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minashiro-mcl-etc · 2 years ago

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Armin Épisode 5 - 100 Continue (solution)

ILLUSTRATION PROPOSITION

Armin n°1

De ce que je veux qu’on fasse de notre week-end, plutôt: c’est un jeu co-op!

A. (Je me suis forcée à sourire. Ce n’est pas vraiment ce que j’avais imaginé...) B. ( J’ai souris largement. Passer le week-end sur un jeu ne peut que me faire du bien!) Illustration

Armin n°2

Je vois, direct dans le vif du sujet! Parfait! Illustration Il n’y a pas d’écran titre? Pas de menu, rien...?

Choix de la tenue: AFK 195G (Lance / Épée 65G, Gants 20G, Robe 70G, Bottes 40G)

Armin n°3 (neutre, sans conséquence)

Non non, prends celui que tu préfères, je prendrai l’autre!

A. Ok! Alors je prends le chevalier, si ça te va. (tenue rouge) B. Très bien, alors je prends le mage, si c’est bon pour toi. (tenue bleu)

Armin n°4

C’est quand même une grosse responsabilité...

A. C’est long surtout. On joue bientôt, tu penses? B. Chut! On est les seuls à pouvoir le faire! Illustration

Le maire Deraim n°1

Aventuriers! Acceptez-vous cette noble et dangereuse quête?

A. Tu crois qu’on peut dire non? Ça a l’air compliqué. B. Allez, Armin, il faut dire oui! Tu vois bien qu’on est leur seule chance! Illustration

Le maire Deraim n°2

Après quoi je vous délivrerai la CLÉ du TOMBEAU DES VOIES PERDUES.

A. Il est sérieux?! Le monde est en danger, on a dit! B. Parfait! Ça nous mettra en jambes pour sauver le monde! Illustration

Armin n°5

Alors, comment tu veux faire? Tu prends ceux des tomates, je prends ceux des citrouilles?

A. Je ne sais pas... Ils son mignons, non? J’ai pas envie de les tuer... B. Hahaha! Comme si j’allais t’en laisser la moitié! Illustration

Armin n°6

Le maire va pouvoir faire de bonne soupe grâce à nous!

A. Je trouve qu’on démarre très fort! Illustration B. Allons le voir justement, on a pas toute la nuit.

Objectif N°1 - Rends-toi au tombeau des voie perdues.

Armin n°7

Bon. Tu es prête à affronter un labyrinthe “truffé de monstres et de Piège”?

A. Je suis plus que prête, je suis impatiente! Illustration B. Je ferais bien une pause, avant de nous lancer.

Objectif N°2 - Entre dans le labyrinthe.

TATA

Condition: Avant d’entrée. Lieu: Village Cadeau: Fauteuil gaming Coût: 18 PA

Armin n°8 (neutre)

On peut essayer... Qu’est-ce que t’en penses?

A. Franchement, comme tu veux. Vas-y on essaie de foncer, on sera plus vite fixés. B. Je trouve ça tiré par les cheveux. Restons prudents.

Armin n°9

Qu’est-ce que tu penses qu’il faut faire?

A. On devrait rester ensemble. Nous séparer ne peut pas être une bonne idée. B. Allons au plus simple: chacun prend sa couleur. C. Chacun prend la couleur de l’autre? Complémentarité, tout ça...? Illustration

Armin n°10

A. On est vraiment des aventuriers hors pair! Illustration B. C’est trop facile, c’est même pas drôle!

Armin n°11

Le pauvre Nath a perdu un pari... Encore...

A. Moi aussi, je peux parier? On pourrait avoir le double de burgers! Illustration B. Tu lui a Vraiment fait traverser toute la ville?! C. J’espère que ce n’est pas le même genre de paris que tu fais avec moi...?

Nathaniel

A. Tu peux nous regarder jouer un peu, si tu veux. B. Aller, tu me fais de la peine. Prends ma place un moment, si tu veux. C. Pas de chantage affectif avec moi, il faudra attendre ton tour! Illustration

Armin n°12

A. Tu diras à ton pote que son labyrinthe est décourageant B. Tu pourras dire à ton pote que son labyrinthe est très réussi! Illustration

Ephraim Dred

Pourquoi n’ai-je pas écout�� la mise en garde de L’ORACLE AVEUGLE?!

A. Oui, bon, on a compris, c’est bon, meurs! B. Ahahah! C’est tellement too much! Illustration

Armin n°13

À mon avis on a fini, il n’y a plus de danger.

A. Si il n’y a plus de danger, J’ai bien une autre idée, pour... célébrer notre victoire...

B. Magnifique,! Je m’en vais l’ouvrir de ce pas! Illustration

C. Bon, très bien, finissons-en!

Coût de l’épisode 706PA (avec Tata)

---------------------------------------------------------------------

ILLUSTRATION HOT

Armin n°1

De ce que je veux qu’on fasse de notre week-end, plutôt: c’est un jeu co-op!

A. (Je me suis forcée à sourire. Ce n’est pas vraiment ce que j’avais imaginé...) B. ( J’ai souris largement. Passer le week-end sur un jeu ne peut que me faire du bien!) Illustration

Armin n°2

Je vois, direct dans le vif du sujet! Parfait! Illustration Il n’y a pas d’écran titre? Pas de menu, rien...?

Choix de la tenue: AFK 195G (Lance / Épée 65G, Gants 20G, Robe 70G, Bottes 40G)

Armin n°3 (neutre, sans conséquence)

Non non, prends celui que tu préfères, je prendrai l’autre!

A. Ok! Alors je prends le chevalier, si ça te va. (tenue rouge) B. Très bien, alors je prends le mage, si c’est bon pour toi. (tenue bleu)

Armin n°4

C’est quand même une grosse responsabilité...

A. C’est long surtout. On joue bientôt, tu penses? B. Chut! On est les seuls à pouvoir le faire! Illustration

Le maire Deraim n°1

Aventuriers! Acceptez-vous cette noble et dangereuse quête?

A. Tu crois qu’on peut dire non? Ça a l’air compliqué. B. Allez, Armin, il faut dire oui! Tu vois bien qu’on est leur seule chance! Illustration

Le maire Deraim n°2

Après quoi je vous délivrerai la CLÉ du TOMBEAU DES VOIES PERDUES.

A. Il est sérieux?! Le monde est en danger, on a dit! B. Parfait! Ça nous mettra en jambes pour sauver le monde! Illustration

Armin n°5

Alors, comment tu veux faire? Tu prends ceux des tomates, je prends ceux des citrouilles?

A. Je ne sais pas... Ils son mignons, non? J’ai pas envie de les tuer... Illustration B. Hahaha! Comme si j’allais t’en laisser la moitié!

Armin n°6

Le maire va pouvoir faire de bonne soupe grâce à nous!

A. Aller, Allons-y! Hauts les cœurs! Illustration B. J’ai le temps de finir mon macchiato?

Objectif N°1 - Rends-toi au tombeau des voie perdues.

Armin n°7

Bon. Tu es prête à affronter un labyrinthe “truffé de monstres et de Piège”?

A. Je suis plus que prête, je suis impatiente! B. Je ferais bien une pause, avant de nous lancer. Illustration

Objectif N°2 - Entre dans le labyrinthe.

TATA

Condition: Avant d’entrée. Lieu: Village Cadeau: Fauteuil gaming Coût: 18 PA

Armin n°8 (neutre)

On peut essayer... Qu’est-ce que t’en penses?

A. Franchement, comme tu veux. Vas-y on essaie de foncer, on sera plus vite fixés. B. Je trouve ça tiré par les cheveux. Restons prudents.

Armin n°9

Qu’est-ce que tu penses qu’il faut faire?

Armin n°10

A. On est vraiment des aventuriers hors pair! Illustration B. C’est trop facile, c’est même pas drôle!

Armin n°11

Le pauvre Nath a perdu un pari... Encore...

A. Moi aussi, je peux parier? On pourrait avoir le double de burgers! B. Tu lui a Vraiment fait traverser toute la ville?! C. J’espère que ce n’est pas le même genre de paris que tu fais avec moi...? Illustration

Nathaniel

Armin n°12

A. Tu diras à ton pote que son labyrinthe est décourageant B. Tu pourras dire à ton pote que son labyrinthe est très réussi! Illustration

Ephraim Dred

Pourquoi n’ai-je pas écouté la mise en garde de L’ORACLE AVEUGLE?!

A. Oui, bon, on a compris, c’est bon, meurs! B. Ahahah! C’est tellement too much! Illustration

Armin n°13

À mon avis on a fini, il n’y a plus de danger.

A. Si il n’y a plus de danger, J’ai bien une autre idée, pour... célébrer notre victoire... Illustration B. Magnifique,! Je m’en vais l’ouvrir de ce pas! Illustration C. Bon, très bien, finissons-en!

Armin n°13

Il reste plus qu’à ouvrir le coffre...

A. Tu as raison, on doit finir de sauver le monde!

B. Tu as dit qu’il n’y avait plus de danger, on a tout notre temps. Illustration

C. Bon, d’accord. Je vais ouvrir le coffre. Et après...

Coût de l’épisode 748PA (avec tata)

#amour sucre #my candy love #MCL #Corazon de Melon #beemoov #armin #mcl al armin #Solutions #100 continue #guide #sucrette #outfit #Outfits #Illustration #illustrations

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chinomiko · 8 months ago

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Hi Chino, how you doing??

I'm sorry if you have answered this before, I haven't found your answer if it exists. My first question is on the 26th episode of Eldarya, where there were bugs preventing players from getting Ezarel's illu. Has it been fully fixed? It must be the 3rd time I play the episode with guides and never got it :(

My second question, still on Eldarya, is whether you think it is reasonable to hope for a sort of Alternate Life DLC like in MCL, but with Ezarel and Valkyon, or even pre-white sacrifice Lance? I think many of us keep login in in this hope, so I was wondering if there was any chance it would ever happen?

Thanks for answering our questions, love you!! ❤️❤️❤️

Hello there ! Regarding your first question, I think I know you got the illus in the end. But if anyone has a doubt at some point, it is better to contact with the game's support directly. They are the ones with the right tools to be able to check and help you :) (I can't ) ----- Regarding this other main recurrent question, First of all, thank you so much to everyone who likes my characters and worlds so much ! As a creator it really means a lot and I can only hope my future characters and stories will get as much passion from you. And so, I am sad to say this but Eldarya and MCL hsl/cl/ll/al are considered finished games by now and as for today*, no more content (new seasons, new episodes, ALs, etc... ) are planned for those sorry 🥲🥲🥲 *"as for today" meant as "never say never", or "we never know", but this is not a clue to hint there are some secret projects going on or whatever, there isn't.

