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Ken Meeks had a stroke following a serious car accident.

His left arm and leg haven’t been the same since.

The Ohio resident is hoping a device being studied in a new clinical trial will help return some function to his arm.

Meeks is taking part in the trial at the Neurological Institute at Ohio State University’s Wexner Medical Center. It’s one of the first hospitals in the world to try out an experimental treatment to help people recover from stroke.

Vivistim therapy involves the use of a neurotransmitter implanted just below the skin on the chest in a minimally invasive outpatient surgery.

The device is connected to the vagus nerve in the neck. The vagus nerve transmits signals to the brain, telling it what and when to learn.

The purpose of the device is to help “rewire” circuits in the brain that control motor functions.

Vagus nerve stimulation has been used to treat other conditions, including epilepsy and depression.

For this study, the device is being used along with rehabilitative therapy to see if the combination will help improve upper limb movement following a stroke.

According to the Centers for Disease Control and Prevention, almost 800,000 people in the United States have a stroke every year.

Stroke is one of the top causes of serious long-term disability.

Once the damage has been done, it takes a lot of work to make even small gains.

For people like Meeks, it’s worth trying something new.

How nerve stimulation works

Dr. Marcie Bockbrader is a research physiatrist for the Neurological Institute at Ohio State University’s Wexner Medical Center and a principal investigator for the trial.

The device may be promising, but it won’t be a quick fix.

Bockbrader notes that it doesn’t work on its own.

 

“It’s a device that helps the brain get into a state where it can benefit more from therapy. There’s a button that the therapist presses to activate the device as participants do therapy. The intent of the pulse is much like a heart pacer — to pace the brain. It’s about half a second of stimulation. We think that this very brief pulse is like a ‘wake up and pay attention’ to the brain to use what happens next to help relearn how to use a paralyzed limb,” she explained.

Bockbrader says this trial is focusing on the upper limbs in part because people need their hands to take care of themselves.

“If you can use your hands, you can do a lot of what you need to do with a wheelchair. If you can’t use your hands, you need people around to help more,” she said.

Bockbrader says some patients may feel a buzzing or tingling sensation from the stimulation. Others feel a hoarseness or lump in the throat when trying to swallow.

“There may be some discomfort from having the stimulation. If a patient doesn’t like that, we turn the intensity down. So, we’re still delivering pulses, but they can’t feel it,” she said.

 

The vagus nerve could potentially stimulate the muscles that help with swallowing. For that reason, the trial isn’t currently enrolling people who have difficulty swallowing.

“But it’s possible this therapy could eventually be used to help people who have trouble swallowing. That’s something that can be studied down the line after the device is shown to be safe and effective in this group of people,” Bockbrader added.

The long road back from stroke

Meeks, 63, had his stroke in summer 2016.

He’d already been through a lot of therapy before joining the trial.

“When I left the hospital, my left arm and fingers were nearly completely paralyzed. By that, I mean it pretty much hung limp at my side. I had to move it with my right hand,” he told Healthline.

 

At first, much of his therapy involved just moving the hand and fingers in any way possible. As he progressed, he worked on trying to move small objects and using video games.

“Then my wife found this study on the internet, so I looked at it, signed up, and became patient number one at OSU,” he said.

He’s been hard at work for months now.

For the first six weeks, he had inpatient therapy for two hours a day, three days a week.

He’s currently in a one-month in-home rehabilitation phase. This involves a half hour of therapy every day.

Even home therapy isn’t easy, says Meeks.

“It’s hard enough to get up in the morning and go through this tedious process of getting dressed and getting a cup of coffee. Then to do therapy is difficult. More mentally than physically. You do repetitive things — gross motor movement, something for the fingers, then something for the wrist. Repetitiveness is the key to all of this,” he said.

Although he hasn’t felt any real change in his daily life, he’s hopeful and says he’s scoring better on tests.

“Neuroplasticity is a very slow process. The fact that I don’t see a change right now is, I don’t think, unexpected,” he said.

Meeks hasn’t had any side effects from the device aside from some discomfort right after the surgery.

Clinical trial still recruiting

Thirteen institutions in the United States, plus five in the United Kingdom, are taking part in this trial. And they’re still seeking participants.

