#Coronary syndrome

[ricisidro]

LIVE: TVUP Health Updates

Webinar #206

August 23, 2024 (Friday) 12nn

Comprehensive overview of Acute Coronary Syndrome (ACS), focusing on its pathophysiology, clinical presentation, diagnostic evaluation, and therapeutic strategies including the latest evidence-based guidelines and best practices for managing ACS, including the role of percutaneous coronary intervention (PCI) and pharmacological interventions. 

#AcuteCoronarySyndrome #ACS #HeartHealth #coronary #cardiology #heart #cardiovascular #cerebrovascular #MedicalEducation #HealthAwareness

#decreasedbloodsupply #atherosclerosis #hypertension #heartattack #stroke #cholesterol

[merchantservicesarticles101]

What Does PCI Stand For?

[medtalksblog]

Cardiovascular Health Issues

Heart-related problems are always serious because they can be life-threatening. Acute Coronary Syndrome (ACS) is a condition where there is a sudden decrease in blood flow through the coronary artery. This prevents the adequate supply of blood to the heart. Consequently, individuals may face severe complications, including stroke, angina, or the most common, a heart attack.

[jaydenirish]

Cardiometabolic Risk CME

Master cardiometabolic risk with our CME program! 🩺💡 Enhance your skills and knowledge. Learn more:

[berryblogg]

"11 Effective Strategies for Combating Fatigue Syndrome"

[everythingwaschocolateandsugar]

The Global Cardiac Biomarkers Market size was valued at USD 8.42 billion in 2019 and is predicted to reach USD 28.29 billion by 2030, with a CAGR of 11.6% from 2020-2030.

[jeraliey]

It's still not just a cold.

"This study showing that severe acute respiratory syndrome coronavirus directly infects coronary artery plaques, producing inflammatory substances, really joins the dots and helps our understanding on why we're seeing so much heart disease in COVID patients," Peter Hotez, MD, professor of molecular virology and microbiology at Baylor College of Medicine in Houston, told Medscape.

Oh, also?

CDC predicts respiratory disease season will be similar to last year

"The CDC said it expects a similar number of respiratory disease cases this year as last year, with 15 to 25 new weekly hospitalizations per 100,000 people."

"As of Friday, nearly 12 million people have gotten the new Covid-19 vaccine since they were authorized last month, according to HHS. That’s millions more than the week prior, but still less than 4% of the US population."

No one is protecting themselves. And no one else will protect you.

Even if you're not worried for yourself....don't be one of the people that carries it to someone else. We're all responsible for the most vulnerable people in our society. (That could be you, by the way.....)

WEAR. YOUR. MASK.

[butch-reidentified]

do you actually have a genetic disorder??

how does it work whats it called

I have vascular-type Ehlers-Danlos Syndrome (vEDS - though many patients prefer to use VEDS for reasons discussed in the link at the end of this post). it's a connective tissue disorder with several subtypes, but vascular-type is the only type that's deadly. current typical life expectancy is like 48ish, but even then, that's if you take a certain class of medication that I can't take (makes my blood pressure so constantly and severely low that I become bedbound) - when I was first diagnosed with unspecified EDS, the lifespan estimates for VEDS were closer to 40 years. that doesn't necessarily mean I can't possibly live a good bit longer - there have been patients who've lived about as long as a typical healthy person, but there's no way to predict it or mitigate it. lifestyle, in this case, makes basically zero difference. I could be the fittest and healthiest lifestyle person on earth or be a couch potato who eats nothing but fast food and it wouldn't really mean much in terms of this either way.

I've posted before about my EDS (never in detail idt) & it's mentioned in the About Me section of my Pinned, but had avoided getting the test for VEDS until fairly recently - not fully intentionally, just got caught up in life and kind of already suspected based on certain traits and symptoms I have that are associated with the vascular type (including a history of SCAD*). it's actually good I waited bc they found a new variety of the gene mutation since my initial diagnosis that may be present in a whole 50% of VEDS patients!

*SCAD = Sudden Coronary Artery Dissection, often considered a type of heart attack, where your artery just zshlurps n pops a hole in it. I recently had read a few studies showing that female people, especially if otherwise broadly healthy, are more able than males to heal from SCAD without or with very conservative medical intervention (I don't even go to hospital atp for pretty much anything my body does, but I did briefly die once and have posted my NDE experience here before), however I'm struggling to find these studies all of a sudden. that said, the below AHA article mentions that "among patients with acute myocardial infarction, patients with SCAD have a lower risk of mortality, which is attributed primarily to their younger age, female sex, and low prevalence of atherosclerotic risk factors."