#chinomiko #my candy love #eldarya #otome game

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tetrakys · 2 years ago

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Eldarya: The Dragon's Call

Pinning this post to leave the links for the AUs of Lance and Valkyon.

Chapter 1 is out, it’s mostly an introduction and it’s the same for both routes. After this, the story is slowly going to branch off with some different dialogues and scenes according to the route.

More info below following some questions I’ve received (my asks are open if you have more).

Why are you writing this? Is the company involved?

No, absolutely not, I’m not affiliated to the company in any way. I’m writing this because I’m a fan and Valkyon and Lance are my favourite crushes. I dislike what was done to the characters in ANE and asked Chino to tell me “her version” of what she would’ve done if she still worked on Eldarya (since she wasn’t involved in ANE at all, only the very main idea of the worlds merging is hers, but she didn't work on it). I personally consider her version of the story more “canon” since she is the original creator, she made these characters and she knows how they would behave etc. She came up with the main plot for this AU and we brainstormed together. If one day the company decides to make Eldarya AL games, I will delete this fic because this would be the story Chino would tell.

How do you know Chino?

I sent her a message two years ago to congratulate her for the 10 years anniversary of MCL, we started talking and became good friends. We’ve met many times now and travelled together, and she was also one of my bridesmaids 🥰. (I didn’t know her at all when I was making guides for the first 6 routes of Moonlight Lovers, we started talking in March 2021.) She’s a good person and cares a lot about the fans and the games, otherwise being a fan myself I would’ve never been able to like her and become her friend. You should send her some love on her instagram @chi.no.miko if you have the chance.

So, what is the story about?

The story is set at the beginning of ANE, starting between episode 3 and 4. It tells the quest of Erika trying to bring Valkyon back. If this was made as a game, Erika would go on a quest with with each one of the guys depending on the route (so, single route basically). She of course would connect or reconnect with the chosen crush during the adventure. With Valkyon though it’s slightly different for obvious reasons, and you’ll see how if you decide to read his route.

How long is this story going to be?

I have planned 10 chapters but the number is not set in stone.

What’s the release pace?

I’m not giving myself a schedule as I’m busy with work, but I would like to write one chapter every one or two weeks, we’ll see if I can do it.

Can you even write?

Debatable. I’m not a writer but I like to think that I have a good vision of how the characters behave. You can check my AO3 for my past fics on MCL, Eldarya and Moonlight Lovers (I also have a masterlist here on tumblr, it's mostly the same stuff but some things are just here or just there). I’ve written about most of the crushes. However please keep in mind that English isn’t my first language so there will be for sure lots of typos and such 🙏

#eldarya #eldarya the dragon's call #about my writing #my writing #edc

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mcl-alloveragain · 2 years ago

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BLOG GUIDE! (About me, requests, masterlist.)

--- About me:

Hello!! My name's Dusia, I'm '04 and I'm from Poland

My pronouns are she/they!

My LI is Nathaniel (but if Armin was in the game from the very beginning, it would probably be him lol, too bad I already fell in love with mr. student body president)

I play MCL since 31.07.2015, but I abandoned the game after UL came out, because I was missing my best boys too much to enjoy it anymore. I came back because of Kentin's AL and I'm gonna finish the story... someday.

--- Requests:

I mostly write headcanons, because they are short and I'm still a bit insecure about my english, but I'm fine with drabbles as well and I'm gonna translate my fics at some point, so I think I can pull off one shots as well, it would just take me much more time. I love to write tho, so feel free to request anything you want!!

I'm fine with nsfw stuff as well (cause i'm horny af) but again, those requests may take me a bit longer because I'm not too familiar with nsfw vocabulary (I know basic stuff since I read some smut in English, but still...)

I'm not very comfortable with writing things about characters UL and LL exclusive, like Hyun, Rayan or Eric, because I simply don't know them at all. Priya is fine since she was already introduced in HSL. But I'm not saying no, so if you really want to read something about them, I'll try my best......

What I will NEVER write tho:

Anything that includes any type of sexual abuse or violence. Please don't romanticize this. When I'm writing nsfw pieces, my charaters are always adults and events happen with mutual consent.

I don't write BDSM. Simply because I know nothing about it and I don't want to distribute a false image of this type of relationships.

(list to be updated)

--- Masterlist:

~HEADCANONS~

[all HSL boys]

Your favourite ways to spend time with each other

[individual HSL]

Before the breakup [Armin]

~DRABBLES~

[TBU]

~SCENARIOS~

My scenarios for Armin's AL ep.2

~ONE SHOTS~

[TBU]

~FANFICTIONS~

[TBU]

--- Some other posts about my boys:

ARMIN🎮

Armin and Candy's break up songs

Candy's break up song

Playlist inspired by Armin's Alternate Life [ep.1]

CASTIEL🎸

My Favourite Castiel's Illustrations

KENTIN🐕

My Favourite Kentin's Illustrations

LYSANDER🖋️

My Favourite Lysander's Illustrations

NATHANIEL🐈

My Favourite Nathaniel's Illustrations

--- My MCL OCs:

[TBU]

--- UL/LL related:

[TBU]

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waterfiltergurus · 2 years ago

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Is Birmingham Tap Water Safe to Drink in [year]? (According to Data)

