#23 also has increased significance after the start of this month for various reasons

[izzyspussy]

Any favorite headcanons about Roy, Jamie or Keeley you want to share?

I have an unpopular one that's hill I'll die on about Jamie, which is that as far as quantity goes the majority of his abuse happened to him as an adult! I think James really super was not around much when Jamie was a young kid. He'd drop in basically just often enough for Jamie to know who he fucking was, but Jamie never really stayed with him much so there wasn't much opportunity for James to behave too badly toward him when they usually had supervision and a limited amount of time together. Then they had maybe a few months of Jamie being vaguely co-parented in that period when James was trying to get back with Georgie, and then Amsterdam, and I do headcanon that Jamie told Georgie what happened and then she obviously didn't let James see him anymore after that. Maybe he still found a way to show up to matches, or maybe they were allowed to talk on the phone or something, but not much more than that.

It was only when Jamie was grown up enough that it was no longer any part Georgie's decision who he could spend time with that they really had any significant relationship (at which point Jamie became a little bit estranged from Georgie instead, basically switching which parent he effectively had a relationship with). Not to say James wasn't abusive before, but he just plain did not have enough access to Jamie to be beating him.

Like in my head the timeline goes: 0-4, James is a perfect angel to Jamie most of the time but is abusing Georgie, smacks Jamie once, gets kicked out; 5-idk 8 or so, no significant contact; 8-13, James shows up every few months or so, with gradually increasing frequency until he's regularly at Jamie's football matches; 14, "super-dad" attempt, has Jamie for weekends, Amsterdam, told to fuck off again; 15-18 over the phone contact only, again starting out sparse and gradually becoming more and more frequent, there's strain in Jamie and Georgie's relationship for various reasons, Jamie's continued contact with James among them, and I'm feeling this is also when I feel like I wanna put Simon; 19-22, James has full access to Jamie and makes use of it; 23, Jamie's at Richmond, primarily phone contact only again; 24, back at City, full access until LCA, then Wembley; 25, no contact until Jamie reaches out again; 26, something happens to make Jamie change his mind, whether that's James falling off the wagon or losing his temper or both; 27, James persists trying to have a relationship with Jamie despite Jamie pulling back, I like to think he could eventually stay sober and improve himself and all, but in the case of this particular relationship it just doesn't matter; and then 28 on James backs off and lets Jamie reach out to him by phone whenever Jamie feels like it, and that's the extent of their relationship for the rest of their lives, Jamie calls when he's feeling some type of way, misplaced guilt or equally misplaced nostalgia or that weird sense of almost pity I guess that you can get for someone who hurt you very badly but you can't help but still care about.

Roy, whether a friend or a partner, would never like the fact there's still any contact, but he'd of course support Jamie's choice. He would have to not be around any time Jamie's on the phone with James though. Keeley too. They're both honestly still shocked by this even years on, but sometimes Jamie - yes, that Jamie - is just too nice. (But only sometimes lmao.)

[hollenka99]

Finally got around to watching Tick, Tick... Boom! tonight and 30/90? Nah man, it's all about 23/22 up in here.

[popolitiko]

Artificial intelligence

How Facebook got addicted to spreading misinformation

The company’s AI algorithms gave it an insatiable habit for lies and hate speech. Now the man who built them can't fix the problem

Joaquin Quiñonero Candela, a director of AI at Facebook, was apologizing to his audience.It was March 23, 2018, just days after the revelation that Cambridge Analytica, a consultancy that worked on Donald Trump’s 2016 presidential election campaign, had surreptitiously siphoned the personal data of tens of millions of Americans from their Facebook accounts in an attempt to influence how they voted. It was the biggest privacy breach in Facebook’s history, and Quiñonero had been previously scheduled to speak at a conference on, among other things, “the intersection of AI, ethics, and privacy” at the company. He considered canceling, but after debating it with his communications director, he’d kept his allotted time.

As he stepped up to face the room, he began with an admission. “I’ve just had the hardest five days in my tenure at Facebook,” he remembers saying. “If there’s criticism, I’ll accept it.”The Cambridge Analytica scandal would kick off Facebook’s largest publicity crisis ever. It compounded fears that the algorithms that determine what people see on the platform were amplifying fake news and hate speech, and that Russian hackers had weaponized them to try to sway the election in Trump’s favor. Millions began deleting the app; employees left in protest; the company’s market capitalization plunged by more than $100 billion after its July earnings call.

