Erdene Resource Development Co. (TSE:ERD - Get Free Report)'s stock price passed above its 50 day moving average during trading on Friday The stock has a 50 day moving average of C$0.79 and traded as high as C$0.88 Erdene Resource Development shares last traded at C$0.87 The business's 50 day simple moving average is C$0.79 and its two-hundred day simple moving average is C$0.68 The firm has a market capitalization of C$307.37 million Director David Vaughn Mosher sold 200,000 shares of Erdene Resource Development stock in a transaction on Monday The shares were sold at an average price of C$0.82 acquired 400,000 shares of the business's stock in a transaction dated Monday The shares were acquired at an average cost of C$0.65 per share insiders bought 2,685,500 shares of company stock worth $2,022,378 MarketBeat keeps track of Wall Street's top-rated and best performing research analysts and the stocks they recommend to their clients on a daily basis. MarketBeat has identified the five stocks that top analysts are quietly whispering to their clients to buy now before the broader market catches on.. and Erdene Resource Development wasn't on the list While Erdene Resource Development currently has a Hold rating among analysts top-rated analysts believe these five stocks are better buys View The Five Stocks Here Sign up for MarketBeat All Access to gain access to MarketBeat's full suite of research tools Thousands of incidents occur each year in which oil or chemicals are released into the environment as a result of accidents or natural disasters Spills into our coastal waters and inland waterways the environment and the economies on which we rely causing substantial disruption of marine transportation with potential widespread economic impacts When spills occur, NOAA Scientific Support Coordinators (SSCs) coordinate scientific information and provide critical information to the FOSC. A multidisciplinary team of scientists, including oceanographers, modelers, biologists, chemists, and geologists support the SSCs during spill events as well as for drills, exercises, and contingency planning. SSCs are strategically located around the country effectively providing local services to a range of users in public and private sectors and provides expertise on issues such as dispersant use ERD has responded to virtually every major marine spill in the U.S ERD's expertise is frequently sought internationally While oil and chemical spills are the major focus ERD also provides support for incidents such as downed aircraft The Emergency Response Division typically responds to 150 incidents annually. News, photos, and other information about current and historical spill incidents is available at OR&R's IncidentNews site field-oriented job aids to assist preparedness for response communities NOAA provides standard techniques for observing oil and evaluating and selecting cleanup technologies that have been widely accepted by response agencies Some of ERD's more widely distributed products: Each year, ERD provides training to approximately 1,000 individuals in industry and government on the scientific aspects of oil and chemical spill response The goal of ERD training is to transfer scientific expertise and experience to the broadest possible audience Successful training promotes more efficient planning and spill response History of oil spill response at NOAA: In the days and weeks following the grounding and spill from the tanker Argo Merchant on December 15 NOAA began its first major coordinated oil spill response activity From the Beginning: The 40 Year History of NOAA’s Emergency Response Division: An International Oil Spill Conference Proceedings (2017) article authored by OR&R staff Chart for Erdene Resource Development Corporation (ERD:CA) Providing the latest insights and updates for stock traders across Canada data models consisting of multiple tables are almost always essential we’re excited to announce the public preview of a brand-new data experience that simplifies working with complex data models in an Entity Relationship Diagram (ERD) view with the assistance of Copilot This innovative feature allows you to seamlessly work with data from a variety of sources all through a simple drag-and-drop interface akin to how you currently interact with app visuals ready to handle the tedious and repetitive tasks such as populating sample data freeing you up to focus on creativity and strategy a single sentence can be transformed into a comprehensive multi-table data model complete with a Copilot-ready business app streamlining your workflow like never before The feature is currently available in English. To access it, simply enable Copilot (preview) features for your environment go to the Power Apps home page and turn on the ‘Try the new data experience’ toggle the new data experience can be accessed through various entry points it’s available anywhere you can create new tables today offering a seamless integration into your workflow The new data experience now enables you to interact with multiple tables in an ERD view through intuitive drag-and-drop actions This visual ERD framework allows for a clear understanding of how your tables interconnect to form a robust data model it simplifies table and relationship management empowers you to establish relationships between tables with just a few clicks You now have the power to create tables from a variety of sources, including natural language, Excel files, SharePoint lists, or from the ground up. Effortlessly establish relationships between these tables and observe as they amalgamate into a singular, comprehensive data model. This integration not only simplifies data management, but also provides a holistic view of your data ecosystem, enabling the creation of more meaningful business apps. You can create tables by simply describing them. Whether you need one table or multiple, Copilot will generate the necessary tables along with relationships based on your instructions. Specify the number of columns for each table, and whether you want relationships included when requesting a multi-table data model. Copilot takes your configurations and turns them into reality. You can also bring your own data by importing from external sources such as Excel or SharePoint lists. Copilot streamlines the setup by recommending table names, descriptions, column data types and formats, as well as column headers, tailored to the data you upload. After the import, you’ll have the opportunity to review and tweak the tables, ensuring they accurately reflect your data and serve your needs effectively. Copilot is ready to assist you with a wide array of tasks beyond just creating tables. It can populate your tables with sample data: Suggest and create new columns for your table: Or even help you establish relationships between any two tables: These capabilities extend to tables created from all sources, ensuring a fully Copilot-powered experience for managing your data model. To get started, select ‘View prompts’ and explore the predefined Copilot prompts that can help bootstrap your data model. Data shows Microsoft Power Platform improves business outcomes. Accelerate innovation and reduce costs as you analyze data, automate processes, and build apps, websites, and agents with Power Platform. Levy explained that he tends to think of his shows like films. “The runway isn’t spiritually fulfilling enough,” he said, noting that the film aspect only came in after long weeks in the studio putting together a collection that could easily have included a beloved character or two. Influences included the Viennese Succession, art brut, primitive art, and a love of jewelry—the designer wears lots—from the ornate silver belt with a pin closure on look 1 to a doctor bag in box leather set with a Patek Philippe watch. Vivienne Westwood Fall 2025 Ready-to-Wear Maison Rabih Kayrouz Fall 2025 Ready-to-Wear Tonight, we may see two worlds collide Is this the end of the large sales areas as we knew them? But would they really want to go? Ready, set, bet! On this occasion, we spoke with street artist Davide Vavalà China focuses on in transit shopping From Instagram sponsorship to million-dollar ads In Italy, there are figures embodying this vision, yet the fashion industry continues to overlook them The example of four emerging brands that challenge convention The brand new leather good from the French fashion house in the colours of Indian summer Following in the footsteps of Léna Situations, Mister V, Amixem and Andie Ella, Squeezie is now launching his new brand From Dubai to Brignoles, the revenge of a forgotten fruit From those for the pope's funeral to those for the inauguration of a government, to simple toasts The US President's attempt to save Hollywood passes, not surprisingly, through duties Which promises to reveal the whole truth about the rapper's famous “parties” Between bad experiences and a few too many statements about Anna Wintour And why it is important to constantly update your bio While in Italy university graduates are seeking their fortune abroad, US researchers are fleeing from Trump From May the 2nd to 4th Its two co-founders tell us why you should apply to it Interview with Samuel Ross Interview with Willy Chavarria Interview with Louis Gabriel Nouchi Interview with Mowalola Interview with Marni’s Francesco Risso Interview with Jean-Charles de Castelbajac Interview with Byredo’s Ben Gorham Interview with Ottolinger Interview with Massimo Giorgetti Beyond the traditional realms of fashion The eight finalists tell their stories A record year at the competition for young designers in Trieste The Chinese designer debuted at Milan Fashion Week with the support of Dolce&Gabbana Fashion might have forgotten the art of fantasy, but the Shanghai-based designer hasn’t Interview with Hillary Taymour, founder and creative director of Collina Strada The collab between Napapijri and PDF by Domenico Formichetti was the first chapter of a new way of making fashion Interview with the PROTOTYPES Duo Y2K satire by Shukri Lawrence and Omar Braika in collaboration with Barragàn The Danish brand that questions contemporary manufacturing When personalisation and durability come together in your virtual dressing room, and not only The cage, a metaphor for the alienation that drives the individual in the bleak postmodern landscape is a theme that has entered the imagination of Henri Alexander for some time now A symbol that soon became an obsession in the mind of the Atlanta-born designer who chose to transform the Parisian headquarters of Sotheby’s, the world's most renowned auction house, into the set of The Experiment by installing a series of cages - a simplified version of the “stainless steel (synthesizer) prison unit” launched by the brand last March - to present the SS25 collection of Enfants Riches Déprimés a borderline play of contrasts gave voice to the most explicit paradox generating a sort of perverse short circuit: rich kids criticizing capitalism through clothes that only equally rich kids can afford In a room with violet-toned marble walls and cream-colored carpet Alexander said about the collection: «Everything for me is very personal I choose everything day by day as I work on the collection with fictitious guards shaving the prisoners' heads the collection alternated structured tailoring suits and loden coats with lamé sweaters and crotch-hugging shorts accompanied by latex gloves and leg warmers becomes the voice of this macabre exploration of forced assimilation and silent oppression that underlies modern existence Trench coats made by layering belts with jingling silver straps gave way to the fetishism of jumpsuits a play of domination culminating in an homage to Steven Shainberg’s Secretary could only use her lips to perform her office duties To enrich the narrative or perhaps to confuse us further in a dense game of references, young baronets with deliberately emaciated faces strutted in their frayed pastel-toned culottes a light blue dress paired with pointed slippers evoking Sofia Coppola’s punk court of Marie Antoinette we found a cream silk dress with trompe d’oeil lingerie details paired with the brand’s now-characteristic towering platforms before yielding the stage to Renata Litvinova a well-known fashion figure and close friend of the Gvasalia brothers and Lotta Volkova When asked if there was a more literal and autobiographical meaning behind the extensive use of cages in constructing the narrative around the collection Alexander laughed: «I think my brand is really based on repression but I don’t necessarily do things for some hidden meaning I have a feeling that drives me to do something I’m sure there could be some sort of psychoanalytic exploration» One thing is certain: the designer has sublimated a past made of Swiss boarding schools and rehab centers into an imagery for “elite punks” that over the years has been enriched with DIY biker jackets costing $7,000 sweaters with decadent illustrations of Lou Reed or characters from Hugo’s Les Misérables torn tees emblazoned with the Le Rosey crest both the brand and Alexander himself have acquired a new awareness pushing the design towards an increasingly elevated tailoring mastery and building a clear narrative around the themes that ERD’s work questions the self-imposed slavery we maintain while pursuing autonomy and success creating a collection that is a meta-reflection on the false idols that drive our frantic search for self-determination Get access to exclusive contents and keep yourself updated Get access to exclusive contents and keep yourself updated Select the topics in which you are interested: Every month a newsletter to receive updates from our creative media agency So you don't miss the chance to attend nss world events Every month the latest news from the French vertical of nss There are a lot of optics on the market these days, and what’s out there can be overwhelming. It’s easy to get into the rut of just sticking with the big three or four brands you’re familiar with, but you’d be missing out if you do. There are some great optics from companies that you may not know yet and the ERD-1 from C&H Precision is probably one of them I’d been seeing C&H optics pop up in my social media feed for a while now and decided to take a closer look. The optic I picked up for review is their ERD-1 enclosed optic designed for rifle and carbine use the ERD-1 has a square window which gives you more viewing area It uses a red 2 MOA dot surrounded by a 56 MOA circle but also has a selectable multi-reticle if you want other options.The ERD-1 uses a single CR 2032 3V Lithium battery you aren’t going to be swapping batteries in this one very often There are 10 brightness settings including 2 night vision levels.  