How safe is Birmingham, AL's drinking tap water? How does this City's water supply compare to other cities and states in the country? And are there any contaminants that exceed safety levels in Birmingham's drinking water? Find the answer to all of these questions in this guide. 📌 Birmingham's tap water is considered generally safe to drink. We couldn't find any evidence that the City violates any public health standards for its drinking water quality. However, you should also consider factors such as how your water is delivered to your home (due to potential lead contamination from pipes) and act accordingly if a boil water notice is issued by your local water utility. **Note: this guide refers to water quality in Birmingham, Alabama - NOT Birmingham, Michigan. 🚰 Can You Drink Birmingham Tap Water? Yes, the drinking water supplied in Birmingham complies with federal drinking water standards and is therefore safe to drink. According to the city's Water Quality Report, contaminant levels in Birmingham's tap water are generally found at lower levels than the MCLs (Maximum Contaminant Levels) set by the Environmental Protection Agency (EPA). An EPA database from 2019-2022 showed that Birmingham had no (0) recent violations of the Safe Drinking Water Act. In fact, the most recent violation was in 2014 - good news for water customers across the City. However, Birmingham Water Works Board (which supplies Birmingham's public drinking water supply) is NOT compliant with all of the Health Guidelines set by the Environmental Working Group. The Environmental Working Group has no legal power over water facilities and simply sets its own guidelines based on its belief that the EPA's water quality guidelines under the Safe Drinking Water Act (SDWA) are too lenient. So, Birmingham tap water doesn't violate any of the EPA's standards and is legally safe for human consumption. However, 10 contaminants detected in Birmingham's public drinking water supply exceed the EWG's recommendations. We've done a deep dive into these contaminants later. There's also a very real possibility of lead in Birmingham's drinking water supply. Lead, a toxic and carcinogenic heavy metal, commonly enters water as it travels through the distribution system - many underground water pipes are old and made from lead materials. So, while lead isn't detected at the treatment plant, it may be present at dangerous levels in your Birmingham tap water, depending on the pipes the water travels through to reach your home. Some Birmingham residents were sent water filters with notes warning about lead in their water supplies in 2022, although according to a PR manager from Birmingham Water Works, these filters were supplied "just in case (customers) felt uneasy" while work was undertaken to replace the City's remaining lead distribution pipes. You can check out the current and upcoming pipe replacement projects on the Birmingham Water Works Board (BWWB). 👉 Find out more about which 10 states have the worst-quality tap water in our eye-opening guide. Birmingham SDWA Violations Within 10 Years Data Source: EPA ECHO database 🗺️ Where Does the Tap Water in Birmingham Come From? Birmingham's tap water comes from the Cahaba and Warrior rivers and the Lake Purdy Reservoir, three raw surface water sources. Surface water is more at risk of pollution and contamination than groundwater (from underground sources like springs and aquifers). The Cahaba and Warrior rivers are more exposed to the elements, and contaminants may enter the water through surface runoff and air fallout. Due to this increased risk, BWWB has implemented schemes to reduce the potential for surface water contamination. One such scheme is the Watershed Protection Policy, which limits development in areas of land where drinking water sources are located. The Board has also purchased land in these areas to further reduce the risk of pollution and maintain high-quality raw water, reducing treatment efforts at water utilities. BWWB collects and tests thousands of water samples per year. This includes testing the raw water on site and conducting tests throughout the water service area. Testing indicates the presence of contaminants of concern and enables BWWB to continue to deliver water at an acceptable and legal standard of quality to its customers. After water has been taken from the source, it is delivered to one of four treatment plants in the City: - The Western Filter Plant - The Putnam Filter Plant - The Shades Mountain Filter Plant - The Carson Filter Plant In each treatment plant, water is disinfected and filtered to control microbial contaminants, remove physical impurities, improve water quality, and ensure that it is safe to drink before being distributed to homes. The 9-stage water treatment process is as follows: - Screening - Water is screened to remove plants, logs, large debris, and fish, before being delivered to the water treatment plant. - Chemical treatment - Chemicals are added to the water. - Mixing - Chemicals are rapidly mixed into the water to ensure that the entire water supply is evenly treated. - Coagulation and flocculation - Coagulants are added to the water to encourage impurities and natural organic matter to clump together, forming "flocs". - Sedimentation - A sedimentation basin is used to store water, and floc particles settle to the bottom of the tank and are removed from the water. - Filtration - Numerous gravel and sand filters are employed to remove lingering contaminants in the water. - Disinfection - The water is treated with chlorine or similar disinfectants to kill bacteria and other microbiological contaminants and prevent recontamination in the water distribution system. - Storage. Before distribution, water is stored in a clear well or closed tank. - Distribution. Water is delivered around the City to supply millions of gallons to customers per day. 📉 Who Regulates Birmingham Drinking Water? The City of Birmingham tap water is managed by the Birmingham Water Works Board and is regulated by the Environmental Protection Agency and the Alabama Department of Environmental Management (ADEM). The EPA regulates all public water utilities in the country through water testing and quarterly monitoring. Under the Safe Drinking Water Act, the EPA established the National Primary Drinking Water Regulations, which features a list of regulated tap water contaminants based on research into the health effects of these contaminants. If Birmingham (or any other City water utility) is found to provide water containing contaminants that exceed the EPA's guidelines, the City will be enforced by the EPA to remedy the problem - with evidence of the resolution. 📊 Birmingham Annual Water Quality Report The most recent Water Quality Report (or Consumer Confidence Report) for Birmingham, Alabama is dated from January to December 2021. The Report shares findings on the City's water quality with the public. These findings include the detection of tens of trace contaminants, and we can see from the report that all contaminants were present below the EPA's Maximum Contaminant Levels, meaning that water in the City is generally safe to drink. However, this doesn't necessarily mean that the water is 100% clean or healthy. For example, the Report documents that the highest amount of nitrate detected in Birmingham's water was 0.36 PPM, and the EPA's MCL for this drinking water contaminant is 10 PPM. So, while nitrate contamination is nowhere close to the EPA's maximum allowance, this dangerous chemical is still present in the water. Some contaminants weren't detected at all in Birmingham's drinking water, which is great news (although detection levels are only applicable to the time of testing prior to the Report's release). These include: - Arsenic - Cadmium - Chromium - Mercury - Lead (although this doesn't account for lead that may enter through water supply lines) Numerous contaminants were detected in trace amounts lower than the EPA's maximum allowances, including: - Barium - Chlorine - Fluoride - Nitrate - Copper - Radium - Numerous disinfection byproducts More on many of these contaminants later. Keep in mind that the data in annual Consumer Confidence Reports is only accurate for the specific testing period. The EPA continues to reevaluate its standards and regulations based on emerging evidence on the dangers and health effects of certain contaminants. Some contaminants currently aren't regulated by the EPA, such as emerging contaminants like PFAS. We recommend reading through the Consumer Confidence Report for Birmingham, Alabama and familiarizing yourself with the terms and figures included in the Report. You could also compare the Report to previous annual Water Quality Reports (available on the BWWB website) if you want to learn more about how the City's water quality has changed over time. ☣️ Contaminants Found Above Guidelines in Tap Water in Birmingham There are no contaminants found above EPA legal guidelines in Birmingham drinking water. So, in this section, we'll be looking at the contaminants that exceed Health Guidelines set by the EWG. Remember that the EWG doesn't have any power to enforce water facilities to adhere to its guidelines. However, if you, like the EWG, believe that the EPA shouldn't allow even trace levels of certain contaminants in your water, you'll be interested to learn of the contaminants that the EWG deems to be present in unsafe amounts: Haloacetic acids (HAA5)† and Haloacetic acids (HAA9)† Two types of haloacetic acids produced as byproducts of chlorination disinfection are HAA5 and HAA9. In Birmingham's drinking water, 25.2 PPB (parts per billion) - 26.8 PPB of these contaminants were detected - between 268 and 421x the EWG's Health Guidelines of 0.1 PPB and 0.06 PPB. The legal limit for HAA5 is 60 PPB, and HAA9 currently has no legal limit. Total trihalomethanes (TTHMs)† Another disinfection byproduct affecting Birmingham's drinking water quality are total trihalomethanes (TTHMs), which are linked to potential health effects including cancer. 37.1 PPB of TTHMs were detected by the EWG, which is 247x the EWG's recommended Health Guideline of 0.15 PPB. However, the EPA's legal limit for this impurity is 80 PPB. Hexavalent Chromium Hexavalent chromium, or chromium-6, is one of the most dangerous contaminants and toxic chemicals. This carcinogenic contaminant often leaches into surface water supplies due to industrial pollution and can't be removed with a standard water filter. The EWG's Health Guideline for chromium-6 is 0.02 PPB, and 0.0778 PPB of this contaminant is found in Birmingham's drinking tap water - 3.9 x the Health Guideline. The EPA currently doesn't have a legal limit for this drinking water contaminant. Nitrate and Nitrite Nitrate and nitrite are forms of nitrogen that enter drinking water sites through fertilizer runoff and leakage from landfills, wastewater, and urban drainage. These contaminants may cause nausea, headaches, and increased heart rate when consumed in large quantities. 0.406 PPM of nitrates and nitrites were detected in Birmingham's water systems, which is 2.9x the EWG's Health Guideline of 0.14 PPM. The EPA's legal limit for these contaminants is 10 PPM. Radium (-226 & -228) Several types of radium, -226 & -228, were detected in Birmingham's tap water. Radium has serious health effects, including cancer, anemia, and depression of the immune system, if long-term exposure occurs. 0.14 pCi/L ((picoCurie per liter) of radium was recorded in Birmingham's water, which is 2.8x the EWG's recommended Health Guideline of 0.05 pCi/L. The legal limit for radium in drinking tap water is 5 pCi/L. Other Disinfection Byproducts Several other disinfection byproducts, including bromodichloromethane, dibromochloromethane, and chloroform, were also detected above the EWG's Health Guidelines. Between 0.846 PPB and 15.0 PPB of these impurities were detected in Birmingham's drinking water - that's between 8.5 x and 69x the EWG's Health Guidelines. There is no official legal limit for any of these impurities. We can see from this list that Birmingham's biggest water quality issue is disinfection byproducts. This is the case with many water supplies in the US for two reasons: - Most local authorities disinfect their water with chemicals like chlorine and chloramine, which release disinfection byproducts into water systems. - Many of these drinking water contaminants aren't regulated under federal drinking water standards. Disinfection byproducts are linked to several serious health problems, including cancer, liver damage, and decreased nervous system activity. Thankfully, these impurities can be removed from your drinking water at home with a good water filter. 🧫 Main Contaminants Found in Birmingham Tap Water We've looked at the contaminants present in concerning amounts in Birmingham, Alabama drinking water. Now let's look at the drinking water contaminants that aren't considered (by the EPA or EWG) to be dangerously abundant, but are still present in Birmingham's tap water: - Aluminum - A heavy metal that often leaches into water from pipes; may have several short-term health effects if consumed in excess, such as vomiting, diarrhea, skin rashes and ulcers, and nausea. - Barium - A naturally occurring metal that gets into water from certain types of sedimentary and igneous rocks;may cause diarrhea, vomiting, abdominal cramps, blood pressure fluctuations, difficulty breathing, and muscle weakness if consumed in excess. - Fluoride - A mineral that occurs naturally and is produced artificially and added to water supplies due to its dental health benefits; may cause dental fluorosis (discoloration of the teeth) and skeletal fluorosis (a metabolic bone disease) if large amounts are consumed. - Manganese - A mineral that contributes to water hardness; has no known health effects but may result in heavy mineral deposits/scale formation in plumbing and appliances if present in high quantities. - Strontium - A silvery heavy metal that occurs naturally in minerals like calcium carbonate; high-level exposure may cause cancer but no harmful effects are experienced if present in low levels. - Vanadium - A naturally occurring impurity that's found in numerous fossil fuel deposits and minerals; not harmful when found in levels naturally present in water. ⛲ Birmingham Drinking Water in Public Places Now we know the ins and outs of Birmingham's drinking water quality - but what about the water supplied to public places, like bars, restaurants, drinking water fountains, and hotels? All hotels in Birmingham should supply drinking water that's clean and safe to their rooms. This water should be exactly the same water that's delivered to your faucets at home. If you're not sure whether or not the water in your room is safe for drinking, check at reception. The hotel bar should be able to provide you with clean drinking water if not. You can also drink tap water supplied at restaurants. It's a legal requirement for restaurants to provide free tap water on request, and some restaurants may provide filtered tap water for free. If you prefer not to drink the public water supply in Birmingham, you can buy popular bottled water brands, like Aquafina, Dasani, Smartwater, and La Croix, in grocery and convenience stores in the City. You should find a few novelty bottled water options, too, like flavored water (including strawberry lemon infused water) and sparkling bottled water. 💬 Frequently Asked Questions Can you drink the tap water in Birmingham? Yes, you can drink the tap water in Birmingham. Water supplied by Birmingham Water Works is safe and compliant with EPA guidelines. However, there are some concerns about lead in Birmingham's water, and according to the Environmental Working Group (an independent organization that thinks the EPA's standards aren't strict enough), contaminants including disinfection byproducts, radium, nitrate, and nitrate are found in dangerous levels in Birmingham tap water. Can you drink bathroom tap water Birmingham? You should be able to drink bathroom tap water in Birmingham - but if you have old pipes, test your water to check. Some old pipes and bathroom fixtures are made from lead and other heavy metals, so water flowing out of a bathroom faucet could be dangerous to drink. If you're in a hotel, check with the reception if you're unsure whether or not your bathroom water is safe to drink. Is Birmingham tap water the best? Birmingham tap water isn't the best, but it's certainly better than other Cities and states. Birmingham's water hasn't violated any EPA standards since 2014. Alabama's water on the whole doesn't compete with states with the best water, nor is it classed as some of the worst drinking water in the US. Does Birmingham AL fluoridate its water? Yes, Alabama is one of the states that fluoridate their water, and Birmingham's tap water is fluoridated. Fluoride is added to some public drinking water supplies because it's good for dental health and prevents tooth decay, but some folks choose to filter it out of their water due to emerging evidence of the potential health concerns of fluoride. Does Birmingham AL have hard water? Yes, Birmingham, AL typically has hard water. Water in Alabama ranges from soft to very hard, but Birmingham's tap water is generally moderately to very hard, depending on the exact water source. Signs of hard water include limescale deposits around your faucets and fixtures, reduced efficiency of water using appliances, poor lather with soap, and dry, itchy skin and hair. Why does Birmingham water taste different? If you're not used to the taste of Birmingham's tap water, it's probably simply because the water in your own city or state comes from a different source or is treated with different methods. Birmingham drinking water is chlorinated, which may give the water a chemical taste, and the city fluoridates its water, which may contribute to its mineral taste. How clean is Birmingham water? Birmingham water is considered clean by EPA standards. Chlorine is used for disinfecting tap water in the City to prevent diseases caused by bacteria and other microorganisms, and the contaminants detected in the City's water supply are below the EPA's Maximum Contaminant Levels. However, there are still trace contaminants found in Birmingham water, including nitrates and chlorine byproducts. Read the full article

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postsforposting · 1 year ago

