POPULARITY
N Engl J Med 2013;368:1379-1387Background In 2013, it had been established that primary PCI for STEMI was the preferred strategy. Yet many patients did not have prompt access to primary-PCI capable hospitals and transfer delays could impact outcomes. The vast majority of patients with STEMI who present to non-PCI facilities do not subsequently get primary PCI within recommended times.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Delays led to the development of prehospital care, such as ECGs in the ambulance, and pre-hospital delivery of fibrinolysis. The Strategic Reperfusion Early after Myocardial Infarction (STREAM) study evaluated whether a fibrinolytic-therapy approach consisting of prehospital or early fibrinolysis with contemporary antiplatelet and anticoagulant therapy, coupled with timely coronary angiography, provides a clinical outcome similar to that with primary PCI in patients with STEMI who present early after symptom onset.Patients Eligible patients had a) STEMI within three hours, b) could not have primary PCI within one hour of first medical contact. No formal exclusion criteria were listed in the main manuscript.Baseline Characteristics A total of 1892 patients underwent randomization in 1:1 fashion. The mean age of patients was 59 years. Less than 15% of both groups were older than 75 years. Females were 20%. More than 90% of patients were Killip class 1. Less than 10% of enrolled patients had had prior CHF, MI, or PCI.Procedures Patients were randomized in a 1:1 ratio to fibrinolysis followed by timely coronary angiography or primary PCI. All patients were transferred to a PCI-capable hospital; for all non-PCI community hospitals participating in the study, a well-developed hub-and-spoke relationship with a PCI-capable site was required.The fibrinolytic strategy included early use of concomitant antiplatelet and anticoagulant medications, as well as additional discretionary glycoprotein IIb/IIIa antagonists. Tenecteplase was administered in a weight-based dose and was combined with low-molecular-weight enoxaparin, weight and age adjusted.Antiplatelet therapy consisted of clopidogrel in a 300-mg loading dose (omitted for patients ≥75 years of age) followed by 75 mg daily and aspirin (150 to 325 mg) immediately followed by 75 to 325 mg daily. Urgent coronary angiography in the fibrinolysis group was permitted at any time in the presence of hemodynamic or electrical instability, worsening ischemia, or progressive or sustained ST-segment elevation requiring immediate coronary intervention, according to the investigator's judgment.Endpoints The primary end point of the trial was a 30-day composite of death from any cause, shock, congestive heart failure, or reinfarction. Single efficacy end points as well as safety end points consisting of ischemic stroke, intracranial hemorrhage, nonintracranial bleeding, and other serious clinical events were recorded.The statistical analysis plan was complicated. A sample size of 1000 patients per study group was planned, and the rate of the primary end point in the primary PCI group was projected to be 15.0%. After one-fifth of patients had been enrolled, trialists amended the protocol to reduce the dose of tenecteplase by 50% in patients older than 75 years because of excess ICH. ECG criteria for inferior MI was also changed to require at least 3 mm (up from 2) of ST elevation in two contiguous leads.This trial was designed as a proof-of-concept study. All statistical tests were of an exploratory nature.Results The median time delay from the onset of symptoms to first medical contact and randomization was similar in the two groups ( 61-62 minutes). The median times between symptom onset and start of reperfusion therapy (bolus tenecteplase or arterial sheath insertion) were 100 minutes and 178 minutes, respectively (P
Ray Simpson was a pioneering guitar maker in New Zealand and made his first electric guitar in the 1940s. In the 1960s he helped start up Beverley Bruce and Goldie a company making amplifiers and guitars. At the time. Ray designed some of the early Jansen guitars and eventually went on to produce his own "Simpson" guitars, which have since become collectors items. In this podcast Larry Killip talks to Ray Simpson's son Peter.
In de Nederlandse literatuur is de schrijver Belcampo, pseudoniem van Herman Schönfeld Wichers, uniek. Nederlandse schrijvers beperken zich meestal tot realistische verhalen en romans, terwijl het werk van Belcampo fantastisch en surrealistisch is. Hij verandert één element in de werkelijkheid en fantaseert daar consequent op door. Wat gebeurt er als je jezelf in de trein tegenkomt? Hoe zou de Dag des Oordeels er uit zien in het gereformeerde plaatsje Rijssen en welke rol zou de schrijver daar zelf in kunnen spelen? Nico Keuning schreef over een biografie over de kleurrijke figuur Belcampo, arts en schrijver. De titel van het boek is Groots en onbekommerd en hierin volgt volgt hij Belcampo als buitenstaander in het Rijssen van toen, als tbc-patiënt in Renkum en Davos, als student in Amsterdam, op zijn zwerftochten in het buitenland en als arts-schrijver in Groningen. In het tweede uur en de podcast van Wat blijft: Bob Goudzwaard was econoom en politicus en werkte voor het wetenschappelijk instituut van de ARP. Later werd hij ook Tweede Kamerlid voor die partij, hij was één van de initiators van het CDA. Goudzwaard was de grondlegger van het begrip ‘economie van het genoeg', ook wel ‘consuminderen' genoemd. In Nederland moest hij lang op waardering wachten, internationaal genoot hij veel aanzien. Hij was hoogleraar aan de Vrije Universiteit in Amsterdam. Annette van Soest volgt zijn spoor terug en praat met twee van zijn dochters Mariëtte en Annelies, zijn biograaf Joost Hengstmengel en docent filosofie en goede vriendin van Goudzwaard Esther Somers. Wat Blijft, na de dood van Bob Goudzwaard? Presentator: Nicole Terborg Redactie: Redactie: Jessica Zoghary, Nina Ramkisoen, Geerte Verduijn, Sushmita Lageman Eindredactie: Bram Vollaers Productie: Mare de Vries
Lynfield-based Larry Killip describes himself as "possibly the most famous person that you have never heard of". With a musical career stretching back to the mid-60s, Killip's first band The Zarks was formed with a few high school buddies. Since then he's continued to write and perform in various iterations, but the work most people would be familiar with is the hundreds of jingles Killip has written - for everything from Columbine stockings to Skyline Gottages. He joins Colin Peacock to reflect on his unusual career, his work with indie pop darlings The Beths, and his ever-growing collection of vintage gear and ephemera.
Current Pro Golfer Riley Killip joins the pod to talk about his journey through 3 schools in college golf as well as finding his way back to competing on the pro scene. They finish the episode with starting 5 Golfers.
N Engl J Med 2014;371:1016-1027Background: Prior trials have demonstrated that combining P2Y12 inhibitors with aspirin in patients with acute coronary syndrome reduces cardiovascular events. Prasugrel, in the TRITON-TIMI 38 trial, and ticagrelor, in the PLATO trial, were administered in the hospital.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Older trials had suggested that early administration of glycoprotein IIb/IIIa inhibitors improves outcomes in patients with ST elevation myocardial infarction (STEMI).The ATLANTIC trial sought to test the hypothesis that pre-hospital compared to in-hospital administration of the P2Y12 inhibitor, ticagrelor, improves outcomes in patients with STEMI.Patients: Patients were enrolled if they had STEMI and had experienced symptoms for at least 30 minutes but no longer than 6 hours, and were expected to have EKG to balloon inflation of less than 120 minutes. Patients were excluded if they had prior intracranial bleeding, moderate to severe liver disease, gastrointestinal bleeding within 6 months, planned fibrinolytic therapy or required dialysis.Baseline characteristics: The average age of patients was 61 years with 80% being men. The average weight was 80 kg. About 14% had diabetes, 9% had prior myocardial infarction, 4% had chronic obstructive pulmonary disease and 2% had chronic renal failure. TIMI risk score was 0-2 in 61% of the patients. About 90% had Killip class I. Coronary angiography was performed in 98% of the patients and percutaneous coronary intervention (PCI) with stent placement was performed in 82%. The use of glycoprotein IIb/IIIa inhibitors was high in the study and was administered before percutaneous coronary intervention in 29% of the patients.Procedures: Patients were randomized 1:1 to receive ticagrelor en route to the hospital/ catheterization lab (group 1) or at the catheterization lab (group 2). In group 1, patients received ticagrelor 180mg en route to the hospital and placebo in the catheterization lab. In group 2, patients received placebo en route to the hospital and ticagrelor 180mg in the catheterization lab. Following that, all patients received ticagrelor 90mg twice daily for at least 30 days and the treatment was recommended to continue for 12 months. Clinical endpoints were adjudicated up to 30-days post randomization.Endpoints: There were two coprimary endpoints – proportion of patients who did not have 70% or greater resolution in their ST-segment elevation before PCI and proportion of patients without TIMI grade III flow in the infarcted artery before PCI. Review of EKG and angiographic data was blinded.A secondary prespecified endpoint included the composite of all-cause death, myocardial infarction, stent thrombosis, stroke or urgent revascularization at 30 days.Analysis was performed based on the modified intention-to-treat principle, defined as patients who received at least one loading dose of the study drug. Patients with missing EKG or angiographic data were excluded from the primary endpoint analysis.The sample size estimate was based on an anticipated event rate of 15% in the control group for the EKG endpoint. They estimated that 779 patients would be needed in each group to show a 6% absolute difference with 80% power and an alpha of 2.5%.Results: The trial randomized 1,862 patients, 909 patients to the prehospital group and 953 to the in-hospital group. The median time from randomization to angiography was 48 minutes and the median time between the two loading doses was 31 minutes.There was no significant difference in the proportion of patients who did not have 70% or more ST segment resolution before PCI (86.8% for the pre-hospital group vs 87.6% for the in-hospital group, OR: 0.93, 95% CI: 0.69 – 1.25; p= 0.63) or the proportion of patients who did not have TIMI III flow in the infarcted artery before PCI (82.6% for the pre-hospital group vs 83.1% for the in-hospital group, OR: 0.97, 95% CI: 0.75 – 1.25; p= 0.82).There was also no significant difference for the secondary composite endpoint (4.5% vs 4.4%, OR: 1.03, 95% CI: 0.66 – 1.60; p= 0.91). Stent thrombosis at 30-days was lower in the pre-hospital group (0.2% vs 1.2%, OR: 0.19, 95% CI: 0.04 – 0.86; p= 0.02). Myocardial infarction was not significantly different between both groups (0.8% vs 1.1%; p= 0.53). All-cause death was numerically higher in the pre-hospital group (3.3% vs 2.0%, OR: 1.68, 95% CI: 0.94 – 3.01; p= 0.08).Major bleeding not related to CABG was not significantly different between both treatment groups (1.3% in both groups using the TIMI criteria and 2.9% in the pre-hospital group vs 2.5% in the in-hospital group, using the STEEPLE criteria).Conclusion: In patients with STEMI, pre-hospital administration of ticagrelor did not improve outcomes compared to in-hospital administration. Although pre-hospital administration of ticagrelor reduced stent thrombosis at 30-days, this did not reduce all-cause mortality. In fact, all-cause mortality was numerically higher in the pre-hospital group.A notable finding is that within the in-hospital group, definite stent thrombosis occurred in 1.2% of patients while 1.1% were adjudicated to have myocardial infarction. Stent thrombosis is a serious condition that leads to myocardial infarction. The trial protocol used many definitions for myocardial infarction. This underscores the complexity of counting and adjudicating events in clinical trials and highlights the importance of relying on outcomes less susceptible to bias, such as mortality.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe
N Engl J Med 2012;367:1297-1309Background: In patients with acute coronary syndrome, clinical guidelines recommend early angiography particularly in those deemed moderate to high risk. However, a proportion of patients do not undergo revascularization, and these patients have poorer outcomes compared to those who do undergo revascularization.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.The TRITON-TIMI 38 trial demonstrated that prasugrel, when compared to clopidogrel, reduces ischemic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI). Notably, in the TRITON-TIMI 38 trial, 99% of the patients underwent PCI at the time of randomization.Expanding upon the findings of TRITON-TIMI 38, the TRILOGY ACS trial sought to test the hypothesis that aspirin plus prasugrel is superior to aspirin plus clopidogrel in patients with acute coronary syndrome, without ST segment elevation, who are managed medically without revascularization.Patients: Patients were enrolled if they had unstable angina or non-ST elevation myocardial infarction and were treated medically without revascularization, within 10 days of the index event. Patients with non-ST elevation myocardial infarction had elevated cardiac biomarkers. Patients with unstable angina had ST-segment depression of more than 1 mm in two or more electrocardiographic leads and negative cardiac biomarkers. Patients had to have one of the following: age of 60 years or older, diabetes mellitus, prior myocardial infarction or prior revascularization with either PCI or coronary-artery bypass grafting (CABG). Main exclusion criteria were history of stroke or TIA (this group had net harm with prasugrel in TRITON-TIMI 38), renal failure requiring dialysis and patients taking oral anticoagulants.Baseline characteristics: The trial enrolled 9,326 patients at 966 sites in 52 countries. The average age of patients was 66 years, with 78% were below 75 years old, and 61% were men. About 70% of the patients had non-ST elevation myocardial infraction as their index event. The average GRACE score was 122. About 82% had hypertension, 59% had hyperlipidemia, 38% had diabetes, 43% had prior myocardial infarction and 20% were current or recent smokers. The majority of patients were stable, with 88% classified as Killip class I.Angiography before randomization was performed in 41% of the patients. Medications at randomization included beta-blockers in 78% of the patients, ACEi or ARB in 75%, statins in 83% and proton pump inhibitors in 25%.Procedures: The trial was conducted as double-blind double-dummy study. Patients who underwent randomization within 72 hours after the first medical contact received a loading dose of 30mg of prasugrel followed by 10mg daily. The maintenance dose of prasugrel was 5mg daily for patients aged 75 years or older or patients who weighed less than 60 kg. Patients who underwent randomization after 72 hours of the first medical contact received open label clopidogrel before randomization and the maintenance study drug after randomization. Clopidogrel was given as a loading dose of 300mg followed by a maintenance dose of 75mg daily. Aspirin was given in all patients and the recommended dose was 100mg per day or less. Study drugs were given for a minimum of 6 months and a maximum of 30 months.Endpoints: The primary efficacy endpoint was a composite of death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke among patients < 75 years old. Safety endpoints were bleeding not related to CABG based on Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) criteria for severe or life-threatening bleeding and Thrombolysis in Myocardial Infarction (TIMI) criteria for major bleeding, and neoplasms.Analysis was performed based on the intention-to-treat principle. The trial was event-driven. To ensure 90% power to detect 22% relative risk reduction of prasugrel over clopidogrel with a two-sided alpha of 5%, a total of 688 patients,
