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2 episodes with msfc
2 episodes with msfc
2 episodes with msfc
2 episodes with msfc
ကျိုက်မရောမြို့နယ်၊ ဓမ္မသကျေးရွာကို စစ်ကောင်စီစစ်သင်္ဘောကနေ လက်နက်ကြီးပစ်ခတ်ခဲ့တာကြောင့် နေအိမ် ၃၀၀ ကျော်မီးလောင်ဆုံးရှုံးခဲ့ပြီး လူဦးရေ ၆၀၀၀ ကျော်ဟာ အိုးမဲ့အိမ်ဲ့ဖြစ်ခဲ့ရတယ်လို့ မွန်ဖက်ဒရယ်ကောင်စီ (MSFC) လူ သားချင်းစာနာထောက်ထားမှုနှင့်ကယ်ဆယ်ရေးဌာနမှူးက ပြောပါတယ်။ အောင်ခန့် သတင်းပေးပို့ထားပါတယ်။
NASA's Chief Scientist Dr. Jim Green joins Tim to talk about big plans for the red planet, Mars. Jim has had a long and distinguished career on some of the agency's major research projects and missions that have explored the rest of our solar system, from Mars to Pluto. In this episode, Jim gets into detail on what we have learned, can learn and will learn from Earth's next door neighbor. He uncovers some of the secrets of Mars. This episode was originally released on September 27, 2021. https://traffic.libsyn.com/forcedn/shapingopinion/Encore_-_Life_on_Mars.mp3 Next to the Moon and the Sun, the most captivating celestial bodies in our night sky for mankind over thousands and thousands of years has been Mars. The red planet. The fourth rock from the sun. So, it made sense when we started to make plans for space travel, Mars would figure prominently into those plans. As far back as the inception of both the Soviet and American space programs in the late 1950s and early 1960s, space scientist started making plans to explore Mars. By July 4, 1997, NASA was able to land a spacecraft on Mars. The Mars Pathfinder was launched on December 4th 1996. Six months later, it landed on Mars. The unit featured the first-ever robotic rover that sent an unprecedented amount of data on the planet back to scientists at NASA. After that, there were other missions, which included Mars orbiters, landers, and excavators. And the United States hasn't been the only country working to explore the planet. The Soviet Union, then Russia, then China, then India, and even the United Arab Emirates have launched missions to Mars. Each time, we learn something new and something significant about Mars. But in the end, there is one question that continues to drive mankind's quest to visit Mars. Is there life on that planet, and if so, what does it look like? Jim Green has worked to find the answers to this and many other questions throughout his career as a scientist at NASA. Links NASA's Mars Exploration Program James L. Green, NASA Why We Explore Mars, National Geographic Nicolaus Copernicus, History.com Jezero Crater – Mars, NASA About this Episode's Guest Dr. Jim Green Dr. Jim Green Photo courtesy of NASA NASA's Chief Scientist, Dr. Jim Green received his Ph.D. in Space Physics from the University of Iowa in 1979 and began working in the Magnetospheric Physics Branch at NASA's Marshall Space Flight Center (MSFC) in 1980. At Marshall, Dr. Green developed and managed the Space Physics Analysis Network, which provided many scientists, all over the world, with rapid access to data, other scientists, and specific NASA computer and information resources. In addition, Dr. Green was a safety diver in the Neutral Buoyancy tank making over 150 dives until he left MSFC in 1985. From 1985 to 1992 he was the Head of the National Space Science Data Center (NSSDC) at Goddard Space Flight Center (GSFC). The NSSDC is NASA's largest space science data archive. In 1992 he became the Chief of the Space Science Data Operations Office until 2005 when he became the Chief of the Science Proposal Support Office. While at GSFC, Dr. Green was also co-investigator and the Deputy Project Scientist on the Imager for Magnetopause-to-Aurora Global Exploration (IMAGE) mission. From 1992 to 2000 he was also the Deputy Project Scientist for Mission Operations and Data Analysis for the Global Geospace Science Missions WIND and POLAR. He has written over 110 scientific articles in referred journals involving various aspects of the Earth's and Jupiter's magnetospheres and over 50 technical articles on various aspects of data systems and computer networks. From August 2006 to April 2018 Dr. Green was the Director of the Planetary Science Division at NASA Headquarters. Under his leadership several missions have been successfully executed, including the New Horizons spacecraft flyby of Pluto,
We start this week off with a roundup of news from NASA with the announcement of the Artemis II crew, its Mars Habitat, the second independent review of the Mars Sample Return, and a celebration of two missions hitting 50 - 50 orbits for Juno and 50 flights for Ingenuity (and you can even an audio recording of the Mars helicopter here). We then chatted about Blue Origin's Club for Future and the FAA licensing of Starship's launch attempt. The first of our main stories was a discussion of the successful launch of ESA's JUICE mission to study the icy moons of the Jovian system, including taking some selfies as it began its journey. We wrapped up with a report from the recent NASA student launch competitions, which you can see for yourself on MSFC's YouTube. Show recorded 4-16-2023 Panelists: Dr Kat Robison and Mark Ratterman
John Inness is a guidance, navigation, and control engineer at Marshall Space Flight Center supporting various projects including SLS, HLS, Solar Cruiser, SVGS, and more. He is originally from North Carolina where he went to North Carolina State University for aerospace engineering and co-oped at Marshall Space Flight Center while a student. Upon graduation, he began full time work at MSFC. In his spare time, John enjoys playing music, cooking and trying various foods, hiking, and ultimate frisbee. As always, stay tuned after for our takeaways. --- Support this podcast: https://anchor.fm/shawna-christenson2/support
In this episode of the Georgia Tech Research Podcast, host Scott McAtee talks to Glenn Lightsey, Ph.D., of Georgia Tech, and GTRI's Jud Ready, Ph.D., about their collaboration efforts on the Lunar Flashlight, a CubeSat that will be launched into space with a mission to map water and ice deposits on the moon's surface. Talking Points: Lunar Flashlight was developed by NASA's Jet Propulsion Laboratory (JPL), NASA's Goddard Space Flight Center (GSFC), the University of California, Los Angeles (UCLA), Georgia Tech, and NASA's Marshall Space Flight Center (MSFC). Researchers in Georgia Tech's School of Aerospace Engineering worked with MSFC to develop the spacecraft's propulsion system – a new technology that uses an improved environmentally-friendly propellant. The team collaborated with GTRI to assemble and test the Lunar Flashlight in a set of unique facilities in Atlanta.
The University of Arizona's Medical Students for Choice program works to spread awareness of reproductive health issues and to ensure that women receive the full range of reproductive health care choices by organizing, advocating, training and supplementing our medical school curricula. This episode is an engaging conversation with MSCF participants Jeenal Shah and Mathili Khandekar. TALKING POINTS (list bullet points): Short intro of guests by Ethan Jeenal Shah Jeenal was born and raised in Phoenix, Arizona in a family of immigrants from India. For her undergraduate education, she went to West Chester University of Pennsylvania and graduated with a Bachelor of Science degree in Cellular and Molecular Biology with a minor in chemistry. Currently, she is a third-year medical student at the University of Arizona College of Medicine. When she started at the U of A in 2019, Medical students for choice was one of the first clubs she joined. Jeenal's interests in medical school have been surrounded by helping underserved populations, from working closely with the Tucson migrant population to helping low-risk juvenile detainees at the Pima County Jail. Her desire to advocate for women's health and reproductive justice stems from the women in her family who worked hard to allow her to be in this position, obtaining an education and medical degree. Mathili Khandekar Maithili is a second-year medical student here at the University of Arizona College of Medicine-Tucson campus and is currently one of the directors of the Medical Students for Choice club on campus. She was originally born in India but has grown up in Phoenix, Arizona since she was 5 years old. She graduated from the University of Arizona Honors College in May 2020 with a degree in Physiology and double minors in business administration and molecular biology. In her free time, she loves to dance, read, travel and explore new places, and go hiking. She is very passionate about improving health education amongst the community and hopes to continue this throughout her medical journey as a physician. Welcome to you both. Q & A: Mathili, can you start out by telling our listeners a little bit about the Medical Students for Choice Program? Q & A: Jeenal, I know this is an international organization with a chapter here at the University of Arizona, one of more than 220 around the world? How does that help MSFC fulfill their mission, having that larger network? Q & A: Mathili, why was it important for you to be a part of this work? I've got to imagine going to medical school is a full-time job, in and of itself? Why prioritize this? Q & A: Jeenal, same question for you. Why is this so important to you? Q & A: Mathili, one of the benefits is being able to observe clinical abortions in-person. My guess is that Covid has compromised this. How have you worked around this obstacle? Q & A: Jeenal, there is a worldwide shortage of abortion providers. Do you think this is work that you will incorporate into your practice after graduation? Thank you so much Jeenal and Mathili. This was definitely my privilege to have this time with you all. And, thanks to all of you for listening and the privilege of your time. We'll be back soon for another great conversation. Look forward to connecting with you then.