One of the things that intrigued me about the ERD-1 was that it appeared to be a very rugged build CNC machined body and is both shockproof and waterproof which is good for 1 meter submersion for up to 30 minutes.  It mounts to a Picatinny rail through the use of four bolts Solid is an understatement when you have the ERD-1 locked on to your rail I got the ERD-1 just in time to work with the MEAN Arms Bearing Delay Upper mounted on my SIG M400 lower The MEAN is a slick 9mm set up designed to be a drop in 9mm conversion for your rifle caliber lower although you are cranking down four screws instead of the usual two the ERD-1 almost seems like a monolithic feature of the upper It isn’t going anywhere once its secured to your rail Not that you’ll have to do that often with the ERD’s battery life and shake awake feature anyway I’m still old school I guess and don’t always trust the shake awake system It seems to work quite well on the ERD-1 though even after it had been sitting days between use the sight was on by the time I put the gun to my shoulder but the on works as soon as any movement is detected.  and it’s easy to see through the big 27.5 x 36mm window The circle-dot reticle was easy to pick up and the brightness setting range was more than enough to accommodate even bright summer sun on the range The windage and elevation knobs are well marked in 1 MOA per click adjustments. I’ve used the term easy a lot so far It’s solid and well thought out and things performed as they should I’m a fan of things that don’t need fidgeting with to do their job If you want to try the other reticle options on the ERD-1 Just hold in on the “+” button and the reticle will blink then switch to the next setting Let up on the button to confirm your choice just a circle with no dot or the dot and circle reticle Especially on the MEAN Bearing Delay Upper so I also tried the ERD-1 out on my Aero Precision .308 SBR Re-sighting in from the 9mm to the .308 was again quick and uneventful I didn’t run thousands of rounds through the Aero The ERD-1 was unaffected and held zero without issue With its rugged mount I think it might find a permanent home on the .308 especially if I pair it up with a magnifier Overall I used the ERD-1 throughout the summer and into early fall and probably have put 1,000 or so rounds of 9mm and .308 through two different platforms using it It’s held zero without issue and has performed well in lighting conditions ranging from bright summer sun to dusk Temperature ranges were from the high 90s to the mid 50s just your typical Western Pennsylvania weather for this time of year It rolled around in the back of the Jeep without a case on a few trips and had a couple spills where it was knocked over in my shop and at the range just normal use with the occasional bobble but it’s withstood all of that just fine 10 Levels of brightness (1&2 are night vision compatible)Motion Control (shake awake)Shockproof (Rated for All rifle ammo)Waterproof (ipx7 Check out Ammo To Go, the ammunition retail sponsor of TTAG Product and gun reviews are performed independently and product mentions made based on the quality of the product and value of interest to gun owners we may earn a commission to help support the costs of operating the site and keeping it free for our visitors Every firearm dot optic on the market today no matter if they are stamped Made in USA or not no matter if the supply or manufacturing company is US based or not contains parts or materials that originated in China even if those parts or materials were sourced in the U.S or from another country not China or it says ‘made in Taiwan’ or some other country But sure sits up high for any application other than an AR… and doesn’t appear to have any mount height adjustability As an aside I just came back from a charity Outlaw pistol match out in by the Chatham County Sheriff’s Dept CNH is local to Savannah and they donated 6 optics (5 pistol and website in this browser for the next time I comment Δdocument.getElementById( "ak_js_1" ).setAttribute( "value" and insights to help you stay informed on the latest trends in gun culture We are excited to announce that makers can now visualize and manage existing tables in the ERD table designer you can use your existing tables to build more robust data models the enhanced ERD view will allow you to review your existing and new tables side-by-side more easily This update and other data workspace features are now available in 20 languages worldwide For more information about the availability of data workspace, see Create and edit tables using Power Apps You can now add existing tables to your workspace either manually or with Copilot recommendations Copilot will suggest the most relevant tables based on the set of tables currently in your workspace you can also filter to show only tables in current solution The ERD view and interaction of data workspace have also been enhanced to streamline the management of your data model You can now review column details about your tables as well as to show and hide columns and relationships of your tables While we are working on enabling a full editing experience of existing table within data workspace currently you can only add existing tables to data workspace in read-only mode you will need to open the table in a new tab This also means that you will not be able to create one-to-many relationships to existing table in the data workspace You can find more information about limitations of data workspace in this doc: Limitations using the table visual designer Data shows Microsoft Power Platform improves business outcomes Accelerate innovation and reduce costs as you analyze data Erdene Resource Development Corp. (ERD.CA) offers investors the best of both worlds: A near-term gold producer plus extraordinary exploration upside, explains Brien Lundin, executive editor of Gold Newsletter Erdene has not only outlined the gold-rich BK deposit in Mongolia but also multiple other gold and polymetallic discoveries and targets in the broader Khundii district that it controls in conjunction with 50% partner Mongolian Mining Co What really excites the company’s geological team is that exploration has revealed the potential to unlock a new large-scale gold district within the Central Asian Orogenic Belt It hosts giant gold and gold-copper deposits such as Kumtor (14 million ounces gold) That’s the remarkable exploration potential of Erdene’s assets there’s gold production on the table with the first gold pour at BK slated for mid-2025 open-pittable deposit is projected to generate uncommon profits A recently updated feasibility study on BK demonstrates the strong economics of this deposit and what it will mean for Erdene’s market value With 513,700 ounces of reserves and an average head grade of over 3 g/t gold (about three times the global average for an open pit mine) BK has a projected after-tax net present value of $275 million and a rich after-tax internal rate of return of 49% at $2,200/oz All-in sustaining costs are projected to be just $869/oz. which implies truly extraordinary cash flows at today’s much higher gold prices The best part: These remarkable economics are why Erdene and its local partner are rapidly advancing BK toward construction and cash flow but they have truly only scratched the surface of this remarkable new district’s potential The key here is that Erdene has been conducting a large exploration drilling program on nearby and outlying targets on its property licenses and the results have been consistently returning high-grade hits throughout the year as the mine rapidly progresses toward production we have the best of both worlds with Erdene — a severely undervalued development story with the kicker of exceptional exploration upside in the near- and medium-terms Subscribe to Gold Newsletter here… Your 2025 Portfolio: Preparing for Maximum Profit Subscribe to MoneyShow’s daily investment newsletter Top Pros' Top Picks and get actionable advice from our top experts including the hottest stocks to buy and sell ETFs and funds for short- and long-term capital appreciation and a wide variety of dividend-paying stocks set to deliver a steady stream of safe Get an edge on the markets with our weekly trading newsletter and receive timely trade ideas covering stocks and more to keep you on the right side of the action From trading basics to advanced strategies and high-probability set-ups the insights you need from our all-star lineup of trading pros is delivered straight to your inbox The stock market offers virtually any combination of long-term opportunities for growth and income as well as short-term investments for trading gains MoneyShow’s weekly Virtual Learning Letter showcases a variety of on-demand webcasts and video market commentary by top financial experts covering the hottest financial topics each week Support@MoneyShow.com Enfants Riches Déprimés (ERD) showed their Printemps/Été 2025 collection at Sotheby’s Paris and the silent oppression that defines the modern experience The collection serves as a boldly placed vintage aesthetic critique of capitalism and the universal worship of wealth and youth deconstructed designs accented with antique silver comes a vintage patchwork facade of new designs and dresses unleashing characters endlessly for the audience's gaze The runway transformed into a thought-provoking installation, with designer Henri Alexander employing the motif of the cage to symbolize the alienation felt in today’s postmodern landscape Models were placed within a series of cages echoing the “stainless steel (synthesizer) prison unit” introduced by the brand earlier this year This setting created a powerful juxtaposition between excesses and oppression with structured tailoring— the Napoleonic jackets and tailored vests—paired against lamé sweaters and daring skin-baring shorts reflecting what I’m going through,” Alexander shared emphasizing the iterative process of creation The collection’s raw seams and self-binding details offered a unique visualization of constraint the glossy materials highlighted the emptiness of excess Leather played a central role in the collection also embodying the darker narrative of forced assimilation and rejection Trench coats constructed from varied layered belts adorned with jingling silver chains showcased a striking blend of fetishism and elegance With a nod to power dynamics and submission The atmosphere was further charged by the appearance of young baronets in frayed pastel culottes and a light blue dress reminiscent of Sofia Coppola’s Marie Antoinette blending historical references with contemporary critique A cream silk dress featuring trompe l’oeil lingerie details paired with ERD’s signature towering platforms This added depth to the visual narrative ERD was trying to display As well as one unexpected twist; a smaller cage on a model’s wrist housed a live rat encapsulating the collection's provocative edge The looks remain timeless and show a refreshing take on vintage allure; captivating Enfants Riches Déprimés masterfully navigates the complexities of wealth Stay up-to-date with exclusive events and content The C&H Precision ERD-1 is an enclosed optic This means that the matter in charge of creating the reticle you see in the glass is protected from the elements and is less likely to be damaged or obstructed in those precious moments you may need it We have witnessed a rise in popularity for these types of optics when it comes to carry guns and battle rifles equipped with red dot optics it is a true red dot equipped with a multi-reticle system The MSRP of the C&H ERD-1 Red Dot Sight is currently at $494.95 which is pretty competitive compared to other larger enclosed red dot sights that are not holographic When you have something like this I am not sure why someone would lean into a holographic but hey large windowed rifle optic that will be a perfect match for your gas rifle or PCC It was built for those who want a larger window on a tough It utilizes a picatinny rail mount for widespread compatibility Available in red dot with 2 moa dot and 56 moa circle with a selectable multi-reticle.” As I mentioned the first time I saw and held the ERD-1 was at Shot Show 2024 and I was totally star-struck Everything about this thing was very appealing The T&E sample I received is likely very much a first sample off of the line The box is blank and there were no instructions included I am guessing I was one of the first to step up to the review plate Thank goodness they tracked one down for me because this optic was on my mind for months It is on the heavier dense side so if you are going for a lightweight build it may not be for you but if it’s going on a battle rifle or SBR build it fits the bill because it feels like a tank I really like the mounting setup and the battery access as well