N Engl J Med 2008; 358:2218-2230Background The use of percutaneous coronary intervention (PCI) is associated with improved outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Nonetheless, there was a need to further improve survival rates. As seen in OASIS-6, the 30-day mortality in the control arm was still high at 8.9%. Glycoprotein IIb/IIIa inhibitors emerged as a potential solution. US clinicians widely adopted these agents; their use soared to over 90% of STEMI cases undergoing primary PCI. But IIb/IIIa inhibitors increase the risk of bleeding and thrombocytopenia.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Bivalirudin, a direct thrombin inhibitor, has been shown to reduce bleeding when used instead of heparin plus glycoprotein IIb/IIIa inhibitors in patients with ACS without ST segment elevation. The Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial sought to test the hypothesis that bivalirudin is superior to the combination of heparin plus glycoprotein IIb/IIIa inhibitors in patients with STEMI who were undergoing primary PCI.Patients Patients were enrolled if they were within 12 hours from the onset of symptoms and had ST-segment elevation of 1 mm or more in two or more contiguous leads, new left bundle-branch block or had posterior myocardial infarction. There were numerous exclusion criteria including bleeding diathesis, coagulopathy, intracerebral mass, prior hemorrhagic stroke, platelet count< 100,000 cells/ ml, hemoglobin< 10 g/dl plus many more.Baseline characteristics The trial enrolled 3,602 patients. The average age of patients was 60 years and 77% were men. About 53% had hypertension, 43% had hyperlipidemia, 16% had diabetes, 11% had prior myocardial infarction and 46% were current smokers. The majority of patients were stable, with 91.5% classified as Killip class I. Primary PCI was performed in about 93% of the patients and coronary artery bypass graft surgery in 1.7%.Heparin before coronary angiography was administrated in 76.3% in the heparin plus glycoprotein IIb/IIIa inhibitor arm and 65.8% in the bivalirudin arm. During coronary angiography heparin was administered in 98.9% patients in the heparin plus a glycoprotein IIb/IIIa inhibitor arm and 2.6% in the bivalirudin arm. Glycoprotein IIb/IIIa inhibitors were given to 94.5% patient in the heparin plus glycoprotein IIb/IIIa inhibitors arm and 7.2% in the bivalirudin arm.Procedures The trial was open-label and patients were randomly assigned 1:1 to receive unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor or bivalirudin alone. Heparin was administered to keep activated clotting time of 200 to 250 seconds. An initial intravenous bolus of 60 IU/ kg was given followed by boluses as needed. Bivalirudin was administered intravenously with an initial bolus of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/hour. A glycoprotein IIb/IIIa inhibitor was administered before PCI in all the patients in the heparin group. It was also administered in selected patients in the bivalirudin group if there was no reflow or there was a large thrombus after PCI. The main glycoprotein IIb/IIIa inhibitors used were abciximab or eptifibatide.Endpoints The study had two primary endpoints at 30-days. The first endpoint was major bleeding not related to coronary artery bypass graft surgery. The second endpoint was a composite endpoint of major bleeding, all-cause death, reinfarction, target-vessel revascularization for ischemia or stroke.Analysis was performed based on the intention-to-treat principle. Assuming a 30-day event rate of 9% for the first endpoint and 12% for the second endpoint in the heparin plus glycoprotein IIb/IIIa inhibitor group and 6% for the first endpoint and 9% for the second endpoint in the bivalirudin group, a sample size of 1,700 patients in each group would have 99% power to show superiority of bivalirudin for the first endpoint and 80% power for the second endpoint.Results The study randomized 1,802 patients to the heparin plus glycoprotein IIb/IIIa inhibitor group and 1,800 patients to the bivalirudin group.The first primary endpoint was significantly lower with bivalirudin (4.9% vs 8.3%, RR: 0.60, 95% CI: 0.46 - 0.77; p
In this episode of the CONNECT x Leadership Jersey podcast, Jodie Yettram talks to branding specialist Katie Killip about her journey into the design world… from getting her first job in a local graphic design studio to starting her own business in London and being recently named one of the UK's top 100 female entrepreneurs…Katie believes in using design to drive positive change, particularly by helping socially conscious brands enhance their branding through environmentally friendly practices.She spoke about how she revamped the branding of Pride events in Jersey and Guernsey, her commitment to sustainability the importance of keeping up with trends – and how they are influenced by nostalgia, technology, and popular social change. ★ Support this podcast ★
NEJM 1995;333:1670-6.Background Up to this point in history, a series of trials had been conducted using ACEi's in post-MI patients. A small to moderate short-term benefit had been shown when the drugs were started immediately (GISSI-3 and ISIS-4) and much greater long-term benefits were demonstrated when the drugs were started 5-11 days, on average, following AMI in patients with LV dysfunction and congestive heart failure (SAVE and AIRE).The SAVE and AIRE trials, however, were more selective and it was not clear how representative they were among all potentially eligible patients. Thus, TRACE authors sought to re-test the hypotheses tested in SAVE and AIRE with a focus on generalizability of trial procedures and results. Specifically, the Trandolapril Cardiac Evaluation Study (TRACE) sought to test the hypothesis that trandolapril would reduce all-cause mortality in post-MI patients with LV dysfunction when used in the majority of consecutively screened, potentially eligible patients.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients Consecutive patients ≥18 years of age who were hospitalized with a confirmed AMI were screened between day 2 and 6 after the onset of symptoms. All screen eligible patients underwent echocardiography and those with a wall motion index of ≤1.2, which corresponds to an EF ≤35%, were considered for enrollment. The key exclusion criteria included an absolute or relative contraindication to an ACEi or a definite need for an ACEi, severe uncontrolled diabetes, a serum sodium 2.3 mg/dl.Baseline characteristics The average age of patients was 68 years and 72% were men. Approximately one third of patients had a prior MI, 13% had diabetes, 23% had hypertension and smoking status was not listed. The average wall motion index was 1.0. Two thirds of patients had a Q wave MI (anterior 47% and inferior 19%). The mean time to randomization was 4.5 days. Forty-five percent of patients received thrombolysis. The average blood pressure and heart rate were 120/70 mmHg and 76 beats per minute, respectively. At the time of randomization 16% of patients were receiving a beta blocker and 28% digoxin. Before randomization, 60% of patients had been classified as Killip class ≥2 and at the time of randomization it was 21%.A total of 6,676 consecutive patients experienced an AMI of whom 2,606 had a wall motion index of ≤1.2. There was an inverse relationship between wall motion index and mortality. In patients with scores ≥1.3, 40% had signs of CHF and the 1-year mortality rate was 12%. Among patients with scores ≤1.2, 74% had signs of CHF and the 1-year mortality was 34%.Of the 2,606 eligible patients, 859 (33%) were excluded. The most common reasons for exclusion included need for mandatory ACE inhibition [6%], cardiogenic shock [4%], death during screening [3%], renal failure or a single kidney [2%], intolerance of the test dose of trandolapril [1%], lack of consent [8%], or other reasons [8%].Altogether, 1,749 (67%) of patients with a wall motion index score ≤1.2 were enrolled.Procedures Eligible patients were given a test dose of 0.5 mg of trandolapril, which led to the exclusion of 1% of patients. These patients were not included in the ITT analysis. Double-blind medication was started between day 3 and day 7 after AMI. Patients were randomly assigned to receive 1 mg of trandolapril once daily or matching placebo. After two days, the dose was increased to 2 mg once daily. After four weeks, the dose was again increased, to 4 mg once daily. If the highest dose was not tolerated, patients could continue with a dose of 2 mg or 1 mg once daily, but the drug was withdrawn if a dose of 1 mg once daily was not tolerated.Outpatient visits were scheduled one and three months after the infarction, with subsequent visits every three months. Echocardiography was repeated after 3, 6, and 12 months.The original protocol specified that treatment would continue for at least 12 months. When the results of the SAVE study were published in 1992, showing no survival benefit until after almost one year of treatment with ACE inhibitors, the steering committee decided (without any knowledge of the results of the study) to extend the closing date to 24 months after the last random assignment.Endpoints The primary study endpoint was all-cause mortality. Secondary endpoints were death from a cardiovascular cause, sudden death, progression to severe heart failure, recurrent MI, and change in wall motion index.The investigators estimated they would need a sample size of 1,500 patients to detect a 25% relative reduction in the risk of death with 80% power and 1-sided alpha of 2.5%. This was based on an estimated death rate of 30% at 12 months in the placebo group; however, the steering committee increased the sample size to 1,860 patients to allow for the possibility of a lower-than-expected placebo mortality rate.In the spring of 1992 the overall mortality of randomized patients followed for 1 year was 24%. Inclusion of patients was therefore terminated at the end of June 1992 at the point where 1,749 patients had been randomized.Results The final analysis included 1,749 patients; 876 in the trandolapril group and 873 in the placebo group.Information on the percentage of patients discharged on various doses of the study drug are not provided.Compared to placebo, trandolapril significantly reduced all cause death by 22% [(35% vs 42%; 95 percent confidence interval, 0.67 to 0.91 p = 0.001)}. The mortality curves diverged early (Kaplan–Meier estimate of mortality at one month 9% vs 11%) and continued to diverge throughout the follow-up period. Trandolapril also significantly reduced secondary endpoints, including death from CV causes, sudden death, and progression to severe heart failure but it did not significantly reduce reinfarction.Examination of subgroups showed no evidence of treatment effect heterogeneity for all cause mortality, but again, similar to the SAVE and AIRE trials, the size of TRACE limits subgroup testing.Premature withdrawals from study drug, not including death, occurred in 37% of patients in the trandolapril group compared to 36% in the placebo group. The most common reason for withdrawal was need for treatment with an open-label ACEi and this occurred more in the placebo group. Withdrawal due to cough, hypotension and reduction in kidney function were rare in both groups but slightly more common in patients on trandolapril compared to placebo.Conclusions In the majority (67%) of consecutively screened patients with AMI complicated by left ventricular dysfunction, trandolapril significantly reduced death over at least 2 years of follow-up with a number needed to treat of approximately 14 patients. Results from TRACE strengthen support for ACEi in post-MI patients, and the trial has high external validity. It not only tested the intervention in two-thirds of potentially eligible patients but was highly transparent about why patients were excluded. A clinician looking to apply the procedures used in TRACE to the management of patients in clinical practice would not have to guess whether or not their patient would have been included. This is rare in clinical research and the investigators should be applauded for their efforts.Investigators studying ACEi in post-MI patients have triangulated the population of patients who benefit from this therapy. In our opinion, TRACE provides the final piece to the puzzle. There is no doubt about the clinical efficacy of these drugs in the overwhelming majority of post-MI patients and higher risk patients stand to benefit the most.Thank you for reading Cardiology Trial's Substack. This post is public so feel free to share it. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe
Lancet 1994;343:1115-22.Background By the time GISSI-3 was undertaken, evidence had emerged suggesting afterload reduction with angiotensin-converting-enzyme (ACE) inhibitors improved morbidity and mortality in patients with chronic systolic heart failure and these agents were already an established treatment for acute, severe heart failure based on theoretical grounds, despite lack of evidence from large scale RCTs. There was also lower level evidence that nitrates reduced mortality in patients with acute MI and these drugs were broadly used in coronary care units at the time. The GISSI-3 trial was undertaken to test the hypotheses that 6 weeks of treatment with lisinopril alone or transdermal glyceryl trinitrate (GTN) alone reduced the combined endpoint of mortality and severe LV dysfunction at 6 weeks compared to controls.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients Patients were eligible if they presented with chest pain and ST segment elevations of ≥1 mm in any limb lead of the electrocardiogram and/or ≥2 mm in any precordial leads and were admitted to the cardiac intensive care unit (CCU) within 24 hr from the onset of symptoms. Absolute contraindications included: severe heart failure requiring any of the study treatments, Killip class 4, high risk of hemodynamic deterioration after treatment with vasodilators (SBP 70 years of age (41% of excluded vs 27% of enrolled). As expected, excluded patients had higher in-hospital mortality (12% of excluded vs 6% of enrolled).Seventy-eight percent of patients enrolled were men and nearly three quarters were under the age of 70. Patients with anterior STEMI accounted for approximately 27%, those with inferior 32% and non-Q-wave MI's approximately 19%. Time from symptom onset was between 12-24 hours in 40%, between 6-12 hours in 25% and less than 6 hours in 35%. The vast majority of patients had a Killip score of 1 (85%) with the remainder having a Killip score of 2 (14%). Procedures The study used a 2x2 factorial design, resulting in 4 treatment groups: lisinopril alone, transdermal GTN alone, combination therapy with lisinopril and transdermal GTN, or no trial therapy.Patients randomized to oral lisinopril received 5 mg at the time of randomization, followed by 5 mg 24 hours later and 10 mg 48 hours later to be continued at a dose of 10 mg daily for 6 weeks. Patients with SBP 70 years of age, lisinopril significantly decreased the combined endpoint (OR 0.83; 24.8% vs 28.3%; 95% CI 0.74-0.94) and death (14.0% vs 15.6%). Odds ratios were not provided on individual components of the endpoints in pre-specified subgroup analyses. In women, lisinopril significantly decreased the combined endpoint (OR 0.86; 20.8% vs 23.4%; 95% CI 0.74-0.99) and death (10.7% vs 12.9%). Adverse event outcomes are not provided for these subgroups.Unlike lisinopril, transdermal GTN did not significantly reduce the combined endpoint (OR 0.94; 15.9% vs 16.7%; 95% CI 0.87-1.02) or death (OR 0.94; 6.5% vs 6.9%; 95% CI 0.84-1.05). There were no significant differences in any other clinical events. In pre-specified subgroup analyses, transdermal GTN did not significantly reduce the combined endpoint; however, absolute differences in death were very close to those seen with lisinopril.Additional results from this trial can be gleaned from analyses of patients based on whether they were in 1 of 4 treatment groups based on the factorial design 1) lisinopril + GTN control, 2) GTN + lisinopril control, 3) lisinopril control + GTN control (i.e., double control), or 4) lisinopril + GTN (i.e., double treatment); however, caution was urged in interpreting these underpowered comparisons that included sample sizes half as large as the primary comparison groups.Compared to double controls, neither lisinopril alone or GTN alone significantly reduced the combined endpoint or death but the absolute differences in events mirrored the primary analyses; however, the combination of lisinopril and GTN significantly reduced both the combined endpoint (OR 0.85; 14.8% vs 17.0%; 95% CI 0.76-0.94) and death (0.83; 6.0% vs 7.2%; 95% CI 0.70-0.97). These treatment effects were slightly larger than those for lisinopril alone.Conclusions GISSI-3 is the first trial to show that immediate treatment with ACE inhibition can reduce death and severe LV dysfunction in patients with acute myocardial infarction and this benefit is maintained in women and elderly patients who are at higher risk for experiencing adverse events. The NNT for the combined endpoint and death at 6 weeks was 71 and 125, respectively. The NNTs to prevent these outcomes in women and elderly patients were considerably lower (e.g., relative risk reductions were preserved resulting in higher absolute treatment benefits). The same effect was not observed for transdermal GTN; however, there was some hint from the trial that GTN may have a synergistic effect when used in combination with lisinopril.It must be pointed out that, like the earlier beta blocker trials, patients in GISSI-3 were hemodynamically stable and severe heart failure was an absolute contraindication. Thus, this trial does not say anything about the efficacy of ACE inhibition or nitrate therapy for patients with acute myocardial infarction complicated by acute heart failure and/or hemodynamic instability. Yet both treatments were frequently used for severe heart failure based on pathophysiologic reasoning at the time (e.g., effects of reducing preload and afterload on congestion and cardiac performance).Thank you for reading Cardiology Trial's Substack. This post is public so feel free to share it. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe
Lancet 1990;336:65-71.Background Large trials up to this point had established the role of thrombolytic therapy and aspirin in patients with acute MI. The next question centered on the different types of thrombolytic agents as well as the merits of adding high dose heparin to aspirin following revascularization. Data from smaller studies showed that alteplase (tPA) had a higher recanalization rate at 90 minutes compared to streptokinase (SK). “Recanalization” is a surrogate endpoint – a person doesn't necessarily care whether their artery is open or not at 90 minutes, but instead, whether they live or die, and how they live in the aftermath of a heart attack. The GISSI-2 trial sought to test the hypothesis that tPA would reduce the composite hard endpoint of mortality and extensive LV dysfunction compared to streptokinase (SK) and that heparin plus aspirin compared to aspirin alone would do the same.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients Patients were eligible who presented with chest pain and ST segment elevations of ≥1 mm in any limb lead of the ECG and/or ≥2 mm in any precordial leads and were admitted to the CCU within 6 hr from the onset of symptoms. Absolute contraindications included: recent or current bleeding, stroke within the previous 6 months, a surgical or invasive procedure or trauma within the previous 2 weeks, uncontrolled hypertension defined as SBP ≥200 mmHg or DBP ≥110 mmHg, or previous treatment with SK within 6 months.Baseline characteristics The number of patients who were admitted to CCUs with acute myocardial infarctions (MI) over the study period was 38,086 and 12,490 (33%) were ultimately enrolled. Reasons for exclusion included: more than 6 hr from onset of symptoms (61%), contraindications to fibrinolysis (15%), unlikely to have acute MI (13%), administrative reasons (5%), ST depressions (4%) and 1% were not reported. Similar to GISSI-1, which also provided information on patients enrolled versus those who were not, women were more likely to be excluded (30% of excluded vs 20% of enrolled) as were patients >70 years of age (41% of excluded vs 22% of enrolled). The death rate of those excluded was higher (11% of excluded vs 9% of enrolled).Approximately 80% of patients enrolled were men under the age of 70. Patients with inferior (34%) and anterior STEMI's (31%) composed more than half of the cohort. 72% of patients presented within 3 hours of symptom onset and over 95% had Killip scores of II or below with the vast majority being Killip I (78%).Procedures Immediately following randomization half of all patients received either 1.5 MU of SK infused over 1 hour or 100 mg of tPA infused over 3 hours. Since this was a 2x2 factorial design, half of all patients also received 12,500 U of subcutaneous heparin twice daily starting 12 hours after the beginning of the tPA or SK infusion and to be continued until hospital discharge.All patients without specific contraindications were recommended to receive oral aspirin 325 mg/day and 5-10 mg of IV atenolol, even before randomization, as soon as evolving MI was diagnosed.Endpoints The combined primary endpoint consisted of all-cause mortality plus the number of patients who had late (day 4 or later) clinical congestive heart failure, or extensive LV damage (LVEF
Welcome back to Lead On! Katie Killip joins host David Dearie, Katie has 14 years in the Navy and is a Chief Select as well as a Master at Arms! We start out the episode by discussing the Online Foundry Class and her experience with the program, we then move on to how she made it to Chief and some advice to get where she is now today. For more information about the Enlisted Leadership Foundation, please visit us at https://www.enlistedleadershipfoundation.org/. Hosts: David DearieGuest: Katie Killip- Chief Select, Master at ArmsTime Stamps & Show Notes: (00:00 - 00:55) Introduction (00:56 - 02:06) Thoughts on the Foundry Class(02:07 - 04:24) Becoming a Chief (04:25 - 05:17) Closing Thoughts
Today I am joined by Sophie Killip, a remarkable voice in the field of eating disorder recovery. Sophie is not only a certified eating disorder therapist but also someone who deeply understands the journey of recovery through recovering from her own struggles. Before Sophie became a Therapist, she struggled with negative body image and disordered eating during her teen and undergraduate university years. So this episode is packed with insight to aid your journey. We will explore the topic of "Navigating Body Image Challenges During Eating Disorder Recovery." Sophie and I dive into the complexities of body image struggles that often go hand in hand during the eating disorder recovery journey.Together, we'll unpack valuable insights and practical strategies for finding self-acceptance and self-love amongst the challenges recovery brings. Sophie's wisdom and warmth shine through as she shares her expertise and personal experiences, offering a beacon of hope to those on the path to recovery.Tune in for an episode filled with empathy, guidance, and inspiration as we navigate the intricate terrain of body image challenges during eating disorder recovery. It's a conversation you won't want to miss!//Follow Me:Instagram: @flourishwithciandra @recovertoflourish_podTikTok: @flourishwithciandraWebsite: https://flourishwithciandra.com/Contact: info@flourishwithciandra.com//Follow Sophie:Website: https://foodbodyself.co.uk/Instagram: @therapist.sophSupport the showSOCIALS:Instagram: @flourishwithciandra @recovertoflourish_podTikTok: @flourishwithciandraWebsite: https://flourishwithciandra.com/Contact: info@flourishwithciandra.com
Ken Killip was looking forward to an outing with friends to the Rocky Mountains in August of 1998. He was a firefighter and had some military training and was a generally fit individual. Prior to the trip, many of his friends decided not to go, and as he planned for his departure he had a bad feeling in his gut that he brushed off. He and his friend, John York set out for a hike up Mt. Ida, one that Ken would never forget. --- Support this podcast: https://podcasters.spotify.com/pod/show/kaycee-mcintosh/support
Screenwriter Kevin Sampson on the complexities of his new true crime drama for ITV, The Hunt for Raoul Moat. Max Porter found huge success with his first book, Grief is the Thing with Feathers, acclaimed as a tender, funny and original story of loss. His latest, Shy, completes the trilogy about grief that began with that book. It tells the story of a teenage boy in the 90s, setting off in the middle of the night from a residential house in the countryside for disturbed children. Opera director Adele Thomas on the reaction to her Twitter thread about what a stage director earns. Throughout the 1970s and 1980s, photographer Chris Killip immersed himself in communities in the north-east of England. The Baltic Centre for Contemporary Art in Gateshead presents a career retrospective, with the stark yet tender images he made at its heart. The poet Katrina Porteous, who like Killip has worked on the Durham coast, reviews the exhibition. Presenter: Nick Ahad Producer: Ekene Akalawu
Where do you place your focus on yourself: from the outside or on the inside? When last were you grateful for what your body can do for you? How can embodiment practices help you to develop a loving relationship with yourself? In this podcast episode, I speak about body embodiment versus body image with Sophie Killip. We consider ways in which to develop body positivity, as well as what it means to live inside and experience having a body. Sign up for the FREE e-course to understand your eating disorder and embark on the road to recovery. SHOW NOTES: Click here Follow me on Instagram @behind_the_bite_podcast Visit the website: www.behindthebitepodcast.com
Where do you place your focus on yourself: from the outside or on the inside? When last were you grateful for what your body can do for you? How can embodiment practices help you to develop a loving relationship with yourself? In this podcast episode, I speak about body embodiment versus body image with Sophie Killip. We consider ways in which to develop body positivity, as well as what it means to live inside and experience having a body. Sign up for the FREE e-course to understand your eating disorder and embark on the road to recovery. SHOW NOTES: Click here Follow me on Instagram @behind_the_bite_podcast Visit the website: www.behindthebitepodcast.com
What do miracles tell us about God's presence? How do we define the miraculous? Where does one miracle begin and human agency end? In this series, originally recorded in December 2021, we'll explore a text from Hadar's Hanukkah 5782 Companion, illuminating the evolving relationship between humanity and miracles.