You can find the Optamiz app in your favorite app store!If you'd like to purchase a digital copy of Plant-Based Jumpstart on the Optamiz app or the Optamiz website, use the discount code: MSFIT at the checkout and get 10% off and the MS Fitness Challenge no-profit will get 10% of each sale. Learn How To Get Involved With The MS Fitness ChallengeDonate To The MS Fitness Challenge.Learn How High-Performance Expert, MS Warrior, and Podcast Host, Maureen Manley, MA Can Help You or Your Organization Move Into Your Potential and Champion Results!
NASA's Chief Scientist Dr. Jim Green joins Tim to talk about big plans for the red planet, Mars. Jim has had a long and distinguished career on some of the agency's major research projects and missions that have explored the rest of our solar system, from Mars to Pluto. In this episode, Jim gets into detail on what we have learned, can learn and will learn from Earth's nextdoor neighbor. He uncovers some of the secrets of Mars. https://traffic.libsyn.com/secure/shapingopinion/Revealing_the_Secrets_of_Mars_auphonic.mp3 Next to the Moon and the Sun, the most captivating celestial bodies in our night sky for mankind over thousands and thousands of years has been Mars. The red planet. The fourth rock from the sun. So, it made sense when we started to make plans for space travel, Mars would figure prominently into those plans. As far back as the inception of both the Soviet and American space programs in the late 1950s and early 1960s, space scientist started making plans to explore Mars. By July 4, 1997, NASA was able to land a spacecraft on Mars. The Mars Pathfinder was launched on December 4th 1996. Six months later, it landed on Mars. The unit featured the first-ever robotic rover that sent an unprecedented amount of data on the planet back to scientists at NASA. After that, there were other missions, which included Mars orbiters, landers, and excavators. And the United States hasn't been the only country working to explore the planet. The Soviet Union, then Russia, then China, then India, and even the United Arab Emirates have launched missions to Mars. Each time, we learn something new and something significant about Mars. But in the end, there is one question that continues to drive mankind's quest to visit Mars. Is there life on that planet, and if so, what does it look like? Jim Green has worked to find the answers to this and many other questions throughout his career as a scientist at NASA. Links NASA's Mars Exploration Program James L. Green, NASA Why We Explore Mars, National Geographic Nicolaus Copernicus, History.com Jezero Crater - Mars, NASA About this Episode's Guest Dr. Jim Green Dr. Jim GreenPhoto courtesy of NASA NASA's Chief Scientist, Dr. Jim Green received his Ph.D. in Space Physics from the University of Iowa in 1979 and began working in the Magnetospheric Physics Branch at NASA's Marshall Space Flight Center (MSFC) in 1980. At Marshall, Dr. Green developed and managed the Space Physics Analysis Network, which provided many scientists, all over the world, with rapid access to data, other scientists, and specific NASA computer and information resources. In addition, Dr. Green was a safety diver in the Neutral Buoyancy tank making over 150 dives until he left MSFC in 1985. From 1985 to 1992 he was the Head of the National Space Science Data Center (NSSDC) at Goddard Space Flight Center (GSFC). The NSSDC is NASA's largest space science data archive. In 1992 he became the Chief of the Space Science Data Operations Office until 2005 when he became the Chief of the Science Proposal Support Office. While at GSFC, Dr. Green was also co-investigator and the Deputy Project Scientist on the Imager for Magnetopause-to-Aurora Global Exploration (IMAGE) mission. From 1992 to 2000 he was also the Deputy Project Scientist for Mission Operations and Data Analysis for the Global Geospace Science Missions WIND and POLAR. He has written over 110 scientific articles in referred journals involving various aspects of the Earth's and Jupiter's magnetospheres and over 50 technical articles on various aspects of data systems and computer networks. From August 2006 to April 2018 Dr. Green was the Director of the Planetary Science Division at NASA Headquarters. Under his leadership several missions have been successfully executed, including the New Horizons spacecraft flyby of Pluto, the MESSENGER spacecraft to Mercury, the Juno spacecraft to Jupiter,
Learn more about ThermApparrel! Use discount code: MSFC to receive 10% off your purchase of ThermApparrel's UnderCool Vest.Organizations offering financial assistance for cooling products: (Please note: You can only get an UnderCool Cooling Vest from the MS Foundation and the MS Society. UnderCool is not available through MSAA, but they do have other cooling options that might work for you.MS Foundation - 888-673-6287Cooling ProgramGrants and ProgramsNational MS Society - 1-800-344-4867MS NavigatorsMS Navigator brochure - The Navigators are awesome and can help you with financial assistance for a vest and with the appeal process.Insurance and Financial InfoFinancial Assistance Programs (Medication)MSAA - 800-532-7667Cooling ProgramHow MSAA Can Help (click on the How MSAA Can Help tab)Learn How To Get Involved With The MS Fitness Challenge.Donate To The MS Fitness Challenge.Learn How High-Performance Expert, MS Warrior, and Podcast Host, Maureen Manley, MA Can Help You or Your Organization Champion Results!
Abortion is technically legal in every U.S. state. Despite this, rampant restrictions still exist which not only limit people from making autonomous choices about their own bodies, but also compromise the health care treatment they have access to. Medical Students for Choice are on a mission to create tomorrow's abortion providers and pro-choice physicians. Find out how you can take simple steps to remove the stigma surrounding abortion. Want to support Medical Students for Choice? https://msfc.org Find the episode on Great.com: https://great.com/great-talks-with/my-body-my-choice-changing-the-landscape-of-abortion-care
From the BEL archieves, * Real Science Radio has a Far Ranging Conversation with Krauss: Co-hosts Bob Enyart and Fred Williams present Bob's interview of theoretical physicist (emphasis on the theoretical), atheist Lawrence Krauss. Fred says, "It's David vs. Goliath, but without the slingshot." As the discussion ranges from astronomy and anatomy to cosmology and physics, most folks would presume that Dr. Krauss would take apart Enyart's arguments, especially when the Bible believer got the wrong value for the electron-to-proton mass ratio. But the conversation reveals fascinating dynamics from the creation/evolution debate. (The planned 25-minute interview ran 40 minutes, so there's also a Krauss Part II and once in each half we say, "Stop the tape, stop the tape," to comment.) * "All Evidence Overwhelmingly Supports the Big Bang": Contradicting Dr. Krauss'
From the BEL archieves, * Real Science Radio has a Far Ranging Conversation with Krauss: Co-hosts Bob Enyart and Fred Williams present Bob's interview of theoretical physicist (emphasis on the theoretical), atheist Lawrence Krauss. Fred says, "It's David vs. Goliath, but without the slingshot." As the discussion ranges from astronomy and anatomy to cosmology and physics, most folks would presume that Dr. Krauss would take apart Enyart's arguments, especially when the Bible believer got the wrong value for the electron-to-proton mass ratio. But the conversation reveals fascinating dynamics from the creation/evolution debate. (The planned 25-minute interview ran 40 minutes, so there's also a Krauss Part II and once in each half we say, "Stop the tape, stop the tape," to comment.) * "All Evidence Overwhelmingly Supports the Big Bang": Contradicting Dr. Krauss'
Free resources provided by the MSFC:https://msfitnesschallenge.org/no-cost-programs/The upcoming 8-week MS Fitness Challenge:https://obpfitness.com/8-week-challenge/More information and resources related to Optimal Body Personal Fitness: https://obpfitness.com/about-the-membership/
https://tamingthewalrus.com/How to get involved with the MS Fitness Challenge:DonateMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
Episode Highlights...COVID-19's impact on Angela's life / living with MSAngela's initial MS diagnosis 16 years ago and how she's courageously fought back against the diseaseHer motivations for changing her diet and the impact nutrition has had on her healthWhy waking up in time to watch the sun rise is such an important part of her daily routineHow she got involved with the MS Fitness Challenge and how the charity has helped her thrivePersonal reflections and an inspirational message of hope How to get involved with the MS Fitness Challenge:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupMSFC 100,000 Pushup ChallengeHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
The MS Fitness Challenge is on a mission to raise $100,000 by doing 100,000 push-ups across the globe! Following the launch of the MSFC 100,000 Push-up Challenge, David Lyons & Stephen Glaus discuss the details of this exciting campaign.Some key takeaways...How the crazy idea for the 100,000 Pushup Challenge was bornDetails on how the challenge worksInstructions on how to get involvedFundraising tipsWhy this fundraising effort is so importantA plea for wide spread participationAn overview of the prizes awarded to the top 3 earnersCLICK HERE TO START YOUR OWN TEAMOR CLICK HERE TO DONATEHow to get involved with the MS Fitness Challenge:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupMSFC 100,000 Pushup ChallengeHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
After spending several years as a research analyst for the health and wellness industry, David Block soon realized a significant disparity between the value proposition of most vitamins and minerals and the corresponding quality of the ingredients encapsulated within them. Determined to stand apart from the competition while also making a meaningful difference in the lives of others, David started the premium supplement company, Previnex. The company "believes everyone deserves the opportunity to live the longest, healthiest, most active life possible, and they believe that at their healthiest, people can make the greatest impact on their communities, families, and the world!"By having a laser-focused approach to sourcing only the finest ingredients validated through vigorous research and testing, Previnex products deliver real and lasting results. Feeling purposed to make a difference in the world, David decided to carry the precepts of his "no compromise" attitude in life over to a philanthropic mission to fight for malnourished children and those that can’t fight for themselves. Through the Previnex: "Get Health. Give Health." program, over 700,000 vitamins have been donated and delivered to children in Haiti, El Salvador, Peru and Guatemala. David's care for others has also been made evident by his willingness to partner with and support the MS Fitness Challenge. Some key takeaways: An in depth look into David's background, how he became so well-versed with nutrition, and what inspired him to start PrevinexDistinguishing factors that set Previnex apart from the countless others boasting nutritional superiority Why Previnex products can be beneficial for people living with MSHow the "Get Health. Give Health." program is saving the lives of malnourished childrenThe impact COVID-19 has had on delivering vitamins around the worldRecommendations for those looking to try Previnex products for the first timeDavid's goals and dreams for the futureKey resources:Previnex Website USE CODE: MSFC15David's Previnex COVID-19 Blog ArticleContact David:LinkedInFacebookInstagramTwitterHow to get involved with the MS Fitness Challenge:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupMSFC 100,000 Pushup ChallengeHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