“We’re looking at people in the chronic phase of stroke because it gives them the chance to recover naturally as much as possible,” Bockbrader said.

The typical participant is about nine months out from a stroke and has done all the therapies they’re eligible for.

“But we know the potential to improve is still there, though at a slower rate. This ability to improve lasts for years, so we’re accepting patients 10 years out from a stroke. It’s a fairly wide window,” she said.

 

To really be able to tell how much and whether the device is helping, the researchers are choosing a middle-of-the-road impaired population. This includes people who can flex and extend the wrist and move the thumb, but can’t use their hands the way they should for daily living.

“This suggests to us that connections between the arm and the brain are still there but not working at 100 percent efficiency. There’s still room for improvement. If the device is found to be effective, we can start looking at whether it can be beneficial for those more severely affected by stroke. It’s early on in the evaluation process,” Bockbrader said.

Recruitment will probably continue for the next two years.

Bockbrader says it’s a complicated three-phase study design. The initial two phases can last up to a year and a half.

“But if people choose to, we will keep the stimulator in and follow them yearly after that. There’s no end in sight for people who want to keep the stimulator in place and feel it’s helping. If they don’t, removal is a short outpatient surgery,” she said.

Interested stroke survivors can contact the recruitment office of the nearest participating institution.

“Because it’s fairly intense therapy in the clinic for the first six weeks, it’s helpful if they live nearby one of the study centers,” Bockbrader said.

If accepted, participants aren’t responsible for study-related expenses. The study is sponsored by MicroTransponder Inc., developer of the Vivistim device.

Moving forward

The trial is ongoing and double-blind, so Meeks doesn’t know yet if he’s in the control group or not.

But he doesn’t hesitate to recommend the study to others dealing with the aftermath of stroke.

“First of all, it will probably help you, even if only from the therapy itself. And from an altruistic point of view, anything that moves the science forward will not only help you in the long run, but will help somebody else,” he said.

And he has some other advice for stroke patients.

“Use anything you can find in your environment that helps you keep moving forward. If you keep moving, then you’ll keep making progress, even if it’s small, and you won’t backslide,” he said.

Bockbrader believes that regardless of where someone is in recovery after a stroke, there’s always potential to get better.

“There’s this idea that you’ve reached a maximum level of function after certain therapies or a certain amount of time. The reality is that’s probably not true. To get better, people often have to go off the beaten track to get an opportunity to boost their potential. That’s one of the things I like about studies like this. It’s one of the ways you can do that,” she said.

She told Healthline that after a stroke, some of the brain’s connections that are important to movement get disconnected or destroyed. Many people have difficulty using their hands after a stroke.

This article first appeared on HealthLine.com.

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LOS ANGELES (AP) – A decade before his ex-girlfriend was killed in what investigators say was a targeted explosion, Stephen Beal’s wife died in what a coroner deemed a “mysterious case.”

Christine Beal’s death in 2008 came a few weeks after she fell down a flight of stairs in their Long Beach home while carrying a heavy piece of furniture with her husband. The bureau landed on her pelvic and hip area.

The Los Angeles County coroner’s office said it was not clear if the death was related to trauma, but said there were no signs of foul play and ruled the manner “undetermined.” An autopsy said her death was caused by pancreatitis, electrolyte imbalance and chronic lead intoxication.

Stephen Beal won $550,000 in a lawsuit against a life insurance company that denied his claim after asserting the death was not an accident.

On Wednesday, Beal was arrested and accused of possessing an unregistered destructive device by FBI agents investigating the bomb blast that killed his former girlfriend inside the day spa she owned in a medical office building in Aliso Viejo, about 50 miles (80 kilometers) south of Los Angeles.

Beal, a 59-year-old actor and model rocket enthusiast, was not charged with the fatal explosion, but he remains in custody as authorities search for a motive and suspect.

Ildiko Krajnyak, 48 and a native of Hungary, had dated Beal until recently and they were business partners. She was killed when she opened a cardboard box Tuesday afternoon. Two patrons, a mother and daughter, were seriously injured.

Beal told authorities he hadn’t made any bombs and that he didn’t possess enough explosive material for a blast the size of the one that ripped a corner out of the building and shook the neighborhood.

He was arrested after a search of his home found two improvised explosive devices, three guns and more than 100 pounds (45 kilograms) of explosive material, according to court documents.