[mariacallous]

In 2013, the US Food and Drug Administration made an unprecedented recommendation, advising that women should receive a lower dosage of the insomnia drug zolpidem than men. The rationale behind it was that medication seemed to affect women for longer periods, which could become a safety issue.

However, in 2019, research conducted at Tufts University concluded that the differential effect of the medication had nothing to do with sex. Rather, researchers found that what determined the rate at which the person cleared the drug from their system was their body size. The report concluded that the reduced prescribed dosage for women could in fact lead to underdosing and a failure to effectively treat insomnia. “They were using sex as a proxy for body size because we tend to collect data about sex; we don’t collect data about body size,” says Angela Saini, author of The Patriarchs: How Men Came to Rule. “This is the perverse way that sometimes medicine works: You base your diagnostics on the data you have rather than the data you need.”

Indeed, Saini argues that many of the prevailing gaps in health outcomes between men and women have nothing to do with biological sex. “It can be so tempting for scientists to look at a gap and want to find a simple biological explanation for it, but when it comes to gender and health those simple explanations often don’t exist,” she said.

Of course, sex differences do exist in aspects of health, such as reproductive health and physiology. However, what research suggests is that, in most cases, the health-related difference between men and women—from disease symptoms to drug efficacy—is really quite marginal. “The differences that do exist are down to gender,” Saini says. “Differences in the way people are treated and thought about and the assumptions we make about them.” That, according to Saini, is what explains many of the failures when it comes to women’s health.

Consider, for instance, the common misconception that women present atypical heart-attack symptoms, different from men’s. This prevailing myth was quashed by a 2019 study, funded by the British Heart Foundation, at the University of Edinburgh. The research, which involved nearly 2,000 patients, showed that, in fact, 93 percent of both sexes reported chest pain—the most common symptom—while a similar percentage of men and women (nearly 50 percent) also felt pain radiating from their left arm. “The problem of underdiagnosis of women is because health professionals and even the women themselves who are having a heart attack believe heart attacks are something that mostly happens to men,” Saini says. Estimates indicate that differences in care for women have led to approximately 8,200 avoidable deaths due to heart attacks in England and Wales since 2014.

“It’s not about men discriminating against women; this is often about women not being listened to—sometimes by other women,” she says. Another example that starkly illustrates how gender can affect health outcomes came from a 2016 Canadian study about patients who had been hospitalized with acute coronary syndrome. The research showed that the patients who experienced higher rates of recurrence were the ones who performed gender roles stereotypically associated with women—like doing more housework and not being the primary earner at home—independently of whether they were a man or a woman. “This was because people who carried out a female social role were more likely to be anxious.” Saini says.

If these disparities are caused by the way patients are perceived and treated, the solution, to Saini, is clear: “We need to be careful to diagnose the problem where it is, not where we imagine it to be.” She highlights the successful work of Jennie Joseph, a British midwife who, in 2009, founded the Commonsense Childbirth School of Midwifery in Orlando, Florida, to support women without access to maternal health care. Research has shown that Black mothers, both in the US and in the UK, are three times more likely to die than white women.

“Joseph lowered maternal mortality rates among minority women simply by improving the quality of their care, listening to their concerns, and responding when they say they’re in pain,” Saini says. “We don’t need technology to solve this issue. We just very simply can’t allow our biases and prejudices to get in the way.”

[bullshit-tqia]

Your psychiatrist and surgeon do not care for you.

They want to make money off of you.

They are willing to get you exogenous hormones that can give you higher rates of depression, cancer, cysts on your clitoris, PCOS, liver, kidney, and heart disease, blood clots in the lungs, strokes, polycythemia and hyperlipidemia, thrombosis, brain tumors, acute coronary syndrome, malignant hypertension, anemia, a worsening of psychosis, hepatitis, and to briefly mention dizziness, nausea, and chronic headaches. This is from hormones alone. They do not tell you this because your doctors make money off of you and don’t want to dissuade you from giving them hundreds of dollars.

Long term studies admit that they lose a large portion of their participants, but they assume that those participants are happy.