as the large button adjustments/placement It is a very good-looking optic and a perfect profile for someone looking for that holographic sight look without the battery drawbacks and price tag Mounting the ERD-1 was extremely easy It has four screws securing it so with those tightened down to 15 to 20 inch pounds (not sure what the right spec is as I said my early sample did not have instructions) it was not going anywhere It uses a side load battery so that was super easy to install but in a pinch I can see unscrewing the locking screw being an issue Good thing this lasts for around 5 years worth of battery and has an auto shutoff With the dot up and running it yielded a crisp and clear reticle Everyone I have shown it to remarked how crisp it was It was just as nice as the one I saw at SHOT Who knows maybe it’s the same one since this is a sample Prepping for some range time I wanted to give the ERD-1 a great go of it with a new pistol and future SBR build Needless to say it really suited the compact package and complimented the looks all day long I paired it with my new AT3 Tactical lower and a Silencer Central Backcountry for that added flair I do need to pick up some backup sights for this build but I was in a rush For my sake drop your favorite backup sights in the comments Rolling into the range day I was vibrating with excitement Fellow TFB writer and AllOutdoor editor Adam S was with me on my range trip and even he remarked how impressed he was with the clean lines of the optic and the crispness of the reticle I set up a few targets at 25 yards and typically I wouldn’t bother sighting a review optic in to precisely besides getting it on paper mainly because you can still tell how something groups or if there is a change in point of impact Does not really matter if there is a bullseye where the holes are Since I wanted to have as much time with the ERD-1 I took the extra time and effort to get it hitting bullseyes and loud enough to hear through my earplugs Everything kept on target and there weren’t any noticeable shifts from the optic The window was clear whether I shot out in the sun or under the low light of the range canopy The brightness settings felt sort of lacking Not in a sense they were not bright enough rather I just noticed that some of the higher levels felt like there should have been a level in between each other it felt like I was at setting 8 and then clicking up once the brightness would increase pretty noticeably as if it jumped to a figurative 10 It almost looks like an etched reticle on a prism optic the dot itself developed a slight fuzz but very slight Many other dots in this price range are far worse in my experience In closing, I want to say thank you to C&H Precision for allowing TFB and myself the opportunity to try out their new ERD-1 Red Dot Sight we would like to know what all of you guys and gals think Do you believe that this new-fangled enclosed optic is worth spending your money on Would you take this out to the range on the regular Let us know all of your thoughts in the comments below Staff Writer: TheFirearmBlog & AllOutdoor.com | Certified Gunsmith | Published Author | Firearm History Enthusiast More by Sam.S This looks like a decent first attempt? and I haven't seen anything similar from any other MFG, so this may have been one of their first actual designs (or something they had real design input into) Aye, but you can be damn sure it ain't gonna come off or lose zero because the mount wasn't up to recoil. $495 does appear to be the going rate, which is way too close in price to the made-in-not-China SIG Romeo 8H, and a good bit more than a Holosun AEMS. Volume 2 - 2021 | https://doi.org/10.3389/falgy.2021.734000 This article is part of the Research TopicChronic rhinosinusitis in patients with NSAID-exacerbated respiratory diseasesView all 4 articles Patients with non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) often suffer from chronic rhinosinusitis (CRS) with nasal polyps Although this disease is also seen in NSAID-tolerant patients CRS in N-ERD often is more severe and more treatment resistant; local nasal therapy (nasal corticosteroids) and endoscopic sinus surgery are employed like in NSAID-tolerant patients but with limited and/or short-lived effects This mini-review gives an overview of the current additional treatment options for CRS in N-ERD antileukotriene therapy and biologicals are discussed based on the current body of literature Selecting the right treatment strategy depends on shared-decision making local availability and cooperation between ENT-surgeons Patients with CRS and N-ERD are at risk for uncontrolled sinonasal disease, requiring more surgeries and/or more intense medical therapy, often with unsatisfactory results (15) This review aims to give an update of the current therapeutic options for the management of CRS in patients with N-ERD In the past decades, CRS was divided between “with polyps” (CRSwNP) or “without polyps” (CRSsNP) based on the endoscopic appearance of polyps. However, with the newest update of the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS2020), a more diverse classification is proposed (1) CRS is first classified as primary or secondary based on the absence or presence of underlying pathology such as cystic fibrosis Primary CRS is then divided between localized or diffuse disease and endotyped roughly as either Type 2 or Non-type 2 disease The CRS found in N-ERD patients thus classifies as primary diffuse Type 2 CRS We will use this latter terminology in the rest of this review although most literature is based on the former (simplified) diagnosis of CRS(wNP) Following the management schemes of EPOS2020 the first line of treatment for primary diffuse CRS is appropriate medical therapy (AMT) but not limited to local corticosteroids (either spray Those achieving disease controls with AMT should be advised to continue their medication without the need for further investigation or therapy when patients indicate a poor disease control with AMT it is advised to perform additional investigations in order to differentiate the disease as a Type 2 or Non-type 2 primary diffuse CRS patients with CRSwNP and N-ERD fulfill the criteria for Type 2 disease Studies show that especially patients with N-ERD show a limited effect of AMT and/or FESS, resulting in higher oral corticosteroid use, more frequent surgery and a lower quality of life (15, 21). Qualitative analyses show that patients experience great frustration as they often find themselves trapped between their allergist suggesting more oral corticosteroids and their ENT-surgeon advocating yet another surgery (22) many N-ERD patients have to deal with a chronic yet uncontrolled disease state of their CRS It is therefore pivotal that treating physicians acquaint themselves with the additional treatment options listed below N-ERD patients are advised to avoid NSAIDs, selective COX-1 inhibitors, and alcohol consumption (21) as these might trigger a sudden increase in symptoms from the upper and lower airways COX-2 inhibitors are generally well-tolerated We are not aware of studies reporting on the success of such avoidance stratagems or how often patients are (unintentionally) exposed to these drugs or triggers numbers were small and a large portion of participants had mild CRS based on baseline SNOT-22 scores A different diet with high omega-3/low omega-6 fatty acids showed promising result in a small pilot trial with 10 adult patients suffering from primary diffuse Type 2 CRS and N-ERD (25) Along with biomarkers indicating a change in cellular fatty acid composition SNOT-22 scores decreased 15.1 points on average (95% CI: −24.3; −6.0) after a 2-weeks high omega-3/low omega-6 fatty acids diet This unblinded setup might contain placebo effects and the findings remain to be confirmed in larger studies Aspirin therapy after desensitization (ATAD) is based on a two-step treatment: first patients are desensitized by exposure to increasing doses of oral aspirin; second they continue using high doses of aspirin daily Several studies have investigated this treatment option in primary diffuse Type 2 CRS in N-ERD patients The finding that N-ERD patients experience a short period (24–72 h) of symptom alleviation after a challenge with aspirin, and that they are refractory to additional aspirin challenges (26), has led to the development of several desensitization protocols. A widely used protocol aims at oral aspirin 625 mg twice daily after a startup phase (27) There have been several studies describing the effect of such protocols on CRS signs and symptoms four of which are placebo-controlled trials ATAD was shown to have a significant effect over placebo in the reduction of SNOT-22 scores or other symptoms scores this did not reach the threshold for a clinically relevant difference The lung functions scores (FEV-1) were significantly better with ATAD The meta-analyses were based on relatively small pooled patient groups ATAD is a relevant treatment option for primary diffuse Type 2 CRS in N-ERD patients education and shared decision making are key for a successful application of this treatment it seems logical to use antileukotriene drugs in the treatment strategy of CRS in general After reviewing the current evidence on antileukotrienes in CRS, the EPOS2020 steering committee concluded that the use of such drugs in CRS was not advised, as (limited) evidence shows no benefit over the use of nasal corticosteroid or when used in combination with nasal corticosteroids. Only in patients not tolerating nasal corticosteroids, one might consider antileukotrienes although there a no supporting studies (1) the zileuton group used this drug for 77 days on average (range 6–300 days) Although these two studies are small and from their setup give limited evidence it seems that also for N-ERD patients specifically antileukotrienes are not to be recommended as an additional treatment strategy for their CRS It is important to recognize, however, that the European Academy for Allergy and Clininal Immunology (EAACI) position paper on the diagnosis and management of N-ERD does describe the use of antileukotrienes in N-ERD patients as add-on therapy for their asthma (21) a N-ERD patient with both CRS and asthma might benefit from these drugs but the indication should be derived from the lower airway disease status With the advent of biological therapy, the management of primary diffuse Type 2 CRS has been tremendously revolutionized. Pivotal trials and the first real-life data show rapid disease control and improvement of the quality of life, often beyond the effect sizes that treatment strategies hitherto could offer (40–42) these trials target patients with primary diffuse Type 2 CRS per se either in the context of N-ERD or in NSAID-tolerant patients No randomized-controlled trials with N-ERD patients only have been performed Dupilumab is a monoclonal antibody directed against the alpha unit of the IL4/IL13 receptor. It was approved late 2019 as add-on therapy for CRSwNP. In a post-hoc analysis from a previously published phase 2a trial (45) the N-ERD patients (n=19) and NSAID-tolerant patients (n = 41) were compared Both groups showed significant improvements in disease control after 16 weeks of treatment as assessed by imaging (Lund-Mackay score) patient-reported outcome measures (SNOT-22 total score and smell test score (University of Pennsylvania Smell Identification Test) Eight N-ERD patients were in the dupilumab-treated group Their nasal polyp scores were significantly reduced by a mean of 2.51 whereas the NSAID-tolerant patients had a non-significant reduction of 0.72 Mepolizumab is an antibody directed against IL-5. It is currently not registered for use in CRSwNP patients, but for asthma only. In a retrospective study including 17 N-ERD patients receiving mepolizumab for severe asthma, SNOT-22 scores were observed to decrease significantly and relevantly by 17.7 points (n = 11). Specific SNOT-22 questions on nasal congestion and smell/taste also showed an improvement with three or more doses of mepolizumab (46) depending on the local situation/availability In order to better understand and compare treatment effects we would advise authors of future studies on primary diffuse Type 2 CRS to report effects in N-ERD patients separately It remains to be elucidated whether the presence of N-ERD represents a clinically relevant subgroup when it comes to treatment outcomes or that most patients with primary diffuse Type 2 CRS in the context of N-ERD respond largely similar to NSAID-tolerant patients This mini-review describes the possible therapeutic options for primary diffuse Type 2 CRS in N-ERD patients Apart from the customary appropriate medical therapy and surgery ATAD and especially biologicals hold most promise for the future The treatment options are summarized in Table 1 For most of the therapeutic options described patient counseling and shared-decision making are key to success all of these represent a long-term therapy Treating physicians should be keen to inquire for patient preferences clear communication with the patient is essential with an important role for managing expectations a patient-tailored approach includes treatment plans for the upper airway (as discussed here) Most of these treatments are therefore best employed in close collaboration between allergists Summary of treatment options for primary diffuse Type 2 CRS in N-ERD the evidence for most treatment options relies on relatively small studies studies targeting N-ERD patients specifically are needed and studies including both NSAID-tolerant and intolerant patients should report on the subgroup of N-ERD subjects separately Especially biologicals deserve attention in the coming years not only with a focus on treatment outcomes