Stephen Young, a friend and nearby neighbor, said he couldn’t imagine Beal doing anything violent. He rejected suspicions in the neighborhood about the death of Christine Beal and said it was a tragic accident.

“If there was anything unusual about that she certainly had time to confide in a nurse or someone like that,” he said. “I have no doubt it was truly an accident. I think he really suffered from the loss of his wife for several years.”

After the death of Christine Beal, 48, a coroner’s investigator wrote that Beal was “uncooperative, not wanting to ‘reveal’ information to the hospital staff about (his wife),” according to a copy of her autopsy report obtained by The Associated Press.

A toxicology screening showed she had benzodiazepine in her system, a medication commonly used for anxiety.

The tests showed her blood lead level was 24 times greater than the number set by the National Institute for Occupational Safety and Health and 100 times greater than the average for adults in the U.S., according to the Centers for Disease Control and Prevention.

The autopsy report said medical examiners couldn’t conclusively say whether the fall contributed to her death and said it was a “mysterious case.”

“Death is probably natural, maybe trauma contributed but this is not known,” the report said.

Beal filed a lawsuit against his employer and insurance company after they denied his claim. A doctor hired by the insurance company said it was unlikely the death was “solely by an accident.”

Ultimately, Beal prevailed in his suit against Marsh & McLennan, his former employer, and American Life Insurance Company of New York.

Beal and Krajnyak met online in June 2016 and dated for about 18 months. Photos on his Facebook page showed them vacationing in Cuba, Portugal and Mexico.

Beal spoke frequently of Krajnyak and seemed happy after the difficulty of losing his wife and having his adult children move out of the house, Young said.

The couple’s romance cooled earlier this year after disputes over exclusivity and finances, authorities said.

Beal called sheriff’s deputies in Orange County about two hours after Tuesday’s explosion, at the urging of his current girlfriend who had heard about the blast on news reports and knew he had a business in the building.

Beal didn’t enter a plea during an initial court appearance Thursday and was due back in court on Monday. His public defender would not comment on the case.

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Associated Press journalists Amanda Lee Myers in Long Beach and Brian Melley in Los Angeles contributed to this report.

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Follow Michael Balsamo on Twitter at www.twitter.com/MikeBalsamo1 .

Copyright © 2018 The Washington Times, LLC.

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WASHINGTON (Reuters) – The U.S. Drug Enforcement Administration on Friday reversed an order that halted a Louisiana drug wholesaler’s opioid sales over allegations it failed to report suspiciously large orders by pharmacies for the narcotics, court documents showed.

Seeking to battle a national opioid abuse crisis, the agency of the Justice Department imposed the suspension on Shreveport-based Morris & Dickson Co on May 2. It accused the 177-year-old company of failing to “properly identify large suspicious orders for controlled substances sold to independent pharmacies.”

The company immediately disputed the charge, and last week a U.S. District Court judge in Shreveport entered a temporary restraining order blocking the DEA from enforcing the suspension.

“This is a striking vindication for our family company,” Paul Dickson, president of Morris & Dickson, said in a statement posted on the company’s website on Friday.

“This proves what we’ve said all along – that DEA’s hasty action was unjustified. We have always taken our responsibility to prevent diversion seriously.”

The DEA’s order marked the first time during President Donald Trump’s administration that it had moved to immediately block narcotic sales by a distributor as the agency attempts to combat a national opioid abuse epidemic.

A DEA probe focusing on purchases of the highly addictive painkillers oxycodone and hydrocodone showed that, in some cases, pharmacies were allowed to buy as much as six times the quantity of narcotics they would normally order, the agency said.

The U.S. government is trying to crack down on opioid abuse through a number of measures, including a proposal last month to tighten rules governing the amount of prescription opioid painkillers that drugmakers can manufacture in a given year.

Reporting by Eric Walsh; Editing by Cynthia Osterman

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People say I need to dedicate a separate day to each body part. Is that not right?

No – and it might even be counterproductive. “The problem I see most beginners make is following routines that are too advanced for them,” says Dan Forbes, a strength and conditioning coach and founder of Veteran Athlete. “As every guy who’s been training for a few years knows, the first year or two in the gym is a special time, when it’s possible to make progress each and every session. Those ‘newbie’ gains are glorious, and the best ways to capitalise on them are to get moving properly and work hard.