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found some citations:

It is now understood that the serum total tryptase level much more reflects the total body MC load than the total body MC activation state[40-42]. As such, serum tryptase is expected to be elevated in mastocytosis but usually is elevated little to none in MCAS. “Spillover” into blood circulation of tryptase and other MC mediators initially released in the tissues can be influenced by many factors. Hence, a normal value for a mediator in blood or other bodily fluid does not rule out its unregulated release in tissue. In fact, about 20% of SM patients present with serum tryptase < 20 ng/mL[37,43,44], but such patients rarely harbor the more advanced forms of SM [aggressive SM (ASM) and MC leukemia (MCL)] which require therapeutic approaches different from those used for the more common indolent SM and MCAS. Marrow aspiration/biopsy, an uncomfortable procedure for some patients, is warranted in cases of suspected mastocytosis but seldom yields diagnostic findings in cases of MCAS not already manifesting significant hematologic abnormalities (LBA and GJM, unpublished data). Therefore, a serum tryptase persistently elevated to > 20 ng/mL in two or more specimens facilitates an initial decision whether to evaluate further for SM with biopsies as appropriate including at least marrow, and possibly also skin, upper and lower gastrointestinal (GI) tract mucosa, and potentially other tissues, especially those at the environmental interfaces. An initial serum tryptase < 20 ng/mL makes SM (especially ASM and MCL) much less likely, and since the prognosis of, and therapeutic approach toward, indolent SM and MCAS are presently indistinguishable, there appear to be no adverse consequences if the clinician initially misdiagnoses the uncommon low-tryptase SM as MCAS.

Afrin LB, Molderings GJ. A concise, practical guide to diagnostic assessment for mast cell activation disease. World J Hematol 2014; 3(1): 1-17 [DOI: 10.5315/wjh.v3.i1.1]

In time, the enormous complexity of the biology of tryptase in its many isoforms would become more apparent [15], and it also would become more apparent that serum tryptase levels reflect the total body load of MCs far more than their activation state. [16, 17] kin et al. proposed a fundamentally new conceptual- ization that all mast cell disease first and foremost manifests aberrant mast cell activation, thus engendering a new “top-level” designation of “mast cell activation disease” (MCAD) to describe the full range of pathologic mast cell states. The proliferative (and rare) diseases of cutaneous and systemic mastocytosis would comprise one element of MCAD, while the (increasingly apparently quite prevalent) various forms of the relatively non-proliferative mast cell activation syndrome (MCAS) would comprise the other principal element of MCAD. Akin et al. further ventured that a diagnosis of MCAS would be permitted if the patient demonstrated repeated episodes consistent with aberrant mast cell mediator release, laboratory evidence of such release, absence of any other diseases better fitting the entirety of the clinical picture, and demonstration of at least partial response to therapy targeted at MCs or MC mediators. However, it almost immediately became evident that the mutational heterogeneity of MCAS leads to heterogeneity of not only clinical presentation but also therapeutic responsiveness, rendering the criterion for therapeutic response somewhat impractical. [41] Valent et al. released an updated proposal for diagnostic criteria for MCAS only a year later in which the requirement for therapeutic response was relaxed (i.e., desirable but not necessary). [42] Given the paucity of highly sensitive and specific markers for mast cell disease and the challenges in finding aberrant expression of even those few markers, Valent et al. also proposed a new way to interpret the serum tryptase level. The serum tryptase level, long a staple in diagnosing SM, is virtually always elevated little to none in MCAS, likely due to the relative dearth of MC proliferation in MCAS.

In: Mast Cells ISBN: 978-1-62618-166-3 Book chapter 6, 2014

Sorry about the formatting on that one, that's how it is on the page. These are both from the same guy and might be referencing the same data.

I got my biopsy results today. The good news is there's no new or unknown disease wrecking my insides.

The bad news is it's most likely my MCAS burning down my GI tract.

I say "likely" because the GI doctor had the humility to admit the medical world doesn't know enough (yet) about conditions like MCAS to say for sure, only that the areas biopsied showed elevated numbers of mast cells and that the inflammation and damage are consistent with mast cell dysfunction.

I got to watch in real-time as the GI doctor added the mast cell stabilizers to my regimen of meds, the exact ones the allergist denied me 3 years ago because he said I needed psych treatment and was mistaking anxiety for anaphylaxis because I 'googled too many things.'

Part of me hopes the allergist gets notified and chokes to death on eating crow. A larger part of me is just relieved it happened before I developed internal bleeding or cancer.

Anyway. We're testing new meds soon to try and bring down my base inflammation to something lower than "my insides literally feel like they're burning."

I'm also starting even more supplements to try and combat the mass deficiencies likely being caused by the MCAS inflammation. I've been told to take twice the daily recommended amount of pre-natal supplements on top of my existing regimen, and if that fails, they'll start infusions. (The hope is that my stomach isn't so far gone that oral meds won't help, so fingers crossed.)

Apparently, this is the year we finally stop my gradual death from malnutrition for good. Well, better late than never, I guess.

#mcas #histamine intolerance #disability #tryptase

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elexmori-mcl · 3 years ago

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Sticky sweet

word count: 1.0 k

characters: Elex (OC) x Lysander (MCL AL)

tags: nsfw, teasing, submissive L

If your favorite LI is not included in the event, you''ll have to take action yourself. And Lysander should be careful who he provokes, unless that' s exactly his goal.

"It smells fantastic in here". Lysander curiously entered the kitchen for the source of the scent. Elex whirled around, trying to block her boyfriend's field of vision with nervous movements. The latter was irritated for a moment by her, but then decided to play along and averted his gaze toward the garden. "Does your activity in the kitchen have anything to do with today's date?" "Yes..." Feeling embarrassed, she moved a bit to the side to present her work to him. On the counter was a fresh baking pan full of cinnamon buns baked to a golden yellow, still steaming and spreading their fragrance across the room. She sheepishly turned her back on him and pushed the bowl of white icing toward the baking pan. "I just wanted to spread the glaze on top." With a spoon in her hand, she began spreading lines of icing on the cinnamon buns. Lysander wrapped his arms around her waist from behind and kissed her cheek. "What on earth did I do to deserve you?" "Hmm... Maybe the white rabbit's performance won me over back then?" A second kiss, lower this time. "That was all?" "And your ability to put my nervousness at ease." "Mmm..." He placed the next kiss in the crook of her neck as he continued to hold her hips. "And... I just fell madly in love with you."

Satisfied with her performance, she stroked her fingers over the inside of the spoon to pick up the last bits of icing. She wanted to quickly put this into her mouth, but one hand stopped her and guided them to Lysander's lips instead. Irritated, she turned around and looked into a smirking face. Watched by her, he opened his mouth so that his tongue slowly traveled up her index finger. The fingertip itself was pushed into his mouth and sucked on with pleasure. His victim's face flushed with shame, but at the same time she could not avert her gaze. The thin, sugary mass was running down her middle finger, which did not go unnoticed. Defiantly, Elex spread both her middle and index finger after Lysander slowly released the latter from his mouth. He locked his eyes on her insistently as he reached between both fingers and gently licked the spot. Slowly, almost agonizingly slowly, he moved along this time as well. He knew how to design this game to provoke her. After his tongue circled her fingertip, he finally let go of her hand. "Sweet and sticky."

keep reading

As soon as he had uttered this remark, she had dipped her left hand into the bowl and was running it over his lips. "Then let me taste it, too." Her hands cupped Lysander's cheeks and pulled them down to her. Looking for support from the sudden movement, he grabbed the counter with both hands while his upper body was pressed against his girlfriend. She kissed him timidly on the mouth at first, so that their lips barely touched. At the same time, due to her tight grip, he could neither resist nor kiss her more intimately. After another fleeting touch, she ran her tongue over her lips and looked thoughtfully to the side. "Sweet... And I know for a fact that I'll be blushing bright red when Rosa and Leigh come over for brunch tomorrow. I'll be thinking about this about this while we're eating the leftovers." She turned back to her partner and they exchanged a conspiratorial look. Her teeth dug into her lower lip before she turned to whisper in his ear. "But then, it shall be worth it." Barely uttered, her lips met his again, this time more greedy and demanding. He let her have her way, surrendering to their shared lust. Hands wandered to his neck to grasp it, while she pressed against him at the same time, trying to get away from the counter. In a brief moment when they separated, Lysander grasped her thighs to encourage her to jump up. Immediately she crossed her legs behind him and devoted herself to his lips again. This time it was his lower lip she bit, causing him to suck in a sharp breath. "Into the bedroom, now."

Her commanding tone left no room for discussion, but that was exactly the dominant nature he wanted to provoke from her. The stairs seemed endless to him, mostly because Elex had buried herself in the crook of his neck. As her fingers ran through his hair, his neck was covered in kisses and he pressed her body against himself with each step. Once he reached the top, he let himself fall backwards onto the bed with her. She was now sitting on top of him. Slowly she straightened up and focused her weight on her lower body, pressing against him once again. His hands reached for hers to intertwine them as he defenselessly let her move her hips on him. A low moan escaped him and in turn he arched up to increase the friction. Elex placed his hands around her hips so that he could set the rhythm.

Laying her head back she finally let him hear her rising lust as well. Each sigh only stimulated him more, making his movements against her lower body more and more frantic. In response, his partner raised up and looked down at him. The impatience in his expression almost made her grin, if it weren't for that desire leading up to it at the same time. Deft fingers worked their way around the straps of his pants and slid his shirt over his chest as a result. When he wanted to let his own hands wander over her body she held him firmly in place. Instead, he set about massaging her butt through her skirt while pressing her against him again. With a gentle movement over his eyes, she motioned him to close them. Shortly after, Lysander felt her lips over his belly button. Soft kisses rained down on him as he intensified his grip on her. Unable to see anything, he could clearly hear her ragged breathing and every moan in return. As her tongue circled his nipple, a shudder ran through his body. "You drive me crazy..." he admitted out of breath. "And maybe this is exactly how I imagined our Valentine's Day."

#mcl al #mcl lysander #mcl alternate life #mcl elex #elexlysander #who said the last sentence? Lys or Elex?

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jibrillenyan · 6 years ago

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[it] Video Spin-off disponibile! | The video for the 3rd spin-off is available in Italian.

