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Off Key - General Discussion

3.7k Topics 25.7k Posts

A place to talk about whatever you want

  • Tuner - finally, a movie about a piano tuner

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    ShiroKuroS
    The New Yorker picks up the story, during a visit to the Faust Harrison showroom. https://archive.is/EyWA4
  • GCA Giant Cell Arteritis

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    MikM
    The Medical Context (Giant Cell Arteritis) If "GCA" refers to Giant Cell Arteritis (Temporal Arteritis), "fixing" it is a time-sensitive medical emergency to halt systemic blood vessel inflammation and protect the patient's sight. 1. Emergency Systemic Suppression Immediate High-Dose Glucocorticoids: If GCA is highly suspected, treatment must start immediately—even before a biopsy confirms it—to mitigate the risk of permanent blindness. Oral Protocol: Usually initiates with high-dose oral prednisone (typically 40–60 mg daily). IV Pulse Protocol: If the patient is already presenting with acute visual changes or transient vision loss, they require immediate admission for intravenous "pulse" therapy (typically methylprednisolone 1,000 mg daily for 3 consecutive days) to protect the optic nerve. 2. Confirming with a Temporal Artery Biopsy While blood work looking for elevated inflammatory markers like Erythrocyte Sedimentation Rate ($ESR$) and C-Reactive Protein ($CRP$) helps guide suspicion, a temporal artery biopsy remains a gold standard for definitive diagnosis. Locate & Mark: Pre-op. The surgeon uses a Doppler ultrasound to locate the superficial temporal artery on the side of the forehead and marks the path. Local Anesthesia: Incision Prep. A local anesthetic is injected around the marked path to numb the area completely while keeping the patient awake. Isolate & Resect: Surgical Execution. A small incision is made along the temple. The surgeon isolates a small segment of the artery (ideally 1 to 2 cm to account for "skip lesions" where inflammation is patchy), ties off the remaining ends safely, and removes the sample. Closure & Pathology: Post-op. The skin is closed with stitches or staples, and the tissue sample is sent to pathology to look for inflammatory giant cell infiltration in the vessel wall. 3. Long-Term Maintenance and Tapering The 12-to-18-Month Taper: Steroids cannot be stopped abruptly. Once inflammatory markers return to normal and symptoms disappear, the dose is incredibly slowly tapered over a year or longer to prevent dangerous adrenal drops and disease flares. Steroid-Sparing Biologics: To minimize the systemic side effects of long-term high-dose steroids (such as osteoporosis, hyperglycemia, and hypertension), an IL-6 receptor antagonist like Tocilizumab is frequently introduced as an adjunct therapy. Which of these frameworks matches the problem you are trying to solve right now?
  • Bloomscrolling--what's in bloom where you are?

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    A
    Got home to find our rockery flourishing [image: 1780655237532-20260605_103854.jpg] SWMBO plants whatever and wherever It simply dwarfs what was meant, at least in my mind, to be a prominent centrepiece 3' monolith amongst alpines. Really lovely flowers [image: 1780655466860-20260605_103905.jpg]
  • Laughter is the best medicine

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    J
    30 years ago today, l asked my childhood sweetheart, my best friend and the most gorgeous woman l know to marry me. All three said no.
  • WWJD?

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    B
    Probably scoop up some water and turn it into wine. Not entirely off topic: Your Tax Dollars at Work: The Trump Regime’s New Christian Persecution Propaganda Film
  • Mark Cuban Cost Plus Drugs

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    RontunerR
    Your comment about deciding "how bad I feel" to take a pill describes this morning perfectly... In the midst of another cluster, but so glad there is something that can put it on the back burner for the day.
  • Hay Mary Anna

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    MikM
    I’d imagine being an author would make the home’s history…intriguing Quirt’s clients should eternally grateful for his Diligence.
  • Evanescent

    gardens
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    AxtremusA
    Good idea. Too bad the technology (or the budget) is not there to make the balls crystal and seamless.
  • Ötzi the Iceman and his microbiome

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    No one has replied
  • What do chefs cook at home?

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    MikM
    Sounds delicious and healthy. Going into the bookmarks.
  • The Future of U.S. Science Research Funding

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    No one has replied
  • ICE and DHS strike again

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    ShiroKuroS
    Both of these incidents are terrifying to me. I feel like there’s less news attention to ICE’s activities, but the activities themselves continue.
  • For our train buffs

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    wtgW
    [image: IKQ7HYOFINFIJMSPYHCPTZ4RH4.jpg?auth=5a5fdc2d282f1ada0a865ffc14dec1eb33e9eaea7d92a07926c41c0fccb96409&width=1280&smart=true&quality=90] Big Boy is in our area. https://www.nbcchicago.com/news/local/here-he-comes-million-pound-steam-locomotive-big-boy-rolls-into-chicago-area-this-week/3943201/ @steve-miller - Coming your way very soon! https://www.cleveland.com/news/2026/06/big-boy-no-4014s-northeast-ohio-route-is-set-see-the-towns-it-will-roll-through.html
  • Fog and bacteria

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    C
    I knew fog was creepy. Did not know it was infected.
  • Towns rebel against data center projects

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    AxtremusA
    Erin Brockovich gets involved: https://www.yahoo.com/news/us/articles/erin-brockovich-says-people-angry-165957745.html For now she's not taking side (at least not overtly). She's just advocating for more transparency and crowd-sourcing information about plans for data centers.
  • Stalin's wine cellar

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    MikM
    Good use of ill-gotten gains. I've read that the wine industry in Georgia is booming. Never had one but I'm sure we will.
  • Solving the Saturn rotation rate mystery

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    D
    Well, "science" is a interesting topic but like any sub-branch of any epistemological system, science is not an exact science (pun intended). Questions like these aren't "solved" and then set in stone or displayed in a glass case. "Measurements suggested the giant planet's rotation rate was changing over time, as if Saturn were somehow speeding up or slowing down. That puzzling result left scientists searching for answers." I'd venture to say it appeared to be "changing" in fact because it was and is always changing. This isn't so much a mystery as it is the nature of the universe. I just posted about this topic in my Chronos and Kairos thread. https://wtf.coffee-room.com/topic/3681/kairos-the-ancient-greek-art-of-knowing-when-to-act#:~:text=Kairos%3A The-,ancient,-Greek art of We human beings have to be vigilant continuously about what Karl Marx (the writer whose work is canonical among intellectuals, not the "communist" we all love to hate) called reification. Reification involves setting up a continual feedback loop where we "play back" what we think we know in a way that the only outcome is our belief, whatever it was when we started believing it, can only end up being fallaciously reinforced. The planets, the galaxy, the universe-- are never static and if a human being truly wanted to map their machinations, he or she would die trying...
  • And so it begins. (weather)

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    D
    Highd up to 89, scattered showers. Lows around 80, but for some reason the lows are are going to drop to low to mid 70s for several days. That will be nice. Not worried about hurricane season. I'm actually more worried about tornadoes after experiencing one.
  • Kennedy Center

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    D
    I'm a layperson and even I can tell you the applicable law is as plain as day.
  • Population boom to bust

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