in By www.express.co.uk Published On :: Tue, 12 Nov 2024 20:28:00 +0000 A mum-of-four was tragically found dead at her home following a fire. Full Article UK
tri G.Skill announces Trident Z5 DDR5-6600 32GB memory kits By www.bit-tech.net Published On :: Thu, 21 Oct 2021 10:00:00 +0000 Claims they are the world's fastest DDR5 memory kits, offer CL36-36-36-76 timings. Full Article
tri Most detailed map of uterine lining yields clues about endometriosis By www.newscientist.com Published On :: Tue, 03 Sep 2024 23:10:55 +0100 An intricate atlas of the inner lining of the uterus could help researchers better understand conditions like endometriosis, infertility and abnormal menstruation Full Article
tri Most effective migraine drugs revealed by review of trial data By www.newscientist.com Published On :: Thu, 19 Sep 2024 16:12:20 +0100 A meta-analysis of 137 clinical trials finds triptan drugs are among the most effective for treating migraines, while newer ditan and gepant drugs were rated less highly Full Article