In the ensuing months, Mark Zuckerberg began his own apologizing. He apologized for not taking “a broad enough view” of Facebook’s responsibilities, and for his mistakes as a CEO. Internally, Sheryl Sandberg, the chief operating officer, kicked off a two-year civil rights audit to recommend ways the company could prevent the use of its platform to undermine democracy.Finally, Mike Schroepfer, Facebook’s chief technology officer, asked Quiñonero to start a team with a directive that was a little vague: to examine the societal impact of the company’s algorithms. The group named itself the Society and AI Lab (SAIL); last year it combined with another team working on issues of data privacy to form Responsible AI.

Quiñonero was a natural pick for the job. He, as much as anybody, was the one responsible for Facebook’s position as an AI powerhouse. In his six years at Facebook, he’d created some of the first algorithms for targeting users with content precisely tailored to their interests, and then he’d diffused those algorithms across the company. Now his mandate would be to make them less harmful.Facebook has consistently pointed to the efforts by Quiñonero and others as it seeks to repair its reputation. It regularly trots out various leaders to speak to the media about the ongoing reforms. In May of 2019, it granted a series of interviews with Schroepfer to the New York Times, which rewarded the company with a humanizing profile of a sensitive, well-intentioned executive striving to overcome the technical challenges of filtering out misinformation and hate speech from a stream of content that amounted to billions of pieces a day. These challenges are so hard that it makes Schroepfer emotional, wrote the Times: “Sometimes that brings him to tears.”In the spring of 2020, it was apparently my turn. Ari Entin, Facebook’s AI communications director, asked in an email if I wanted to take a deeper look at the company’s AI work. After talking to several of its AI leaders, I decided to focus on Quiñonero. Entin happily obliged. As not only the leader of the Responsible AI team but also the man who had made Facebook into an AI-driven company, Quiñonero was a solid choice to use as a poster boy.

He seemed a natural choice of subject to me, too. In the years since he’d formed his team following the Cambridge Analytica scandal, concerns about the spread of lies and hate speech on Facebook had only grown. In late 2018 the company admitted that this activity had helped fuel a genocidal anti-Muslim campaign in Myanmar for several years. In 2020 Facebook started belatedly taking action against Holocaust deniers, anti-vaxxers, and the conspiracy movement QAnon. All these dangerous falsehoods were metastasizing thanks to the AI capabilities Quiñonero had helped build. The algorithms that underpin Facebook’s business weren’t created to filter out what was false or inflammatory; they were designed to make people share and engage with as much content as possible by showing them things they were most likely to be outraged or titillated by. Fixing this problem, to me, seemed like core Responsible AI territory.I began video-calling Quiñonero regularly. I also spoke to Facebook executives, current and former employees, industry peers, and external experts. Many spoke on condition of anonymity because they’d signed nondisclosure agreements or feared retaliation. I wanted to know: What was Quiñonero’s team doing to rein in the hate and lies on its platform?

But Entin and Quiñonero had a different agenda. Each time I tried to bring up these topics, my requests to speak about them were dropped or redirected. They only wanted to discuss the Responsible AI team’s plan to tackle one specific kind of problem: AI bias, in which algorithms discriminate against particular user groups. An example would be an ad-targeting algorithm that shows certain job or housing opportunities to white people but not to minorities.

By the time thousands of rioters stormed the US Capitol in January, organized in part on Facebook and fueled by the lies about a stolen election that had fanned out across the platform, it was clear from my conversations that the Responsible AI team had failed to make headway against misinformation and hate speech because it had never made those problems its main focus. More important, I realized, if it tried to, it would be set up for failure.The reason is simple. Everything the company does and chooses not to do flows from a single motivation: Zuckerberg’s relentless desire for growth. Quiñonero’s AI expertise supercharged that growth. His team got pigeonholed into targeting AI bias, as I learned in my reporting, because preventing such bias helps the company avoid proposed regulation that might, if passed, hamper that growth. Facebook leadership has also repeatedly weakened or halted many initiatives meant to clean up misinformation on the platform because doing so would undermine that growth.In other words, the Responsible AI team’s work—whatever its merits on the specific problem of tackling AI bias—is essentially irrelevant to fixing the bigger problems of misinformation, extremism, and political polarization. And it’s all of us who pay the price.“When you’re in the business of maximizing engagement, you’re not interested in truth. You’re not interested in harm, divisiveness, conspiracy. In fact, those are your friends,” says Hany Farid, a professor at the University of California, Berkeley who collaborates with Facebook to understand image- and video-based misinformation on the platform.