“Doing complex split routines, where you divide your weekly workouts into body-part sessions, as a beginner is like using a sledgehammer to open a nut. They build too much fatigue, which impedes the body’s learning process, increases recovery time and slows progress.”

So what should I do instead?

Keep it simple. No, simpler than that. “One go-to routine for beginners is the ‘one set of 20’ routine created by Dr Michael Yessis,” says Forbes. “The concept is simple. Select one exercise per body part, choose a weight that you can do 20 reps with and get after it. The next time you go to the gym you perform the same routine with only one instruction: beat your last session. A couple of extra reps, the next size dumbbell up – whatever it is, you must make progress.

“I have clients do this until they fail to make progress for two sessions in a row. Then I drop the reps to 14 and repeat, then I drop them to ten reps – and only then do I introduce multiple sets. This approach will let you make progress every session. Who doesn’t love that?”

How many days a week do I need to go to the gym?

Three is Forbes’s recommendation for beginners. “That’s less about recovery time and more about keeping plenty of options in the bag for when you reach the point where you need to do increase frequency to keep seeing progress. If you can’t manage three, two days a week will still get the job done. For those keen beans who want to do more, I don’t hold them back – do whatever frequency you want.

“The key with increasing or decreasing training frequency is to remember to keep overall training volume the same when possible. For example, if a client has 20 sets of total work for their quads in a programme and goes from training twice a week to four times a week, I’ll simply spread those 20 sets across four days.”

OK, I’m officially intermediate. What are my options?

“When someone has a bit of training experience, I like an upper/lower split,” says Forbes. “An upper/lower split allows you to spread the training load across the week. I’d usually go for a power-building set-up – think big, compound lifts done with low reps at the start of the week, then some higher-rep isolation work later in the week. This increases strength while you build some lean mass.

“With this type of set-up you can ensure that your muscles get exposed to the three key drivers of muscle growth – mechanical tension, muscle damage and metabolic stress – across each week. But you’ll also keep engaged by shifting the focus of the sessions across the week.”

What if I want to improve one body part?

“To focus on a particular body part, you want to increase the amount of work that muscle is doing in a training cycle, known as the training load,” says Forbes. “In these situations, I opt for a higher-frequency set-up rather than adding in a training session specifically for that body part. It allows for a higher quality of work and higher work output.

“For example, if you were to perform flat bench presses, incline bench presses, dips and flyes, by the time you get to the dip you’ll have already activated the key muscles, accumulated fatigue and lactic acid, and caused some muscle damage. In a nutshell, you’re spent.

“In comparison, if I set up a training programme so that you perform flyes and dips on a lower body focus day, you’ll be able to use more weight. That means a greater training load for that muscle and a more frequent stimulus to grow and adapt.”

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After quitting his job as a graphic designer and heading out for a trip across Australia on a longboard back in 2005, Dave Cornthwaite came up with the Expedition1000: a plan to take on 25 journeys around the world, each using a different form of non-motorised transport – and with a minimum distance of 1,000 miles. So far he’s completed 12, including a traverse of the Mississippi River on a stand-up paddleboard, a 1,001-mile swim down the Missouri River and more than 3,000 miles of sailing across the Pacific Ocean. Along the way, he’s written three best-selling books, delivered hundreds of lectures, and created life-enhancing brand SayYesMore. And he’s still got 13,000 miles to go…

What’s the adventure you’re most proud of?

I’ve never been asked this! I guess I never really considered pride as a factor, but I look back fondly at skateboarding across Australia – that was five months of solid work which totally changed my life. Paddleboarding the Mississippi was a lot of fun. I’m currently water-biking the Norwegian coastline and maybe this one, when finished, will be my proudest moment. It’s lovely combination of tough and magical.

The biggest physical challenge you’ve faced?

Swimming the Missouri, hands down. I didn’t swim so well when I started…

What was the most dangerous situation you’ve found yourself in?

There are two. The first, I was hit by a car south of Memphis and ended up 30 metres off the road. Luck got me out of that one. And on this trip around Norway, I’ve had moments where not coming home is a distinct possibility. It’s really important when you’re out at sea by yourself that you don’t panic, and in two-metre swells with an offshore wind, waiting is not an option. You just have to keep moving and do everything you can to get back to land.