Robin Brockelsby is an Entrepreneur, Motivational Speaker and Past President of Crisis Support Services of Nevada – which is 1 of 6 national crisis support lines in the US. She owns and operates multiple corporations in Northern Nevada – but her most important job is as a wife and mom to 3 teenagers. She is a two-time TEDx speaker with talks on "Overcoming Fear" and "How She is Living Her Best Life with Multiple Sclerosis", and was recently featured by Yahoo Entertainment & Lifestyle in their “Inspired By” series.She uses her extensive training in crisis and stress management to educate, inspire and empower others to succeed in conquering their challenges & fears and contributes regularly to the cause of the MS Fitness ChallengeSome key takeaways: .COVID-19 and it's impact on Robin's lifeRobin's MS diagnosis story and what living with the disease has been like for her during the past yearThe impact MS has had on Robin's career ambitionsHer passion for Crisis Support Services of Nevada and why mental health is a critical factor for those living with MSInsights related to Robin's recent TED talk on her MS storyHow she became acquainted with David Lyons and what motivated her to get involved with the MS Fitness ChallengeReflections on how fitness and holistic health strategies have helped Robin manage her MS progressionHopeful inspiration for finding the hidden gifts stored within life's challengesRobin's key resources:About RobinCreative CoveringsCrisis Support Services of NevadaCall: 1-800-273-8255Text: 'CARE' to 839863MS TED TalkContact Robin:LinkedInFacebookInstagramTwitterHow to get involved with the MS Fitness Challenge:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
Spaceflight news— Rocket Lab completes successful demonstration of mid-air capture. (rocketlabusa.com) (youtube.com) (spacenews.com) — Tim Dodd published a great interview with Peter Beck (youtu.be)Short & Sweet— Mars helicopter has been attached to NASA rover. (nasa.gov)— Starliner gets a second flight test. (spacenews.com)— Long March Fails to loft Nusantara Dua (spacenews.com) (spaceflightnow.com)— Masten Space Systems wins lunar lander award from NASA. (spacenews.com)Questions, comments, corrections— Chris Hofmann: It’s not LOX vents that have flares, it’s Methane.— Ben Hallert and Chris Hofmann: Grasshopper didn’t explode, that was F9R dev (twitter.com/chairboy/)— Ben Hallert: “Starpopper” was the same thing as SN1. (twitter.com/chairboy)— Eric Blood via email: worm logo (PDF: nasa.gov)— Apollo 13: Home Safe viewing party — April 14, Tuesday at 7 p.m. Eastern — Join us on Discord and Watch2Gether! (discordapp.com) (watch2gether.com)This week in SF history— 16 April 1965: first five-engine test stand firing of S-IC at MSFC (nasa.gov) (heroicrelics.org) (wikipedia.org)— Next week in 1971: Like Jar-Jar and an off-cast 620C
What's the most important vitamin? According to Dr. Mark Vance it's one of two: either the vitamin you need the most (the one you're most deficient in) or perhaps most importantly - Vitamin H, or Vitamin "Hope". Prior to being involved with alternative therapies for hard to treat / difficult aliments - Dr. Vance began his medical career by pursuing knowledge and experience through traditional pathways common to medical practitioners. It was after a unique experience with a patient in desperate need for alternative medicine that Dr. Vance finally found his true calling in life and started his own medical practice at Vance Medical. After becoming acquainted with David Lyons and the MS Fitness Challenge, Mark decided to get involved with the MSFC and render his support as the charity's Director of Medical Services.Some key takeaways: Mark's interest in becoming a doctor based upon a mission to help othersGeneral disinterest / lack of passion for the practice enticed Dr. Vance to consider alternative therapiesThe impact Mark's newfound purpose in life had on his career and his outlook on lifeFriction between the alternative therapies and the overall medical community and why it existsHow one question would manifest itself as one of the greatest opportunities of Mark's lifeRecollections of last year's MSFC Training Camp and personal insights of how Dr. Vance's alternative treatments proved to break the barriers of seemingly insurmountable skepticismAfter heeding a patient's recommendation, Mark would get the chance to meet David Lyons and his wife KendraA basic breakdown of some of the most effective alternative therapies for people with MS to include: herbal remedies, hormone therapy, intravenous vitamin C, and perhaps most promising - Low Dose Naltrexone. Opportunities for listeners to get involved and advocate for the benefits of alternative therapies for MSStrong and compelling reminders to take your daily dose of "Vitamin H"How to contact Doctor Vance: Website: https://www.vancemedical.com/E-mail: info@vancemedical.comPhone: (208) 258-7558How to get involved:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
Kendra Lyons may very well be the reason the MS Fitness Challenge exists. After seeing the success and the impact David Lyons found through bodybuilding and fitness, she inspired him to start a charity that would go on to be a globally recognized banner of hope for people living with MS. Some key takeaways:Kendra's experiences as a nurse working with MS patients and how that framed her initial understanding of what MS was likeHow David & Kenra first met and her initial impression of him and his remarkable abilities in spite of MSAn incident in which Kendra learned that David does not share food - even with the person who would become his wifeDavid's past injuries during training and how they've taught Kendra to be mindful of the risks associated with MS and physical training while also acknowledging the importance of fitness and the need to train smartlyThe moment Kendra realized that David had the potential to inspire others to embark on their own MS fitness journeys Initial goals of the MS Fitness Challenge and how the organization evolved into what it is today Emotional stories of the hope and impact the MSFC has had on MSers as well as their familiesChallenges family members and close friends face when caring for someone with MS and the importance of taking the time to focus on self-health strategiesDavid's impact on Kendra's personal fitness habits and lifestyleKendra's reflection on the path her and David have traveled as well as her hopes and dreams for the future of the MS Fitness ChallengeHow to get involved:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
Monica Pelle has been working with David Lyons for several years, in an effort to help people within the MS Fitness Challenge discover the best and most effective dietary and lifestyle strategies that will enable them to thrive with MS. Some key takeaways: How Monica fell in love with healthy lifestyle habits and what motivated her to want to share that with othersHer first encounter with David and Kendra Lyons and the impact their passion and enthusiasm had on herReasons why diet and nutrition are such critical factors to living well with MSA basic breakdown of what a successful MS diet looks likeExamining inflammatory additives and subtractives and their effect on MSersAdvice on how to achieve lasting success by implementing a micro-step approachKey principles on the significance of toxins in the body, how they impact people with MS, and how to manage themWhy the upcoming MS Fitness Challenge Training Camp is such a valuable experience, especially as it relates to discovering MS dietary and lifestyle strategiesMonica's personal insights as to how working within the MSFC has impacted and changed her lifeConcluding takeaways that include a call-to-action that can kick-start healthy MS habitsHow to get involved:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Contact Monica:E-Mail:Monica@Organized-Wellness.comPhone: (720) 408-5520Website: www.Organized-Wellness.comWould you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
David Lyons is the leading industry expert on all things MS and fitness. Here are some highlights you won't want to miss!Some key takeaways: How David became inspired to start the MSFCUnique factors that differentiate the MSFC from other MS-supporting charitiesReasons why fitness is the key to living well with MSAn explanation of all the MSFC resources that are available to people with MS The benefits of finding a fitness trainer who knows and understands MSCurrent MSFC goals and objectivesInformation on the upcoming MSFC Training Camp in Los AngelesDavid's personal insights on how the charity has impacted his lifeDetails on fundraising needs and how to contributeHow to get involved:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
David Lyons is the leading industry expert on all things MS and fitness. Here are some highlights you won't want to miss!Some key takeaways:Where to start if you're someone just finding their way to fitnessHow exerting energy at the gym can actually be a productive way to fight MS fatigueAdvice on how to overcome obstacles and setbacks when they occurThe MS Fitness Challenge is NOT about bodybuilding - it's about helping people become the best possible version of themselves; it's about taking control of the disease.David accredits his strength and ability to inspire others to God and his faith in Jesus ChristSome key resources:The MSFC website: msfitnesschallenge.com David's Books: Everyday Health and Fitness with Multiple Sclerosis | David's Goliath: Winning the Battle Against All Odds Online MS Training: MS WorkoutsFind an MS TrainerHow to get involved:DonateMSFC Training Camp - Los AngelesMSFC Facebook GroupHow to reach us:E-Mail: msfcinfo1@gmail.comPhone: (855) MSFIT4U (673-4848)Would you like to be on the MSFC Podcast? Contact the host, Stephen Glaus at stephen.glaus@msfitnesschallenge.com
On this episode of the Public Radio Hour, we mark the 20th anniversary of the Chandra X-Ray Observatory. Marshall Space Flight Center for X-ray astronomy Dr. Martin Weisskopf joins MSFC historian Brian Odom to talk about Chandra's history and discoveries. We also look ahead to the future of X-ray observation with research astrophysicist and NASA study scientist Dr. Jessica Gaskin ...