Welcome back to another episode of the podcast! This week I am joined by the amazing Sophie Killip, an eating disorder and body image therapist. Join us as we discuss food freedom and body image, lessons we learned as little girls that shaped us into the women we are today, and the ups & downs of learning to accept yourself for who you are. Find Sophie on IG @_eatingdisordertherapist
Hello there, welcome to another episode of Am I Bananas!! In this episode, I talk to Sophie Killip, the eating disorder therapist, about how to feel validated when you don't feel sick enough to have an eating disorder. Feeling invalid, or not sick enough, is a common eating disorder experience. In this episode we talk about what to do when you feel invalid.Please see resources below. //Resources:Sophie's Instagram: @_eatingdisordertherapistCounselling Directory: https://www.counselling-directory.org.uk/counsellors/sophie-killip //Follow me below:Instagram: @flourishwithciandra @amibananasYouTube: @loveciandraTikTok: @flourishwithciandraContact: flourishwithciandra@gmail.com
Sophie Killip is a Therapist and Coach who specialises in eating disorder recovery and body image healing. She completed her master's degree in the US and lived there for several years during her early 20s before returning home to England. She currently works in private practice, a university counselling service, and an inpatient treatment centre for young people who are recovering from anorexia. In this episode we discuss: Sophie's relationship with her body and food throughout her life. Factors that impact body image for teenagers and young adults. The normalisation of diet culture in our society. How we define body image. What positive body image actually is. Body acceptance vs body neutrality. Ways to improve body image. Taking the power back from trying to get the ‘perfect picture'. Meal support sessions and ERP snacks. Affirmations My body is an instrument, not an ornament. I am so much more than my body. I'm worthy and loveable without needing to change my body. Connect with Rachel. Dr. Rachel Evans is a psychologist, hypnotherapist and eating disorder survivor. She brings together academic knowledge and theories, therapeutic skills and personal experience for a unique perspective on eating disorder recovery. Rachel helps ambitious women to stop restricting, bingeing and purging. and to feel comfortable in their body. https://eatingdisordertherapist.co.uk/ https://www.instagram.com/rachel.evans.phd/ https://www.facebook.com/rachel.evans.phd Connect with Sophie. https://www.instagram.com/_eatingdisordertherapist/ https://mailchi.mp/6f32bc2acd3a/guidedjournal --- Support this podcast: https://anchor.fm/rachel-evans8/support
The Intuitive Customer - Improve Your Customer Experience To Gain Growth
Podcast Summary A lot of the behavioral sciences can feel intimidating. However, it doesn't have to be. The Five Rules Podcast Series is our attempt at giving you an easy entry point into the complex and messy world of Behavioral Science. 5 Rules for Effective Customer Research That Make A Difference Customer research is an essential part of any organization's customer strategy. However, it requires more than emailing a customer survey out over seven years or so. Customer research requires a few things to be effective in driving the metrics that matter for your experiences. This episode, with guest Sam Killip, Director of Customer Research from consumer research platform, Attest, which helps organizations understand their customers. Attest's global online consumer platform taps into hundreds of thousands of consumers around the globe. Killip says their clients survey consumers to understand consumers' views and what they're doing, thinking, and feeling to feed into their customer strategy. With her help, we devised a list of five rules for making these efforts effective. Key Ideas to Improve your Customer Experience The 5 Rules for Effective Customer Research That Make a Difference include: 1. Define the right method. 2. Get under the skin of the customer. 3. Cast your net wide. 4. Respect the respondents. 5. Do them little and often rather than large-scale. Here are a few key moments in the discussion: 03:09 Killip explain a little background about Attest and how she came to her position there after a long career in law before joining the team. 05:04 We share the first rule, Define the right method, and discuss why survey answers are not always the best way to understand why customers do what they do. 08:55 We introduce the second rule, Get under the skin of the customer, and why mom and pop shop owners knew this one from day one, and how larger companies can gain that same understanding. 14:36 When talking about rule number three, Cast your net wide, Tillip explains how you can get into trouble when you make too many assumptions about your who your customers are. 20:18 As we move into the second to last rule, Respect the respondents, we focus on appreciation for the people who provide the customer voice and the essential nature of keeping them engaged with the project. 23:49 We cover the last rule, Do them little and often rather than large-scale, and why this one is essential to keeping your finger on the pulse of the customer sentiment. Please tell us how we are doing! Complete this short survey. Customer Experience Information & Resources LinkedIn recognizes Colin Shaw as one of the 'World's Top 150 Business Influencers.' As a result, he has 289,000 followers of his work. Shaw is Founder and CEO of Beyond Philosophy LLC, which helps organizations unlock growth by discovering customers' hidden, unmet needs that drive value ($). The Financial Times selected Beyond Philosophy LLC as one of the best management consultancies for the last two years. Follow Colin on Linkedin and Twitter. Click here to learn more about Professor Ryan Hamilton of Emory University. Why Customers Buy: As an official "Influencer" on LinkedIn, Colin writes a regular newsletter on all things Customer Experience. Click here to join the other 22,000 subscribers. Experience Health Check: You already have an experience, even if you weren't deliberate about it. Our Experience Health Check can help you understand what you have today. Colin or one of our team can assess your digital or physical Customer Experience, interacting with your organization as a customer to define what is good and what needs improving. Then, they will provide a list of recommendations for critical next steps for your organization. Click here to learn more. How can we help? Click here to learn more about Beyond Philosophy's Suite of Services.
The Intuitive Customer - Improve Your Customer Experience To Gain Growth
Podcast Summary A lot of the behavioral sciences can feel intimidating. However, it doesn't have to be. The Five Rules Podcast Series is our attempt at giving you an easy entry point into the complex and messy world of Behavioral Science. 5 Rules for Effective Customer Research That Make A Difference Customer research is an essential part of any organization's customer strategy. However, it requires more than emailing a customer survey out over seven years or so. Customer research requires a few things to be effective in driving the metrics that matter for your experiences. This episode, with guest Sam Killip, Director of Customer Research from consumer research platform, Attest, which helps organizations understand their customers. Attest's global online consumer platform taps into hundreds of thousands of consumers around the globe. Killip says their clients survey consumers to understand consumers' views and what they're doing, thinking, and feeling to feed into their customer strategy. With her help, we devised a list of five rules for making these efforts effective. Key Ideas to Improve your Customer Experience The 5 Rules for Effective Customer Research That Make a Difference include: 1. Define the right method. 2. Get under the skin of the customer. 3. Cast your net wide. 4. Respect the respondents. 5. Do them little and often rather than large-scale. Here are a few key moments in the discussion: 03:09 Killip explain a little background about Attest and how she came to her position there after a long career in law before joining the team. 05:04 We share the first rule, Define the right method, and discuss why survey answers are not always the best way to understand why customers do what they do. 08:55 We introduce the second rule, Get under the skin of the customer, and why mom and pop shop owners knew this one from day one, and how larger companies can gain that same understanding. 14:36 When talking about rule number three, Cast your net wide, Tillip explains how you can get into trouble when you make too many assumptions about your who your customers are. 20:18 As we move into the second to last rule, Respect the respondents, we focus on appreciation for the people who provide the customer voice and the essential nature of keeping them engaged with the project. 23:49 We cover the last rule, Do them little and often rather than large-scale, and why this one is essential to keeping your finger on the pulse of the customer sentiment. Please tell us how we are doing! Complete this short survey. Customer Experience Information & Resources LinkedIn recognizes Colin Shaw as one of the 'World's Top 150 Business Influencers.' As a result, he has 289,000 followers of his work. Shaw is Founder and CEO of Beyond Philosophy LLC, which helps organizations unlock growth by discovering customers' hidden, unmet needs that drive value ($). The Financial Times selected Beyond Philosophy LLC as one of the best management consultancies for the last two years. Follow Colin on Linkedin and Twitter. Click here to learn more about Professor Ryan Hamilton of Emory University. Why Customers Buy: As an official "Influencer" on LinkedIn, Colin writes a regular newsletter on all things Customer Experience. Click here to join the other 22,000 subscribers. Experience Health Check: You already have an experience, even if you weren't deliberate about it. Our Experience Health Check can help you understand what you have today. Colin or one of our team can assess your digital or physical Customer Experience, interacting with your organization as a customer to define what is good and what needs improving. Then, they will provide a list of recommendations for critical next steps for your organization. Click here to learn more. How can we help? Click here to learn more about Beyond Philosophy's Suite of Services.
#1364: Bruce Sidlinger discusses Red Bull stunt, Bill Cheney and Mark Haughwout talk chess and Killip Chess Club going to championship in Dallas. #1364, Tuesday, April 26 Jeff's top news pick include VP Harris gets Covid (0:00-15:00), an AZ 84 year old gets robbed in her driveway and a stock market meltdown. Bruce Sidlinger returns (15:01-61:10) to discuss reparations, pilots jumping out of planes and other must listen to ideas and factoids! Bill Cheney (61:11-74:16) talks about the Killlip Chess Club going to the national chess championship. Donations towards the Killip Chess Club here… https://www.gofundme.com/f/killip-chess-masters-goes-to-nationals
For centuries, midrash has helped reconcile problematic, troubling, and hurtful texts by understanding them in a new light. In this lecture, Rabbi Avi Killip studies modern women's midrash from the book “Dirshuni” that offers one approach to hearing, and maybe even healing from our most difficult texts. That is the power of midrash. This lecture was originally delivered as part of Hadar's Summer Learning Retreat in June 2021.
For centuries, midrash has helped reconcile problematic, troubling, and hurtful texts by understanding them in a new light. In this lecture, Rabbi Avi Killip studies modern women's midrash from the book “Dirshuni” that offers one approach to hearing, and maybe even healing from our most difficult texts. That is the power of midrash. This lecture was originally delivered as part of Hadar's Summer Learning Retreat in June 2021.