biologicals will prove not to be cost-effective in a broad group of primary diffuse Type 2 CRS patients but only in the more severe cases; N-ERD patients typically fall in the latter group SR performed the literature search and wrote the initial manuscript RL and WF reviewed and updated the manuscript All authors contributed to the article and approved the submitted version and SR received research grants by Sanofi and Novartis WF and SR have been employed as consultant for Sanofi All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher European position paper on rhinosinusitis and nasal polyps 2020 PubMed Abstract | CrossRef Full Text Chronic rhinosinusitis in Europe–an underestimated disease Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample Epidemiology of chronic rhinosinusitis in Bushehr southwestern region of Iran: a GA2LEN study Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology Radiologic sinus inflammation and symptoms of chronic rhinosinusitis in a population-based sample Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis–a GA(2) LEN study Direct and indirect costs of adult patients with chronic rhinosinusitis with nasal polyps The health and productivity cost burden of the “top 10” physical and mental health conditions affecting six large U.S Assessing quality of life and burden of disease in chronic rhinosinusitis: a review The GALEN rhinosinusitis cohort: chronic rhinosinusitis with nasal polyps affects health-related quality of life Nasal symptoms in patients with NSAID hypersensitivity CrossRef Full Text | Google Scholar aspirin sensitivity and allergy in chronic rhinosinusitis: data from the UK National Chronic Rhinosinusitis Epidemiology Study Respiratory hypersensitivity reactions to NSAIDs in Europe: the global allergy and asthma network (GA(2) LEN) survey Clinical characteristics of patients with chronic rhinosinusitis with nasal polyps and aspirin-exacerbated respiratory disease Aspirin-exacerbated respiratory disease: mediators and mechanisms of a clinical disease Endotypes of chronic rhinosinusitis with nasal polyps with and without NSAID - intolerance The Amsterdam Classification of Completeness of Endoscopic Sinus Surgery (ACCESS): a new CT-based scoring system grading the extent of surgery Long-term outcomes of different endoscopic sinus surgery in recurrent chronic rhinosinusitis with nasal polyps and asthma Evaluation of the effect of endoscopic partial middleturbinectomy surgery on the quality of life of patients with chronic rhinosinusitis and nasal polyps Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)-a EAACI position paper The burden of non-steroidal anti-inflammatory exacerbated respiratory disease from the patient's perspective - a qualitative analysis of posts from the Samter's Society A novel treatment adjunct for aspirin exacerbated respiratory disease: the low-salicylate diet: a multicenter randomized control crossover trial Effectiveness of personalized low salicylate diet in the management of salicylates hypersensitive patients: interventional study Dietary fatty acid modification for the treatment of aspirin-exacerbated respiratory disease: a prospective pilot trial Aspirin desensitization in aspirin-sensitive asthmatic patients: clinical manifestations and characterization of the refractory period Aspirin desensitization in aspirin-exacerbated respiratory disease Aspirin desensitization for ASA triad patients–prospective study of the rhinologist‘s perspective Objective and subjective sinonasal and pulmonary outcomes in aspirin desensitization therapy: a prospective cohort study Long-term sinonasal outcomes of aspirin desensitization in aspirin exacerbated respiratory disease Outcomes after complete endoscopic sinus surgery and aspirin desensitization in aspirin-exacerbated respiratory disease Clinical and immunological efficacy of aspirin desensitization in nasal polyp patients with aspirin-exacerbated respiratory disease Aspirin desensitization for patients with aspirin-exacerbated respiratory disease: a randomized double-blind placebo-controlled trial Aspirin desensitization in patients with aspirin-induced and aspirin-tolerant asthma: a double-blind study Low-dose aspirin desensitization in individuals with aspirin-exacerbated respiratory disease High discontinuation rates of peroral ASA treatment for CRSwNP: a real-world multicenter study of 171 N-ERD patients Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis The effect of antileukotrienes on the results of postoperative treatment of paranasal sinuses in patients with non-steroidal anti-inflammatory drug-exacerbated respiratory disease Effect of Zileuton treatment on sinonasal quality of life in patients with aspirin-exacerbated respiratory disease Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre Efficacy and safety of omalizumab in nasal polyposis: 2 randomized phase 3 trials Reduced need for surgery in severe nasal polyposis with mepolizumab: randomized trial Omalizumab treatment in Samter's triad: case series and review of the literature Omalizumab in patients with NSAIDs-exacerbated respiratory disease Effect of subcutaneous dupilumab on nasal polyp burden in patients with chronic sinusitis and nasal polyposis: a randomized clinical trial A retrospective analysis of mepolizumab in subjects with aspirin-exacerbated respiratory disease State-of-the-art overview on biological treatment for CRSwNP Keywords: NSAID (non-steroidal anti-inflammatory drug) Fokkens WJ and Reitsma S (2021) Therapeutic Options for Chronic Rhinosinusitis in N-ERD Patients Received: 30 June 2021; Accepted: 06 August 2021; Published: 24 August 2021 Copyright © 2021 van der Lans, Fokkens and Reitsma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution or reproduction in other forums is permitted provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited in accordance with accepted academic practice distribution or reproduction is permitted which does not comply with these terms *Correspondence: Sietze Reitsma, cy5yZWl0c21hQGFtc3RlcmRhbXVtYy5ubA== Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish To the members of Erie Roller Derby it doesn't matter whether you're an expert skater or new to wheels whether you're part of the LGBTQ+ community or not they compete as the Erie Roller Derby All-Stars and the Bayfront Bombshells But the participants in this community-based roller derby league do more than practice their sport they promote inclusion of players and fans roller derby has always been a place for people who are looking for a place to belong," said Allison McCartney public relations manager for Erie Roller Derby "ERD strives to cultivate a community that embodies the acceptance we as a league are committed to we are focused on supporting and representing the queer community in Erie including making our events and league a welcoming and safe place for all members of the LGBTQIA+ community." McCartney said Erie Roller Derby was formerly known as Eerie Roller Girls "We want everyone to know that no matter your race you have a place on our team," said Sydney Alloway She has been with ERD about two years and is a jammer/pivot "If anyone needs a safe space or if they want a place to be themselves while staying active then Erie Roller Derby is a great place to be," Alloway said Skaters this year ranged from ages 18 to 48 Home rink: Erie area's Presque Isle Skating & Event Center has new owners and a new name skating is only a fraction of what we help each other out with," she said adding that the league "excels in compassion and thoughtfulness" and has a group chat that's a source of support in many ways "One of our skaters is a mechanic," Damon said "Even though car maintenance isn't a huge part of roller derby itself that skater offered to host a seminar of sorts to share her skills with us We're constantly looking out for one another and that includes multiple aspects of our lives What makes Erie Roller Derby different is that care for our fellow teammates transcends the boundaries of the rink and pours into our everyday lives." McCartney estimated that 75% of Erie Roller Derby skaters identify as members of the LGBTQ+ community The support between the skaters and the community is reciprocal with ERD members taking part in Pride events and members of the LGBTQ+ community attending league games "Our June bout is Pride-themed each year to help spread the message of acceptance that Pride represents," McCartney said ERD members went to Pride on the Bay before their June 29 game which a group from the NWPA Pride Alliance attended Roller derby participants then skated in Erie's Pride Parade the next day "Pride Month at Erie Roller Derby is truly a sight to behold," Damon said "We don't just stop at raising a rainbow flag I feel like communities as a whole have only tolerated me at best," Damon said I've always felt as though that part of my identity has had to remain unattached to whatever sport or service I was providing I was shocked to find that diversity was not just accepted Damon said that's not just true for the LGBTQ+ community "All types of people all the time are always being uplifted," she said is a bench coach/blocker who lives in Wesleyville and grew up in a small town where she said she was the first Black person who played basketball She said ERD members are "embracers of people" who never judge others "Erie Roller Derby is more than just a group of people showing Pride and support to our community," Wall said "We are a group of people who love playing and talking about roller derby but also giving people who feel like the world has turned their back on them and give them a home A safe place where they can be whomever they want to be Alloway goes to teammates for things not related to derby "I feel comfortable talking to them about so many things and they always make my emotions feel valid," she said "We always uplift each other in every way we can Damon said she was "whole-heartedly welcomed" by the team and have lent advice for not just Final Girl And that's why I feel like being an ERD member extends beyond the rink," she said Wall said ERD is "a safety net of people who will just let you be a shoulder to cry on I have found genuine friends for the first time in years that I feel like I can trust with parts of my life I hold close to my chest They fill a hole I had in my life that I didn't realize was truly missing."  "We don't see anyone as anything other than human We ask preference and we stick to that unless we are told otherwise It's a sign of respect and acceptance and it's a nonnegotiable to any person on the team." Erie Roller Derby will take on the Black Diamond Rollers out of Elmira Tickets are $10 in advance or $15 at the door and are free for ages 10 and younger Dana Massing can be reached at dmassing@timesnews.com This Digest summarizes significant decisions of the former DILHR Industrial Commission the Labor and Industry Review Commission (LIRC) the former Wisconsin Personnel Commission and the Wisconsin courts under the Wisconsin Fair Employment Act the Wisconsin Public Accommodations and Amusements Law the Wisconsin Family and Medical Leave Act and the other laws within the program responsibilities of the Wisconsin Equal Rights Division (ERD) Summaries of selected decisions of ERD Administrative Judges under the Wisconsin Family Medical Leave Act and other laws which are directly appealable to circuit court are also included The decision summaries are organized according to subject matter in reverse chronological order (most recent cases first) 2024 Wisconsin Case Law Decision Digest 2024 Equal Rights Decision Digest Case Supplement Copies of the 2024 Equal Rights Decision Digest may be purchased from Document Sales (search "digest") Contact the Bureau of Hearings and Mediation A proud partner of the network THIS SERVICE MAY CONTAIN TRANSLATIONS POWERED BY GOOGLE GOOGLE DISCLAIMS ALL WARRANTIES RELATED TO THE TRANSLATIONS AND ANY IMPLIED WARRANTIES OF MERCHANTABILITY FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT The Department of Workforce Development (DWD) website has been translated for your convenience using translation software powered by Google Translate Reasonable efforts have been made to provide an accurate translation no automated translation is perfect nor is it intended to replace human translators Translations are provided as a service to users of the DWD website and are provided "as is." 