What is becoming more likely to me is that these participants died. And their deaths will never be considered or remembered. How can we be sure that transitioning is good long term if we have no record to even begin to consider that being true?

Gender Affirming Care is not regulated or approved for being a good solution to gender dysphoria.

When was the last time we thought that removing parts of the body was a good solution to helping mental problems? Oh yeah, with lobotomies.

There is no proof of “gendered brains.” The amount of white matter between women and men is so slight that it’s as defunct as race science. They overlap so heavily with little evidence of proper structural distinctions that it is dishonest to pretend there is any major pattern. There is no proof that even these “differences” observed in trans women vs. cis men are because of gender dysphoria, or are the effects of hormones. We have no understanding of how gender dysphoria manifests or how it works.

You are being experimented on.

If hormones can worsen your mental health because they are exogenous, how are you being treated? Even if gender affirming care lessened gender dysphoria, it is being exchanged with depression and possible psychosis. You are exchanging one bad thing for another. This will not help you long term.

Gender Dysphoria will still manifest through your memories, your knowledge of chromosomes, and the fact that you have a secret

It cannot go away as long as you are aware of your own transition. It is not helping you. You have to continue to delude yourself that it is working for it to work. That is the definition of a placebo.

Why was the first drafted solution to gender dysphoria hormones and surgery and not therapy?

Why? Nobody has given me an answer to this. We have never even tried to see if any antidepressants or therapies work to help gender dysphoria in a way that won’t make you targeted, bullied, and fearful for our lives. That is fucking cruel.

Listen to detransitioners, listen to the trans people who suffered as a result of surgery.

It may not be rare. Recent studies have shown that every trans person that was put on hormones had a negative effect to their health. EVERY. Why is the assumption that we must suffer to be happy? Why can’t we be nonconforming without giving up the rest of our lives to be on hormones and having surgery after surgery? Why? Genuinely, why?

There are trans women who had colon vaginoplasty, where they use part of the colon to create a vagina. These women start to shit through their vaginas. And these surgeries often follow a previously failed SRS procedure. It is a last ditch effort and it is horrific to your body.

While having complications, many detransitioners and trans people were ghosted by their doctors.

They don’t give a fuck about you. They want to make money off of you. As trans people and detransitioners were suffering after their surgeries, their doctors abandoned them because well…they didn’t have to do anything to help them. Because gender affirming care is not approved or regulated. There is no proof that it even helps beyond a few surveys that may not have honest answers and exclude detransitioners and those who killed themselves as a result of their failed surgeries.

I transitioned, and now I may be suffering dire consequences of it, because I bought into this idea that experimenting on my own body would be worth it. But now I feel the same as I did before I detransitioned and after. Nothing has fundamentally changed. I was still dysphoric but I was making myself deeply unwell to satisfy society’s perception of what a woman should be.

You can grow your hair out, you can wear makeup, you can be feminine. You can cut your hair short, you can ditch makeup, and you can be masculine. You don’t have to hurt yourself to fit into this standard when it is logically possible for you to accept how you were born.

It cannot be impossible for you to be happy.

These greedy doctors are preying on vulnerable people to make money.

[crosstheveil]

Health: Adrenal Glands

TCM: Jing, Kidneys

GNM: Off Track (cortex), Unbearable Stress (medulla)

Greek: Sanguine (cortex), Choleric (medulla)

Chakra: Root

Astrology: Mars, Aries-Libra; ex. managing adrenal health can be especially important for natal placements like Mars in Libra/7th, Mars in Pisces/12th, South Node conjunct Mars, etc.

The adrenal glands, which sit atop the kidneys, play a central role in the body's response to stress, fatigue, immune challenges, and several key physiological and metabolic functions. Issues related to the adrenal glands is very common yet highly under-diagnosed. They consist of two regions:

Adrenal Cortex: Derived from the mesodermal base substance cholesterol, the adrenal cortex produces hormones such as cortisol, corticosterone, aldosterone, and male sex hormones. These hormones play vital roles in physiological functions. Cortisol and corticosterone, known as stress hormones, contribute to the regulation of metabolism, inflammation, and blood sugar, and assist in long-term stress response by enriching the blood with minerals and glucose. Their anabolic effects also aid in healing and regeneration. Aldosterone helps maintain blood pressure by regulating the balance of salt and water in the body. The adrenal cortex's production of male sex hormones can influence the reproductive system. If unresolved, chronic stress may lead to excessive cortisol production, causing problems like weight gain and high blood sugar.