{:it}Video Spin-off disponibile!{:}{:en}The video for the 3rd spin-off is available in Italian.{:}

{:it}Il video in italiano dello spin-off è disponibile [qui] Scusate il ritardo ma la mia connessione viaggia a criceti zoppi u_u;

La “guida” sarà disponibile entro domani. Alcune persone hanno problemi a collegarsi al sito, se capitasse anche a voi andate su https://www.irusu.it/eldarya ! A questo punto può darsi si tratti solo di un problema di cache, ma sto comunque dando un’altra occhiata per sicurezza.

PS: Hanno aperto le pre-iscrizioni per la versione da cellulare di eldarya, lo trovate su play store…

[EN] As usual, I won't buy the spin-off for the english version of the game, so the only version you will find here is the Italian one, but @sakurina-mcl published the English video 2 days ago, you can find it on her blog and YT channel.

If you have issue loading the guide go directly here: https://www.irusu.it/eldarya at this point it’s probably just a matter of cache, but I’m investigating the issue.

PS: It's now possible to pre-register for the mobile version of the game, you can find it on the play store and/or iThing-store (maybbe?)!

View On WordPress

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fitfuturesacad · 4 years ago

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A look at the techniques of conducting, the benefits of utilising and the FMS and MCS in athletic, rehabilitative and general populations.

What is movement screening?

Movement screens have grown in popularity, especially in the athletic field, due to the increased incidence of injuries (Mokha, Sprague, and Gatens 2016). The design and implementation of training programmes providing a pre-habilitation and conditioning element to reduce the rate of injuries purposefully, has increased (Gamble n.d.; Mokha et al. 2016). Practitioners can familiarize themselves with the mechanisms for injury and train accordingly (typically seen with dynamic warm-up derivatives like the FIFA 11+, and general strength training initiatives). All training plans must be individualized, based on a thorough assessment of the movement capabilities or incapabilities of the individual athlete or client. A movement screen is an assessment whereby the practitioner looks to challenge the athlete or client’s function and motor control during a range of “specific” movement tasks (Gamble n.d.; Mokha et al. 2016). If an athlete or client demonstrates high levels of movement function and motor control during these tasks, they have a reduced likelihood of experiencing an injury (Mokha et al. 2016). Additionally, they have heightened athletic prowess, resulting in efficiency and high levels of performance during running, cutting to change direction, and other athletic tasks (Mokha et al. 2016).

Is the use of movement screening widespread?

The Functional Movement Screen (FMS) and the Movement Competency Screen (MCS) are perhaps the two most consistently utilised movement screens and will be the focal point of this report. The FMS is highly commercial and has experienced plenty of success (Gamble n.d.; Mokha et al. 2016). It is used extensively overseas, particularly in the United States. Many successful American sports franchises, such as the NFL’s Green Bay Packers and Atlanta Falcons, and perhaps most notably the MLB’s Chicago Cubs, use the FMS (Mokha et al. 2016). The MCS, on the other hand, while not possessing the following of the FMS, is used by High-Performance Sport NZ (HPSNZ) within their athletic development programmes.

Functional Movement Screen

The FMS is the most renowned movement competency screen in existence today (Mokha et al. 2016). It is a point-based screen that assesses if an individual possesses efficient movement patterning, with the primary goal of reducing injury risk (Mokha et al. 2016). The FMS can help practitioners to identify limb asymmetries which are known to increase the likelihood of injury 2.73 times (Mokha et al. 2016). The premise behind identifying injury risk is to help remedy that risk to keep athletes competing at a high level. Secondarily, it is essential to understand how well an individual can move as we need to assess whether they are ready to exercise at all, let alone bear load.

The FMS reportedly offers insight into the presence of motor control, proprioception and balance issues. Identifying limb asymmetry is another reported benefit. A person with suboptimal movement capabilities or a limb asymmetry is at a higher risk of injuries such as thigh strains, hamstring tears, hip adductor pain, patellofemoral pain and ACL/MCL rupture (Mokha et al. 2016). Injury risk factors are multifactorial, so it is about understanding the most consistent risk factor for all injuries; that is, someone who has experienced trauma previously has an elevated injury risk. The FMS test results can guide a practitioner to progress an individual appropriately, particularly following an injury in pursuit of a return-to-play aspiration. Addressing an injury involves managing pain and alleviating movement restrictions, but the mechanism that caused it, e.g. poor motor control, must also be dealt with.

Scoring the FMS

A straightforward scoring system exists. Practitioners should ask the client to perform the exercises to the best of their abilities and tell them if anything hurts. Simple, right?

A zero (0) is recorded if the individual experiences any pain performing the movement, irrespective of their quality of movement.

A one (1) is recorded if the individual is unable to complete the movement.

A two (2) is recorded if the individual can perform the movement, but there are compensations or imperfections evident while doing so.

A three (3) is recorded if the individual can perform the movement as directed.

The composite score is the sum of all the individual movement scores together, e.g. 14 out of 21.

Assessed Movement Competencies

There are seven movement competencies assessed in the FMS; these are:

Overhead Squat

How:

Feet shoulder-width apart

Knee over foot

Dowel over foot

Torso and tibia parallel

No valgus collapse in the knee

NB:Butt-wink is not an issue

Hurdle Stepping

How:

Adopt a single leg stance

Line up the string or top of the hurdle with the tibia tuberosity

Assess if they can maintain stable torso and head

Step over and clear hurdle

In-line Lunge

How:

Adopt a split stance

Keep dowel touching: Head, thoracic spine and sacrum

One joint, e.g. hip, knee, ankle or poor core stability, could affect the whole movement pattern. Correcting the dysfunction will correct the movement pattern.

These first three movements are challenging and can expose limitations and compensatory movement. The hurdle step and in-line lunge mimic the split stance, unilateral nature of life and many athletic tasks.

Shoulder Rotators

How:

Reach one hand/arm over the top of your shoulder

Reach the other hand/arm behind your back

Make a fist with both hands and try to touch each one

If the hands are within: one hand length = 3; 1 and ½ hand lengths = 2; > 1 and ½ hand lengths = 1; pain = 0

The shoulder rotator test is a clearing test that measures shoulder health and mobility as well as thoracic spine mobility, both of which help the overhead squat. If the squat is poor, it could be the result of the shoulder rotators and dysfunction through the thoracic spine.

Hamstring ROM Lift

How:

Position the client in neutral, e.g. no external or internal rotation through the hip

Place the dowel at “mid-thigh,” e.g. halfway between the knee and the ASIS of the non-assessed limb.

If the malleolus of the ankle on the assessed limb, can reach past mid-thigh with no knee bend and hips remain neutral, record a 3

Between the knee and the dowel, record a 2

Can’t go past the knee, record a 1

If pain is evident record a 0

If a client demonstrates incompetency during the hurdle step or in-line lunge, it could be due to poor hamstring ROM. If the client cannot get their leg 6 inches off the ground, then there is the mobility issue.

Push up

How:

Position client in the push-up position. Hands should be just outside shoulder-width apart

Hand placement should result in thumbs being just above the forehead

The client must maintain good posture through the torso and spine

If the client cannot perform one repetition in this position, or if they are female, position hands so that thumbs are in line with the chin

If the client cannot perform one repetition in this position, position their hands so that their thumbs are in line with the shoulder joint

If the client cannot perform one repetition in this position, they achieve a 1.

An assessment of trunk stability.

Rotary Stability

How:

Get the client positioned on all fours.

Get the client to extend the arm and leg on the same side of the body.

From this extended position, get the client to bring their arm and leg back towards the starting position and ask that they attempt to touch the elbow to knee.

If the client can perform this with minimal issue or loss of balance, then they score a three. If they do not score a three then have the client perform the same movement with alternate sides, e.g. left arm and right leg. Doing this would result in a score of 2.

Movement Competency Screen

The MCS also helps determine an individual’s movement competency to help practitioners gain an understanding of how their clients move and whether or not the movement they produce is free of dysfunction and pain. Numerous variables can influence the movement competencies of an individual (Gamble n.d.). However, the premise behind the screen is to develop an understanding of how an individual can move, so their prescribed training does not exceed their capabilities (Gamble n.d.). Therefore, the MCS is a tool used to ascertain if a practitioner can assertively load a particular pattern, or if a developmental approach would be better suited to the individual.

There are 11 movement tasks within the MCS:

Bodyweight Squat

Countermovement Jump

Lunge and Twist (Slow)

Lunge and Twist (Fast)

Bilateral broad jump with unilateral landing

Push up

Explosive push up

Bend and pull (Slow) NB: Performed like a Pendley row.

Bend and pull (Fast)

Bodyweight single leg squat

Bilateral countermovement jump with single-leg landing

The unilateral tasks are completed on both sides of the body. Instruct the individual to perform 2-4 repetitions of each movement task.

For a video on how to complete these movements, please refer to the following link.

https://www.youtube.com/watch?v=EMU0bM7ACAM

Scoring the MCS

The scoring is a little more sophisticated than it is for the FMS, although it is still relatively easy to perform from a practitioner’s stand-point. There are five levels commonly used to design and implement strength training and rehabilitation programmes; the scoring is based on these levels:

Assisted Bodyweight

Bodyweight

External load at slow movement speeds

Eccentric training

Plyometric

The practitioner needs to determine which level the observed movement capabilities would allow the individual to perform safely. Then guide any programme design moving forward.

Below is the MCS scoring sheet as developed by Dr Matt Kritz.

Below is the MCS rationale sheet developed by Dr. Matt Kritz.

FMS and MCS: Rationale for movement screening

As mentioned above, the FMS and MCS feature movement patterns with characteristics of significant sporting and athletic tasks. Both screens indicate the function and motor control that an athlete or client possesses concerning executing these movement tasks, and are point-based systems, that is, for each movement task within the screen, a score of competency is recorded. The overall score (a summation of all individual movement task scores) is believed to relate to the individual’s risk of injury and performance capabilities (Mokha et al. 2016). Higher total scores reportedly indicate a reduced likelihood of the client experiencing an injury and more considerable athletic prowess (Mokha et al. 2016). Individual task scores for both tests are indicative of the intrinsic injury risk to specific regions of the body, which is particularly advantageous if a particular body part is susceptible to injury in a specific sporting discipline, e.g. knee injuries in football or netball.