What would you say is the biggest thing you’ve learned about yourself during your adventures?

Everything! I was clueless when I started. I guess with each adventure I’m still surprised what new challenges and situations there are. Slowly, I’m realising that I’m never really going to be an expert in anything, so maybe that’s it. I’ve been powered by ambition for so long, but now I realise that if that’s your drive you can never really be truly happy. So now I’m chilling out.

What’s the biggest thing you’ve learned about the world during your adventures?

That people are good. I forget this when I’m in a big town and nobody talks to anyone or knows their neighbour. Then on every adventure, strangers take me into their homes in minutes. People are good and kind, and that’s global.

What’s the next big challenge you have your eye on?

Well, I’d like to survive this one before looking forward. But kitesurfing the east African coast has been on my mind, and I love the idea of putting on a monofin and swimming 1,000 miles underwater…

What’s your advice to an average guy who wants to inject some adventure into their lives?

What the heck are you waiting for? It’s not a competition. Just make a decision and do something challenging that means you’ll bring home a good story.

Find out more about Cornthwaite’s drive to get people into adventuring at sayyesmore.com

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Interested in Ebola?

Add Ebola as an interest to stay up to date on the latest Ebola news, video, and analysis from ABC News.

Three new cases of the often lethal Ebola virus have been confirmed in a city of more than 1 million people, Congo’s health minister announced, as the spread of the hemorrhagic fever in an urban area raised alarm.

The statement late Friday said the confirmed cases are in Mbandaka city, where a single case was confirmed earlier in the week.

There are now 17 confirmed Ebola cases in this outbreak, including one death, plus 21 probable cases and five suspected ones. It was not immediately clear what link the new cases might have to others.

The World Health Organization on Friday decided not to declare the outbreak a global health emergency, but it called the risk of spread within Congo “very high” and warned nine neighboring countries that the risk to them was high. WHO said there should be no international travel or trade restrictions.

The outbreak is a test of a new experimental Ebola vaccine that proved effective in the West Africa outbreak a few years ago. Vaccinations are expected to start early in the week, with more than 4,000 doses already in Congo and more on the way.

A major challenge will be keeping the vaccines cold in the vast, impoverished country where infrastructure is poor.

While Congo has contained several Ebola outbreaks in the past, all of them were based in remote rural areas. The virus has twice made it to Congo’s capital of 10 million people, Kinshasa, in the past but was rapidly stopped.

Health officials are trying to track down more than 500 people who have been in contact with those feared infected, a task that became more urgent with the spread to Mbandaka, which lies on the Congo River, a busy traffic corridor, and is an hour’s flight from the capital.

The outbreak was declared more than a week ago in Congo’s remote northwest. Its spread has some Congolese worried.

“Even if it’s not happening here yet I have to reduce contact with people. May God protect us in any case,” Grace Ekofo, a 23-year-old student in Kinshasa, told The Associated Press.

A teacher in Mbandaka, 53-year-old Jean Mopono, said they were trying to implement preventative measures by teaching students not to greet each other by shaking hands or kissing.

“We pray that this epidemic does not take place here,” Mopono said.

The WHO, which was accused of bungling its response to the West Africa outbreak —the biggest Ebola outbreak in history with more than 11,000 deaths— appears to be moving swiftly to contain this latest epidemic, experts said.

There is “strong reason to believe this situation can be brought under control,” said Dr. Robert Steffen, who chaired the WHO expert meeting on Friday. But without a vigorous response, “the situation is likely to deteriorate significantly.”

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with bodily fluids of those infected.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.

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Follow Africa news at //twitter.com/AP—Africa



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I call them “the eyebrows that fell onto the pizza.”

They are not very enticing, those tinned anchovies, a dull sandstone red-brown and their wee bones ready to tickle your throat if you don’t chew them well enough. If you chew them at all … .

People avoid anchovies not merely because they look weird, but because they claim anchovies are too strong in the flavor department. I mean, they are the definition of “fishy,” right?

But we eat anchovies all the time without knowing it, mainly because we don’t see them coming. They’re the sixth ingredient listed (out of around 12) in Worcestershire sauce. They’re in every proper Caesar salad dressing, never mind if they’re not also laid whole on top of the romaine; they’re in every proper black olive tapenade.