While some view MS as a "disability," David Lyons knows a diagnosis is not a sentence to be bound to a wheelchair.Multiple sclerosis (MS) takes different forms and is categorized into four different types. While some view this condition as a "disability," but David Lyons knows an MS diagnosis is not a sentence to be bound to a wheelchair. Diagnosed at age 47, David went through a period of darkness and doubt about his future. He lost the muscle mass he'd worked so hard to build in his many years in the gym. Ultimately, he decided that was not the future he wanted to live.Now, he's helping others with MS and other conditions to meet their fitness and lifestyle goals. In his book, Everyday Health and Fitness with Multiple Sclerosis: Achieve Your Peak Physical Wellness While Working with Limited Mobility, David provides solutions for overcoming mental hurdles, nutrition fundamentals to properly fuel workouts, easily adaptable exercises, and motivation. As Amazon describes it, the book is a "road map for every person who wants to conquer a disease or disability, and just get moving."David also co-founded the MS Fitness Challenge (MSFC) with his wife Kendra in order to help others with MS.Listen as David joins Dr. Bond to share his own journey through MS and the great work the MSFC is doing.
While some view MS as a "disability," David Lyons knows a diagnosis is not a sentence to be bound to a wheelchair.Multiple sclerosis (MS) takes different forms and is categorized into four different types. While some view this condition as a "disability," but David Lyons knows an MS diagnosis is not a sentence to be bound to a wheelchair. Diagnosed at age 47, David went through a period of darkness and doubt about his future. He lost the muscle mass he'd worked so hard to build in his many years in the gym. Ultimately, he decided that was not the future he wanted to live.Now, he's helping others with MS and other conditions to meet their fitness and lifestyle goals. In his book, Everyday Health and Fitness with Multiple Sclerosis: Achieve Your Peak Physical Wellness While Working with Limited Mobility, David provides solutions for overcoming mental hurdles, nutrition fundamentals to properly fuel workouts, easily adaptable exercises, and motivation. As Amazon describes it, the book is a "road map for every person who wants to conquer a disease or disability, and just get moving."David also co-founded the MS Fitness Challenge (MSFC) with his wife Kendra in order to help others with MS.Listen as David joins Dr. Bond to share his own journey through MS and the great work the MSFC is doing.
In this episode we discuss the early years of the American Space Program and the Apollo 11 moon landing.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/Mercury-launch-vehicles.png) Mercury launch vehicle(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/220px-Buzz_salutes_the_U.S._Flag.jpg) Buzz Aldrin salutes the American flag.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/220px-As11-40-5886.jpg) Neil Armstrong on the moon.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/Apollo_11_CSM_photographed_from_Lunar_Module_AS11-37-5445.jpg) Columbia as seen from the Lunar Module.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/220px-Apollo_11_Crew.jpg) Apollo 11 crew.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/150px-Apollo_11_Launch_-_GPN-2000-000630.jpg) Saturn V launching Apollo 11 into space.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/180px-Ed_White_with_Space_Gun_maneuvering_unit.jpg) Ed White conducting the first American space walk.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/220px-Gemini_spacecraft.jpg) Cross-section of a Gemini spacecraft.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/800px-Chimpanzee_Ham_in_Biopack_Couch_for_MR-2_flight_MSFC-6100114.jpg) Ham and technicians preparing for launch.(http://theamericanhistorypodcast.com/wp-content/uploads/2019/08/800px-Launch_Complex_14-MA-9.jpg) Mercury Launch Complex
Discussion about the changing role of women at Marshall Space Flight Center. Six women panelists share experiences and stories about culture, NASA and the future. Recorded April 2019.
Brian Odom talks about the "full stop" 20-month investigation after Apollo 1 fire and its impacts. He reviews the Jupiter-C vehicle and Redstone missile programs, Nixon's undelivered speech in case Apollo 11 failed, and Huntsville's role in solving the next set of hard problems.
While some view MS as a "disability," David Lyons knows a diagnosis is not a sentence to be bound to a wheelchair.Multiple sclerosis (MS) takes different forms and is categorized into four different types. While some view this condition as a "disability," but David Lyons knows an MS diagnosis is not a sentence to be bound to a wheelchair. Diagnosed at age 47, David went through a period of darkness and doubt about his future. He lost the muscle mass he'd worked so hard to build in his many years in the gym. Ultimately, he decided that was not the future he wanted to live.Now, he's helping others with MS and other conditions to meet their fitness and lifestyle goals. In his book, Everyday Health and Fitness with Multiple Sclerosis: Achieve Your Peak Physical Wellness While Working with Limited Mobility, David provides solutions for overcoming mental hurdles, nutrition fundamentals to properly fuel workouts, easily adaptable exercises, and motivation. As Amazon describes it, the book is a "road map for every person who wants to conquer a disease or disability, and just get moving."David also co-founded the MS Fitness Challenge (MSFC) with his wife Kendra in order to help others with MS.Listen as David joins Dr. Bond to share his own journey through MS and the great work the MSFC is doing.
While some view MS as a "disability," David Lyons knows a diagnosis is not a sentence to be bound to a wheelchair.Multiple sclerosis (MS) takes different forms and is categorized into four different types. While some view this condition as a "disability," but David Lyons knows an MS diagnosis is not a sentence to be bound to a wheelchair. Diagnosed at age 47, David went through a period of darkness and doubt about his future. He lost the muscle mass he'd worked so hard to build in his many years in the gym. Ultimately, he decided that was not the future he wanted to live.Now, he's helping others with MS and other conditions to meet their fitness and lifestyle goals. In his book, Everyday Health and Fitness with Multiple Sclerosis: Achieve Your Peak Physical Wellness While Working with Limited Mobility, David provides solutions for overcoming mental hurdles, nutrition fundamentals to properly fuel workouts, easily adaptable exercises, and motivation. As Amazon describes it, the book is a "road map for every person who wants to conquer a disease or disability, and just get moving."David also co-founded the MS Fitness Challenge (MSFC) with his wife Kendra in order to help others with MS.Listen as David joins Dr. Bond to share his own journey through MS and the great work the MSFC is doing.
