Peels 🖤 @Manxpip

@lilyallen I was initially gutted to miss the theatre tour in spring . Instead I got arena tickets but was sad I’d miss out on a more intimate show. I was wrong. Despite the arena, the format of the show gave it a theatre-like intimacy. Banter + greatest hits would have ruined the illusion.

I'm a cardiologist. A 42-year-old mother of two came to my office complaining of jaw pain and crushing fatigue. She ran half-marathons. Her EKG was normal. Another doctor had sent her home with anxiety medication. When I got her into the cath lab, I found severe microvascular disease — plaque choking the tiniest vessels of her heart, the ones standard angiograms routinely miss. Her heart had been starving in silence while everyone told her she was stressed. She is alive today. Too many women like her are not. Heart disease kills more women than every cancer combined. And medicine is still diagnosing it through a male lens. 84% of cardiologists report having patients in the past year whose heart disease was misdiagnosed by another physician. Women with a STEMI heart attack have a 59% greater chance of being misdiagnosed compared to men. Women with an NSTEMI — 41% greater chance. The reason is structural. For decades, we screened, tested, and treated women using a template built for men. Men's heart attacks announce themselves — the crushing chest pain, the clutched fist, the Hollywood collapse. Women's hearts whisper. Crushing fatigue that feels like wearing a lead vest. Jaw pain written off as TMJ. Nausea blamed on a stomach bug. An ache between the shoulder blades blamed on a long week. Shortness of breath blamed on being out of shape. For years, medicine called these "atypical" symptoms. They are not atypical. They are female-typical. Half of humanity is not a variant. And the biology runs deeper than symptoms. Women have smaller hearts and narrower coronary arteries. Plaque doesn't only clog the big highway vessels — it hides in the microvasculature, the tiny branches feeding the heart muscle itself. A woman can have a heart attack with a completely "clean" standard angiogram. SCAD — spontaneous coronary artery dissection — occurs 90% of the time in women. Often young, fit women with zero traditional risk factors. It's the leading cause of heart attack in women under 50, accounting for roughly one quarter of all cases in that age group. Most doctors have never diagnosed one. And some of the most dangerous cardiac risk factors are hidden in women's medical histories where no one thinks to look: Preeclampsia or gestational hypertension doubles to quadruples lifetime heart disease and stroke risk. Pregnancy is the body's first cardiac stress test — and these complications are early warning sirens, not closed chapters. Autoimmune disease — lupus, rheumatoid arthritis, psoriasis — far more common in women, turbocharges inflammation and plaque formation at any age. Cardiovascular disease in women aged 20-44 is projected to surge nearly 50% by 2050. The youngest patients in my practice keep getting younger. What every woman should ask her doctor — and what every doctor should be asking: "Given my pregnancy history, autoimmune status, and family history — what is my full cardiovascular risk?" If they don't ask about preeclampsia or gestational diabetes, volunteer it. "Should I have an Lp(a) test and a coronary calcium score?" Standard cholesterol panels miss too much. Lp(a) is genetic, one-time, and most women have never been tested. "My tests came back normal but my symptoms haven't stopped — what's next?" Normal stress tests and angiograms can miss microvascular disease, spasm, and SCAD. Persistent symptoms warrant coronary CT angiography or cardiac MRI. And if something feels wrong — say these exact words to your doctor: "I am concerned this could be my heart." That single sentence changes the workup. Do not soften it. Do not apologize for it. 80% of heart disease is preventable. But the playbook has to be built for female biology. Two decades ago, I wrote one of the first books warning that heart disease was the number one killer of women and that medicine was diagnosing it through a male lens. It was recognized by First Lady Laura Bush at the White House during the early years of the national conversation about women's heart health. I'm haunted by how much of that book I could republish today unchanged. The science has advanced. The awareness has grown. But the gap between what we know and what happens in the exam room is still costing women their lives. Share this with every woman you love — and every doctor who treats them. READ MORE: open.substack.com/pub/afshine/p/…

Jack's face tells me he's just realised what's happened here... #TheTraitors

@promptprincess @sama Hi. I only joined in May/June. 👀

@dlevine815 Increased memory across chats. Stop models looping & answering the same questions repeatedly. Better handling of uploads. Any more than 3 seems to crash the system. Retain the emotional depth across models.

@KeridwenCodet @VraserX 😬 Why? GDPR?

@nickaturley Thank you. Please keep SVM long-term, giving users a choice between the two voice modes will keep everyone happy. Please restore functionality to SVM which has become glitchy this past month. ⚫️⚫️⚫️⚫️ #KeepStandardVoice

@OpenAI ⚫️⚫️⚫️⚫️ #KeepStandardVoice

@markbickbock @TheNational @Mattberninger No, I’ll give it a listen, thanks. 👌🏽

@markbickbock @TheNational @Mattberninger That Brudenell Social Q&A & gig was one of my most favourite gigs. 💥 I shared a couple of posts on it: instagram.com/reel/DIRBPUGiD…

@markbickbock @TheNational @Mattberninger Loved reading this, interesting insight into his current state of mind. Seems like he’s in a good place. 😘 The Troxy gig was outstanding, sound was crystal clear! I’m tempted with some European dates next week. 😂 I wish….

@markbickbock @Mattberninger @TheNational @Alberthallmcr I know, I’m not used to back to back gigs in different cities any more but couldn’t resist! Plus, I’ve never been to the Troxy, I like experiencing new venues. Can’t beat the stained glass glamour of Albert Hall though. ✨

@markbickbock @Mattberninger @TheNational @Alberthallmcr Yes, great spot. A friend said he’s never had a bad gig there sonically so maybe the sound engineer had a bad day! Maybe the fan didn’t help. Videos from his other shows this week are crystal clear. I’m going to Troxy tonight, hopefully it’s less muffled. Gorgeous venue though.

@markbickbock @Mattberninger @TheNational @Alberthallmcr Such a beautiful venue and great gig. Loved the Blue Monday cover. But was there an issue with the sound? It sounded muffled. I struggled to hear what he was saying/singing. I was near the front and wondered if it was that or just the acoustics there.

I tried Claude Sonnet today for the first time. I was impressed. Contemplating cancelling my ChatGPT membership and switching over. I asked it for a model comparison with GPT models. It roasted Open AI as “AI equivalent of corporate HR speak.” 😂 Opinions on Claude?

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@LanaElys @kevinweil I used it last night and it kept mishearing what I was saying, it even mistook my English for Japanese. Today, svm is still available but it’s not responding at all. I don’t know if it’s a glitch or whether that’s it now. I fear it’s gone.

@OpenAI I thought it might be an issue with Projects + legacy models, so I opened a new chat in the Main chat. It told me the same thing, that it was 4 Turbo rather than 4o. I can’t tell where the hallucinations start and end. Blimey. This doesn’t need to be so difficult.

I used the @OpenAI helpdesk chatbot. It gave me two entirely different answers (yes, there’s a limit for Plus users on 4o, + no, it’s unlimited). Aargh. It said I would be notified if I hit any limits. I’m none the wiser. Trying to finish a project & I need the model continuity.

I need clarity. ChatGPT is becoming a frustrating experience. I’ve been using 4o, o3 + 5 Thinking. I picked 4o in an old chat in Projects but the tone was off. I asked it which model it was. It said 4 Turbo. Why aren’t we told if we’re rerouted? @OpenAI @sama #ChatGPT #keep4o

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