You can bet many chefs use them at the restaurants where they feed you: in pasta puttanesca, on the hanger steak for steak frites, in the fish sauce at every Thai or Vietnamese joint you’d ever patronize.

Never noticed, did you? And those chefs’ foods are tasty, eh?

Most times in your own kitchen, it’s a good idea to think like a chef anyway. They and their kin have figured out a lot for us. We pay them for flavor; why not imitate it at home for less a charge?

Chefs use anchovies all the time to add enormous savor to foods. Anchovies are a food very high on the umami or glutamate scale (as are Parmigiano-Reggiano cheese, dried tomatoes, mushrooms, soy sauce and sweet corn). A little goes a long way to make us salivate over sauces, dressings, braising liquids, toppings, stews and other wet foods that use anchovy, even a bit.

Frankly, the intense flavor, even aroma, of anchovy melts into and quite disappears when used these ways in the kitchen. The pungency of the misplaced eyebrow is just a one-off at the pizza parlor; it’s not the norm in good cooking.

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Roxborough State Park will participate in Colorado Public Lands Day 2018. (Cyrus McCrimmon, Denver Post file)

Saturday marks the second annual Colorado Public Lands Day, which will be celebrated with special events at many of the Colorado’s 41 state parks. And at one of them, there’s even a special event for Fido.

Eldorado Canyon State Park south of Boulder will be initiating dogs and their owners into its Eldo Bark Ranger Program. Furry friends will receive Eldo Bark Ranger dog tags, while their masters will be asked to sign a pledge card that they will keep their dogs on leashes.

Colorado Parks and Wildlife has compiled a list of Saturday’s special events, volunteer projects and adventures. There will be a group hike at Chatfield State Park. At Roxborough State Park in Douglas County and Lory State Park west of Fort Collins, volunteers are invited to help pull mullein, a weed that crowds out native plants and is harmful to wildlife. At Barr Lake State Park near Brighton, there will be a clean-up effort with tree planting.

Colorado was the first state to establish its own public lands day through a 2016 bill that passed with bipartisan support in the legislature. Normal admission fees will be in effect Saturday. Daily pass prices at Colorado State Parks vary from $3-$9.The Eldorado event will require an $8 vehicle fee and a $5 donation is requested.

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Every year, I end up testing barbecue recipes in the rain, with an umbrella balanced precariously on one shoulder, but this year’s mission coincided with the hottest April week in 70 years. Barbecue sales doubled, supermarkets ran out of burgers, rosé and sun cream, and I leapt on the balmy bandwagon by celebrating the spring sun with ingredients from Mexico to Thailand. I’m keeping my fingers crossed for more scorchers this summer, but there’s enough chilli heat here to keep us all nice and warm, just in case.

Thai marinated onglet skewers with peanut and lime dressing (pictured above)

If you can’t get hold of onglet, which is a great secondary cut of beef that’s perfect for the barbecue, experiment with other cuts such as rump or sirloin. You will need 12 wooden skewers, about 21cm long, soaked in water for 10 minutes

Prep 15 min
Marinate 2 hr+
Cook 35 min
Serves 6 (2 skewers each)

1kg onglet steak (also known as hanger steak)
1½ tbsp vegetable oil

For the marinade
6 garlic cloves, peeled and finely chopped
3cm piece fresh ginger, peeled and finely chopped
10 makrut lime leaves, stalks discarded, roughly chopped
1 red chilli, finely chopped (remove the seeds if you don’t like too much heat)
150ml soy sauce
2 tbsp rice-wine vinegar
1 tbsp mirin
75ml maple syrup
2-3 limes, juiced, to get 40ml
1½ tbsp fish sauce

For the dressing
1 tbsp soy sauce
1 tbsp maple syrup
½ tbsp rice-wine vinegar
1 tbsp lime juice
1 small garlic clove, peeled and finely chopped
2 spring onions, finely chopped
1 red chilli, finely chopped (again, discard the seeds if you want it less hot)
1 tbsp roasted salted peanuts, roughly chopped
1 tbsp pumpkin seeds, toasted and roughly chopped

Cut the meat against the grain into 5mm-thick slices, removing any silverskin or gristle as you go. Mix all the marinade ingredients in a non-reactive container, then add the meat and toss to coat. Leave to marinate for at least two hours (and up to two days).