Adrenal Medulla: The endodermal adrenal medulla manages emotional and physical stress by producing the hormones noradrenaline, dopamine, and adrenaline. These hormones are pivotal in activating the "fight, fright, flight" response, a physiological reaction that occurs in response to a perceived harmful event or threat. This acute stress response increases heart rate, blood sugar, and mental alertness, along with other physiological changes. Chronic anger or emotional upheaval can strain the adrenal medulla, leading to an energetic drain.

Stress

The adrenal glands are highly sensitive to stress, and chronic stress can lead to various disorders:

Psychiatric Disorders: Neuroses, post-traumatic stress disorder (PTSD), depression, anxiety disorders, bipolar disorder.

Neurological Disorders: Migraines, peripheral neuropathy, dizziness, tremors.

Glandular Disorders: Issues related to other glands including the thyroid which is responsible for cell growth; for instance, uterine cancer, polyps, hypothyroidism, hyperthyroidism.

Cardiovascular Disorders: Coronary artery disease, stroke, heart attack, hypertension, arrhythmias.

Respiratory Disorders: Asthma, chronic obstructive pulmonary disease (COPD), difficulty in breathing.

Immunological Disorders: Possible tumor promotion, reduced resistance to infection, autoimmune disorders, chronic inflammation.

Metabolic Disorders: Diabetes, obesity, metabolic syndrome, difficulty in regulating blood sugar.

Gastrointestinal Disorders: Ulcers, irritable bowel syndrome (IBS), chronic indigestion, malabsorption.

Genitourinary Disorders: Impotence, incontinence, menstrual problems, urinary tract infections, kidney dysfunction.

Musculoskeletal Disorders: Muscle weakness, chronic fatigue, fibromyalgia, joint pain.

Skin Disorders: Acne, eczema, psoriasis, skin thinning.

Cysts and Cancer

Adrenal Weakness: If the adrenal glands don't produce enough adrenaline, the heart may pump slower, leading to fluid accumulation and cysts in the prostate, ovaries, and breasts. These cysts can harden and potentially lead to cancer.

Blood Flow: Increasing blood flow can help resolve cysts if addressed quickly.

Signs of Imbalance

Frequent sickness, fatigue, low libido, low backache, chronic health issues, dark circles under the eyes, hair loss, early greying, frequent urination at night, cold hands and feet, brain fog, pain and weakness in the lower back, loins, thighs, knees and lower body, urinary weakness and debility, polyuria and nocturia, impotence and male sexual dysfunction, moodiness and irritability, depression, muscle or bone loss, autoimmune conditions, chronic fatigue, hormone imbalance, body aches, unexplained weight loss, lightheadedness, skin discoloration (hyperpigmentation), weakened stress response, insulin resistance, sleep problems, weight gain, sweet and salty food cravings, difficulty getting up in the morning, increased PMS or menopausal symptoms, inability to handle stress, increased allergies, frequent sighing, cravings for salty foods, higher energy levels in the evenings, overuse of stimulants like caffeine.

Traditional Chinese Medicine (TCM)

Jing (essence): The statement by the Chinese that the kidneys harbor our Jing refers to the adrenals having the highest concentration of neural crest cell derivatives in the entire body. Strong Jing corresponds to robust characteristics like strong teeth, which are made by neural crest cells, while weak Jing relates to signs of aging like grey hair and deafness, also linked to neural crest cells. Jing's manifestations include the progression from youth to adulthood, reflected in functions controlled by the pituitary (aided by neural crest cells), and can be seen in the structure of the face and jaw. Neural crest cells also create the heart's connective tissue, affecting lifespan. Jing as a concept is not the same as neural crest cells but they represent the body's inherent organizational strength. Weak organizational energy leads to neural crest cells that don't form properly or function well, resulting in genetic disorders affecting facial development. The Chinese recognized these markers as indicators of weak Jing.