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Volume 11 - 2017 | https://doi.org/10.3389/fnhum.2017.00207 This article is part of the Research TopicTime Patterns and their Functions in Human NeuroscienceView all 7 articles This study was conducted to identify characteristics of the perceptual threshold level and electroencephalogram (EEG) responses to vibrotactile stimulations at various high frequencies and to examine the possibility of distinguishing vibrotactile stimulations by frequency through such response characteristics The vibrotactile stimulations of six frequencies (150 275 and 300 Hz) were exerted on the first joint of the right index finger The perceptual threshold level was defined as the first minimum perceived intensity when the intensity stimulation was exerted step by step at each vibration frequency EEG response characteristics were investigated by examining a single index corresponding to the peak or area of event-related desynchronization/synchronization (ERD/ERS) and seven specific indices derived by combining the single ERD/ERS indices There was a significant difference in the perceptual threshold level across different frequencies the differences in vibration stimulus between 150 Hz and 200 Hz and between 150 Hz and 225 Hz were significant the single index of the peak or area of ERD/ERS did not show a significant difference by frequency and ERS × (ERS−ERD) showed a significant difference between vibration stimulations at 150 Hz and 200 Hz and between vibration stimulations at 150 Hz and 225 Hz among the specific indices combined using the peak values of ERD/ERS ERS × (ERS−ERD) showed a significant difference between 150 Hz and 225 Hz and between 225 Hz and 275 Hz among the specific indices combined using the area of ERD/ERS The perceptual threshold level and the specific indices of ERD/ERS suggested in the present study can be used as quantitative measurement indices to distinguish high-frequency vibration stimulation To utilize in devices considering the features of tactile information processing vibrotactile information should be clearly distinguished in a quantitative fashion recent work has used electroencephalogram (EEG) features to detect quantitative distinctions of vibrotactile information Several studies have examined ERD and ERS features for vibrotactile stimulation. For example, Spitzer et al. (2010) generated vibrotactile stimulation at a frequency of 16–41 Hz for the index finger, which can be perceived as flutter, to examine the ERD/ERS features. Neuper and Pfrurtscheller (2001) also considered ERD/ERS features by generating a vibrotactile stimulation at a frequency of less than 22 Hz on the hand and foot These two studies shared some commonalities vibrotactile stimulations were classified by controlling the frequency which is the most fundamental physical trait of vibration no stimulation more intense than a “flutter” was considered from a qualitative perspective even though the physical classification is available for low- and high-frequency vibrotactile stimulation Although examining the use of an EEG index for classification of very minute vibrations is important the disadvantage is low applicability for devices requiring stimulation that can be qualitatively distinguished at the human perception level another disadvantage is that only a single index of ERD and ERS is used Although ERD and ERS are sensitive to physical movement in order to ensure that vibrotactile information is clearly distinguished and perceived it is necessary to add specific indices that can amplify the excitatory and inhibitory effects of ERD/ERS of high-frequency vibration stimulations as well as low-frequency vibration stimulations it would be possible to distinguish the high-frequency vibrotactile stimulations by frequency using more specific indices that amplify the excitatory and inhibitory effects of ERD/ERS as well as the basic information of ERD/ERS as EEG indices sensitive to physical movement due to the nature of vibrotactile stimulations An effective approach to vibrotactile stimulation is to utilize frequencies that can be qualitatively distinguished at the human perceptual level This study thus examined the features of seven ERD/ERS indices segmented with vibrotactile stimulations of relatively high frequencies (150–300 Hz) compared to preceding studies in order to determine whether or not these indices can be used for detailed classification of vibrotactile stimulation This study was carried out in accordance with the recommendations of the Institutional Review Committee of Konkuk University and written informed consent was obtained from all subjects in accordance with the Declaration of Helsinki (KU-IRB-11-46-A-1) A vibrating stimulation was exerted with the use of a vibration stimulation system developed by our research team (Chung et al., 2014). The developed system generates vibrations by sending a sinusoidal electric signal to the solenoid coil and using a Lorentz force that is electromagnetically generated by interaction with an external magnetic field (Figure 1) The stimulation frequency could be controlled within a range of 0–400 Hz The stimulation intensity could be controlled in 20 stages Stimulation was controlled with the use of E-Prime S/W (Psychology Software Tools The area of contact between the solenoid coil and finger was 1.8 × 1.8 cm2 Before the experiment to measure the EEG, we examined the perceptual threshold level for different intensities of six vibration frequencies: 150, 200, 225, 250, 275 and 300 Hz. The perceptual threshold level was defined as the stimulation at the minimum intensity that the subject perceived for each vibration frequency. The experimental trial to examine perceptual threshold level comprised a rest phase (6 s) and stimulation phase (0.1 s; Figure 1) relaxed condition without any stimulus being applied a certain stimulation intensity was exerted at a certain vibration frequency to the first joint of the right index finger of the subject 275 and 300 Hz) and intensity (level 1–20) were exerted in sequence and the level of stimulation intensity at which the subject felt the vibration for each frequency was determined In order to verify the significant difference in perceptual threshold level obtained for each frequency a repeated one-way analysis of variance (ANOVA; PASW Statics 18) was conducted Bonferroni analysis was carried out for post hoc verification The experimental trial to measure the EEG also comprised a rest phase (6 s) and stimulation phase (0.1 s; Figure 1) The rest phase was the state in which no vibration stimulation was exerted different intensities of six vibration stimulations (150 A total of 60 trials were conducted by randomly repeating the stimulation of six vibration frequencies 10 times and there was a 10–min break between each session 30 stimulations were exerted at each vibration frequency which was a stimulation intensity that could be perceived at all frequencies based on the results of the initial perceptual threshold experiment was used as the stimulation intensity for the EEG experiment Neural signals were recorded using an EEG device (Quick Amp EEGs were measured at a sampling frequency of 500 Hz Based on the 10–20 electrode system Ag/AgCl electrodes were placed over a total of 16 locations (AF3/4 which is the somatic sensory domain (Somatosensory area in the left hemisphere) In order to restrict stimulations other than vibration (e.g. external visual factors were blocked with the use of a black partition Each subject was instructed to place his arm on the desk with a vibration stimulator while in a comfortable sitting position on a chair The experiment started when the EEG was stable with limited body movement Acquired data were analyzed with MATLAB (Mathworks Bandpass filtering was conducted at 0.5–40 Hz after channel location of the acquired data Because the vibration stimulation was exerted on the right index finger detailed analysis was conducted regarding the somatic sensory domain of the contralateral side (i.e. The recorded EEG signals were filtered using a Butterworth filter (0.1–50 Hz) The data of one participant was discarded because of abnormal impedance range Once the EEG had been divided into epochs from 0.5 s before stimulation to 3 s after stimulation for each vibration frequency and short-time Fourier transform (sTFT) was conducted for spectrum analysis over a total period of 3.5 s The sTFT data were divided into three frequency bands: the alpha domain (10–13 Hz) and sensorimotor rhythm (SMR) domain (10–30 Hz) which was subtracted from the log after squaring the sTFT value After all trials of each subject were averaged the data from all subjects were averaged to calculate the average power By calculating the average power value for the three frequency domains the peak and area of ERD and ERS were extracted The peak and area were extracted by comparing the power values before stimulation (0 s) to 1 s after stimulation for ERD and between 1 s and 3 s after stimulation for ERS Along with the peak and area of ERD and ERS for the three frequency domains the following seven indices were also calculated: ERS − ERD These seven indices were calculated from the peak and area of ERD and ERS in the alpha domain (10–13 Hz) and the same calculation was conducted in the beta and SMR domain Based on a reference that suggested a significant change in the ERD signal in the alpha domain and ERS signal in the beta domain due to tactile stimulation the seven indices were each calculated using ERD (peak and area) in the alpha domain and ERS (peak and area) in the beta domain Reliability analysis was conducted to verify the reliabilities of the peak and area values of both ERD/ERS extracted from the trials of each subject and the seven indices to which ERD/ERS were applied The results showed that all values of Cronbach’s alpha which indicates a high level of reliability In order to verify whether or not there was a significant difference in vibration frequencies measured by the seven indices and the peak and area of ERD and ERS a one-way repeated ANOVA (PASW Statistics 18) was conducted and Bonferroni analysis was conducted for post hoc verification linear-by-linear association was used to examine the association between perceptual threshold level and each index value Figure 2 shows the perceptual threshold level for each frequency The mean and standard deviation (SD) of the perceptual threshold level was 8.05 ± 2.99 at 150 Hz There was a significant difference in the perceptual threshold level for each frequency (p < 0.001) The post hoc verification showed a significant difference in perceptual threshold level between 150 Hz and 200 Hz (p = 0.002) and between 150 Hz and 225 Hz (p = 0.006) the perceptual threshold level was lower at 200 and 225 Hz compared to at 150 Hz which indicates high sensitivity to the vibrotactile frequency Mean value of the perceptual threshold level of all subjects for each frequency the above three index values were higher for vibration frequencies of 200 Hz and 225 Hz compared to at 150 Hz The analyses of the association of perceptual threshold level with the three indices that showed a significant difference revealed that there was a significant difference in ERS − ERD (p = 0.047) and ERS × (ERS − ERD; p = 0.031) whereas no significant difference was observed in ERD × (ERS − ERD; p = 0.100) Findings for seven types of indices calculated with the peak of the event-related desynchronization (ERD) in the alpha domain and event-related synchronization (ERS) in the beta domain Findings for seven types of indices calculated with the area of the ERD in the alpha domain and ERS in the beta domain Findings for three types of indices that presented significant differences in statistical analysis using the peak of the event-related desynchronization (ERD) and event-related synchronization (ERS): (A) ERS − ERD (B) ERS × (ERS − ERD) (C) ERD × (ERS − ERD) The association of perceptual threshold level with the two indices that showed a significant difference was examined and a significant difference was found in both ERS − ERD (p = 0.044) and ERS × (ERS − ERD; p = 0.050) Findings for two types of indices that presented significant differences in statistical analysis using the area of the ERD and ERS: (A) ERS − ERD (B) ERS × (ERS − ERD) The objective of this study was to examine whether vibrotactile stimulation can be perceptually distinguished at high frequencies and quantified with ERD/ERS indices. The results showed a difference in the perceptual threshold level between 150 Hz and 200 Hz and between 150 Hz and 225 Hz for each frequency of the vibrotactile stimulation. These results correspond to those of Mountcastle et al. (1972) who suggested that humans are most sensitive to detection thresholds when the vibration frequency is 200–250 Hz The sensitivity to frequency bands coincides with the sensitivity of Pacinian corpuscles the perceptual distinction of vibrotactile stimulation at high frequencies may be dependent on the sensitive receptive field of Pacinian corpuscles Although the EEG findings of this study were limited to the C3 domain the possibility of such an interpretation cannot fully be excluded considering the low spatial resolution; this represents one limitation of the present study there was a distinctive magnitude difference in vibrotactile stimulation at 150 Hz and 200 Hz that could be perceived with the (ERS − ERD) index Vibrotactile stimulations of 275 Hz and 300 Hz which had a similar perceptual threshold as 200 Hz also displayed an outstanding magnitude difference with vibrotactile stimulation of 200 Hz according to the (ERS − ERD) index Because the (ERS − ERD) index displays the size of the total effect reflecting both excitatory and inhibitory effect followed by vibrotactile stimulation it can be considered to calculate the amount of energy attributable to vibrotactile stimulation the ERS × (ERS − ERD) index which amplifies the size effect of ERS considering the energy attributable to vibrotactile stimulation clearly distinguishes the magnitude of the vibrotactile stimulation at 150 Hz and 225 Hz The ERD × (ERS − ERD) index was found to clearly distinguish the magnitudes of the vibrotactile stimulation between 150 Hz and 200 Hz and between 200 Hz and 250 Hz Extracting the common feature of all three indices not only clearly distinguished the vibrotactile stimulations of 150 Hz and 200–225 Hz at the perceptual threshold level but also markedly distinguished each vibrotactile stimulation to reflect the feature of the ERD/ERS single index which only presented the inclination due to the small size of the effect the above three indices can be used for quantitative measurement to clearly distinguish high vibration frequencies this study is significant in that it explored new indices based on ERD/ERS while previous studies mainly examined the feature of ERD/ERS with regard to vibrotactile stimulations a method was developed that enables more distinctive extraction of the feature of the ERD/ERS single index the new index needs to be validated through future studies on vibrotactile stimulations M-HC and S-CC conceived and designed the experiments H-SK and S-YG contributed reagents/materials/analysis tools M-HC and BK drafted the article or revised it critically for important intellectual content The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest This article was supported by Konkuk University “Comparison of skin stretch and virbrotactile stimulation for feedback of proprioceptive information,” in Symposium on Haptic Interface for 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beta synchronization after wrist Functional segregation of movement-related rhythmic activity in the human brain Oscillatory correlates of vibrotactile frequency processing in human working memory Relationship between speed and EEG activity during imagined and executed hand movements Keywords: event-related desynchronization (ERD) response event-related synchronization (ERS) response Kim W-R and Chung S-C (2017) Perceptual Threshold Level for the Tactile Stimulation and Response Features of ERD/ERS-Based Specific Indices Upon Changes in High-Frequency Vibrations Received: 04 November 2016; Accepted: 10 April 2017; Published: 25 April 2017 Copyright © 2017 Choi, Kim, Kim, Gim, Kim and Chung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) provided the original author(s) or licensor are credited and that the original publication in this journal is cited *Correspondence: Soon-Cheol Chung, c2NjaHVuZ0Bra3UuYWMua3I= † These authors have contributed equally to this work. Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish. Volume 16 - 2022 | https://doi.org/10.3389/fnins.2022.1045715 Movement-related oscillations in the beta range (from 13 to 30 Hz) have been observed over sensorimotor areas with power decrease (i.e. ERD) during motor planning and execution followed by an increase (i.e. Several electrophysiology studies have used beta ERD and ERS as functional indices of sensorimotor integrity primarily in diseases affecting the motor system Recent literature also highlights other characteristics of beta ERD and ERS implying their role in processes not strictly related to motor function Here we review studies about movement-related ERD and ERS in diseases characterized by motor dysfunction We also review changes of beta ERD and ERS reported in physiological aging three conditions without overt motor symptoms The review of these works shows that ERD and ERS abnormalities are present across the spectrum of the examined pathologies as well as development and aging They further suggest that cognition and movement are tightly related processes that may share common mechanisms regulated by beta modulation Future studies with a multimodal approach are warranted to understand not only the specific topographical dynamics of movement-related beta modulation but also the general meaning of beta frequency changes occurring in relation to movement and cognitive processes at large Such an approach will provide the foundation to devise and implement novel therapeutic approaches to neuropsychiatric disorders No matter the precise significance of beta ERD, ERS, and movement-related beta modulation in general, all past studies have considered them as hallmark of the sensorimotor system functioning (Espenhahn et al., 2017) and thus as possible biomarkers of motor symptoms in several neurological and psychiatric diseases movement-related beta activity has been extensively studied in patients with Parkinson’s disease (PD) the second most common neurodegenerative disorder that is still diagnosed with the appearance of motor symptoms only a few studies focused on cognitive and behavioral disorders that are not specifically characterized by motor symptoms conditions where subclinical motor or sensorimotor abnormalities can be experimentally detected we wished to answer the following questions: Are abnormalities of movement-related beta ERD and ERS clearly and specifically linked to motor symptoms Are these abnormalities present in pathological conditions other than classical motor disorders We thus focused on studies investigating movement-related ERD and ERS in the beta range during motor tasks performed with a limb and recorded with electrophysiological techniques with high time resolution (such as EEG and DBS) that allows for differentiating phases of planning The reviewed papers were on pathologies both specifically affecting the motor system [e.g. (MS)] and in conditions that are not strictly associated with motor disorders The research of the literature did not disclose studies about beta ERD or ERS in other psychiatric conditions The results of this review indicate that abnormalities of movement-related beta ERD and ERS have been described not only in classical motor disorders but also in pathologies that do not present with overt motor signs such electrophysiological abnormalities do not appear to be specifically linked to motor symptoms but they were rather associated to non-motor problems the review of those studies suggests that beta ERD and ERS cannot be considered pure biomarkers of specific motor aspects but they rather represent neural mechanisms common to features of motor and non-motor functions Throughout the present paper, we use the terminology of beta ERD to indicate decreases of beta power before and during movement and beta ERS for increases of beta power after movements. A description of all the retrieved studies is reported in Tables 1–4. A summary of the results are in Table 5 Review of studies on movement-related beta ERD and ERS in stroke and ALS Review of studies on movement-related beta ERD and ERS over cortical and subcortical structures in Parkinson’s disease with EEG cortical (ECoG) and subcortical (STN DBS) recordings Review of studies on movement-related beta ERD and ERS in dystonia Review of studies on movement-related beta ERD and ERS in development and aging Summary of the results of EEG and MEG studies in neuropsychiatric diseases While there is no clear explanation for these phenomena one could speculate that the prolonged ERD is due to the loss of the appropriate neuronal population to be recruited so that greater neuronal loss is associated with longer ERD duration and poorer motor performance the reviewed studies suggest that that abnormalities of ERD and ERS in stroke patients are somewhat related to abnormal motor function in general or specifically during the motor task see supplemental material) that was proportional to the degree of corticospinal damage The contrasting results of the two studies could be due to differences in the selections of the range of beta band The reviewed studies indicate that, in general, the finding of abnormal ERD/ERS in ALS did not directly relate to motor dysfunction, the main problem of this disease. However, correlation between cognitive scores with ERS amplitude was reported at least in one study (McMackin et al., 2021) This suggests that movement-related beta ERD/ERS may reflect cognitive problems that often accompany ALS in the absence of motor task performance disruption many factors could have played a role in the diverse results the great number of tested variables as well as large within- and between-group variabilities in terms of age Greater coherence between DBS and MEG recordings in beta frequency range was associated with increased reaction time confirming the role of beta oscillations in motor planning While ERD amplitude was similar in non-fatigued MS patients and healthy controls the fatigued MS patients displayed a smaller ERD than the other two groups The greater fatigue scores corresponded to a larger ERD reduction suggesting that non-motor features may contribute to ERD amplitude confirming a disruption of beta ERS mechanisms The authors further suggested that neuronal damage in MS either from decreased neuronal density or demyelination may lead to a decrease in neuronal firing and thus to a reduced ability to synchronize The authors stated that the lack of difference in terms of occipital beta ERD is possibly related to intact occipital function in this group of participants compared to the previous one An alternative explanation should take into account the lack of online visual feedback during the task compared to the other studies greater ERD amplitude was associated with slower walking cadence suggesting that increased ERD amplitude in CP may result from abnormalities in energy regulation Many of these papers also reported delayed timing of ERD The contrasting results of these papers could be due to differences in tasks, sample size, and age ranges. Most importantly, age may not be the best predictor of cortical changes since other individual factors play important roles in aging processes, such as motor practice, lifestyle, gender, genetics, and differences in plasticity and energy mechanisms (Dachtler and Fox, 2017; Ricci et al., 2019a) This review suggests that neurological and psychiatric disorders with or without overt motor problems present with abnormalities of movement-related beta ERD and ERS and that such abnormalities are, in many cases, not directly related to motor symptoms. As summarized in Table 5 most studies found decreased ERD amplitude in stroke and PD; decreased ERD and ERS amplitudes were described in MS especially in patients with fatigue; conversely ERD with abnormally increased amplitude was reported in CP a process accompanied by changes in motor and cognitive function ERD and ERS amplitudes increase during development a finding that has been linked to the reduced cortical inhibition and high plasticity typical of childhood contrasting results about the effects of old age suggest that age per se is not associated with changes in movement-related beta oscillations and other factors related to lifestyle and perhaps genetics may play significant roles Only a few studies have investigated possible changes in neuropsychiatric conditions without clinically evident sensorimotor impairment and ERS associated with simple finger movements were spread beyond the normal motor cortical network over areas that Such an enlarged recruitment suggests that first neurodegeneration in AD must also affect the sensorimotor function which is often present later on in the disease Decreased ERS amplitude correlated with the progression of schizophrenia and also with the degree of schizotypal personality; in OCD similar ERS findings were not related to motor performance abnormalities of movement-related beta ERD and ERS were found in all the neuropsychiatric diseases we have reviewed and such abnormalities were not necessarily dependent on the presence of motor symptoms it is likely that cognition and movement share common processes –both regulated by beta modulation – that allow for focusing and suppressing irrelevant phenomena with a sort of center-surround suppression mechanism of action This view of common mechanisms underlying motor and cognitive processes such as those expressed by beta modulation transcends the conceptual separation of the different brain functions into motor and cognitive categories and should ultimately guide new research 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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) *Correspondence: Elisa Tatti, ZWxpc2F0YXR0aUBtc24uY29t; Angelo Quartarone, YXF1YXJ0YXI2NUBnbWFpbC5jb20=; M. Felice Ghilardi, bGljZS5tZzc5QGdtYWlsLmNvbQ== †Present Address: Francesca Ferraioli The latest Mr Porter exclusive capsule collection sees the retailer collaborate with cult Parisian brand Enfants Riches Déprimés The limited-edition 37-piece collection spans ready-to-wear creating a 360 wardrobe that underscores the ERD world denim and workwear form the core of the offering and patchworks decorate a leather biker jacket Wide-leg tailoring and double-knee workwear trousers are accompanied by leather cowboy boots and a branded bowling bag The collection is completed by a range of collectables including a white bronze astray engraved with the brand’s monogram “The capsule has so many great pieces with countless hours of hand-worked craftsmanship,” said Henri Alexander Levy “Mr Porter has held many of ERD’s best pieces over the years as a retail partner they understand the importance of investing in the more elaborate and most high-end garments in our offering We are really looking forward 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They were rock-solid during dynamic day shoots and night shoots, as well as maneuvering in and around vehicles. I even landed a hit on a steel silhouette with a Walther PDP F-Series from about 120 yards away What do you think of the new C&H Precision ERD-1? Let us know below. Want to learn more about the latest rifle optic tech? Check out our guide to red dots vs holographic sights Hand-Picked Ammo & Firearm Discounts Scott Murdock is a Marine Corps veteran with a basic working knowledge of shooting He's passionate about helping readers find quality gear that's worthy of their money You can find more of his work at Task & Purpose Subscribe to Pew Pew Tactical's sales and deals email Get Our Top Shooting Drills and Zeroing Targets ($47 value - but FREE for a limited time) And stay in touch with newsletters of our best articles on techniques We hate SPAM and promise to keep your email address safe Teletalk looks forward to the Economic Relations Division (ERD) as the lone state telecom operator's 4G mobile broadband network expansion project remains stalled following cancellation of its first tender.The operator is now weighing multiple options -- whether to select one of the three original companies issue a new tender among all of them or exclude the previous entities and invite fresh bids.To navigate this situation Teletalk sought guidance from the Bangladesh Public Procurement Authority (BPPA) through a letter on February 18 the BPPA recently provided opinion in a letter signed by its director (deputy secretary) Sakhawat Hossain