Our teenage years present many challenges. One universal obstacle I saw few of us avoid was the trap of comparing ourselves to others, particularly our physical bodies. Someone was always thinner, more muscular, prettier, taller, or had better skin. Many of those thoughts and feelings never went away but progressing through our 20s we not only realize but start to believe there are way more important facets of ourselves than our outward appearance. Realizing it and getting there are two different things though. It's hard to embrace and embody all of our physical attributes, especially those areas we've always been insecure about and others that are becoming apparent as we age. Even though I'm not quite sure if I'll ever fully get to loving my entire body, there are actions that my guest believes that we can take to get closer. I'm excited to introduce you to Sophie Killip, a Mental Health Counselor and Coach. Sophie's philosophies include working towards body acceptance, embracing size diversity, and looking at health from a holistic viewpoint not one singular measurement like weight. We have a great conversation about why fat is not a feeling, normalizing body diversity, replacing self-criticism with self-compassion, and much more. Show Notes: [2:11] The difference between body positive, neutrality, and acceptance [6:14] We are heading in the right direction but we still have room for improvement [16:08] Fat is not a feeling and health at every size [28:51] When did chubby become a problem? [31:11] How to normalize body diversity and challenge judgment [35:13] What to say instead of “looks like you lost weight” [42:17 ] Replacing self-criticism with self-compassion and confidence [50:07] Body gratitude exercise Mentions: Aerie Clothing Brand Mike Marjama Overcomes Eating Disorder on Path to MLB More of Sophie: Instagram: @counsellorsophie More of Justin & The Struggle is Real: Show Notes: https://justinpeters.co/thestruggleisreal/ Instagram: https://www.instagram.com/justinleepeters/
Does the way that you see yourself make it difficult for you to let go of parts of your personality? How does clinical hypnotherapy break the negative perception? How can it be beneficial to someone recovering from an eating disorder?In this podcast, I interview Bonnie Killip about self-perception and clinical hypnotherapy. We discuss how hypnotherapy can help you overcome unhealthy mindsets, realize your potential, and allow you to know youself better. Sign up for the FREE e-course to understanding your eating disorder and embarking on the road to recovery.SHOW NOTES: Click hereFollow me on Instagram @behind_the_bite_podcastVisit the website: www.behindthebitepodcast.com
Does the way that you see yourself make it difficult for you to let go of parts of your personality? How does clinical hypnotherapy break the negative perception? How can it be beneficial to someone recovering from an eating disorder? In this podcast, I interview Bonnie Killip about self-perception and clinical hypnotherapy. We discuss how hypnotherapy can help you overcome unhealthy mindsets, realize your potential, and allow you to know youself better. Sign up for the FREE e-course to understanding your eating disorder and embarking on the road to recovery. SHOW NOTES: Click here Follow me on Instagram @behind_the_bite_podcast Visit the website: www.behindthebitepodcast.com
Does the way that you see yourself make it difficult for you to let go of parts of your personality? How does clinical hypnotherapy break the negative perception? How can it be beneficial to someone recovering from an eating disorder?In this podcast, I interview Bonnie Killip about self-perception and clinical hypnotherapy. We discuss how hypnotherapy can help you overcome unhealthy mindsets, realize your potential, and allow you to know youself better. Sign up for the FREE e-course to understanding your eating disorder and embarking on the road to recovery.SHOW NOTES: Click hereFollow me on Instagram @behind_the_bite_podcastVisit the website: www.behindthebitepodcast.com
Does the way that you see yourself make it difficult for you to let go of parts of your personality? How does clinical hypnotherapy break the negative perception? How can it be beneficial to someone recovering from an eating disorder? In this podcast, I interview Bonnie Killip about self-perception and clinical hypnotherapy. We discuss how hypnotherapy can help you overcome unhealthy mindsets, realize your potential, and allow you to know youself better. Sign up for the FREE e-course to understanding your eating disorder and embarking on the road to recovery. SHOW NOTES: Click here Follow me on Instagram @behind_the_bite_podcast Visit the website: www.behindthebitepodcast.com
In this episode Gaby speaks to Sophie Killip, a Mental Health Counsellor & Coach, specialising in body image and eating problems. Sophie recently joined the Talk Twenties Ambassador Team as our new Wellbeing Expert and empowers individuals to step into their authentic self and develop sustainable self-belief. This episode covers: How to combat negative thoughts about your body Body Ideals and Social Media The difference between body positivity and body neutrality Using affirmations to improve body image FREE Affirmations guide here: https://podcast.talktwenties.com/affirmations Tickets for 20th October Event: https://www.eventbrite.co.uk/e/pins-and-pals-with-talk-twenties-tickets-169951482459
Join Davo & myself as we discuss how the boys faired over the Easter weekend, a look ahead to the crucial game against Notts County, our current top performers and would you pick Young or Ravas after Killip potentially ruled out for the remainder of the season? All this plus a little more! Hosted on Acast. See acast.com/privacy for more information.
Paul J. Wang: Welcome to the monthly podcast On the Beat for Circulation: Arrhythmia and Electrophysiology. I'm Dr. Paul Wang, editor-in-chief with some of the key highlights from this month's issue. In our first paper, Danielle Haanschoten, Hein Wellens and Associates aim to examine survival benefit of prophylactic implantable cardioversion defibrillator (ICD) implantation in early selected high-risk patients with primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). A randomized, multicenter, controlled trial compared ICD versus conventional medical therapy in high-risk primary PCI patients based on one of the following factors: Left ventricular ejection fraction (LVF) less than 30% within four days of STEMI, primary ventricular fibrillation, Killip class 2 or greater and/or TEMI flow less than three after PCI. ICD was implanted 30 to 60 days after MI, myocardial infarction, primary endpoint was all cause mortality three years of follow-up. The trial was prematurely ended after inclusion of 266 patients, 38% of the calculated sample size. Additional survival assessments was performed in February 2019 for the primary endpoint. A total of 266 patients, 78.2% male with a mean age of 60.8 years were enrolled. 131 were randomized to the ICD arm and 135 patients to the control arm. All cause mortality was significantly lower in the ICD group, five versus 13, hazard ratio of 0.37 after three years follow-up. Appropriate ICD therapy occurred in nine patients at three years follow-up, 5 within the first eight months after implantation. After median long-term follow-up of nine years, total mortality (18% versus 38%, hazard ratio of 0.58) and cardiac mortality (hazard ratio of 0.52) was significantly lower in the ICD group. Non-cardiac death was not significantly different between the groups. LVEF increased 10% or more in the 46.5% of patients during follow-up and the extent of improvement was similar in both study groups. The authors concluded that in this prematurely terminated and thus underpowered randomized trial early prophylactic ICD implantation demonstrated lower total and cardiac mortality in high-risk STEMI patients treated with primary PCI. In our next paper Felipe Bisbal, Eva Benito and Associates aim to test the efficacy of ablating, cardiac magnetic resonance, CMR detected atrial fibrosis plus pulmonary vein isolation (PVI). This was an open label, parallel group, randomized controlled trial. Patients with symptomatic drug refractory AF paroxysmal or persistent undergoing first or repeat ablation were randomized one-to-one basis to receive PVI plus CMR-guided fibrosis ablation, the CMR group or PVI alone, the PVI alone group. The primary endpoint was a rate of recurrence greater than 30 seconds at 12 months of follow-up using a 12-lead ECG and Holter monitoring at 3, 6 and 12 months. The analysis was conducted by intention to treat. In total 155 patients, 71% male, age 59, CHADS2-VASc 1.3, 54% paroxysmal AF were allocated to the PVI group alone (n=76) or CMR group(n=79). First ablation was performed in 80% and 71% in the PVI alone and CMR groups respectively. The mean atrial fibrosis burden was 12%, only approximately 50% of patients had fibrosis outside the pulmonary vein area. 100% and 99% of patients received the assigned intervention in the PVI alone and CMR group. Primary outcome was achieved in 21 patients (27.6%) in the PVI alone group and 22 patients (27.8%) in the CMR group (Odds ratio 0.01, P=0.976). There was no differences in the rate of adverse events, three in the CMR group and two in the PVI alone group. The authors concluded that a pragmatic ablation approach targeting CMR detected atrial fibrosis plus PVI was not more effective than PVI alone in an unselected population undergoing AF ablation with low fibrosis burden. In the next paper, Vivek Reddy and Associates tested a novel neuromodulation therapy of stimulation of epicardial cardiac nerves passing along the posterior surface of the right pulmonary artery. 15 subjects admitted for defibrillator implantation (ejection fraction≤35%) on standard heart failure medications were enrolled. Through femoral arterial access, high fidelity pressure catheters were placed in the left ventricle and aortic root. After electro anatomic rendering of the pulmonary artery and branches, either a circular or basket electrophysiology catheter was placed in the right pulmonary artery to allow electrical intravascular stimulation at 20 hertz, 4 ms pulse width, and less than or equal to 20 milliamperes. Changes in the maximum positive dP/dt, the dP/dtMax indicated change in ventricular contractility. Of 15 enrolled patients, five were not studied due to equipment failure or abnormal pulmonary artery anatomy. In the remaining patients dP/dtMax increased significantly by 22.6%. There was also a significant increase in maximum negative dP/dt, dP/dtMin, mean arterial pressure, systolic pressure, diastolic pressure, and left ventricular systolic pressure. There was no significant change in heart rate or left ventricular diastolic pressure. In this first-in-human study, the authors demonstrated that in humans with stable heart failure, left ventricular contractility could be accentuated without an increase in heart rate or left ventricular filling pressures. In our next paper, Jorge Romero, Luigi Di Biase, and Associates, in their study investigated the incremental benefit of left atrial appendage electrical isolation (LAAEI) in patients undergoing catheter ablation for nonparoxysmal atrial fibrillation (AF). Propensity score-matched analysis was performed using a prospective registry database from 2010 to 2014. All patients in the LAAEI group were matched based on baseline characteristics, echocardiographic parameters, and procedural ablation techniques. Authors identified 1842 patients who underwent catheter ablation for nonparoxysmal atrial fibrillation. Propensity score matching yielded 1092 patients, 546 with LAAEI, and 546 without LAAEI. At five years follow-up, overall freedom from all arrhythmia recurrence, off-antiarrhythmic drugs, in patients who underwent LAAEI was 68.9% versus 50.2% in those who underwent standard ablation (p
Plongeons dans l’Angleterre des années 70 et 80, alors que le Royaume-Uni subit avec violence une crise qu’attisera encore la politique de Margaret Thatcher. Un pays à la déroute, en voie de désindustrialisation, entre colère et dépit dont témoignent les photographies de Chris Killip, disparu en octobre. Celles de territoires en train de disparaitre au fil des fermetures d’usines, du délitement de la culture ouvrière et de la destruction du lien social. Des clichés en noir et blanc, rudes, poignants et mélancoliques, sans effet mais en empathique aigüe avec ses personnages. « En enregistrant leur vie, je valorise leur vie », disait-il souvent. --- Olivier Monssens poursuit son exploration des mouvements, personnalités et phénomènes libertaires, contre-culturels ou de contestation (au sens large) qui ont tenté de changer le cours des choses et ont parfois apporté de vraies révolutions dans les idées, la société, la vie, abordés par thèmes illustrés d'archives belges et internationales. Il sillonnera désormais toutes les époques : celles qui furent le creuset de tant d’utopies toujours, mais aussi les années 80, 90 et jusqu’à aujourd’hui. Le samedi entre midi et 13h sur Classic 21. --- ''Radio Caroline'' avec Olivier Monssens de midi à 13h tous les samedis sur Classic 21.
Plongeons dans l’Angleterre des années 70 et 80, alors que le Royaume-Uni subit avec violence une crise qu’attisera encore la politique de Margaret Thatcher. Un pays à la déroute, en voie de désindustrialisation, entre colère et dépit dont témoignent les photographies de Chris Killip, disparu en octobre. Celles de territoires en train de disparaitre au fil des fermetures d’usines, du délitement de la culture ouvrière et de la destruction du lien social. Des clichés en noir et blanc, rudes, poignants et mélancoliques, sans effet mais en empathique aigüe avec ses personnages. « En enregistrant leur vie, je valorise leur vie », disait-il souvent. --- Olivier Monssens poursuit son exploration des mouvements, personnalités et phénomènes libertaires, contre-culturels ou de contestation (au sens large) qui ont tenté de changer le cours des choses et ont parfois apporté de vraies révolutions dans les idées, la société, la vie, abordés par thèmes illustrés d'archives belges et internationales. Il sillonnera désormais toutes les époques : celles qui furent le creuset de tant d’utopies toujours, mais aussi les années 80, 90 et jusqu’à aujourd’hui. Le samedi entre midi et 13h sur Classic 21. --- ''Radio Caroline'' avec Olivier Monssens de midi à 13h tous les samedis sur Classic 21.