Thanks to everyone that's subscribed to the podcast. If you could do me a favor and leave a review for the podcast, I'd appreciate it! If you take a screenshot of your review and send it to @johnmulnix, pretty much anywhere on the Internet, I will send you a Space Shot sticker and a thank you! Connect with me on Facebook, Instagram, and Twitter, just click the links below. Facebook (https://m.facebook.com/thespaceshot/) Instagram (https://www.instagram.com/johnmulnix/) Twitter (https://twitter.com/johnmulnix) Welcome to the fourth episode of The Cosmosphere Podcast! In this episode, SpaceWorks, triumph and tragedy, and a news update. Come back the first Wednesday of every month for a new episode! Check out the Cosmosphere's website here (http://cosmo.org/) to find out more about the museum. Camps at the Cosmosphere (http://cosmo.org/explore/camps) The Cosmosphere- Facebook (https://www.facebook.com/kscosmosphere/) Cosmosphere Event Calendar (http://cosmo.org/news-and-events/calendar#event-752) If you're interested in learning about SpaceWorks, or if you would like information on how the Cosmosphere can help you with a project, please visit the SpaceWorks website here. SpaceWorks (http://cosmo.org/spaceworks) Check out this link if you want to check out what the Bendix Mobility Test Article looks like. Dr. von Braun Driving the Mobility Test Article (https://archive.org/details/MSFC-6640863) Here's a link to the album of pictures from my visit to SpaceWorks. SpaceWorks Picture Album- The Space Shot (https://www.facebook.com/pg/thespaceshot/photos/?tab=album&album_id=1926872784296356) Cosmosphere Events Calendar (http://cosmo.org/news-and-events/calendar) Carey Digital Dome Theater Showtimes (http://cosmo.org/exhibitions/theater) A huge thank you to Benoit Darcy, from Paris France for allowing us to use music from the album "Apollo" for the podcast. The song in the podcast titles is called "Hypergolic" and is available through streaming services as well as iTunes. Apollo - EP Away From Earth (http://smarturl.it/apolloEP) Welcome to the fourth episode of The Cosmosphere Podcast! In this episode, SpaceWorks, triumph and tragedy, and a news update. Come back the first Wednesday of every month for a new episode! Check out the Cosmosphere's website here (http://cosmo.org/) to find out more about the museum. Camps at the Cosmosphere (http://cosmo.org/explore/camps) The Cosmosphere- Facebook (https://www.facebook.com/kscosmosphere/) Cosmosphere Event Calendar (http://cosmo.org/news-and-events/calendar#event-752) If you're interested in learning about SpaceWorks, or if you would like information on how the Cosmosphere can help you with a project, please visit the SpaceWorks website here. SpaceWorks (http://cosmo.org/spaceworks) Check out this link if you want to check out what the Bendix Mobility Test Article looks like. Dr. von Braun Driving the Mobility Test Article (https://archive.org/details/MSFC-6640863) Here's a link to the album of pictures from my visit to SpaceWorks. SpaceWorks Picture Album- The Space Shot (https://www.facebook.com/pg/thespaceshot/photos/?tab=album&album_id=1926872784296356) Cosmosphere Events Calendar (http://cosmo.org/news-and-events/calendar) Carey Digital Dome Theater Showtimes (http://cosmo.org/exhibitions/theater) _A huge thank you to Benoit Darcy, from Paris France for allowing us to use music from the album "Apollo" for the podcast. The song in the podcast titles is called "Hypergolic" and is available through streaming services as well as iTunes. _ Apollo - EP Away From Earth (http://smarturl.it/apolloEP)
Thanks to everyone that's subscribed to the podcast. If you could do me a favor and leave a review for the podcast, I'd appreciate it! If you take a screenshot of your review and send it to @johnmulnix, pretty much anywhere on the Internet, I will send you a Space Shot sticker and a thank you! Connect with me on Facebook, Instagram, and Twitter, just click the links below. Facebook (https://m.facebook.com/thespaceshot/) Instagram (https://www.instagram.com/johnmulnix/) Twitter (https://twitter.com/johnmulnix) Welcome to the fourth episode of The Cosmosphere Podcast! In this episode, SpaceWorks, triumph and tragedy, and a news update. Come back the first Wednesday of every month for a new episode! Check out the Cosmosphere's website here (http://cosmo.org/) to find out more about the museum. Camps at the Cosmosphere (http://cosmo.org/explore/camps) The Cosmosphere- Facebook (https://www.facebook.com/kscosmosphere/) Cosmosphere Event Calendar (http://cosmo.org/news-and-events/calendar#event-752) If you're interested in learning about SpaceWorks, or if you would like information on how the Cosmosphere can help you with a project, please visit the SpaceWorks website here. SpaceWorks (http://cosmo.org/spaceworks) Check out this link if you want to check out what the Bendix Mobility Test Article looks like. Dr. von Braun Driving the Mobility Test Article (https://archive.org/details/MSFC-6640863) Here's a link to the album of pictures from my visit to SpaceWorks. SpaceWorks Picture Album- The Space Shot (https://www.facebook.com/pg/thespaceshot/photos/?tab=album&album_id=1926872784296356) Cosmosphere Events Calendar (http://cosmo.org/news-and-events/calendar) Carey Digital Dome Theater Showtimes (http://cosmo.org/exhibitions/theater) A huge thank you to Benoit Darcy, from Paris France for allowing us to use music from the album "Apollo" for the podcast. The song in the podcast titles is called "Hypergolic" and is available through streaming services as well as iTunes. Apollo - EP Away From Earth (http://smarturl.it/apolloEP)
Welcome to the fourth episode of The Cosmosphere Podcast! In this episode, SpaceWorks, triumph and tragedy, and a news update. Come back the first Wednesday of every month for a new episode! Check out the Cosmosphere's website here (http://cosmo.org/) to find out more about the museum. Camps at the Cosmosphere (http://cosmo.org/explore/camps) The Cosmosphere- Facebook (https://www.facebook.com/kscosmosphere/) Cosmosphere Event Calendar (http://cosmo.org/news-and-events/calendar#event-752) If you're interested in learning about SpaceWorks, or if you would like information on how the Cosmosphere can help you with a project, please visit the SpaceWorks website here. SpaceWorks (http://cosmo.org/spaceworks) Check out this link if you want to check out what the Bendix Mobility Test Article looks like. Dr. von Braun Driving the Mobility Test Article (https://archive.org/details/MSFC-6640863) Here's a link to the album of pictures from my visit to SpaceWorks. SpaceWorks Picture Album- The Space Shot (https://www.facebook.com/pg/thespaceshot/photos/?tab=album&album_id=1926872784296356) Cosmosphere Events Calendar (http://cosmo.org/news-and-events/calendar) Carey Digital Dome Theater Showtimes (http://cosmo.org/exhibitions/theater) _A huge thank you to Benoit Darcy, from Paris France for allowing us to use music from the album "Apollo" for the podcast. The song in the podcast titles is called "Hypergolic" and is available through streaming services as well as iTunes. _ Apollo - EP Away From Earth (http://smarturl.it/apolloEP)
Facebook (https://m.facebook.com/thespaceshot/) Instagram (https://www.instagram.com/johnmulnix/) Twitter (https://twitter.com/johnmulnix) Episode Links: STS-73 Mission Summary (https://science.ksc.nasa.gov/shuttle/missions/sts-73/mission-sts-73.html) STS-73 Onboard Photo: United States Microgravity Laboratory (USML-2) (https://archive.org/details/MSFC-9515272) Kent Rominger- NASA Biography (https://www.jsc.nasa.gov/Bios/htmlbios/rominger.html) This Week in NASA History: US Microgravity Laboratory-2 Launches – Oct. 20, 1995 (https://www.nasa.gov/centers/marshall/history/this-week-in-nasa-history-us-microgravity-laboratory-2-launches-oct-20-1995.html) Space Shuttle Is Launched On 16-Day Science Mission (http://www.nytimes.com/1995/10/21/us/space-shuttle-is-launched-on-16-day-science-mission.html) Space Shuttle Flight 72 (STS-73) Post Flight Presentation (https://youtu.be/J-q3cXYq9d4?t=7m7s) Blue Origin just sent a jolt through the aerospace industry (https://arstechnica.com/science/2017/10/blue-origin-has-successfully-tested-its-powerful-be-4-rocket-engine/)
Multiple Sclerosis Discovery: The Podcast of the MS Discovery Forum
[intro music] Host – Dan Keller Hello, and welcome to Episode Eighty-three of Multiple Sclerosis Discovery, the podcast of the MS Discovery Forum. I’m Dan Keller. For years, MS researchers have been looking for a measure of MS progression and disability that would be meaningful to clinicians, clinical researchers, patients, and the regulatory agencies that approve new drugs, such as the Food and Drug Administration. To this end, people have looked to composite endpoints that are sensitive to small changes in patient condition and comparable across studies. At the ECTRIMS conference last fall in Barcelona, I met with Dr. Jerry Wolinsky, professor of neurology and director of the MS Research Group at the University of Texas Health Science Center at Houston, who leads us along the path to develop a useful measure incorporating composite endpoints. Interviewer – Dan Keller In terms of assessing progression and disability in MS, is there some advantage to having composite endpoints as opposed to the standard tests we’ve looked at? Interviewee – Jerry Wolinsky There are several different ways to think about composite endpoints. So one of the things that was introduced almost several decades ago was MSFC functional composite. So this was using three different ways of looking at different components of disability in patients with MS. One was a test of cognition. One was a test of fine motor skills in the upper extremities. And one was a test of walking abilities/walking speed. That particular composite looked very attractive. There was a fair amount of theoretical and practical work behind instituting the composite, and it was used in a number of trials. And it was based on some very important, I think, kind of statistical analysis. So what it allowed one to do was to take patients either in a given study or across studies and try to normalize the data that you would get from those patients into something called a z-score, which is a way of ranking and evaluating how far across the group of patients people were scattered. And then one could conceptually add up the z-scores and have a composite number, and a single number that you could use to analyze trial data. It seemed to be rather sensitive, and it seemed to work well. But the z-score is very dimensionless, and it makes little sense to the practicing clinician, or certainly to patients, to know that you’re minus-two or minus-five or plus-two, and that maybe this has moved by two-hundredths of a point from the time you started in the study until you got to the end of the study. So, highly sensitive, seemed very reproducible, maybe even a way to look across studies at different results, but neither