Kidneys & Urinary Tract: The adrenal glands are connected to the kidneys not just through the renal fascia, but also by way of the renal artery, draining into the renal vein, and receiving nerve connections from the renal plexus. The kidneys regulates the body's water content and are essential for maintaining healthy bones, as well as producing healthy bone marrow and blood. It determines the level of adrenaline and dopamine in the body, affecting our energy and rest. In addition, it forms a relationship with the heart through various hormones. During puberty, the adrenal cortex starts to produce sex hormones like testosterone and oestrogen, and this production continues throughout adulthood. Caffeine depletes kidney qi, yang, yin, and essence, contributing to liver and adrenal issues, and long-term exhaustion. Regular coffee drinkers, especially those who don’t feel its effects, may be nearing adrenal exhaustion. Adrenal fatigue is often considered a kidney yang deficiency. If left untreated, it can progress to a kidney yin deficiency. These deficiencies are often marked by a light low groaning tone to the voice, a darkish pallor under the eyes, negative attitudes of insufficiency or inadequacy, needing to sit and not being able to stand for long, and worrying about money. Additionally, those who experience traumatic shock or long term stress often have their hair turn gray or fall out.

Kidney Yang (medulla): Linked to the reactive sympathetic nervous system and the hormones adrenaline, dopamine, and norepinephrine, produced in the adrenals. A deficiency in kidney yang can lead to symptoms like cold hands and feet, edema, night urination, and low libido. This deficiency parallels disorders like adrenal fatigue, hypothyroidism, and sexual dysfunction. This condition is worsened by the use of marijuana, diminishing our natural drive, motivation, and willpower. Adrenaline is used to treat conditions like asthma, anaphylaxis, and slow heart rates. It works on the cell membrane's outside, which is known as the yang aspect of the cell. It never enters the cell but attaches to a receptor on the outside, initiating a cascade of chemicals that open or close gates on the cell's exterior. In the heart and muscles, adrenaline prompts more calcium to enter, which amplifies the force of contraction; in the lungs, it leads to the relaxation of the muscles, permitting more air to flow in; in the brain, it initiates the emotional reactions connected with fear.

Kidney Yin (cortex): Associated with the parasympathetic nervous system and the hormone cortisol, produced in the adrenals. A kidney yin deficiency may manifest as sore back, leg weakness, insomnia, and anxiety. It may parallel disorders like diabetes, high blood pressure, and hyperthyroidism. Although necessary for daily function and stress response, excessive cortisol can lead to fluid retention, osteoporosis, muscle wasting, depression, and diabetes. If our bodies stopped producing cortisol, it would result in significant illness. While adrenaline binds to the exterior of the cell (yang), cortisol is absorbed into the very core (yin). Contrary to the effects of adrenaline which are more immediate, the effects of cortisol can take years.

Greek Medicine

Hot Temperament: The adrenals are generally represented as stimulating and energizing various functions to adapt to stress.

Adrenal Cortex: Sanguine, nutritive, and anabolic, enriching the blood and decreasing swelling.

Adrenal Medulla: Choleric, energetic, and catabolic, stimulating acute stress response.

Faculty Support: Adrenal glands produce supplementary amounts of sexual hormones, bridging a connection between vital and generative faculties; supporting heart and lungs (vital), kidneys and pancreas in blood sugar regulation (natural), enhancing mental alertness and stimulating the sympathetic nervous system functioning (psychic), supporting male sexual function and response (generative).

Root Center: The adrenals form the basic energetic support for the entire organism, associated with the Root Chakra.

Kidneys & Urinary Tract: Weak adrenals may adversely affect the vitality and functioning of the kidneys and urinary tract, which are interlinked with the adrenal glands'. When the kidneys are not effectively eliminating fluids, it can lead to the accumulation of phlegm and moisture. Additionally, the kidneys have a connection to the soles of the feet which may be affected by cold conditions. Conditions of melancholy or devitalization of the adrenals, kidneys, and urinary tract often correlate with chronic fatigue.

Adrenal Exhaustion: Chronic stress and irregular habits can lead to fatigue, irritability, pain, and impotence in men usually caused by flare-ups of Choleric anger or any experiences which feel like a roller coaster. Sexual overindulgence also exhaust the adrenals.

Male Sexual Function: The adrenal glands provide energetic support for male sexual function. Issues with adrenal energy may result in sexual dysfunction, including impotence or premature ejaculation.

Blood Sugar Regulation: In instances of dangerously low blood sugar, the adrenal glands jump into action, raising levels through adrenaline. Chronic instability may involve adrenocortical hormones, aggravating factors in type II diabetes.