For the dressing, mix the first five ingredients in a small bowl. In a separate small bowl, mix the spring onions, chilli, peanuts and pumpkin seeds. Add half this mixture to the soy sauce mixture and set the rest aside – you’ll use it as a garnish.

Drain the meat in a sieve set over a medium saucepan to catch the marinade in the pan; discard the aromatics. Put the marinade on a medium-high heat, bring to a simmer and cook for about three minutes, until reduced and thickened to the consistency of a glaze.

Line a work surface with a few sheets of clingfilm, then spread the meat out in a single layer on top. Cover with a few more sheets of clingfilm, then use a rolling pin to bash the meat until it is very thin – about 2-3mm thick. Thread the meat on to the soaked skewers (about 80g meat per skewer), then brush with a little oil and grill on the barbecue for about four minutes, turning a few times and basting with the reserved glaze until the meat has deep char marks and is golden brown all over. Leave to rest for a few minutes, then transfer to a serving plate.

Drizzle the dressing over the meat, sprinkle the reserved herb and peanut mixture on top, and serve hot.

Charred beetroot with lime salsa and pickled chillies

Yotam Ottolenghi’s charred beetroot with lime salsa and pickled chillies.



Yotam Ottolenghi’s charred beetroot with lime salsa and pickled chillies. Photograph: Louise Hagger for the Guardian

If you’re using shop-bought cooked beets, look for ones with no added vinegar, salt or sugar. Don’t worry if your barbecue doesn’t have a resting rack, but do ensure that you’re cooking the beetroots over the very coolest coals for the first 30 minutes. Use recyclable foil trays if you’re worried about damaging a baking tray.

Prep 12 min
Marinate 30 min+
Cook 40 min
Serves 4 as a side

10 makrut lime leaves, stalks discarded, roughly chopped
1 garlic clove, peeled and roughly chopped
2cm piece fresh ginger, peeled and roughly chopped
1-2 limes, zest finely grated, to get 2 tsp, then juiced, to get 1½ tbsp
90ml olive oil
Flaked sea salt
525g cooked beetroot, shop-bought or freshly cooked, drained and quartered
1 small red chilli, finely sliced on an angle
1½ tbsp white-wine vinegar
½ tsp caster sugar
1 tbsp maple syrup
120g creme fraiche
1 tbsp coriander leaves, finely chopped
1 tbsp dill leaves, finely chopped

Put the first four ingredients, three tablespoons of the oil and a teaspoon of flaked sea salt in a spice grinder and blitz to a loose paste. Put the beetroot quarters in a bowl, add half the paste, toss well to coat and leave to marinate for at least 30 minutes, and up to three hours. Keep the remaining paste for serving.

Spread out the beets on a baking tray, place this on the resting rack of the barbecue over the coolest coals, close the lid of the barbecue and cook for about 30 minutes, until soft and lightly smoked.

While the beetroot is cooking, put the chilli in a small bowl with the vinegar, sugar and half a teaspoon of flaked sea salt. Leave to pickle for at least 30 minutes, or up to three hours.

Brush the beetroot quarters with a tablespoon of the oil and the maple syrup, then put them directly on the grill in a hotter area of the barbecue and cook for four to five minutes, turning regularly, until they’re covered in good char marks.

Spread the creme fraiche on a large plate and top with the beetroot quarters. Spoon the remaining makrut lime paste evenly over the beetroot, then sprinkle over the herbs. Drizzle over the remaining oil and finish with the pickled chilli and a generous sprinkle of flaked sea salt.

Blackened sea bass with scotch bonnet sauce

Yotam Ottolenghi’s blackened sea bass with scotch bonnet dipping sauce.



Yotam Ottolenghi’s blackened sea bass with scotch bonnet sauce. Photograph: Louise Hagger for the Guardian

This is meant to be enjoyed like tacos, where you pile the fish and condiments into tortillas. The fish on its own, with its deep-flavoured, black garlic marinade, will also work a treat with only a squeeze of lime for company, but the dipping sauce is so good, and easy, it would be a shame not to make that, too. In fact, you may well end up hooked on the stuff and find yourself wanting to eat it with all sorts.