patients or physicians and, most importantly, the FDA thought that this would be useful in day-to-day practice. So, while we’ve tested that kind of approach in multiple studies, it just hasn’t worked. But it did set up the notion that we could get a little bit more quantitative in things that could be useful on a daily basis, even using some of the same components of that MSFC. So instead of thinking about how fast could one person walk compared to another, we said, how fast can a person walk using a timed walk of a fixed distance and at one point in time? And then say how much change over an interval of time would represent something that was likely to be reproducible and, more importantly, likely to be correlated with some measure of quality of life that also was deteriorating? So then we got to the notion–and this was really best utilized thus far in the trials of 4-aminopyridine in terms of registration studies there–to say could you show a 20% improvement or more in this timed walk over an interval of time? And in that study, a certain number of patients were able to show it, and there was also some correlative data done to show that that amount of improvement correlated with things which were meaningful to the individual. And so I think that helped facilitate getting that drug through the registration process with the FDA. One of the things that my colleagues and I did in looking at one of the trials in progressive disease, specifically the trial of rituximab in primary progressive MS, where we had the data that goes into the MSFC, because it had been collected in the study, was to try to develop a number of different composites. And actually, when you think about it, the main score that we use to rate studies is the EDSS score, and it itself is a composite. It takes into account graded changes in fine motor skills in what we would call the cerebellar system, in the pyramidal system, in the sensory systems, and cognitive systems. It’s just that the boundaries in moving in these individual functional scales are a little bit more subjective in terms of going from a zero to a one, two, or three. And then the scale itself is rather complicated in terms of how it put together to come to the final score, the extended disability status score. But it’s very well accepted by neurologists, and it’s accepted by the regulatory authorities as the standard. So we took our standard changes on EDSS, which in this particular study had not shown efficacy across the group as a whole. So we looked at that in the placebo arm, and didn’t contaminate that with the treated arm, to say what was the rate of change on the EDSS alone? But then we also said, what about a 20% change over baseline that had occurred in an individual patient over intervals of testing and not just one that occurred at a particular setting compared to baseline, but one that continued to be seen at the next 3 months and the next 3 months. So it looked like it was a sustained change in the same way that we use EDSS now in trials to talk about sustained or accumulated permanent disability, at least over some interval of time. So we said, okay, we can construct a progression curve based on that. And then we said, what does that look like? And said, well, this has some dimensions to it that are interesting. And we did the same thing with the Timed 25-Foot Walk, and we didn’t fool around with the PASAT [Paced Auditory Serial Addition Test] the cognitive measure because nobody likes it. Patients don’t appreciate it, and it’s a rather prolonged and not a simple test to use. And this is one that probably could be easily changed out with other cognitive tests that are probably as reliable and easier to complete. And we looked at how did patients progress using that change in the timed walk and said, well, that’s interesting too. And then we went into the group as a whole and said, okay, how many patients changed on the EDSS over three months, confirmed? How many over six months, confirmed? How many did this on the Timed 25-Foot Walk? Did it cross the 20% threshold? How many did this on the 9-Hole Peg Test and, again, crossing the 20% threshold? And who were these patients, more importantly? So then we could develop series of Venn diagrams–if you will, circles–that showed who did it on just one test, who did it on all tests, who did it on two tests? And looked to see could we get a larger and larger proportion of the population that were showing progression? And the answer is: We could. And for some tests, the incremental change was small, and for other tests the incremental change was relatively large. But when we looked at the results of the study, then, using different kinds of composites, you fail just on EDSS; you fail on EDSS, or you fail on Timed 25-Foot Walk; you fail on Timed 25-Foot Walk or 9-Hole Peg Test—we don’t care about EDSS in that one—you fail on all three. We could see that we could increase the sensitivity, that is, the number of people who were showing progression, using these kinds of composites, and hoped, therefore, that we could increase the sensitivity to drug effect. So then we did the next step, which was to take both the placebo arm and the treated arms and say, okay, how did the curves change? So the overall curve showed no statistical benefit with the EDSS, until you went to subgroup analysis. And that was reported in the original paper. But when we modeled this, of course, the overall didn’t show the statistical effect. That’s where we were starting from. When we added in the Timed 25-Foot Walk, it looked like there was a better split. In fact, the effect size for the treatment improved. And this was not across subgroups, but across the entire population. Interestingly enough, we probably got the biggest punch by throwing out the EDSS and just using the 9-Hole Peg Test and the Timed 25-Foot Walk. That has some advantages, because they can be done by anyone. In fact, they probably could be done remotely, or we probably could convert it to how many steps a day did you take and have your watch feed the message to us over the course of a day. There are a number of interesting different approaches that can be taken to this kind of concept, and some of these are being pursued by a collaborative group spearheaded through the NIH, as well as a private consortium, looking at newer ways to measure progression. The good news is, I’m sure we’ll find things that are more sensitive. The good news is, I’m sure we’ll find things that are easier to apply. Another part of the good news is that the additional work increasingly is carried out with some representatives from the regulatory authorities to give us a feeling for what they really want to see. And what they would like to see is not just that we have composites that are sensitive and reproducible, but each of those composites that, before using them, has been shown to have some relevance for what patients complain of and what patients are looking for. So that’s the good news. The bad news is we have to not only develop them, validate them, show that they work, we’ll probably have to constantly be comparing them back, in our future trials, to the standard, until we get our first drug that really works in these new, validated approaches that are being taken. MSDF Do you think that different drugs will show you different effects on different parameters within the composite score, or do things pretty much move in synchrony? Dr. Wolinsky You know, because multiple sclerosis is such a heterogeneous disease—heterogeneous in many ways, but the simplest one to think about is the lesions don’t exactly form in a way that suits us as trialists. So, many of the lesions are silent for whatever it is we’re trying to test, no matter how carefully we test for them except maybe with really high resolution MRI. So it depends where in the real estate the lesion has hit. So it’s easy to imagine that a relatively small lesion in the cerebellum particularly well-situated could cause some slowing of the ability to do the 9-Hole Peg Test, and yet it might take a very large lesion in the frontal lobe to do the same effect in that system. In the same way, it may take just a small lesion in a pyramidal pathway, either in the spinal cord or in the internal capsule, to cause a significant change in the 25-Foot Walk and do nothing in the 9-Hole Peg Test. So, conceptually, we want to be able separately test—or relatively separately; the brain is fairly interconnected—separately test as many systems as we can and build upon them. Usually with these composites, you don’t lose too much by adding composites, as long as they’re truly independent of each other. As they become more interdependent, then the more you add, you may lose some of your ability to find small changes statistically. They’ll cancel out. MSDF Even though these are composites, you’re still interested in the separate parameters? I mean, it looks like one parameter could offset another, and your composite score could be neutral, even though you have larger changes in the separate parameters. Dr. Wolinsky What you’re trying to do, if you’re setting up your composites correctly, is not to have them cancel. And with the z-score we talked about before, it can cancel. With a composite, where you’re expecting each of the scales to be moving in a particular ordinal fashion that is going from better to worse, you don’t care where the worst comes from, if you’re saying we’ll take worse in any system. Where it gets tricky is, once you get good at that, then you might want to say, well, you get two points for getting worse in the walking system, because that’s more correlated with whether or not someone’s employable than it is if it’s in, let’s say, bladder measures, which we don’t have quantitatively—well, we do, but they’re just harder to apply—or perhaps on using other visual pathway measures that have yet to be introduced into the composites very well. [transition music] MSDF Thank you for listening to Episode Eighty-three of Multiple Sclerosis Discovery. This podcast was produced by the MS Discovery Forum, MSDF, the premier source of independent news and information on MS research. MSDF’s executive editor is Carol Cruzan Morton. Msdiscovery.org is part of the nonprofit Accelerated Cure Project for Multiple Sclerosis. Robert McBurney is our President and CEO, and Hollie Schmidt is Vice President of Scientific Operations. Msdiscovery.org aims to focus attention on what is known and not yet known about the causes of MS and related conditions, their pathological mechanisms, and potential ways to intervene. By communicating this information in a way that builds bridges among different disciplines, we hope to open new routes toward significant clinical advances. [outro music] We’re interested in your opinions. Please join the discussion on one of our online forums or send comments, criticisms, and suggestions to editor@msdiscovery.org. For Multiple Sclerosis Discovery, I'm Dan Keller.