German New Medicine (GNM)

Adrenal Cortex (Off Track)

Conflict: Feeling like you've made a wrong choice or gone down the wrong path.

Under-Functioning: Waterhouse-Friedrichsen syndrome, adrenal gland insufficiency, Addison's disease. Reduced cortisol production, feeling stressed and tired.

Over-Functioning: Excess cortisol (Cushing's disease) with high blood pressure, round face, obesity, muscle atrophy or aldosterone (Conn's syndrome) with high blood pressure, low potassium, weak muscles, thirst, frequent urination.

Adrenal Medulla (Unbearable Stress)

Conflict: Extreme tension from stress, feeling overwhelmed. Something is beyond reach.

Diagnosis: Pheochromocytoma, neuroblastoma. High blood pressure, racing heart, increased blood sugar, sweating.

Astrology

Mars: This planet governs adrenaline, testosterone, male sexual function, playing a role in the catabolic metabolism where fuel is burned. It also oversees the release of toxins, the regulation of red blood cells, iron, and muscle tissue, including tendons and ligaments. It extends to the entire muscular system, embodying vitality and physical strength. The energy of Mars is hot and dry so it's temperament is Choleric. Mars co-rules the adrenals (with Aries/Libra) and the male genitalia (Scorpio).

Aries: Aries is a Choleric sign, and its will to action makes it prone to anger and stress, which deplete and weaken the adrenal glands. The sign is energetic, sharp-eyed, cheerful, and alert, but may become irritable and have a restless tendency to keep going until burnout. This can lead to eyestrain and poor vision as the health of the eyes is dependent on the strength of the adrenals. The preference for stimulants like chili pepper, caffeine, and their attraction to the Sun can overstimulate the adrenal glands, leading them to seek cooling substances like icy drinks, fruits, and seafood.

Libra: Libra, the Sanguine Air sign that rules the kidneys and lower back, is a counterbalance to Aries. The kidneys and genitourinary tract are only as strong and healthy as the adrenal glands, which are their energetic support. Underlying adrenal weakness and exhaustion weakens the kidneys and genitourinary system, leading to urinary debility, urinary tract infections, inflammation or irritation, uremia, and gout. Since male sexual function is also dependent on the strength and health of the adrenal glands, problems may arise in this area.

Aries-Libra Dynamic: Kidneys, adrenals, eyes, head and cranium, low back, lumbar spine, bladder, genitourinary system (especially male), hips and loins. Aries represents personal power, autonomy, honesty, and decisiveness, often leaning towards individualism and assertiveness. Libra, on the other hand, emphasizes cooperation, diplomacy, compromise, and social harmony. While Aries is direct and often acts alone, Libra seeks mutual choice and operates through consensus. This represents a struggle between competition and cooperation, selfhood and partnership, war and peace, doing and being. Finding balance is needed for acid/alkaline balance, as Aries tends to run acidic, and for hormonal balance, where Aries tends toward excess testosterone. The tension between these two forces may cause a lot of frustration and aggravation, particularly in males, manifesting as irritation or inflammation of the genitourinary tract.

Healing and Relief

Diet: Paleo; reduce caffeine, sugars and sweeteners, gluten, starch, white flour, processed foods, and hydrogenated oils.

Nutritional Supplements: Ionic Magnesium, B Vitamins, Omega-3 Fatty Acids, Vitamin C, Zinc, Probiotics, L-Theanine

Herbal Adaptogens: Ashwagandha, Rhodiola Rosea, Holy Basil, Licorice Root, Siberian Ginseng, He Shou Wu

Lifestyle Considerations: Address societal pressure to perform, lack of self-care, and the conflict in real life. Regular exercise of varied intensity. Practice meditation, mindfulness, Tai Chi, Qigong. Express creatively and spend time in nature. Align sleep schedule with circadian rhythm to nourish yin. Hydrate more and add salt to water. Avoid various toxins like dioxin or insecticides which contribute to adrenal malfunction. Spend more time in the sun each day. Don't sit for too long. Try wearing a haramaki, stretch cotton (for summer) or stretch wool (for winter).

These are research notes from the work of Daniel Keown, Michel Odoul, Michael Tierra, Lesley Tierra, Johan Boshwinkel, David Osborn, Judith Hill, Eileen Nauman, Björn Eybl, Caroline Markolin, Deb Shapiro, and Jody Smith.