Larry Killip- song writer- jingle man- studio whiz. Writer, singer, composer. Larry sings on radio stations all over Australasia. AdsS is brought to you by www.besidetheseaside.co.nz Production by www.voicemedia.com.au
This week, world-renowned photographer Chris Killip passed away aged 74. Born and raised on the Isle of Man, Killip has been hailed as being among the influential generation of British documentary photographers of the 1970s. He also lectured at Harvard University as Professor of Visual and Environmental Studies, from 1991-2017. In this programme, we hear some tributes to him, including from his brother. We also listen back to a radio appearance from 8 May 2016, where he appeared on 'Sunday Opinion' with the late Roger Watterson after the launch of an exhibition of Killip's work at the Manx Museum - 'Isle of Man Revisited'. CHRIS KILLIP BIOGRAPHY Born in Douglas in the Isle of Man in 1946, he left school at age 16 and joined the only four star hotel on the Island as a trainee hotel manager. In June 1964 he decided to pursue photography full-time and became a beach photographer in order to earn enough money to leave the Isle of Man. In October 1964 he was hired as an assistant to the leading London advertising photographer, Adrian Flowers. In 1969, after seeing his very first exhibition of photography, at the Museum of Modern Art in New York, he decided to return to photograph in the Isle of Man. He worked in his father's pub (The Bowling Green Hotel) at night, returning to London on occasion to print his work. In 1972 he received one of the commissions from The Arts Council of Great Britain to photograph Huddersfield and Bury St Edmunds for the exhibition Two Views. In 1975 he moved to live in Newcastle upon Tyne on a two-year fellowship as the Northern Arts Photography Fellow. He was a founder member, and exhibition curator and advisor of Side Gallery, Newcastle upon Tyne, as well as the director, from 1977-79. He continued to live in Newcastle and photographed throughout the North East of England. In 1989 he was commissioned by Pirelli UK to photograph the workforce at their tire factory in Burton on Trent. In 1989 he received the Henri Cartier Bresson Award and was invited in 1991 as a Visiting Lecturer, to the Department of Visual and Environmental Studies at Harvard University, Boston USA. In 1994 he was made a tenured professor and was department chair from 1994-98. He retired from Harvard University in 2017. A retrospective exhibition of his work took place at the Folkwang Museum, Essen, then travelled to LE BAL, Paris, and on to the Reina Sofia Museum, Madrid. His work is represented in the exhibition Ideas of the North at the BALTIC Centre for Contemporary Art in Gateshead and his exhibition The Last Ships was held at the Laing Gallery in Newcastle.
Join the Episode after party on Discord! Link: https://discord.gg/ZzJSrGP 'Space guests': Russian cosmonaut captures possible UFO footage from International Space Station Ivan Vagner captured video of mysterious lights which 'appear flying alongside with the same distance,' he said in a tweet Link: https://nationalpost.com/news/space-guests-russian-cosmonaut-captures-possible-ufo-footage-from-iss A one-minute video captured by Russian cosmonaut Ivan Vagner aboard the International Space Station (ISS) appears to show potential UFOs, Global News reports. While passing over Antarctica and Australia, Vagner was recording video of aurora australis — the southern lights — but he managed to catch something else, too. Space guests, or how I filmed the new time-lapse. The peak of aurora borealis when passing over the Antarctic in Australia's longitude, meaning in between them. However, in the video, you will see something else, not only the aurora. Visible are the glowing curve of the Earth and the green of the aurora moving across it. The “space guests” Vagner refers to appear from nine seconds into the video and last until the 12-second mark, a string of four to five lights arranged in a diagonal line. Since the video was shot in a time-lapse, the flash of “objects” which quickly appear and disappear in the video actually lasted some 52 seconds. The objects “appear flying alongside with the same distance,” Vagner wrote in further tweets. “What do you think those are? Meteors, satellites or … ?” While NASA has yet to comment on the sighting, Russia's space agency Roscosmos boosted Vagner's tweet with the note: “An interesting and at the same time mysterious video made by cosmonaut of Roscosmos Ivan Wagner … from the International Space Station.” The other ISS crew members have not addressed the footage but Vagner has reported that it has been submitted to Roscosmos experts for review. The video is being examined at the Space Research Institute of the Russian Academy of Sciences, Russian outlet TASS confirmed. One official told TASS: “It is too early to make conclusions until our Roscosmos researchers and scientists at the Space Research Institute of the Russian Academy of Sciences tell us what they think. It was decided to hand over those materials to experts, who will tell us what that was in their opinion.” The man who tried to contact aliens from his grandma's living room Link: https://www.theguardian.com/film/2020/aug/23/the-man-who-tried-to-contact-aliens-from-his-grandmas-living-room A new documentary follows the 30-year cosmic quest by US space enthusiast John Shepherd. What drove him to beam messages and music, from Can to Coltrane, into space? In the mid-1960s, when he was a boy living in rural Michigan, John Shepherd began thinking of ways to make contact with alien life forms. “It was round about the time that a show called The Outer Limits was on television,” he recalls. “I remember being fascinated by the idea of somehow building my own scientific instruments to explore the mysterious phenomenon that is extraterrestrial life.” In 1972, from the living room of his grandparent's house, he began chasing his dream by broadcasting a series of electronic tone pulses “towards the stars”. So began an extraordinary 30-year journey he called Project STRAT (Special Telemetry Research and Tracking). It would soon take over his life, and the lives of his grandparents, who found themselves living amid an expanding array of what he calls “beautiful and unusual instruments”, including dual-channel oscillators, cathode-ray tubes, giant screens to monitor incoming signals and a low frequency transmitter sending signals millions of miles into deep space. Though he had little money, he trawled military surplus sales and a wholesale electrical warehouse in nearby Traverse City, collecting the materials he needed. In the garden, he erected “a two-storey 150,000 volt output stage” mounted on a pair of tall metal towers made from salvage that included a dismantled ski-lift. In the living room, scientific equipment was arranged, floor to ceiling, along one wall. “Often, people passing by at night in their cars would see a bank of lights blinking in the living room and they'd pull over to stop and stare,” he says. “Maybe they had been watching The Outer Limits, too, and they were wondering what was going on. I remember some people even thought we had built a Russian spy system.” In 1998, due to lack of funds, Shepherd reluctantly dismantled his lab and put everything in storage, where it remains. He guides Killip through the jumbled space with a flashlight, pointing out his beloved machinery – satellite communication equipment, high-powered microwave tubes, a high-voltage transmitter accelerator. “These are just the remnants,” he says, “the leftover pieces of thought.” “I miss it,” he tells me, “I really do, but I saved it all. It's like a collection of beautiful objects. Waiting.” Last Thursday, Netflix premiered an intriguing short film called John Was Trying to Contact Aliens, which earlier this year won the prize for best documentary short at the Sundance festival. Shot, edited and directed by Matthew Killip, son of the revered British documentary photographer, Chris Killip, it distils Shepherd's 30-year quest into just 16 magical minutes. Alien base on Moon proves ETs OWN lunar satellite - bizarre claim ALIEN hunters have claimed to have discovered a base on the Moon which is supposedly PROOF that extraterrestrials OWN our lunar satellite. Link: https://www.express.co.uk/news/weird/1326835/alien-base-moon-conspiracy-theory-ufo-space-proof-aliens-news Conspiracy theorists have been sent into a frenzy after spotting what they believe to be an alien base on the lunar surface. Not only is this proof of aliens, according to certain ET hunters, but also that an advanced species owns the Moon. The bizarre claim was made by prominent alien researcher Scott C Waring after he spotted a strange anomaly on the lunar surface. Mr Waring wrote on his blog UFO Sightings Daily: "Alien base found on Moon, 100 percent proof aliens own Moon. "This is a white structure, which I call the white ceramics. "These structures are near impossible to photograph due the powerful reflection of light bouncing off of them. "I added contrast and they came into focus. I added yellow to the building area so you can see exactly what I see. "It does take years of practice and patience to allow your eyes to adjust to not only the black and white photos, but to search for similar signs of structures that I have found in the past ten years. "This has to be one of the top ten. The map ruler is not accurate, its true size is close to 300 metres across. and 50 metres high." However, the 'alien base' in question is more likely to be a meteorite impact. There are millions of them all over the Moon because it barely has an atmosphere so even a meteor which is as big as a grain of rice can make a sizeable dent in the surface. Sceptics and NASA say the structure and other similar findings are just the effects of pareidolia – a psychological phenomenon when the brain tricks the eyes into seeing familiar objects or shapes where they do not exist. Show Stuff Join the episode after party on Discord! Link: https://discord.gg/ZzJSrGP The Dark Horde Podcast: https://www.spreaker.com/show/the-dark-horde The Dark Horde, LLC – http://www.thedarkhorde.com Twitter @DarkHorde or https://twitter.com/HordeDark Support the podcast and shop @ http://shopthedarkhorde.com UBR Truth Seekers Facebook Group: https://www.facebook.com/groups/216706068856746 UFO Buster Radio: https://www.facebook.com/UFOBusterRadio YouTube Channel: https://www.youtube.com/channel/UCggl8-aPBDo7wXJQ43TiluA To contact Manny: manny@ufobusterradio.com, or on Twitter @ufobusterradio Call the show anytime at (972) 290-1329 and leave us a message with your point of view, UFO sighting, and ghostly experiences or join the discussion on www.ufobusterradio.com Mail can be sent to: UFO Buster Radio Network PO BOX 769905 San Antonio TX 78245 For Skype Users: bosscrawler