stating that the public procurement rules and associated policies outline the procedures for cancelling all tenders under such circumstances.The BPPA advised the Teletalk authorities to proceed accordingly.In light of this the BPPA suggested that Teletalk consult the ERD to explore the possibility of replacing the disqualified EPC (engineering procurement and construction) firms with new highly qualified ones.Industry experts argue that the disqualified trio violated tender rules and should be obstructed for new bid with a fresh tender process initiated.Teletalk managing director Nurul Mabud Chowdhury confirmed that they have decided to send a letter to the ERD in line with the BPPA's advice."We're following government rules and the ERD circular on this issue will guide the next steps," he said adding that the ERD will make the final decision.Bangladesh's ties with China have been strengthened in recent years with Beijing providing $2.97 billion in loans over the last four fiscal years.For Teletalk's 4G expansion project China has committed approximately Tk 20 billion (about $162 million) while the Bangladesh government is contributing Tk 9.0 billion.Under the government-to-government (G2G) framework China was supposed to nominate three companies for the project.However all three bidders were disqualified due to irregularities in the tender process with allegations of a syndicate forming among them.A development expert and communication specialist emphasised that while China has been a key development partner national interests must not be compromised "Transparency and accountability are essential Bangladesh should ensure fair competition."Again a Teletalk SIM user echoed similar concerns stating: "The biggest issue with any project in our country is transparency We should not compromise our independence just because China is financing the project Teletalk must protect its own interests."bdsmile@gmail.com Bishop Daniel Flores addresses the USCCB plenary assembly June 16, 2023.Share The proposal to review Part Three of the Ethical and Religious Directives for Catholic Health Care Services passed unanimously on a voice vote on the final day of the USCCB’s plenary assembly in Orlando The Ethical and Religious Directives for Catholic Health Care Services (ERDs) is a guide released by the bishops to offer ethical standards in health care based on Catholic teaching about human dignity which was approved by the bishops five years ago dealing with professional-patient relationships It does not include guidance on “radical modifications of the human body,” such as surgeries and hormones given for gender dysphoria In March, the USCCB’s administrative committee authorized the publication of a doctrinal note from the conference’s doctrine committee on “moral limits to technological manipulation of the human body.” The note said, among other things, that transgender surgeries are immoral because they “do not repair a defect in the body…these interventions are intended to transform the body so as to make it take on as much as possible the form of the opposite sex, contrary to the natural form of the body. They are attempts to alter the fundamental order and finality of the body and to replace it with something else.” Flores introduced a proposal to incorporate the doctrinal note into the ERDs. The revision would involve the doctrine committee consulting bishops, moral theologians, doctors and other experts to create a draft that would be subject to review, discussion, and vote by the bishops. When Flores asked if there were any questions, several bishops came forward to emphasize that they believe there should be a “broad consultation” on the issue, including the voices of people who identify as transgender. Cardinal Robert McElroy of San Diego made a distinction between “the doctrinal tradition of the Church, particularly on male and female” and the need “to wrestle with the existential question of those who are suffering from dysphoria.” “I think there’s a fundamental difference between a declaration on doctrine, which was issued, and the formulation of the ERDs,” he said. He stressed that the ERDs are not just a statement of doctrine but an application of doctrine to “the existential situation of people who are suffering.” “The ERDs are meant to be a pastoral, medical document to inform and guide the health care ministries,” he said. “I urge therefore that the consultation be very wide and deep, within the medical communities and with people who are suffering from dysphoria also,” he said. Cardinal Joseph Tobin emphasized the need to listen to people and to present things in a way that is understandable to people in the language of the ERDs. “I would like to also encourage a broad consultation, including people who are from the trans community,” he said. Bishop Shawn McKnight of Jefferson City also called for a “wide consultation, especially with the various Catholic health care systems.” Auxiliary Bishop Robert Casey of Chicago, speaking on behalf of Cardinal Blase Cupich, who had to leave the meeting early, asked that the consultation include dioceses with a significant Catholic health care presence. Archbishop Paul Etienne of Seattle also called for a “broader consultation,” saying that policy makers, physicians, and CEOs of health care systems should all be able to weigh in on the discussion. Bishop Michael Olson of Fort Worth, who is a member of the doctrine committee that released the note on technological manipulation of the human body in March, emphasized that there had been extensive consultation leading up to the development of that note. “Part of the process that we had in the doctrinal note was listening not only to members who identify themselves as part of the trans community, but those practitioners, theologians, ethicists, family members as well,” he said. “And what became clear in this process as we compiled and formed the doctrinal note is that there is still a lack of clarity between what is authentic gender dysphoria and then also the gender ideology that in part is preying upon these people and enhancing their suffering, increasing their suffering,” he continued. “So I’m hoping that the development and the process of the ERDs will help us to bring greater clarity between these two phenomena, of gender dysphoria and also gender ideology. So then hopefully we can write a broader pastoral document after the completion of the ERDs.” After fielding questions and comments, the bishops held a voice vote on the proposal. The vote passed unanimously, with no abstentions or votes in opposition. There never can be broad clarity in these matters because every case has its origin in a single human mind and every mind is unique Some people are apparently deeply committed to *something like* a belief that God or nature has played them a cruel trick by creating them with a body of the incorrect sex some have convinced "experts" and a surgeon that the only acceptable solution is sex-reassignment surgery https://en.wikipedia.org/wiki/Gender-affirming_surgery Beliefs no doubt vary widely among different subjects, as do those of the experts relied upon. Presumably the surgeons follow standard procedures. ReplyShare1 reply20 more comments...LatestNo posts The U.S. bishops on Friday voted to move forward with reviewing and updating their directives for Catholic health care services, after several bishops emphasized that the process should include a \u201Cbroad consultation,\u201D including the voices of the transgender community. Bishop Daniel Flores addresses the USCCB plenary assembly June 16, 2023.Share The proposal to review Part Three of the Ethical and Religious Directives for Catholic Health Care Services passed unanimously on a voice vote on the final day of the USCCB\u2019s plenary assembly in Orlando head of the bishops\u2019 doctrine committee It does not include guidance on \u201Cradical modifications of the human body,\u201D such as surgeries and hormones given for gender dysphoria In March, the USCCB\u2019s administrative committee authorized the publication of a doctrinal note from the conference\u2019s doctrine committee on \u201Cmoral limits to technological manipulation of the human body.\u201D that transgender surgeries are immoral because they \u201Cdo not repair a defect in the body\u2026these interventions are intended to transform the body so as to make it take on as much as possible the form of the opposite sex They are attempts to alter the fundamental order and finality of the body and to replace it with something else.\u201D Flores introduced a proposal to incorporate the doctrinal note into the ERDs The revision would involve the doctrine committee consulting bishops doctors and other experts to create a draft that would be subject to review When Flores asked if there were any questions several bishops came forward to emphasize that they believe there should be a \u201Cbroad consultation\u201D on the issue including the voices of people who identify as transgender Cardinal Robert McElroy of San Diego made a distinction between \u201Cthe doctrinal tradition of the Church particularly on male and female\u201D and the need \u201Cto wrestle with the existential question of those who are suffering from dysphoria.\u201D \u201CI think there\u2019s a fundamental difference between a declaration on doctrine and the formulation of the ERDs,\u201D he said He stressed that the ERDs are not just a statement of doctrine but an application of doctrine to \u201Cthe existential situation of people who are suffering.\u201D medical document to inform and guide the health care ministries,\u201D he said \u201CI urge therefore that the consultation be very wide and deep within the medical communities and with people who are suffering from dysphoria also,\u201D he said Cardinal Joseph Tobin emphasized the need to listen to people and to present things in a way that is understandable to people in the language of the ERDs \u201CI would like to also encourage a broad consultation including people who are from the trans community,\u201D he said Bishop Shawn McKnight of Jefferson City also called for a \u201Cwide consultation especially with the various Catholic health care systems.\u201D speaking on behalf of Cardinal Blase Cupich asked that the consultation include dioceses with a significant Catholic health care presence Archbishop Paul Etienne of Seattle also called for a \u201Cbroader consultation,\u201D saying that policy makers and CEOs of health care systems should all be able to weigh in on the discussion who is a member of the doctrine committee that released the note on technological manipulation of the human body in March emphasized that there had been extensive consultation leading up to the development of that note \u201CPart of the process that we had in the doctrinal note was listening not only to members who identify themselves as part of the trans community \u201CAnd what became clear in this process as we compiled and formed the doctrinal note is that there is still a lack of clarity between what is authentic gender dysphoria and then also the gender ideology that in part is preying upon these people and enhancing their suffering increasing their suffering,\u201D he continued \u201CSo I\u2019m hoping that the development and the process of the ERDs will help us to bring greater clarity between these two phenomena of gender dysphoria and also gender ideology So then hopefully we can write a broader pastoral document after the completion of the ERDs.\u201D the bishops held a voice vote on the proposal with no abstentions or votes in opposition Subscribe now and advisory services with a strategic focus on building and infrastructure sectors announced today that it has completed the acquisition of Trinity | ERD an architecture and engineering company specializing in building envelope consulting Trinity | ERD has extensive expertise in servicing the existing buildings market across the country out of their offices in Washington Trinity's team reinforces SOCOTEC's superior technical services platform..." "Adding Trinity to our platform further bolsters our growing presence in the US partnering with Trinity allows us to continue to scale the business ensuring that we grow with our clients and better serve the industry," said SOCOTEC CEO Marc Weissbach Principal of SOCOTEC and Practice Leader responsible for Strategic Partnerships and Integration Trinity's team reinforces our superior technical services platform Having already catered to the existing buildings and forensic engineering service offerings Trinity's services align very well with our holistic approach to pre-construction thereby supporting our clients throughout the entire lifecycle of their most valuable assets." "Trinity is excited to become part of SOCOTEC Our clients will gain access to additional expertise and depth in all areas of the built environment exposing them to expanded capabilities of in-house specialty engineering project advisory and dispute resolution service offerings this partnership will provide unlimited advancement possibilities for our staff," said Colin Murphy Trinity | ERD employs professionals in three offices: Seattle SOCOTEC did not previously have offices in these markets "SOCOTEC is aiming to become the global TIC leader in the Building and Infrastructure sectors with a strong presence in the USA - now having 25 locations Trinity's seasoned and well recognized team of experts will reinforce our skillset as well as contribute to extending our network in the US market By providing expertise along the project lifecycle of built assets we can deliver services from strategy to operations and work for sustainable buildings and infrastructure," added Hervé Montjotin has built its reputation as an independent trusted partner assisting companies