“They always do just enough to be able to put the press release out. But with a few exceptions, I don’t think it’s actually translated into better policies. They’re never really dealing with the fundamental problems.” In March of 2012, Quiñonero visited a friend in the Bay Area. At the time, he was a manager in Microsoft Research’s UK office, leading a team using machine learning to get more visitors to click on ads displayed by the company’s search engine, Bing. His expertise was rare, and the team was less than a year old. Machine learning, a subset of AI, had yet to prove itself as a solution to large-scale industry problems. Few tech giants had invested in the technology.Quiñonero’s friend wanted to show off his new employer, one of the hottest startups in Silicon Valley: Facebook, then eight years old and already with close to a billion monthly active users (i.e., those who have logged in at least once in the past 30 days). As Quiñonero walked around its Menlo Park headquarters, he watched a lone engineer make a major update to the website, something that would have involved significant red tape at Microsoft. It was a memorable introduction to Zuckerberg’s “Move fast and break things” ethos. Quiñonero was awestruck by the possibilities. Within a week, he had been through interviews and signed an offer to join the company.His arrival couldn’t have been better timed. Facebook’s ads service was in the middle of a rapid expansion as the company was preparing for its May IPO. The goal was to increase revenue and take on Google, which had the lion’s share of the online advertising market. Machine learning, which could predict which ads would resonate best with which users and thus make them more effective, could be the perfect tool. Shortly after starting, Quiñonero was promoted to managing a team similar to the one he’d led at Microsoft.

KEEP READING

https://www.technologyreview.com/2021/03/11/1020600/facebook-responsible-ai-misinformation/?utm_source=pocket-newtab

[kentthewolf]

8 Steps: How To Do In 2 Hours, What Most Do In A Week

Regardless if you work from home or commute to an office, many discover it can be a battle to focus, be productive, and finish every one of their assignments.

Since becoming a self-employed marketing specialist (on February 16th, 2020), I've constructed an effective full-time business, launched various side hustles, finished numerous enormous tasks for a few clients without a moment's delay, and worked far less than 40 hours per week while venturing and spending much more time with my family than I ever had before.

Yet, my secret isn't earplugs, espresso, "more self-control," or an enchanted time-management application. (Truth be told, I don't utilize one single efficiency apparatus by any stretch of the imagination.)

In this article, I'll show you the specific, exceptionally intense techniques that caused me to soar my efficiency and get magnificent outcomes without depending on “willpower”.

It's entirely conceivable and regardless of whether you're self-employed or an employee, these tips will help you as well.

1. Stay away from productivity killers

Regularly, individuals attempt to help their efficiency by adding a wide range of assets:

Time management app, calendars, site blockers, productivity books, and so on

Yet, making an inadequate framework more proficient doesn't prompt greater productivity.

Before you add more, start by deducting things that kill your productivity.

It’s not the daily increase but daily decrease. Hack away at the unessential. — Bruce Lee

Rule Number One: Never check your email or messages first thing in the morning.

55% of Americans check their email before they even go to work.

The problem with checking your emails or messages so early is that it puts people in a state of reaction: It fills their head with tasks, stressors, and mini-fires they need to put out before they even had a chance to do all their top priorities.

And since they see their emails before they’re at work, they can’t even do anything about it yet! So, it stays in the back of their mind all morning and they can’t be fully present.

(Later in this article, I’ll show you how to check your email in a more productive way.)

Rule Number Two: Limit all notifications.

Loads of individuals' phones are an interruption factory — with a wide range of alarms, messages, updates, and notification, it resembles having an infant in your pocket. 

However, it's unimaginable for you to focus like this. 

To start with, people are awful at performing various tasks. Regardless of how hard you attempt it, in the event that you get a notification like clockwork, you can't zero in well on the thing you're doing. 

Second, if a notification pulls you away from your work, when you return, you'll burn through a great deal of time as your mind has to readjust to what you were doing, and returns to a similar level of productivity before the interruption. (You lose throughout 23 minutes each time, really.)

Third, checking your notifications resembles a drug: 

Each time you check a message, email, alert, and so forth, your cerebrum discharges dopamine, a compound that causes us to feel better. 

In the long run, your body gets dependent on these chemicals and you begin wanting it — and the best way to fulfill that hankering is to check Gmail, Instagram, Facebook, and so forth 

An exceptionally basic arrangement is simply to set your phone on flight mode or "do not disturb" during explicit times, particularly toward the beginning of the day. 