Join the Episode after party on Discord! Link: https://discord.gg/ZzJSrGP 'Space guests': Russian cosmonaut captures possible UFO footage from International Space Station Ivan Vagner captured video of mysterious lights which 'appear flying alongside with the same distance,' he said in a tweet Link: https://nationalpost.com/news/space-guests-russian-cosmonaut-captures-possible-ufo-footage-from-iss A one-minute video captured by Russian cosmonaut Ivan Vagner aboard the International Space Station (ISS) appears to show potential UFOs, Global News reports. While passing over Antarctica and Australia, Vagner was recording video of aurora australis — the southern lights — but he managed to catch something else, too. Space guests, or how I filmed the new time-lapse. The peak of aurora borealis when passing over the Antarctic in Australia's longitude, meaning in between them. However, in the video, you will see something else, not only the aurora. Visible are the glowing curve of the Earth and the green of the aurora moving across it. The “space guests” Vagner refers to appear from nine seconds into the video and last until the 12-second mark, a string of four to five lights arranged in a diagonal line. Since the video was shot in a time-lapse, the flash of “objects” which quickly appear and disappear in the video actually lasted some 52 seconds. The objects “appear flying alongside with the same distance,” Vagner wrote in further tweets. “What do you think those are? Meteors, satellites or … ?” While NASA has yet to comment on the sighting, Russia's space agency Roscosmos boosted Vagner's tweet with the note: “An interesting and at the same time mysterious video made by cosmonaut of Roscosmos Ivan Wagner … from the International Space Station.” The other ISS crew members have not addressed the footage but Vagner has reported that it has been submitted to Roscosmos experts for review. The video is being examined at the Space Research Institute of the Russian Academy of Sciences, Russian outlet TASS confirmed. One official told TASS: “It is too early to make conclusions until our Roscosmos researchers and scientists at the Space Research Institute of the Russian Academy of Sciences tell us what they think. It was decided to hand over those materials to experts, who will tell us what that was in their opinion.” The man who tried to contact aliens from his grandma's living room Link: https://www.theguardian.com/film/2020/aug/23/the-man-who-tried-to-contact-aliens-from-his-grandmas-living-room A new documentary follows the 30-year cosmic quest by US space enthusiast John Shepherd. What drove him to beam messages and music, from Can to Coltrane, into space? In the mid-1960s, when he was a boy living in rural Michigan, John Shepherd began thinking of ways to make contact with alien life forms. “It was round about the time that a show called The Outer Limits was on television,” he recalls. “I remember being fascinated by the idea of somehow building my own scientific instruments to explore the mysterious phenomenon that is extraterrestrial life.” In 1972, from the living room of his grandparent's house, he began chasing his dream by broadcasting a series of electronic tone pulses “towards the stars”. So began an extraordinary 30-year journey he called Project STRAT (Special Telemetry Research and Tracking). It would soon take over his life, and the lives of his grandparents, who found themselves living amid an expanding array of what he calls “beautiful and unusual instruments”, including dual-channel oscillators, cathode-ray tubes, giant screens to monitor incoming signals and a low frequency transmitter sending signals millions of miles into deep space. Though he had little money, he trawled military surplus sales and a wholesale electrical warehouse in nearby Traverse City, collecting the materials he needed. In the garden, he erected “a two-storey 150,000 volt output stage” mounted on a pair of tall metal towers made from salvage that included a dismantled ski-lift. In the living room, scientific equipment was arranged, floor to ceiling, along one wall. “Often, people passing by at night in their cars would see a bank of lights blinking in the living room and they'd pull over to stop and stare,” he says. “Maybe they had been watching The Outer Limits, too, and they were wondering what was going on. I remember some people even thought we had built a Russian spy system.” In 1998, due to lack of funds, Shepherd reluctantly dismantled his lab and put everything in storage, where it remains. He guides Killip through the jumbled space with a flashlight, pointing out his beloved machinery – satellite communication equipment, high-powered microwave tubes, a high-voltage transmitter accelerator. “These are just the remnants,” he says, “the leftover pieces of thought.” “I miss it,” he tells me, “I really do, but I saved it all. It's like a collection of beautiful objects. Waiting.” Last Thursday, Netflix premiered an intriguing short film called John Was Trying to Contact Aliens, which earlier this year won the prize for best documentary short at the Sundance festival. Shot, edited and directed by Matthew Killip, son of the revered British documentary photographer, Chris Killip, it distils Shepherd's 30-year quest into just 16 magical minutes. Alien base on Moon proves ETs OWN lunar satellite - bizarre claim ALIEN hunters have claimed to have discovered a base on the Moon which is supposedly PROOF that extraterrestrials OWN our lunar satellite. Link: https://www.express.co.uk/news/weird/1326835/alien-base-moon-conspiracy-theory-ufo-space-proof-aliens-news Conspiracy theorists have been sent into a frenzy after spotting what they believe to be an alien base on the lunar surface. Not only is this proof of aliens, according to certain ET hunters, but also that an advanced species owns the Moon. The bizarre claim was made by prominent alien researcher Scott C Waring after he spotted a strange anomaly on the lunar surface. Mr Waring wrote on his blog UFO Sightings Daily: "Alien base found on Moon, 100 percent proof aliens own Moon. "This is a white structure, which I call the white ceramics. "These structures are near impossible to photograph due the powerful reflection of light bouncing off of them. "I added contrast and they came into focus. I added yellow to the building area so you can see exactly what I see. "It does take years of practice and patience to allow your eyes to adjust to not only the black and white photos, but to search for similar signs of structures that I have found in the past ten years. "This has to be one of the top ten. The map ruler is not accurate, its true size is close to 300 metres across. and 50 metres high." However, the 'alien base' in question is more likely to be a meteorite impact. There are millions of them all over the Moon because it barely has an atmosphere so even a meteor which is as big as a grain of rice can make a sizeable dent in the surface. Sceptics and NASA say the structure and other similar findings are just the effects of pareidolia – a psychological phenomenon when the brain tricks the eyes into seeing familiar objects or shapes where they do not exist. Show Stuff Join the episode after party on Discord! Link: https://discord.gg/ZzJSrGP The Dark Horde Podcast: https://www.spreaker.com/show/the-dark-horde The Dark Horde, LLC – http://www.thedarkhorde.com Twitter @DarkHorde or https://twitter.com/HordeDark Support the podcast and shop @ http://shopthedarkhorde.com UBR Truth Seekers Facebook Group: https://www.facebook.com/groups/216706068856746 UFO Buster Radio: https://www.facebook.com/UFOBusterRadio YouTube Channel: https://www.youtube.com/channel/UCggl8-aPBDo7wXJQ43TiluA To contact Manny: manny@ufobusterradio.com, or on Twitter @ufobusterradio Call the show anytime at (972) 290-1329 and leave us a message with your point of view, UFO sighting, and ghostly experiences or join the discussion on www.ufobusterradio.com Mail can be sent to: UFO Buster Radio Network PO BOX 769905 San Antonio TX 78245 For Skype Users: bosscrawler
1 John 4:1-6 The Need, the Standard and the Victory
1 John 3:11-24 Gospel: Love One Another, The World Hates Righteousness, What Kind of Love, Assurance is Found Here
1 John 2:12-17 Know Who You Are Love Wisely
Shona Laing is a New Zealand songwriter/Artist. She has had several hits in her native country, as well as a few minor international hits, most notably "(Glad I'm) Not a Kennedy" and "Soviet Snow". In the 1980s Shona sang and recorded with Manfred Mann's Earthband, she is still active releasing new material in 2020.
1 John 2:3-6 Obedience and Fellowship with God
1 John 1:1-4 Introduction to John - Eternal Life Revealed - Proclaimed for Fellowhip
Philippians 4:4-9 Rejoice! Be Gentle! Pray! Discern all things!
Matthew 28:16-20
The Tomb was dark … The Tomb is empty. Matthew 27:57-28:15
The Exchange … the Mockery … the Darkness -- Matthew 27:11-56
Matthew 26:47-27:10 tell us to Be Sure, To Repent and To Trust the Work of Christ
Matthew 26:17-46 Christ was aware, alone and anguished
Matthew 26:1-16 - Two different people; two responses. What is a faithful sacrifice?
Who is judged? The Righteous? The Wicked? Are we saved by Faith or Works?
No one knows when Christ will return, so we must stay awake!
Stay Grounded … Stay Calm … Stay Faithful
What is exposed? Hypocrisy, False Teaching and the Heart of Christ
Matthew 22:1-14
Like a child who continually depends on his parents or adults with a sense of awe and wonder, we are to depend on God.
A Little Faith - A Little Understanding - A Little Thing - Matthew 17:14-27
Our confession must be true, our understanding must be His and our commitment must be full. Matthew 16:13-28
Using various texts Trevor talks about Membership in the New Testament, Benefits of Membership for a believer and Member expectations here at Hope Community Church.
Is the Word of God sufficient or should we look for more? Do we want a "sign from heaven?"
Ever wonder who the Kingdom is for? Who is an Outsider? How does an Outsider enter the Kingdom
We will see who Jesus Isn't as well as see his compassion and his deity.
Matthew 13:24-52 - What can we learn from the Kingdom from the parables?
Matthew 13:1-23 - Parable of the Sower Understanding the Word - Are you rooted in Joy, Convenience or in the Word?
After seeing miracles of Jesus the Pharisees and teachers asked for a miraculous sign. Matthew 12:38-50
Acts 2:42-47 - The Who, What and Why of the community of Believers.
Reflect on the verses as they pertain to the text not on the sound bite.
Various Scriptures are used showing that Scripture is Authoritative, Powerful and Trustworthy
Deuteronomy 6:4-5 Worship by reading, praying and singing
Our stewardship reflects our faith … various texts are used to demonstrate how we are to use the many things God has given us … all things belong to Him.
Born in Douglas, Isle of Man in 1946, Chris Killip left school at sixteen and joined the isle’s only four star hotel as a trainee manager. In June 1964 he realised that a future in hotel management was not on the cards and instead decided to pursue photography full time. He duly became a beach photographer in order to earn enough money to leave the Isle of Man. In October 1964 Chris was hired as the third assistant to the leading London advertising photographer Adrian Flowers. He then worked as a freelance assistant for various photographers in London from 1966-69. In 1969, after seeing his very first exhibition of photography at the Museum of Modern Art in New York, he had an epiphany: photography was something that could be pursued for its own sake. Chris decided to return to the Isle of Man to make his own work where he made ends meet by working in his father's pub at night, returning to London on occasion to print his work. On a return visit to the USA in 1971, Lee Witkin, the New York gallery owner, commissioned a limited edition portfolio of the Isle of Man work, paying for it in advance so that Chris could continue to photograph. In 1972 he received a commission from The Arts Council of Great Britain to photograph Huddersfield and Bury St Edmunds for the exhibition Two Views - Two Cities. In 1975, he moved to live in Newcastle-upon-Tyne on a two year fellowship as the Northern Arts Photography Fellow. He was a founding member, exhibition curator and advisor of Side Gallery, Newcastle-upon-Tyne, as well as its director, from 1977-9. He continued to live in Newcastle and photographed throughout the North East of England, and from 1980-85 made occasional cover portraits for The London Review of Books. In 1989 he was commissioned by Pirelli UK to photograph the workforce at their tyre factory in Burton-on-Trent. In 1989 he received the Henri Cartier Bresson Award and in 1991 was invited to be a Visiting Lecturer at the Department of Visual and Environmental Studies, Harvard University. In 1994 he was made a tenured professor and was department chair from 1994-98. He retired from Harvard in December 2017 and continues to live in the USA. His work is featured in the permanent collections of numerous major institutions worldwide and his seminal photobook In Flagrante is included in volume II of Martin Parr and Gerry Badger’s influential three part series The Photobook: A History. In episode 094, Chris discusses, among other things: Living in the ‘ivory tower’ of Harvard University The four zines he produced with Pony Ltd - The Station, The Last Ships, Skinningrove and Portraits. How persistence and a chance encounter in a pub opened the door to his Seacoal project The complexities of making a portrait Making In Flagrante and the differences in the recent version How he narrowly avoided a career in hotel management Assisting Adrian Flowers in London during the swinging sixties Why he’s never had the desire to photograph in America Referenced: Koudelka Paul Strand Manuel Alvarez Bravo Mark Neville Henri Cartier Bresson David Bailey Brian Duffy Terence Donavon Art Tatum Daniel Barenboim and Jaqueline Du Pre Clement Freud Bill Jay Graham Smith Martin Parr Paul Graham Algerian/L’Algerié by Dirk Alvermann One Time, One Place by Eudora Welty | Website | “What you’re trying not to do is over-simplify. Your trying to have some sort of cool in there somehow, so that people looking at your pictures are not constrained by you. Meaning you haven’t predetermined everything, that you can embrace ambiguity.”
This week the girls are joined again by Amy to check out 'The Last Ships' exhibition at the Laing Art Gallery in Newcastle, a fantastic documentary series from the late 1970's.