in the areas of quality Today a leading $1.2 billion USD company that more than doubled in size in 6 years (CAGR of 15%) SOCOTEC's mission is to ensure the integrity and performance of building and infrastructure assets and people's safety SOCOTEC helps to optimize the performance of companies in every sector by managing the risks inherent in their activities Drawing on its expertise and positioning itself as a long-term partner SOCOTEC supports its clients throughout their project's lifecycle As a leader in construction inspection and a major player in TIC for the construction and infrastructure sectors the SOCOTEC Group has 200,000 clients with operations in 25 countries 11,000 employees and over 250 external recognitions an industry leader in the building and infrastructure sectors offers the combined highly technical expertise of an expansive and holistic network of experts across six service lines: (i) Building Envelope; (ii) Energy & Sustainability; (iii) Code & Planning; (iv) Project Advisory; (v) Dispute Resolution; and (vi) Specialty Engineering SOCOTEC employs over 400 professionals in more than 20 offices See www.socotec.com and www.socotec.us for more information a global leader in risk management and technical consultancy in construction and advisory services with a strategic focus on.. Computer Software Computer Software Construction & Building Computer & Electronics Do not sell or share my personal information: Now that the Elden Ring Shadow of the Erdtree release date has passed here's everything you need to know before you start the DLC Follow us for daily PC games news, guides and reviews on X, Facebook, Google News, and Steam. Or sign up to our free newsletter. Volume 4 - 2023 | https://doi.org/10.3389/falgy.2023.1080951 Nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) is a clinical syndrome characterized by nasal polyposis It affects approximately 15% cases of severe asthma 10% of nasal polyps and 9% of rhinosinusitis N-ERD results in associated asthma exacerbations Unknown influences cause polyp epithelium to release alarmins resulting in complex type 2 inflammation involving mast cells Arachidonic acid released from such cells is metabolized into mediators N-ERD is characterized by an imbalance in eicosanoid levels Patients with N-ERD present nasal symptoms (congestion nasal discharge) and lower airways symptoms (cough severe hyposmia as well as severe asthma which impacts the quality of life in this disease and leads to safety concerns in patients daily lives Despite the variety of treatment strategies the likelihood of recurrence of symptoms is high in patients with N-ERD The most important strategies for treating N-ERD are listed as following: drug therapies monoclonal antibodies and other therapies associated N-ERD treatment remains a major challenge in the current situation Selecting the appropriate patient for aspirin desensitization monoclonal antibodies or both is essential This review provides an overview on aspirin desensitization and biologics in N-ERD and might help in decision making from both the perspective of the physician and patient but also patient preferences are all factors to take into account when it comes to a choice between biologics or aspirin desensitization the physician is left with two treatment options to attack the persistent airway inflammation: aspirin desensitization or biological therapy no direct trials with aspirin desensitization and biologic therapy in N-ERD patients exist which makes it difficult to choose The treating physician should therefore be continuously attentive for aspirin-related adverse effects and asses the benefit/risk ratio of aspirin desensitization regularly as patients' history can change it is unclear whether initiating biologics immediately after surgery would have a better clinical effect Another important factor to consider is the extent to which the patient can adhere to the treatment. Patients on aspirin treatment after aspirin desensitisation (ATAD) missing their dose for more than two days will gradually regain their intolerance and will need further desensitization (2, 15) It is therefore of utmost importance to continuously monitor patients for aspirin-related side effects there are currently no biosimilars for dupilumab mepolizumab and omalizumab on the market to stimulate market competitiveness and to reduce the costs for the health care system depending on the turnover threshold of the original biological the price of a biosimilar can be up to maximum 47,18% lower than the original price of the original biological The costs must be weighed against effectiveness expressed by “quality-adjusted life year” (QALY) which stands for one year in perfect health In 2008, Shaker et al. investigated the cost-effectiveness of aspirin desensitization with subsequent aspirin therapy in moderate-to-severe N-ERD (34) According to their findings ambulatory desensitization for N-ERD could save $6.768 per QALY and across a wide range of assumptions aspirin desensitization remained cost-effective with less than $50,000 per QALY saved In their modelling of costs of asthma therapy they did not include the potential of aspirin desensitization to reduce the need for omalizumab the abovementioned amounts are probably underestimating the cost saving effect of aspirin Lysine aspirin is more expensive than aspirin tablets but the process of challenge and initial desensitization is faster taking half a day rather than 2–3 days of inpatient care very significantly lower than that of any biologic A full-scale double- blind trial is needed Regarding the biologics, not surprisingly, cost-effective analyses are lacking, given their only recent approval for chronic rhinosinusitis. Anderson et al. reviewed in 2019 the current literature for asthma and the cost-efficacy of omalizumab, mepolizumab, reslizumab, benralizumab and dupilumab. The authors concluded that the prices should be reduced by a minimum of approximately 60% to achieve the cost-effectiveness threshold prices (35) there is something to be said for both biologics and aspirin desensitization as the costs of aspirin desensitization are nothing compared to biologics aspirin desensitization should be tried first when no clear contra-indication exists patients might fear the effect of the biological on their immune system and the fact that only short-term safety data are known Different factors have to be weighed up continuously a trial of ATAD should therefore precede treatment with a biologic the Medical University of Vienna is currently running a study to test the efficacy of a 6-month treatment with dupilumab in inducing tolerance to aspirin evaluated by oral drug provocation testing (ClinicalTrials.gov Identifier: NCT04442256) The estimated study completion date is foreseen by the end of 2022 Table 1. Overview of the indications and contra-indications of biologics, ATAD and combined use (2, 7, 12, 15, 16) The authors declare that the review was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest Aspirin-exacerbated respiratory disease: update on medical management The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: a work group report from the rhinitis rhinosinusitis and ocular allergy committee of the American academy of allergy PubMed Abstract | CrossRef Full Text | Google Scholar SWOT Analysis of chronic rhinosinusitis care anno 2022 PubMed Abstract | CrossRef Full Text | Google Scholar Aspirin tolerance induced in aspirin-sensitive asthmatics Aspirin-sensitive asthma: tolerance to aspirin after positive oral aspirin challenges 7. Simon RA, Adkinson NF, Feldweg AM. Aspirin-exacerbated respiratory disease: NSAID challenge and densensitization. UpToDate (2022). Available at: https://www.uptodate.com/contents/aspirin-exacerbated-respiratory-disease-nsaid-challenge-and-desensitization (Accessed October 17 PubMed Abstract | CrossRef Full Text | Google Scholar Prostaglandin D₂: a dominant mediator of aspirin-exacerbated respiratory disease White paper on European patient needs and suggestions on chronic type 2 inflammation of airways and skin by EUFOREA PubMed Abstract | CrossRef Full Text | Google Scholar Aspirin desensitization and biologics in aspirin-exacerbated respiratory disease: efficacy Major complications of aspirin desensitization and maintenance therapy in aspirin-exacerbated respiratory disease Aspirin desensitization vs biologics for patients with aspirin-exacerbated respiratory disease Controversies in allergy: aspirin desensitization or biologics for aspirin-exacerbated respiratory disease-how to choose EUFOREA Consensus on biologics for CRSwNP with or without asthma EUFOREA Expert board meeting on uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) and biologics: definitions and management Aspirin-exacerbated respiratory disease: clinical disease and diagnosis Aspirin-sensitive rhinosinusitis: the clinical syndrome and effects of aspirin administration Efficacy and safety of benralizumab in chronic rhinosinusitis with nasal polyps: a randomized European Position paper on rhinosinusitis and nasal polyps 2020 CrossRef Full Text | Google Scholar Comparative efficacy and safety of monoclonal antibodies and aspirin desensitization for chronic rhinosinusitis with nasal polyposis: a systematic review and network meta-analysis Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma Survey-Defined patient experiences with aspirin-exacerbated respiratory disease Intranasal lysine-aspirin in aspirin-sensitive nasal polyposis: a controlled trial Effects of lysine-acetylsalicylate (LAS) treatment in nasal polyposis: two controlled long term prospective follow up studies Intranasal lysine-aspirin administration decreases polyp volume in patients with aspirin-intolerant asthma Topical nasal lysine aspirin in aspirin-sensitive and aspirin-tolerant chronic rhinosinusitis with nasal polyposis Intranasal treatment with lysine acetylsalicylate in patients with nasal polyposis PubMed Abstract | Google Scholar A retrospective study on long-term efficacy of intranasal lysine-aspirin in controlling NSAID-exacerbated respiratory disease Audit of nasal lysine aspirin therapy in recalcitrant aspirin exacerbated respiratory disease Aspirin to prevent cardiovascular disease: the association of aspirin dose and clopidogrel with thrombosis and bleeding doi: 10.7326/0003-4819-150-6-200903170-00006 Aspirin desensitization for aspirin-exacerbated respiratory disease in the era of biologics: clinical perspective An economic analysis of aspirin desensitization in aspirin-exacerbated respiratory disease Cost-effectiveness and comparative effectiveness of biologic therapy for asthma: to biologic or not to biologic Appraisal of the real-world effectiveness of biologic therapies in aspirin-exacerbated respiratory disease Efficacy of dupilumab in patients with aspirin-exacerbated respiratory disease and previous inadequate response to anti-IL-5 or anti-IL-5Rα in a real-world setting Inflammatory heterogeneity in aspirin-exacerbated respiratory disease Evaluating enrollment and outcome criteria in trials of biologics for chronic rhinosinusitis with nasal polyps Immunology-based recommendations for available and upcoming biologics in aspirin-exacerbated respiratory disease Omalizumab can inhibit respiratory reaction during aspirin desensitization Mepolizumab does not prevent all aspirin-induced reactions in patients with aspirin-exacerbated respiratory disease: a case series Omalizumab-Induced aspirin tolerance in nonsteroidal anti-inflammatory drug-exacerbated respiratory disease patients is independent of atopic sensitization Biologics for chronic rhinosinusitis with nasal polyps (CRSwNP) PubMed Abstract | CrossRef Full Text | Google Scholar Cost-effectiveness analysis comparing dupilumab and aspirin desensitization therapy for chronic rhinosinusitis with nasal polyposis in aspirin-exacerbated respiratory disease Keywords: NSAID-exacerbated respiratory disease Scadding G and Hellings PW (2023) Monoclonal antibody or aspirin desensitization in NSAID-exacerbated respiratory disease (N-ERD)? Received: 26 October 2022; Accepted: 31 January 2023;Published: 12 April 2023 © 2023 Van Broeck, Steelant, Scadding and Hellings. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) *Correspondence: Dorien Van Broeck ZG9yaWVuLnZhbmJyb2Vja0BrdWxldXZlbi5iZQ== †These authors have contributed equally to this work and share first authorship Specialty Section: This article was submitted to Mechanisms in Allergy a section of the journal Frontiers in Allergy Thank you for completing the form, here is your download: "+jQuery("body").attr("docName")+" Thank you for completing the form, here is the link to your on-demand webinar: On-Demand Webinar Link All-new ERD-1 rifle red dot optic is now available for purchase and is the second of three optics to become available from the new rifle optic line The ERD-1 is a motion-activated red dot that utilizes a shake-to-wake program and will go to sleep after 5 minutes of no activity this optic is waterproof and shockproof – capable of withstanding the tough tests of an outdoor enthusiast the all-new ERD-1 is the pinnacle of marrying precision with strength,” said Buck Holly large-windowed optic will be the perfect pair for any gas gun or pistol caliber carbine.” This red-dot rifle optic’s 27.5-millimeter window has adjustable brightness with the first two levels compatible with night vision and levels 3 through 10 are standard daylight levels the ERD-1 will run for 50,000 hours on a single battery dependent on inclement weather conditions The MSRP for the C&H Precision ERD-1 is $494.95 and is available to ship immediately For more information on C&H Precision visit www.chpws.com About C&H Precision Family of Companies Copyright © 2025 Lexipol. 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