Any observed movement deficiency is interpreted as evidence of issues of motor control or musculoskeletal structure. When one considers the third Newtonian law, the law of reaction, motor control issues that present in faulty movement patterns could lead to injury through improper force application wearing out tendons, ligaments, muscles and joints. It is crucial to have an understanding of the client’s previous injury history, as any movement deficiency could be the result of an earlier injury leading to the dysfunctional movement pattern (Gamble n.d.; Mokha et al. 2016). To further highlight the need for understanding of previous injury history, many clients do not complete their rehab – this is evident in clients who have had surgically repaired ligaments in their knee. Finally, a previous injury is the highest risk factor predisposing an individual to future injury, so practitioners must be mindful of this when assessing a movement competency as it may affect the training approach or corrective exercises prescribed by the practitioner. If any faults are present, the screen should guide the practitioner towards suitable programme design and implementation (Gamble n.d.; Mokha et al. 2016).

FMS and MCS: Evidence supporting movement screens

At the time of writing, there was no research on the MCS, and its benefits, or a correlation with injury risk or athletic prowess on performance test measures (Gamble n.d.). However, there is research on programming relating to the MCS and how it can be used to break down a client’s training based on their competency score (Gamble n.d.). Research on the FMS is available, albeit scarce. Mixed results exist and reportedly, neither screen is overly reliable with many fundamental issues evident (Gamble n.d.; Mokha et al. 2016).

The FMS does not correlate to performance on the 20m sprint test, vertical jump tests (CMJ and SJ), core stability or agility tests.

The FMS cannot discriminate between performance levels, e.g. elite vs amateur etc.

To date, only two studies have investigated the effects of the FMS on injury risk or incidence of injury. A composite score of < 14.0 was reportedly suggestive of an increased injury risk. FMS critics claim it is unreliable because a composite score of 14 out of 21 is representative of an individual scoring 2 out of 3 on much of the movement tasks within the screen.

Reported mean values for a sample of team sport athletes is 15.56.

A study by the American College of Sports Medicine (ACSM) determined that a sample of 170 collegiate sportsmen and women with a composite score of < 14.0 did not correlate with an increased likelihood of injury.

Only the in-line lunge movement task shows any correlation to injury incidence, and this was fair at best.

Issues with Implementation

There are issues with the implementation of the FMS, which subsequently affects the reliability and sensitivity of the screen. Firstly, there is no general agreeance concerning the amount of technical information provided to the client performing each of the movement tasks. Some believe that no information should be provided regarding the proper form or what the assessor is looking for; that way, the athlete or client will be more inclined to demonstrate their natural movement.

The problem with providing a lack of technical support in the completion of the tasks is that minimal direction is said to lead to false negatives. Some clients have the capabilities required to complete the tasks but are scored lower, indicating that they exhibit dysfunctional patterning. The question is: Do movement screens merely tell us how an athlete chooses to move?

Issues with Reliability

As previously mentioned, very few studies have investigated either the FMS or the MCS. Reliability scores are low to moderate with both intra and inter-rater reliability questionable. The FMS’s inline lunge is fair as is the MCS lunge and Twist. However, all other movements demonstrate poor reliability at best.

Issues with over Interpretation

Neuromuscular control is generally accepted to be task-specific, that is, specific to both the nature of the task and any constraints the task imposes. Research has demonstrated an alteration to the kinematics of a countermovement jump if a target is introduced and changes to movement mechanics when a dummy or defender is added to a change of direction speed drill. Therefore, it is naive and perhaps unsafe to assume that a corrective programme based on a stationary task like an overhead squat, could transfer to a reactive task such as a side-step or cutting manoeuvre typical of opponent or hazard evasion in a sport like American Football.

Practical Recommendation for the use of the FMS and MCS

The FMS and MCS do have their place despite their limitations. Personally, in the gym with a regular client, we do not need to perform overly dynamic athletic tasks. We may perform some ballistics or plyometric work, but again these aren’t excessively dynamic. As a result, I feel that the FMS and MCS have their place as the tests help to assess the function and motor control of patterning related to most if not all, gym-based exercise programming.

In a broader sense, it has a role to play in the wider pre-participation test battery of athletes. Athletes should be provided full technical instruction regarding what constitutes proper form to eliminate the potential for false negatives to occur, thus immediately improving the reliability of the assessment.

The assessment should be filmed and performed by the same assessor where possible.

Conclusion

Stationary movement patterns provide the foundation that technical improvement is based. Assessment of these patterns can highlight the misalignment of limbs, particularly in the lower portion of the body. Misalignment is undesirable from a movement efficiency standpoint, and often these deficiencies are further pronounced during dynamic movement, e.g. running. Misalignment and other evident flaws can trickle down to inefficient motion, leading to sub-optimal performance. Furthermore, deficiencies result in the body utilizing more energy to move. They can lead to the improper application of force, i.e. ground reactions forces, which based on the third Newtonian law can lead to wear and tear and physical injury. By discovering movement-related abnormalities practitioners can strive for movement improvements in their programming, vastly influencing movement efficiency by achieving a heightened functionality.

Point-based movement screening widely used in the athletic population, such as the FMS and MCS, are not without their limitations. The primary limitations include a lack of scientific evidence in support of claims that test results can highlight injury risk and performance impairments. Technical information provided to the athlete being screened, regarding what is considered correct movement, is an issue that could influence test outcomes with inaccurate representations of that client’s capability. Practitioners should use screening tests not as a diagnostic tool but as an informative tool that can help identify potential areas of weakness, which can guide programme design and implementation, that is, safe and effective training programmes. This will allow for better programming to improve performance, limited injury risk and ultimately will help keep our athletes from missing competition and our clients from missing gym time.

From a general population standpoint, all the above applies, particularly when one considers that gym users just wish to improve their strength or overall health and well-being. Whether that be via fat loss or not is irrelevant, resistance training has its place. Unless someone can move well and exhibit functionality and heightened levels of mobility, then we cannot load them. The FMS and MCS can help us identify whether a dysfunctional movement pattern exists and allows us to correct it. After that, the foundation will be in place to load our clients and help them reach their goals and not waver from doing so due to an easily remedied movement pattern deficiency.

References

Gamble, Paul. n.d. “Movement Screening Protocols: Rationale versus Evidence.” Journal of Sports Med 83–87.

Kritz, Mathew. 2015. The Movement Competency Screen (MCS).

Mokha, M., Sprague, P. A., and Gatens, D. R., 2016. “Predicting Musculoskeletal Injury in National Collegiate Athletic Association Division II Athletes from Asymmetries and Individual-Test versus Composite Functional Movement Screening Scores.” Journal of Athletic Training 51(4):276–82.

The post A look at the techniques of conducting, the benefits of utilising and the FMS and MCS in athletic, rehabilitative and general populations. appeared first on Fit Futures.

from https://fitfutures.co.nz/a-look-at-the-techniques-of-conducting-the-benefits-of-utilising-and-the-fms-and-mcs-in-athletic-rehabilitative-and-general-populations/

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casfleurz · 2 years ago

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mcl al armin episode 3!! ˶ᵔ ᵕ ᵔ˶

find more of my guides here♡

general info: ♡ ap cost: 800 for park illustration route or 1000 for nsfw illustration route ♡ outfit cost: 190g ♡ 2 illustrations; park one and NSFW one!! you can get one in single play. I've changed a bit the NSFW illustation (it's at the bottom of this post) because I don't know how tumblr deals with light NSFW stuff these dayz >>.<< ♡ fairy: you can meet fairy in front of sweet amoris after leaving your room with armin to go to a cupcake workshop! fairy gift & outfit:

guide: alexy: so, if I deliver breakfast to you for a week, will you be a little less mad at me? ♡ sold! I’m already much less mad at you! / +5

alexy: that’s an… original radio station. just after ads, silence again… ♡ you know, the campus radio station is pretty amateur… / +5

armin: then why did you tell me to hide? ♡ I just didn’t want alexy to be right. / +5

armin: I was talking about your afternoon, not mine… ♡ careful, with your jokes: I could take you at your word… / +5

FAIRY TIME!!! go to amoris high school. auntie will give you a gift (it's pretty nice lingerie just go for it ˃ ᵕ ˂)

hyun: ... ♡ your cupcakes are really delicious, it’s an opportunity to learn! / +5

armin: ... ♡ I almost want to let you win, just to see what you’re thinking of… / +5

candy: ... ♡ (…his little comment about jealousy really got to me. I never had the opportunity to see him jealous, maybe now is the time…) / NSFW ILLUSTRATION ♡ (…if clemence distracts him, that gives me an advantage to apply myself to my recipe and win.) / PARK ILLUSTRATION

NSFW ILLUSTRATION ROUTE:

hyun: ... ♡ hyun, you look muscular too… / +5 ♡ hyun, I could really use a hand too… / +10

hyun: ... ♡ hyun, you handle that perfectly! /+5 ♡ can I try? I’m good at handling things like that. / +10

armin: ... ♡ you’re rather silent… are you thinking about your dare? / +5

armin: well? ♡ (I was craving it; I gasped with excitement.) / NSFW ILLUSTRATION

PARK ILLUSTRATION ROUTE: candy: ... ♡ are you okay, Armin, sweetie? / PARK ILLUSTRATION

♡

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minashiro-mcl-etc · 2 years ago

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Armin Épisode 4 - 409 Conflict (solution)

Armin n°1

A. Tu sais que je n’arrive pas toujours à savoir quand tu plaisantes? B. Bien sûr, le fameux complot des vendeurs de céréales... C. Sans blague?! Et tu sais ça d’où encore? +5

Objectif N°1 - Rejoins Rosa et Alex au Cosy Bear.

Objectif N°2 - Rentre avec Armin.

TATA

Condition: Avant de rentrer à l’apartement Lieu: Ruelle Cadeau: Xbjj-A Coût: 20PA

Armin n°2

T’as pas dit tout à l’heure qu’il fallait que tu travailles, en plus?

A. Si, je sais bien, mais j’ai tellement la flemme! +5 B. Si, tu as raison. Tu as raison, il faut que je révise. C. Si, idéalement... Enfin, je suis plus à vingt minutes près...

Choix de la tenue: MVP 190G (Veste 45G, Bottes 40G, Pantalon 45G, Body 60G)

Rocket (neutre)

A. Tant pis, je vois bien que tu n’as pas envie d’être coopératif. B. S’il faisait quelque chose de louche, tu me le dirais, hein? C. Tu sais... Ton maître et moi, on est... proches.