Multiple Sclerosis Discovery: The Podcast of the MS Discovery Forum
[intro music] Host – Dan Keller Hello, and welcome to Episode Forty-eight of Multiple Sclerosis Discovery, the podcast of the MS Discovery Forum. I’m your host, Dan Keller. This week’s podcast features Dr. Bruce Cree on the EPIC, CLIMB, and SUMMIT clinical trials in MS. But first here are some new items in the MS Discovery Forum. We're very happy to report that MSDF has received three generous grants that will allow us to continue our mission: to focus attention on what is known and not yet known about MS and related conditions in a way that builds bridges among different disciplines. Genzyme has given us two grants. One will allow us to continue producing this weekly podcast for another year, and the other will allow us to develop an additional 12 monthly data visualizations. And Biogen has given us a grant for general operating support. None of these grants will interfere with our editorial freedom, and you can continue to count on MSDF to be an independent source of unbiased MS news. A conference in Cambridge, Massachusetts several weeks ago sponsored by Orion Bionetworks outlined the progress and challenges in turning computational modeling into actionable knowledge in MS and other brain disorders. Allison Provost, who is Orion’s scientific program manager, has written a blog post describing the parts of the conference of particular interest to MS researchers. You can find her post by going to msdiscovery.org and clicking first on News and Future Directions and then on Blogs. According to our curated list of the latest scientific articles related to MS, 50 such articles were published last week. To see the list, go to msdiscovery.org and click on Papers. We selected three of those papers as Editors’ Picks. Two of them are comprehensive review articles: one on biomarkers in MS and the other on MS immunogenetics. The third is an evidence-based consensus guideline on the use of MRI in MS diagnosis. Our Drug-Development Pipeline includes continually updated information on 44 investigational agents for MS. This past week we added 1 new trial, we updated information on 3 other trials, and we added 13 other pieces of information. The drugs with important additions and changes are alemtuzumab, fingolimod, glatiramer acetate, interferon beta-1a, interferon beta-1b, natalizumab, and rituximab. To find information on all 44 compounds, visit msdiscovery.org and click first on Research Resources and then on Drug-Development Pipeline. [transition music] Now to the interview. Dr. Bruce Cree is a neurologist at the University of California, San Francisco. MSDF Executive Editor, Bob Finn, caught up with Dr. Cree in his office at UCSF’s Mission Bay Campus shortly after a departmental seminar entitled “An EPIC CLIMB to the SUMMIT.” Interviewer – Bob Finn Dr. Cree, welcome. Interviewee – Bruce Cree Thank you. MSDF Now EPIC, CLIMB, and SUMMIT are acronyms for three MS clinical studies. So first, what's EPIC, what's CLIMB, what's SUMMIT? Dr. Cree Great question. So the EPIC study is a long-term observational study now in its 11th year at UC San Francisco. It's a a cohort study of multiple sclerosis patients who have been followed annually for the last 11 years. And this cohort initially had about 517 participants, and now – in its 11th year – we have about 91% of those patients coming back for ongoing assessments. The assessments include annual MRI scans, as well as clinical assessments and the blood draws for biomarker studies. The CLIMB study is a similar related study that was developed independently at the Brigham and Women’s Children's Hospital in Boston under the directorship there of Howard Weiner. And it is also a long-term followup study. And now, after about seven years, that study has some 217 patients who have been retained out of the original cohort. SUMMIT is the idea of bringing together long-term, well-curated observational cohorts from multiple sites. And the first iteration of SUMMIT will involve investigators from Basal, Amsterdam, UCSF, and Harvard who will merge together their long-term observational cohorts into a larger study. And the hope here is that we will obtain greater statistical power and be able to answer some of the more pressing questions about MS therapeutics, outcome measures, and utility of both conventional and nonconventional MRI in assisting with the diagnosis and management of patients. MSDF So in the EPIC study, I'm struck by the fact that you've been able to retain 91% of your patients after 11 years; whereas in the CLIMB study they've lost 90% of their patients in just 7 years. How do you account for that difference? Dr. Cree The EPIC study has had a great amount of support for long-term followup and subject retention. And we've gone to great lengths to keep our participants interested in the study and wanting to come back. And we have a terrific group of study coordinators who work day and night to maintain contact with our patients, inform them about why it's important for them to participate in the study. And we've even done outreach where we've gone to people's homes to perform evaluations in their homes where they were too ill to come in, as happens with multiple sclerosis as people develop more advanced disability. So we have very good retention as a consequence of the hard efforts made on behalf of the overall study by the coordinators and other members of the team. MSDF Now you've used several measures of disease progression in the EPIC study, as have others in other studies. There's the EDSS, there's the MSFC, and there are several other measures. But let's talk about the EDSS first. That's probably the most commonly used measures, and it's also the one that people seem to love to hate. Dr. Cree Yes. MSDF Can you tell me about the EDSS and what its advantages and disadvantages are? Dr. Cree Yeah, so the Expanded Disability Status Scale of Kurtzke is an ingenious scale that was really intended to describe where patients are at during the course of their lifespan. And it's a 10-point scale with half-point increment changes after the score of 1. And this scale has been adopted for use as the disability outcome measure in all MS clinical trials. The scale has a fair amount of inter-rater variability, which makes it challenging to administer. Because anytime you have a scale where there's a fair amount of variability it gets harder to interpret change. We did look at the EDSS systematically and looked at change over the first few years in the study and used that as a predictor for long-term disability transitions. We also looked at harder endpoints in the EDSS such as the time it takes for patients to go from no systems, disease onset, to the time where they require a cane to ambulate. You mentioned the MSFC, the Multiple Sclerosis Functional Composite. This is a set of scales that were developed for use in multiple sclerosis that included the Timed 25-Foot Walk, which is a measurement of how fast somebody can walk 25 feet. That is clinically relevant because the speed at which somebody walks correlates quite well with the distance they can walk. So the faster you can walk 25 feet the longer you can walk. The 9-Hole Peg Test is a test of upper arm coordination and function. And the Paced Auditory Serial Addition Test is a test of cognitive function that measures specifically the tension and processing speed. So we looked at these things, and we set up thresholds based on other clinical work that were considered to be clinically meaningful changes. So with respect to the Timed 25-Foot Walk and 9-Hole Peg Test, we were looking for a 20% worsening in function over the course of the trial. And with respect to the Paced Auditory Serial Addition Test – or PASAT – we were looking at the reliable change index for that outcome. And so these have been validated outcomes that are related to actual disability. So we looked at all of these measures. And what we found was that when we looked at our relapsing MS patients about half of the patients experienced worsening in terms of EDSS change over 10 years. For the patients who had progressive multiple sclerosis, about 70% of them worsened. And then for these more stringent measures with respect to the MSFC components, we found lower proportions of patients with relapsing MS in secondary progressive or primary progressive disease had worsening in those outcomes, as well. So those were our endpoints for the study; they're clinical endpoints. MSDF One of the things I noticed in your talk was that there was a great deal of overlap between the EDSS and the overall MSFC score; whereas there wasn't much overlap between the individual components of the MSFC score. What is the significance of that? Dr. Cree Well the EDSS is itself a composite measure, and people tend to forget that. Especially earlier on in the scores that go from 0 to about 4, there you have 6 functional scale scores that contribute to the overall EDSS. That includes assessment of vision, brain stem function, motor function, sensory function, cerebellar function, bowel and bladder function, and cerebral function. And those separate functional scale scores are scored independently and then are summarized into an EDSS score between 0 and 4. After that, the EDSS score becomes really much more of an assessment of how far patients can walk until they have hit the major disability milestones of an EDSS of 6, which is walking with a cane, 6.5 a walker, 7 a wheelchair, or 8 bed bound. MSDF So why is there a lot of overlap between EDSS and MSFC but not so much overlap between the components of MSFC? Dr. Cree So when you look at the MSFC, you have two measures to the MSFC that are looking at motor function: the 9-Hole Peg Test and the Timed 25-Foot Walk. They can also be measures of cerebellar function. Both of things are very well measured in the EDSS by the functional scale scores for pyramidal and cerebellar function. The PASAT is not as well measured in the EDSS, although we have a cerebral functional scale score it's not a very precise measure, and there's a weakness associated with EDSS. Whereas in the MSFC, it's a very precise measurement. When we look at the individual MSFC scores themselves, you can have patients who worsen in terms of walking, patients who worsen in terms of arm function, and patients who worsen in terms of cognitive function. And there is some degree of overlap in those three domains but not complete. And that just underscores how MS will affect different individuals differently. Some people have more ambulatory impairment, other people have more upper limb function impairment, and still other people have more cognitive impairment. MSDF You made an interesting analogy to rheumatology in the treatment MS: the question of whether you should treat to no evidence of disease activity. I wonder if you can talk about that analogy and the NEDA, or no evidence of disease activity, goal. Dr. Cree Sure. So in rheumatology in the 1990s, the discussion at that time had