Prep 15 min
Marinate 1 hr+
Cook 30 min
Serves 4

4 small sustainably sourced sea bass (250-300g each), cleaned, scaled and patted dry (or sea bream, black bream or similar firm-fleshed fish)
Salt
2 tbsp vegetable oil

For the marinade
30g black garlic cloves (about 15)
2 tsp ground cumin
2 tsp ground coriander
1 scotch bonnet chilli, deseeded
1-2 limes, zest finely grated, to get 1 tsp, and juiced, to get 2 tbsp
½ tsp soft light brown sugar
1 tbsp pul biber (Turkish chilli flakes or ½ tbsp of regular chilli flakes)
60ml olive oil
1 tsp flaked sea salt, plus extra to season
Corn tortillas

For the dipping sauce
1 scotch bonnet chilli, deseeded and finely chopped
1 small garlic clove, peeled and finely chopped
5g spring onion, finely chopped
2 tbsp lime juice

For the herb salad
10g mint leaves
10g coriander leaves
2 spring onions, finely sliced on an angle
Flaked sea salt, to taste

Put all the marinade ingredients in the small bowl of a food processor and blitz to a smooth paste. Season the fish inside and out with salt. Set half the marinade aside for serving and rub the rest all over the fish and inside the cavity. Leave to marinate for at least an hour, or overnight.

Mix all the ingredients for the dipping sauce in a small bowl with a good pinch of flaked sea salt. Mix all the ingredients for the herb salad in a medium bowl.

Drizzle each fish on both sides with the oil and put on the barbecue over a medium heat. Grill for six to seven minutes on each side, until cooked through with good char marks. Take care when lifting the fish off the grill, because the skin may stick (I find it best to ease them off gently with a metal spatula). Cover the fish tightly with foil, to keep warm, while you toast the tortillas.

Put a large, cast-iron pan on the barbecue over the hottest coals and, once very hot, lay as many tortillas as will fit in the pan at a time and toast for a minute or so on each side, until warmed through and nicely charred on both sides.

Open the foil parcels, transfer the fish to a large serving plate and serve hot with the tortillas, dipping sauce, herb salad and reserved black garlic marinade.

  • Food styling: Emily Kydd. Prop styling: Jennifer Kay. Food stylist assistant: Katy Gilhooly

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Sleep I’m one of those people who needs their sleep. If I don’t get enough I can be pretty grumpy, so I go to bed early and wake early. I start riding by 7.30am and I’m usually so exhausted from a day’s training my head is on the pillow by 9.30pm. I might watch a bit of telly but then I’m out; I’m like an old person. I’ve always been a deep sleeper; not even the prospect of an Olympic final keeps me awake.

Eat I work with a personal trainer who makes sure I get the right combination of carbs, protein and fats. Everything is worked out to sync with what I’m physically doing each day. For breakfast I’ll have scrambled eggs on wholemeal toast; a chicken wrap and salad for lunch; a healthy meal of meat and lots of vegetables for dinner, plus two snacks of nuts and fruit. On days off I love apple crumble and ice-cream.

Work I often work seven days a week, riding from 7.30 till 5pm, then training at the gym, plus I teach at the weekend, but the days don’t feel long because my job is my passion. I’m much better with a routine. I have a proper holiday once a year where I don’t see a horse for 10 days; I can’t afford to physically or mentally burn myself out.

Family My family is very supportive of what I do and always come to competitions. I see my parents and my siblings regularly but balancing my career with a relationship can be difficult as I’m away a lot. I’m really grateful my fiance Dean respects and understands what I do. He has nothing to do with horses – he’s a builder – which is nice. I could never be with someone who did the same as me because I’m too competitive.

Fun I love shopping. I find it therapeutic. I clothes shop mainly but also buy stuff for my house, my horses, and my dogs, who I love taking for a good walk. I like hanging out with my friends, who aren’t horsey, to get a dose of normality. I’m terrible at sitting around doing nothing. Dean is always like, “Why can’t you just sit down and relax?” but I find it a waste to do nothing so I end up tidying or organising. It’s just the way I am.

The Girl On The Dancing Horse by Charlotte Dujardin is published by Penguin Random House at £20.

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