------ RDV ------

Sucrette (Illustration)

A. (Il faut que j’appelle Rosa et Alex, ils sauront quoi faire...) B. (Je... Je vais attendre. Le confronter directement.) illustration C. (Il faut que j’appelle la police. Je n’ai pas le choix.)

Armin n°3

A. Tu n’aurais pas dû faire une promesse que tu savais ne pas pouvoir tenir. B. Même si j’avais la permission d’utiliser ton PC... Je n’aurais pas dû. C. Je suis désolée. Je me suis imaginée es choses... +5

Armin n°4 (Illustration)

Cet après-midi, je ne suis pas allé au commissariat seulement pour discuter de mon accord de confidentialité.

A. Et donc...? Viens-en au fait, je t’en supplie! Illustration

B. Tu sais que je sais que tu fais exprès? C. (Je n’ai rien dit, je le laisse continuer.)

--------------------------------------------------------------------------

Coût de l’épisode: 1012 PA (avec Tata)

#amour sucre #my candy love #MCL #Corazon de Melon #beemoov #alternate life #armin #mcl al armin #Solutions #outfit #Outfits #Illustration #guide #409 Conflict #tata

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thrashermaxey · 6 years ago

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Ramblings: Gardiner, Bozak, Roslovic, Gourde, and More; Couturier Injury – August 23

Time is flying. It’s been a little over three weeks since the Dobber 2018-19 fantasy hockey guide has been released, which means we’re just a little over three weeks away until the start of training camps. If you haven’t purchased your copy, head to the Dobber Shop right now! We have projections, articles, and a whole lot more waiting for you.

Those Erik Karlsson trade rumours are swirling again, as Elliotte Friedman reports there is interest coming out of the Western Conference. Stay tuned.

There was a report that came out Tuesday evening from Jonathan Bernier (no, not that one) in Le Journal de Montréal that Sean Couturier had re-injured his MCL, the one he injured during their first-round series with the Penguins. This was further expounded upon by David Isaac, a Flyers writer for the Courier Post. He did not explicitly say the injury had reoccurred, but that Couturier had indeed returned to the Flyers’ training facility in Voorhees. His inability to report on the injury was because the Flyers would not comment just yet.

This situation was clarified Wednesday afternoon:

#Flyers say Sean Couturier will miss four weeks with what is reportedly a re-injury to the MCL in his right knee. That puts him at Sept. 19, the fourth of six preseason games.

— Dave Isaac (@davegisaac) August 22, 2018

This is kind of bad news for fantasy owners. Re-injuring a knee ligament is a huge concern, even if the team says it’s just a one-month injury and he should be back for the start of the regular season. It makes me nervous to draft both Couturier and Claude Giroux.

Last week, I had a Ramblings covering one player from each team that I would likely be targeting ahead of most for this year’s drafts. On Tuesday, half the league was covered with one player from each team that I would likely be avoiding in drafts this year. This will cover the second half of the NHL.

Remember that a lot of this is tied to ADP. In fantasy sports, whether season-long or daily, value is the predominant factor. A player likely being able to, or in this case likely not being able to, return a profit on draft investment is what matters most. Also, things could change once we get more solid ADP data, or someone is injured, traded, or demoted. This is just as of this moment.

This column will cover skaters only and is for standard Yahoo leagues.

Nashville Predators – Ryan Ellis

Last week I covered at length why I probably won’t be drafting Ellis this year. As I’ve alluded to, it’s not because he’s bad or won’t be fantasy relevant, it’s about his ADP.

I will say this: his rankings right now might put him in my range. He’s currently the 122nd-ranked player on Yahoo and NHL.com has him at 116. My concern had been that he’d sport at top-100 ADP. I’ll have a better idea of where I’ll draft him once we get more reliable ADP data and my projections are finalized but a top-125 player could be palatable.

New Jersey Devils – Will Butcher

This is where the league will matter. If we were talking about points-only leagues, I would have significant interest in Butcher. But it’s not a points-only league, we need to consider hits, shots, plus/minus, and goals, all four being major concerns. He averaged just 16 minutes a night last year and though he should earn more minutes this year, I don’t see him jumping from 16 a night to 20-21 a night. He’s probably going to be drafted as a third or fourth defenceman in 12-team leagues and I’d probably only draft him as a bench defenceman. He’s a great talent, I just don’t know if the peripheral stats will warrant his draft position.

New York Islanders – Josh Bailey

Most people are expecting a step back for the Islanders wingers this year because of the loss of John Tavares. Except, at least at five-on-five, I’m not sure going from Tavares to Mat Barzal will be a significant downgrade. The problem for Bailey is he might not stay on the top line; there’s a very real possibility that Jordan Eberle jumps to the top line and Bailey is playing with Jan Kovar or Brock Nelson. Anders Lee will probably be fine in fantasy this year, especially in formats such as this, but Bailey will take a huge step back. Even at his likely discount, I will be passing.

New York Rangers – Mats Zuccarello

I am very much a fan of Zuccarello so this is more a question of lineup slotting. By Corsica’s expected goals for, the line of Kreider-Zibanejad-Buchnevich was one of the best in the league last year (seriously, ahead of lines like the top lines in Edmonton, Toronto, and Pittsburgh). They were fine defensively as well, believe it or not. With a new coaching staff, I think Pavel Buchnevich gets another shot on the top line and with it the demotion of Zuccarello down the lineup. With lower-quality line mates, it’ll be hard for Zucc to reach the fantasy heights of which he is capable.

Ottawa Senators – Erik Karlsson

There are enough red flags here. The team will be awful which is going to absolutely murder his plus/minus, possibly worse than last year’s -25. Even a rebound in goals won’t be enough to make up the deficit. He’s not one to rack hit totals so that’s two categories where he will be a hindrance. Even as a third-round pick and the likelihood of 60-plus points, it’s not enough to make up what he will lack elsewhere. This is a guy you trade for mid-way through the season when there are only 20 or so games until the trade deadline and the owner wants to move on, not a guy you draft.

Philadelphia Flyers – Claude Giroux

Were I to be drafting today, Giroux would not be on my list, especially when he’s likely to be a second-round pick. This is a guy who might not manage 200 shots or 40 hits and is coming off a season with a 17.6 percent shooting, where his previous career-high was 14.8 percent back in 2010-11. Not that I think he’ll be abysmal, but even a 25-goal, 75-point season, with his lack of certain peripherals, won’t be enough to return value. Combined with the uncertainty with Couturier, it’s a pass.

Pittsburgh Penguins – Jake Guentzel

Guentzel will probably be a top-100 pick and will be drafted there without top power-play minutes; unless Patric Hornqvist suffers a lengthy injury, he’s not losing his spot. Consider this: last year, in this format, even with his hit totals, Guentzel was just inside the top-150 players. Assuming constant peripheral rates, he probably needs to be a 60-point player just to break even on a top-100 draft pick. In other words, without top PP minutes, we need Guentzel to increase his production by 25 percent just to break even. If we get some sort of indication he’ll be on the top PP unit, this equation changes. For now, he’s being drafted at his likely ceiling.

San Jose Sharks – Logan Couture

Whenever shooting percentages spike, it’s worrisome. Couture set a career-high last year with 16.7 percent. His three-year average before that was 11.7 percent. He was used more often in a defensive role last year and that likely continues this year. Even with a career-high 34 goals he finished just inside the top-100 players. Unless fantasy owners think he can improve on last year, he, like Guentzel, will likely be drafted at their ceilings (for different reasons).

St. Louis Blues – Tyler Bozak

He’ll come cheap in drafts but there’s just not much reason to buy into him this year. He’s not a player who contributes in peripherals so he’s reliant on point production. He may get the chance to skate with guys like Alex Steen and Patrick Maroon, which is fine, but he won’t be on the top PP unit, a unit which will be heavily-used. In Toronto, he was at least in a split-PP situation, and his particular PP unit was lethal. That won’t be the case in St. Louis. A 40-point player with no peripherals is an easy avoid.

Tampa Bay Lightning – Yanni Gourde

Some people may get upset by this, so let’s clear a few things up: I have Gourde in a salary keeper league where I’m keeping him, he’s a good player, and he’s obviously in a good situation with the upper-tier offensive prowess of Tampa Bay. I can’t help but feel, though, that last year was a year where everything went right for him: he shot over 18 percent(!), he registered a point on over 73 percent of goals scored by the Lightning at even strength when he was on the ice (third-highest among all their regular forwards), and the team scored at a higher rate on the second unit power play when he was on the ice than the first unit when Kucherov/Stamkos were on the ice. Even a step back to 20 goals and 30 assists, which would still be a really good year for him, will result in a big loss from his likely ADP.

Toronto Maple Leafs – Jake Gardiner

Much like Ryan Ellis, I’ve also covered, at length, why I won’t be drafting Gardiner this year. There isn’t much need to go any further.

Vancouver Canucks – No one

This might be a cop out, but there’s no one that I’m really avoiding because there are only a handful of guys I’d want to target. I’m fine with Brock Boeser in the fifth or sixth round (probably), Bo Horvat somewhere outside the top-10 rounds, and Alex Edler even later. Maybe a late-round flier on Elias Pettersson. Those are all reasonable to me, and outside of that quartet, I don’t know if I’ll target another Vancouver skater in 12-team leagues.

Vegas Golden Knights – William Karlsson

I know, this is obvious given his shooting percentage. Anyone with even a basic working knowledge of fantasy hockey will understand that. Beyond the shooting percentage though is the plus/minus; he was plus-49 last year. That was the highest plus/minus for a forward since 2002-2003 and no forward since the 2012 lockout had even managed plus-40, let alone nearly plus-50 (H-Ref’s Play Index). That is going to crater. Even if Karlsson doesn’t regress massively in goal-scoring and still manages to score 30-35 tallies, his plus/minus could easily cut in half. I’d rather draft Jonathan Marchessault.

Washington Capitals – John Carlson

In a season where everything broke the way of Carlson, and he managed career-highs in goals, assists, and shots, he was still just outside the top-50 players in this format. He’ll likely be drafted as a top-75 player, which means he’ll more or less be expected to replicate his 2017-18 season. Call me skeptical that he can do it.