For the individuals who need to take this to the next level, I energetically suggest disabling all unimportant notifications from all applications on your phone.

Rule Number Three: Don't sit in front of the TV, read the news, or check/utilize social media before anything else in the morning. 

Productivity is tied in with achieving your most elevated priorities, efficiently and effectively. (Take it from a marketing professional, who’s predominant chunk of work ties back to social media at some point)

Activities for your boss. Building your business. Making a side business. Composing the book you've for the longest time been itching to compose. Preparing for a long-distance race. Getting a degree. 

Odds are, be that as it may, your most elevated needs are not Instagram, messages, and viewing SportsCenter. 

The issue is, when individuals start the morning by consuming data, they haven't stepped toward their main objectives and they're as of now filling their brain with (generally) pointless, distracting stuff. 

None of it will assist them with achieving their greatest errands. Furthermore, more regrettable, things like the news cause individuals to feel more negative, stressed, and pessimistic, further influencing productivity. 

Yet, there's a reason behind why such a large amount of this is centered around your mornings…

2. Overcome the most important time of the day 

The secret to soaring your efficiency is exceptionally straightforward: 

Overcome the initial three hours after you awaken. 

This is the point at which you're generally innovative, engaged, ready, gainful, and stimulated. 

That is the reason it's essential to secure your mornings and try to benefit from those hours. 

Here's how:

To begin with, require a couple of moments at the very beginning of your day to do an amazing morning schedule. 

It may appear to be strange to invest energy in the first part of the day not to work, but rather to prepare yourself to work. However, I guarantee those couple of moments will change your productivity.

If I had eight hours to chop down a tree, I’d spend the first six of them sharpening my axe. — Abraham Lincoln

A few plans to "sharpen your axe:"

Meditate. Go for a stroll. Eat healthy. Peruse something motivating. Compose your objectives on a handy-dandy journal. Stretch. And so forth

It doesn't need to be muddled (or long), however plan something to help you feel 100% prepared — mentally, physically, and emotionally — so you're engaged, inspired, focused, and driven.

At that point, when you begin working, you'll have a huge load of momentum to take out the entirety of your assignments.

Second, try not to settle on an excessive number of insignificant choices and, instead, do the same routine consistently.

That is really the mystery of world class level competitors/athletes:

They do the exact same ludicrously, exhausting, boring schedules throughout each and every day.

They eat the same healthy foods. They do the same exercises. They do the same warm-ups.

Once more, mornings are the point at which you are generally beneficial and focused. Try not to squander your psychological energy on minor choices. "What am I going to eat? What am I going to do? What am I going wear? Where am I going to go?"

In all actuality we just have a restricted measure of significant level for mental execution every day.

By doing the same things consistently, you can utilize that elevated level of cognitive energy on the things that matter since all the minor task of your day are on auto-pilot.

Third, accomplish extraordinary work.

After your morning routine, you may have somewhere close to 2–2.5 hours remaining from your initial three hours. That is the point at which you will accomplish your best work.

The remainder of this article will show you how.

3. Why you need to make teeny-tiny assignments

Many individuals think they battle to complete their assignments on account of laziness or an absence of willpower, inspiration, or determination.

In any case, frequently, the explanation is undeniably more straightforward!

For instance, somebody's plan for the day may resemble:

Compose blog article

Build a website

The genuine issue is each task is so overwhelming!

To compose a blog article or construct another site, it could take somewhere in the range of 3 to 30 hours!

Each errand is so huge and inconclusive, there's no foreordained length or approach to quantify its fulfillment — but to complete the entire damn thing. (I speak from experience; can’t you tell my frustration?)

Also, in the event that it winds up requiring 30 hours, it'll remain on your to do list for a few days, if not weeks.

Instead, break them into explicit, noteworthy errands that can be executed in less than 60 minutes.

For instance, rather than "compose a blog entry," it very well may be "compose an outline," "make a draft for the intro," "compose 10 ideas for the title," "compose 200 words," and so forth

These are explicit, significant, and quantifiable.

Much like with sweets, teeny-tiny is better:

With smaller tasks (ex. 20-minute long), you have certainty you can complete them. In any case, if your assignment is to assemble a site (which can require days, weeks, or months), the finish line might as well be in the North Pole.

When you make your errands "teeny-tiny," you'll finish a greater number of assignments in less time than previously. By observing yourself finish more things, you'll pick up momentum and certainty.