to do with how to treat rheumatoid arthritis. And this concept was advanced, which was a treat-to-target approach. The idea of using increasingly effective therapies to silence and suppress any evidence of active rheumatoid arthritis. And this strategy turned out to be extremely effective in treatment of rheumatoid arthritis. And instead of waiting for people to develop more disability, initiation of early highly effective treatments and really suppressing all joint inflammation became the current standard of therapy. And this has resulted in significant improvements in long-term disability in patients who are living with rheumatoid arthritis. So taking that example and extending it to the field of multiple sclerosis, the idea here is that you have evidence of active multiple sclerosis on MRI scans such as gad-enhancing lesions and new T2 lesions; and evidence of relapses, which are clinical manifestation of acute inflammation; and disability progression, which is looking at the EDSS score and saying okay well if we have a combined measure that looks all of these things, and we try to suppress disease activity perhaps we're going to wind up with better outcomes. And so, this metric of no evident disease activity is defined as no evidence of relapses, no evidence of disability progression by the EDSS, and no evidence of MRI disease activity. And it was originally developed in the context of clinical trials; specifically the pivotal trial of the natalizumab versus placebo study. And a certain proportion of patients in that study met this criteria of no evidence of disease activity. Subsequently, with more recent trials, other compounds have also been looked at and compared to their placebo or active comparator controls. And in each of these studies, you can see differences between treatments with respect to the proportion of patients with no evident disease activity. The field of MS today is considering use of no evident disease activity as a therapeutic strategy or goal so that one would escalate therapy to the point where you see no evident disease activity. And the hypothesis here is that if you are able to effectively reach no evident disease activity that that is similar to putting patients in remission or preventing further disability from occurring. So we were very interested to find out whether there was long-term prognostic value of this marker, no evident disease activity. And so, within the EPIC study, we looked at no evident disease activity over the first two years of the trial, and there was a proportion of our patients from this study who met those criteria: who had no change in terms of disability, no change in terms of clinical relapses, and no evidence of active multiple sclerosis by MRI scan. And we thought that that group would have a better outcome overall than the rest of the cohort. To our surprise, we found that there was no predictive value of no evident disease activity on any of the clinical markers that we looked at for 10 years. So these patients had exactly the same risk for disability progression as patients who had evidence of active multiple sclerosis. And this was very perplexing; we just didn't really understand why that would be the case until we really started to look at the impact of treatment and use of escalation therapy in our cohort. And I think that when you look at the influence of therapeutic intervention in multiple sclerosis the effect size of therapeutic intervention is so great that other markers of biological disease activity such as new lesions wind up being minimized by the therapeutic impact. And as a consequence, things that might have been predicted based on natural history studies – such as brain volume loss, new lesions – become less apparent as having clinical meaning over a 10-year period of time because of the dominant influence of therapeutic intervention. With respect to the no evidence disease activity, one of the questions that I think needs to be answered is do we really have the best markers for this? And if we are going to use a treat-to-target approach, are the things that are currently being looked at in no evident disease activity the right things to look at? And there is now interest in looking at other markers, as well, looking in incorporating, for example, brain volume into the no evident disease activity. And it will remain to be determined whether other ways of looking at no evident disease activity wind up performing better as a long-term predictor. MSDF So when you're confronted with an individual patient – a new patient early in their course of disease – every neurologist is confronted the question of whether you start them with an interferon and escalate as they progress, or whether you start them with a highly active therapy. How do you make that decision, and how does the evidence from EPIC inform that decision? Dr. Cree That's a great question, and I think this is probably one of the most provocative aspects of this long-term study. In EPIC, we used the escalation strategy where we began with so called platform therapies; drugs that are used as disease-modifying therapies that have been around for a long time, specifically the interferons and glatiramer acetate. And in the event that patients experienced relapses or had other markers of worsening such as brain volume loss, many of those patients were escalated onto what we would consider to be high-potency therapies. Drugs like natalizumab or medications that are off-label but still used in treatment of multiple sclerosis like rituximab or cyclophosphamide. So we used this escalation strategy in this cohort. And what we found was the following. Treatment escalation was not associated with improved outcomes. In fact, treatment escalation was associated with worse outcomes in some patients. Now, why would that be the case? Well there's probably a confounder there of the indication to treat so that the patients who were getting escalation therapy are doing worse, and so they get the escalation therapy. So what we don't know from this study is if those patient hadn't gotten escalation therapy how would they have fared? We can't answer that question. That would require a randomized controlled trial. But what this study does provide is this provocative idea that perhaps escalation therapy was really too little too late. That we were identifying a group of people who were at high risk of disability progression, but we weren't really setting things back to restore them onto a normal pathway and certainly not to prevent long-term disability. And this raises the idea that perhaps we should be utilizing these higher-potency therapies earlier. Now, that type of approach – the maximal efficacy approach – doesn't have data yet to support its use, but there are a few provocative studies that suggest that high-potency therapy might be associated with better outcomes. And we have the recent results of the cladribine study in clinically isolated syndrome where we had the best data yet for use of a broad-spectrum immune suppressant in terms of venting, time to the next clinical or radiographic event in patients who have presented with a first demyelinating event. And that study out performed all prior trials in clinically isolated syndrome so raises the question should be using an aggressive therapy right from the get-go? And then, we have the alemtuzumab pivotal trial where alemtuzumab was compared head-to-head versus interferon beta-1a twice weekly in newly diagnosed patients. And in that study, alemtuzumab also out performed interferon beta-1a on many of the short-term markers of inflammatory disease activity. And we recently saw long-term data with alemtuzumab indicating that those patient do really quite well over a four-year period of time. So actually midterm data. So we have a few lines of evidence to suggest that perhaps we should be using these high-potency therapies earlier. What we don't know is the relative risk-to-benefit profile. Certainly these higher-potency therapies carry greater risk to the individual subjects who are treated with these medications. And what we ultimately have to determine is whether those risks at a population level are worth the potential benefits of using a greater potency therapy early on in the course of MS. It's my opinion that it's unlikely that the pharmaceutical industry is going to answer this question for us definitively. This type of approach to compare escalation therapy to high-potency therapy or maximal efficacy therapy from the get-go will require quite a bit of time of followup – at least five years if not longer – and will require large studies. So it seems to me unlikely to be endorsed by the pharmaceutical industry. It also seems unlikely that it's going to be sponsored by national organizations such as the National Institute for Neurological Disease and Stroke because of the extremely high costs associated with this type of clinical trial. So that raises the question how are we going to answer this pressing unmet and unanswered question? And I think observational studies such as EPIC will be able to do this when merged together with other long-term followup cohorts. Today we have treatments that we didn't have 10 years ago, for example, fingolimod, dimethyl fumarate, alemtuzumab. These medications are currently being used in clinical practice. And I think we should be responsible for aggregating data on the patient experience with these medications, putting it into a systematized process for analysis, and aggregating this type of data across multiple centers. And that really is the goal of SUMMIT, which is going to involve pooling together our patient experience with our existing cohort, as well as new cohorts from UCSF, from Harvard, from Basal, from Amsterdam, and hopefully from many other MS centers as well. And then, with that pooled data, we'll hopefully be able to answer this question in a meaningful way. MSDF Well, Dr. Cree, thank you very much. Dr. Cree My pleasure. [transition music] MSDF Thank you for listening to Episode Forty-eight of Multiple Sclerosis Discovery. This podcast was produced by the MS Discovery Forum, MSDF, the premier source of independent news and information on MS research. MSDF’s executive editor is Robert Finn. Msdiscovery.org is part of the non-profit Accelerated Cure Project for Multiple Sclerosis. Robert McBurney is our President and CEO, and Hollie Schmidt is vice president of scientific operations. Msdiscovery.org aims to focus attention on what is known and not yet known about the causes of MS and related conditions, their pathological mechanisms, and potential ways to intervene. By communicating this information in a way that builds bridges among different disciplines, we hope to open new routes toward significant clinical advances. We’re interested in your opinions. Please join the discussion on one of our online forums or send comments, criticisms, and suggestions to editor@msdiscovery.org. [outro music]
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