Winnipeg Jets – Jack Roslovic

Another player who should be fairly cheap in drafts, I will say I’m a fan of his long-term prospects. For now, though, he’ll be stuck in the bottom-6 and likely off the top PP unit. That’s enough to make me stay away for 2018-19. It will be a different story a year from now.

from All About Sports https://dobberhockey.com/hockey-rambling/ramblings-gardiner-bozak-roslovic-gourde-and-more-couturier-injury-august-23/

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marie53blr-blog · 7 years ago

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Social Security Disability Expedites Compassionate Allowances Conditions

http://socialsecuritydisabilityandyou.com/blog/

Released on Tuesday, September 5, 2017

Social Security Disability expedites Compassionate Allowances with a claims. But you must have one of the Compassionate Allowances Conditions below. Also, I have medical documents and test results to prove you one of the Compassionate Allowances Conditions.

However, if you have an attorney, inform him or her about the Compassionate Allowances Conditions. Yet, show you attorney or representative the article and list of Compassionate Allowances.

Compassionate Allowances Conditions

CAL Conditions (A – B)

Acute Leukemia

Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent

Adult Non-Hodgkin Lymphoma Adult Onset Huntington Disease Aicardi-Goutieres Syndrome Alexander Disease (ALX) - Neonatal and Infantile Allan-Herndon-Dudley Syndrome Alobar Holoprosencephaly Alpers Disease Alpha Mannosidosis - Type II and III

ALS/Parkinsonism Dementia Complex Alstrom Syndrome Alveolar Soft Part Sarcoma Amegakaryocytic Thrombocytopenia Amyotrophic Lateral Sclerosis (ALS) Anaplastic Adrenal Cancer - Adult with distant metastases or inoperable, unresectable or recurrent Angelman Syndrome

Angiosarcoma Aortic Atresia Aplastic Anemia Astrocytoma - Grade III and IV Ataxia Telangiectasia

Atypical Teratoid/Rhabdoid Tumor Batten Disease Beta Thalassemia Major Bilateral Optic Atrophy- Infantile Bilateral Retinoblastoma Bladder Cancer - with distant metastases or inoperable or unresectable Breast Cancer - with distant metastases or inoperable or unresectable

CAL Conditions (C – D)

Canavan Disease (CD)

CACH--Vanishing White Matter Disease-Infantile and Childhood Onset Forms (Effective 9/16/2017) Carcinoma of Unknown Primary Site

Cardiac Amyloidosis- AL Type Caudal Regression Syndrome - Types III and IV Cerebro Oculo Facio Skeletal (COFS) Syndrome Cerebrotendinous Xanthomatosis

Child Lymphoblastic Lymphoma

Child Lymphoma Child Neuroblastoma - with distant metastases or recurrent Chondrosarcoma - with multimodal therapy

Chronic Idiopathic Intestinal Pseudo Obstruction Chronic Myelogenous Leukemia (CML) - Blast Phase

Coffin-Lowry Syndrome Congenital Lymphedema

Congenital Myotonic Dystrophy (Effective 9/16/2017)

Cornelia de Lange Syndrome - Classic Form

Corticobasal Degeneration

Creutzfeldt-Jakob Disease (CJD) – Adult Cri du Chat Syndrome Degos Disease - Systemic DeSanctis Cacchione Syndrome

Dravet Syndrome

CAL Conditions (E – H)

Early-Onset Alzheimer’s Disease Edwards Syndrome (Trisomy 18) Eisenmenger Syndrome Endometrial Stromal Sarcoma Endomyocardial Fibrosis Ependymoblastoma (Child Brain Cancer) Erdheim Chester Disease Esophageal Cancer

Esthesioneuroblastoma Ewing Sarcoma Farber Disease (FD) – Infantile Fatal Familial Insomnia Fibrodysplasia Ossificans Progressiva Follicular Dendritic Cell Sarcoma - metastatic or recurrent Friedreichs Ataxia (FRDA) Frontotemporal Dementia (FTD), Picks Disease -Type A – Adult Fryns Syndrome Fucosidosis - Type 1 Fukuyama Congenital Muscular Dystrophy

Fulminant Giant Cell Myocarditis Galactosialidosis - Early and Late Infantile Types Gallbladder Cancer Gaucher Disease (GD) - Type 2

Giant Axonal Neuropathy Glioblastoma Multiforme (Brain Cancer) Glioma Grade III and IV Glutaric Acidemia - Type II Head and Neck Cancers - with distant metastasis or inoperable or unresectable Heart Transplant Graft Failure Heart Transplant Wait List - 1A/1B Hemophagocytic Lymphohistiocytosis (HLH) - Familial Type Hepatoblastoma Hepatopulmonary Syndrome Hepatorenal Syndrome Histiocytosis Syndromes

Hoyeaal-Hreidarsson Syndrome Hutchinson-Gilford Progeria Syndrome Hydranencephaly Hypocomplementemic Urticarial Vasculitis Syndrome Hypophosphatasia Perinatal (Lethal) and Infantile Onset Types Hypoplastic Left Heart Syndrome

CAL Conditions (I – M)

I Cell Disease Idiopathic Pulmonary Fibrosis

Infantile Free Sialic Acid Storage Disease Infantile Neuroaxonal Dystrophy (INAD) Infantile Neuronal Ceroid Lipofuscinoses Inflammatory Breast Cancer (IBC)

Intracranial Hemangiopericytoma Jervell and Lange-Nielsen Syndrome

Joubert Syndrome Junctional Epidermolysis Bullosa - Lethal Type Juvenile Onset Huntington Disease Kidney Cancer - inoperable or unresectable Kleefstra Syndrome (Effective 9/16/2017)

Krabbe Disease (KD) – Infantile Kufs Disease - Type A and B Large Intestine Cancer - with distant metastasis or inoperable, unresectable or recurrent> Late Infantile Neuronal Ceroid Lipofuscinoses Leigh’s Disease Leiomyosarcoma

Leptomeningeal Carcinomatosis Lesch-Nyhan Syndrome (LNS) Lewy Body Dementia

Liposarcoma - metastatic or recurrent Lissencephaly Liver Cancer Lowe Syndrome Lymphomatoid Granulomatosis - Grade III Malignant Brain Stem Gliomas – Childhood

Malignant Ectomesenchymoma Malignant Gastrointestinal Stromal Tumor Malignant Germ Cell Tumor Malignant Multiple Sclerosis

Malignant Renal Rhabdoid Tumor Mantle Cell Lymphoma (MCL) Maple Syrup Urine Disease

Marshall-Smith Syndrome Mastocytosis - Type IV MECP2 Duplication Syndrome Medulloblastoma - with metastases Menkes Disease - Classic or Infantile Onset Form Merkel Cell Carcinoma - with metastases Merosin Deficient Congenital Muscular Dystrophy Metachromatic Leukodystrophy (MLD) - Late Infantile Mitral Valve Atresia Mixed Dementias MPS I, formerly known as Hurler Syndrome MPS II, formerly known as Hunter Syndrome MPS III, formerly known as Sanfilippo Syndrome Mucosal Malignant Melanoma Multicentric Castleman Disease Multiple System Atrophy Myoclonic Epilepsy with Ragged Red Fibers Syndrome

CAL Conditions (N – R

Neonatal Adrenoleukodystrophy Nephrogenic Systemic Fibrosis Neurodegeneration with Brain Iron Accumulation - Types 1 and 2 NFU-1 Mitochondrial Disease Niemann-Pick Disease (NPD) - Type A Niemann-Pick Disease-Type C Nonketotic Hyperglycinemia Non-Small Cell Lung Cancer Obliterative Bronchiolitis Ohtahara Syndrome

Oligodendroglioma Brain Cancer- Grade III Ornithine Transcarbamylase (OTC) Deficiency Orthochromatic Leukodystrophy with Pigmented Glia Osteogenesis Imperfecta (OI) - Type II Osteosarcoma, formerly known as Bone Cancer - with distant metastases or inoperable or unresectable Ovarian Cancer – with distant metastases or inoperable or unresectable Pallister-Killian Syndrome Pancreatic Cancer Paraneoplastic Pemphigus

Patau Syndrome (Trisomy 13) Pearson Syndrome Pelizaeus-Merzbacher Disease-Classic Form Pelizaeus-Merzbacher Disease-Connatal Form Peripheral Nerve Cancer - metastatic or recurrent Peritoneal Mesothelioma Peritoneal Mucinous Carcinomatosis Perry Syndrome Phelan-McDermid Syndrome Pleural Mesothelioma Pompe Disease – Infantile Primary Central Nervous System Lymphoma Primary Effusion Lymphoma

Primary Progressive Aphasia

Progressive Bulbar Palsy Progressive Multifocal Leukoencephalopathy Progressive Supranuclear Palsy

Prostate Cancer - Hormone Refractory Disease – or with visceral metastases Pulmonary Atresia Pulmonary Kaposi Sarcoma Retinopathy of Prematurity - Stage V Rett (RTT) Syndrome

Revesz Syndrome Rhabdomyosarcoma Rhizomelic Chondrodysplasia Punctata Roberts Syndrome

CAL Conditions (S – Z)

Salivary Cancers Sandhoff Disease Schindler Disease - Type 1

Seckel Syndrome Severe Combined Immunodeficiency - Childhood Single Ventricle

Sinonasal Cancer

Sjogren-Larsson Syndrome Skin Malignant Melanoma with Metastases Small Cell Cancer (Large Intestine, Prostate or Thymus)

Small Cell Cancer of the Female Genital Tract Small Cell Lung Cancer Small Intestine Cancer - with distant metastases or inoperable, unresectable or recurrent Smith Lemli Opitz Syndrome

Soft Tissue Sarcoma - with distant metastases or recurrent Spinal Muscular Atrophy (SMA) - Types 0 and 1 Spinal Nerve Root Cancer-metastatic or recurrent Spinocerebellar Ataxia Stiff Person Syndrome Stomach Cancer - with distant metastases or inoperable, unresectable or recurrent Subacute Sclerosing Panencephalitis Tabes Dorsalis Tay Sachs Disease - Infantile Type Thanatophoric Dysplasia - Type 1 Thyroid Cancer Transplant Coronary Artery Vasculopathy Tricuspid Atresia Ullrich Congenital Muscular Dystrophy Ureter Cancer - with distant metastases or inoperable, unresectable or recurrent Usher Syndrome - Type I

Ventricular Assist Device Recipient - Left, Right, or Biventricular Walker Warburg Syndrome Wolf-Hirschhorn Syndrome Wolman Disease X-Linked Lymphoproliferative Disease

X-Linked Myotubular Myopathy

Xerodema Pigmentosum

Zellweger Syndrome

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