Enlouquecemos! Nesse episódio teremos não apenas um artigo na discussão principal mas teremos SEIS! Dessa vez pedimos para os alunos da disciplina Mecanismos Moleculares da Virulência Bacteriana, coordenada pelo Leandro, que fizessem uma análise de diferentes artigos sobre mecanismos de virulência bacteriana. E assim, eles se reuniram para mostrar as táticas de guerra que as bactérias patogênicas podem usar numa batalha contra nosso Sistema Imune, seus mecanismos de virulência. No Microlitros de Notícias, temos uma notícia beeemmm pequenininha sobre mini RNAs virais e também vamos descobrir como bactérias podem transformar você em um doador universal de sangue. A gente tem hoje uma entrevista com a Marcella do blog Tira o Jaleco. Tópicos comentados nesse episódio Mecanismos de virulência Bactérias patogênicas Aderência Evasão Invasão Mecanismos de secreção Toxinas Regulação gênica Mini RNAs virais Bactérias na alteração de tipo sanguíneo Acessem o site de nossos queridos colegas: Tira o Jaleco e História da Ciência Referências desse episódio 2018. Hiroya Oki, Kazuki Kawahara, Takahiro Maruno, Tomoya Imai, Yuki Muroga, Shunsuke Fukakusa, Takaki Iwashita, Yuji Kobayashi, Shigeaki Matsuda, Toshio Kodama, Tetsuya Iida, Takuya Yoshida, Tadayasu Ohkubo, and Shota Nakamura. Interplay of a secreted protein with type IVb pilus for efficient enterotoxigenic Escherichia coli colonization. PNAS. 2018. Quentin Bernard, Alexis A. Smith, Xiuli Yang, Juraj Koci, Shelby D. Foor, Sarah D. Cramer, Xuran Zhuang, Jennifer E. Dwyer, Yi-Pin Lin, Emmanuel F. Mongodin, Adriana Marques, John M. Leong, Juan Anguita, and Utpal Pal. Plasticity in early immune evasion strategies of a bacterial pathogen. PNAS. 2017. Sean P. Riley, Ludovic Pruneau, Juan J. Martinez. Evaluation of changes to the Rickettsia rickettsii transcriptome during mammalian infection. PLOS one. 2017. Nour-Imene Zahaf e Gudula Schmidt. Bacterial Toxins for Cancer Therapy. Toxins. 2018. Geisinger E, Mortman NJ, Vargas-Cuebas G1, Tai AK, Isberg RR. A global regulatory system links virulence and antibiotic resistance to envelope homeostasis in Acinetobacter baumannii. PLOS Pathogen. 2018. Cools F, Torfs E, Vanhoutte B, de Macedo MB, Bonofiglio L, Mollerach M, Maes L, Caljon G, Delputte P, Cappoen D, Cos P. Streptococcus pneumoniae galU gene mutation has a direct effect on biofilm growth, adherence and phagocytosis in vitro and pathogenicity in vivo. Oxford Academic. 2018. Aartjan J. W. te Velthuis, Joshua C. Long, David L. V. Bauer, Rebecca L. Y. Fan, Hui-Ling Yen, Jane Sharps, Jurre Y. Siegers, Marian J. Killip, Hollie French, Maria José Oliva-Martín, Richard E. Randall, Emmie de Wit, Debby van Riel, Leo L. M. Poon & Ervin Fodor. Mini viral RNAs act as innate immune agonists during influenza virus infection. Nature. 2018. Chelsea Whyte. Bacteria can be used to turn type A blood into universal type O. Sobre o Podcast Microbiando A ideia do Microbiando é discutir artigos científicos de ponta em todas as áreas da microbiologia e imunologia. Vamos utilizar uma linguagem bem acessível para destrinchar esses artigos para vocês, mas sem perder o rigor científico e analítico necessário para essa tarefa. Além de discutir artigos nós teremos o quadro Microlitros de Notícias, onde nossos microbiologistas e imunologistas de plantão irão abordar pequenas reportagens e trazer novidades para vocês. No quadro filogenia da Ciência vamos contar um pouco sobre a vida de grandes personalidades que revolucionaram a Microbiologia e Imunologia com suas descobertas. Você pode nos ouvir no Spotify, Google Podcast, Player FM, Podcast Addict, CastBox, Blubrry Podcasting, iTunes e outros agregadores de podcasts. Contatos E-mail: microbiando@micro.ufrj.br Twitter Facebook Instagram Expediente Produção Geral: Leandro Lobo Hosts: Leandro Lobo Equipe de Pauta/Gravação: Adriana Cabalas, Ana Carolina Oliveira,
At age eighteen, Chris Killip saw an image by Henri Cartier-Bresson and decided to become a photographer. Killip, who grew up on the Isle of Man, documents social landscapes and is known for a series of powerful images of struggling industrial communities in North East England. We hear from Killip about his past working as … Continue reading "Chris Killip on Photographing People and Places"
Yuditskii, P (Johannes Kepler Universität) Wednesday 14 January 2015, 11:30-12:30
Larry Killip talks candidly about his album "When I Was A Boy". A brief talk through each song. "When I Was A Boy" released by GAP records in the UK is available on iTunes/Amazon/7Digital and many others. Just search "Larry Killip". When I Was A Boy - Review "In an age of formulaic pop devoid of melody and intelligent lyrics Killip goes against the grain but to anyone who enjoys catchy hooks and infectious playing the 12 tracks will have you singing along after one playing. ‘Johnny Is A Runner’ is a cracking track and with decent radio airplay could be a chart success. Equally ‘Radioman’ underlines Killip’s brilliant song writing talent and ear for sharp lyrics. Catch this CD and you will love it! Guaranteed." Franklin Charles Bishop - Elite Magazine
Transcribed from a 1950s broadcast acetate disc, an interview with Luthier Mr Zettwitz of Auckland New Zealand. Introduction by Larry Killip
The Dallas Four were a four piece band working Auckland New Zealand night clubs in the 1960's. Well known for their close harmonies and polished sound. Larry Killip talks to Drummer and vocalist Jim Ford plus Keyboard and vocalist Graham Gill about their days in the Dallas Four. Iced Tea commercial at the front was broadcast on NZ pirate radio station Radio Hauraki 1968, featuring Hauraki DJ Ross Goodwin.
Larry Killip talks to Shade Smith, songwriter/vocalist/guitarist from New Zealand band The Rumour. The Rumour had several big Shade Smith hits in NZ back in the 1970's, "L'Amour Est L'enfant DeLa Liberte", and "Holy Morning" to mention two. Shade also wrote "Sunshine through A Prism", a big hit for NZ singer "Suzanne", formerly of The Chicks. Here Shade talks about the band's early days in Huntly NZ and takes us through the hits and beyond.
Larry Killip talks about his album When I Was A Boy, Larry features four songs from the album and sings the first line of each song live in the podcast studio then blends in the recorded version.. ‘When I Was A Boy’ is a real throwback to good old fashioned “pop” – each song is a pure gem – great pop tracks which you will love the minute you hear them. Franklin Bishop Elite Lifestyle magazine Larry Killip is an artist/producer downunder with several album releases to his name. The album "When I Was A Boy" was released by Gap Music (www.gapmusic.co.uk) and is available on 7Digital.com, iTunes, Rhapsody.com, Amazon.com and many others.
During the 1960's and 70's the South Island of New Zealand had it's own music thing going down, bands like Chapta and Link were major players in those formative years. Dave Kennedy, with his unique vocal style and musical input had a big part in shaping the destiny of both these bands. Larry Killip, a bit of an old rocker himself, talked to Dave in some detail about those days. Dave Kennedy still sings and plays professionally in 2009, having decided to go back to his southern clan they are the luckier for it.
Larry Killip chats with Judy Hindman (nee Donaldson) from New Zealand 1960s pop duo "The Chicks". Insights into the times and what it was like to be rising pop stars in New Zealand at a very young age back then. 15mins duration.
A candid talk through of the song "Waterfall" by Larry Killip, Larry is an independant artist from New Zealand.
Larry Killip talks about his song Wella Wella Wella Bella from his new album Never Going Back. Larry is a songwriter producer from New Zealand and writes Melodic Rock/Pop with retro flavours.
Larry Killip talks about his song "Then there Was You" from his album "Good To Getaway". Larry discusses the process of writing the song and talks about changes he nearly made to the detriment of the track. Larry sings snippets of the song live, the podcast finishes with a full stream of the finished recorded version. Hear/buy this song at www.cdbaby.com/cd/killip or search iTunes "Larry Killip".
This is a brief chat about my song "I wanna Be Free' which reached number 1 on Cashbox Magazine Pop picks Indie charts feb 2008. I play some riffs from the song on my Les Paul Gold Top, and generally chat about how the song was put together. See the video on Youtube (search "larry killip").
Just rambling on my acousitc guitar, an old epiphone blonde I bought in the 70's. Rough as, just scatting. Larry
My first podcast...albeit with laryngitis!! This is a brief chat about my song "Never Going Back", I play the guitar, and discuss that the song is about my mother leaving home when i was very young. Here's the page for my album: www.lkmusic.co.nz/ngb.htm
Fakultät für Biologie - Digitale Hochschulschriften der LMU - Teil 01/06
Die Gattung Bomarea wurde seit BAKER 1888 nicht mehr revidiert. Seither hat die Zahl gültig veröffentlichter Namen von 105 auf 280 zugenommen. Eine neue Revision ist dringend erforderlich. Ausgedehnte Feldstudien in Peru bilden die Grundlage für die Inangriffnahme dieses Projekts. In der vorliegenden Arbeit wird die taxonomische Geschichte der Gattung rekonstruiert. Bomarea wird gegen die nahe verwandte Alstroemeria abgegrenzt. HUNZIKER (1973) hatte Bomarea sogar eingezogen. Die meisten Autoren erkennen aber beide Gattungen als selbstständig an (KILLIP 1936; NEUENDORF 1977; SMITH & GEREAU 1991; AAGESEN & SANSO 1998). Die wichtigsten Unterschiede zwischen den beiden Gattungen bestehen im Fruchtbau sowie in den Chromosomenzahlen. Die Basiszahl ist in Alstroemeria x = 8 und on Bomarea x = 9. Die 4 bekannten Untergattungen werden überwiegend an Hand von Merkmalen des Ovariums und der Frucht definiert. Die entscheidenden Kriterien zur Identifikation der 4 Untergattungen sind folgende: Bei Bomarea s.str. ist das Ovarium immer unterständig, die Frucht ist dehiszent; Die Arten von Sphaerine sind nicht windend, das Ovarium ist unterständig, die Frucht indehiszent, das Perikarp ist dünn, saftig, und kräftig gefärbt; In Wichuraea ist das Ovarium halbunterständig, die Frucht ist dehiszent; Die Arten des Subgenus Baccata sind immer windend, das Ovarium ist unterständig, die Frucht ist indehiszent mit einer dicken, fleischigen Fruchtwand (HOFREITER & TILLICH 2002). Feldstudien in Peru zeigten innerhalb einer Population eine hohe Variabilität der Merkmale. Die Merkmals-Variabilität ist bei den Arten der Untergattung Wichuraea an höchsten, bei Sphaerine am niedrigsten. Die Verbreitungs- und Evolutionsmuster in Bomarea unterscheiden sich nach den verschiedenen Höhenstufen und ökologischen Bedingungen. Es sind 7 verschiedene Lebensformtypen entstanden. Der Lebensformtyp „windend wachsend in Nebelwäldern“ besiedelt bis auf die Wälder in der Pantepuiregion und im Küstengebirge von Brasilien alle in Südamerika vorkommenden Nebelwaldgebiete. Die Ausbreitungsbarrieren konnten in der Eiszeit überwunden werden, und der im Vergleich zum Tiefland stärker strukturierte Lebensraum hat dazu beigetragen, mehr Arten entstehen zu lassen. Die windenden Tieflandarten haben trotz ihres größeren Verbreitungsgebietes eine weit geringere Artenzahl als die Nebelwaldarten. Die aufrecht wachsenden Nebelwaldarten haben im Süden die Grenze der Nebelwälder erreicht, und ihre Verbreitungsgrenze ist identisch mit der Grenze der windenden Nebelwaldarten. Warum sie nicht nördlich der Amotape-Huancabamba-Region vorkommen ist nicht geklärt, warum sie insgesamt weniger weit verbreitet sind als die windenden Nebelwaldrandarten erklärt sich durch die Verbreitungsmuster der Früchte fressenden Vögel. Die Huancabamba-Niederung stellt keine Ausbreitungsbarriere dar. Es wurde keine Art gefunden die nur nördlich oder südlich bis zur Grenze der Niederung vorkommt. Die Amotape-Huancabamba-Region stellt dagegen ein Diversitätszentrum der Gattung dar. Das zweite Diversitätszentrum ist die Cordillera Central in Peru. Die aufrecht wachsenden Hochgebirgsarten konnten sich teilweise aufgrund geologischer Barrieren nicht so weit ausbreiten, teilweise weil sich die ökologischen Bedingungen in den offenen Lebensräumen stärker ändern als in den Wäldern. Diese Lebensform ist mehrmals unabhängig entstanden. Die Trockengebiete wurden ebenfalls mehrmals unabhängig besiedelt, aber nur von wenigen, teilweise gering verbreiteten Arten. Die Bomarea-Floren in allen Regionen erweisen sich als polyphyletisch. Der aufrecht wachsende Lebensformtyp ist mehrmals entstanden, weil der für diese Lebensform nötige Habitattyp im Gesamtareal der Gattung stark fragmentiert ist. Der Lebensformtyp windend in Nebelwäldern wachsend ist nur einmal entstanden, weil sein Habitat nahezu kontinuierlich im Areal vorkommt oder zumindest während der letzten Eiszeit vorkam. Die Schwestergruppe der Alstroemeriaceae sind die Luzuriagaceae. Innerhalb der Alstroemeriaceae sind die Sphaerinen den Luzuriagaceae am ähnlichsten. Alstroemeria ist sicher monophyletisch, Bomarea ist ebenfalls monophyletisch oder paraphyletisch zu Alstroemeria. Die Alstroemeriaceae gehören ihrer Abstammung nach der austral-antarktischen Flora an.