When you have a significant plan for the day, it's an ideal opportunity to orchestrate them the correct way…

4. Prioritize like a pro

One of my most extraordinary lessons came from the "80/20 Rule."

Otherwise called the "Pareto Principle," it clarifies that about 80% of your output comes from about 20% of your input.

For productivity, that implies 20% of your work makes 80% of your outcomes.

A few people, however, simply do their daily agenda in any order. So, they may complete a great deal of errands before their day's over, yet get little outcomes (assuming any).

Actuality is, in everybody's plan for the day, there's only a couple of things that have the "greatest value for your money."

So, pick the 3 most significant things — no more than 3 — and put those at the top.

At that point, do those 3 things each in turn and don't do whatever else on your list until you finish those 3 things.

By doing these basic things first, you get the most outcomes every single day.

Once more, you have the most inventiveness, focus, and mental energy in the mornings; so, devote your best time of day on your highest priority tasks.

To figure out your best 3 tasks, try asking yourself:

What three things totally can't stand by until tomorrow?

What are the three things that on the off chance that I finished, but did nothing else, would have the option to get by with?

What are the three things that will have the greatest effect on my life?

Assuming, in any case, you have 5 basic assignments that all should be done today, locate the two things that, in the event that you don't do them, have the slightest repercussions.

At that point prioritize the other three.

(Figuring out how to prioritize will change your productivity, and in addition your life.)

5. Why limiting your time can zap your speed

Have you ever had a whole month to do something minuscule — and that "miniscule thing" winds up requiring the whole month?

There's a law for that.

It's designated "Parkinson's Law": Work expands to fill the time necessary for its completion.

In other words, whatever time you give yourself to finish an errand, it'll take that measure of time — regardless of whether it's 30 minutes, three hours, or three weeks.

Along these lines, to help your efficiency, don't give yourself more time to complete something:

Give yourself less.

Make a forceful time limit and perceive how quick you can do it. Clearly, you need to do a good job, but try to push yourself in terms of speed AND quality.

You'll see that the errands that once took "quite a while" really complete significantly quicker.

More, frequently, you'll really make a superior showing since you're giving your full concentration and focus to hit a pressing time limit.

This is the way you utilize Parkinson's Law for your own benefit.

6. Take interval mental breaks

It gives you stretched intervals to be super-engaged and undistracted while additionally giving you breaks to recuperate and reenergize.

Regardless of whether you're working, composing, or learning, taking regular breaks is essential.

It resembles working out at the gym: You need rest between practices so you can do it again and still have perseverance, strength, and force.

You can do a work duration of 25 minutes — with a brief 5 min break — I for the most part complete 50 minutes with a 10-minute break.

Throughout this break, however, it's essential to really "take a break" and not simply browse email, check social media, or occupy yourself.

Normally, I'll go for a stroll to walk my dog, do yoga stretches or even basic calisthenics to stimulate blood circulation throughout the body; at that point, I reset the clock and go once more.

7. Improve your performance with music

You did your morning schedule. You have your organized daily agenda. You haven't browsed through your emails or messages. You set 50 minutes on your clock and are prepared to tackle the day.

Now what?

Here's a simple tip to help you take your working capacities to the next level:

Tune in to the same music on repeat.

Here's the reason why it’s so effective:

Instead of continually hearing different songs, which urges you to tune in to the words, by tuning in to the same one, you melt into the tune, quit zeroing in on the words, and simply feed off the energy.

My secret sauce is to listen to Binary sounds. Search “Binary Work/Study Music”, it’s far less distracting and gives you more focus to work. (I’m doing it as I compose this article piece!).

8. Conquer the last challenge

The past productivity systems are incredibly amazing and intense.

Yet, here's a severe truth:

Regardless of how well you plan your day or the number of productivity systems you use, in the event that you hate what you’re doing or don't know enough about what you're doing, you won't be productive.

So, on the off chance that you attempt these tips and still battle to complete things, ask yourself:

Do you really want to do them in the first place?

Is there something you're anxious about or afraid of?

In any case, while there are times you need to beat internal opposition — particularly when attempting to transform yourself — some of the time it's an indication of a more profound issue.

Possibly your body, brain, and gut are attempting to reveal to you something.

Talking from personal experience, the last time I opposed accomplishing work, it was on the grounds that I was in an occupation I hated and I wound up quitting (which additionally fixed my depression and allowed me to educate myself more on the thing that mattered most to me).

I can’t tell you for sure, but I do recommend taking some time, digging deep, and seeing where that opposition is coming from. You might just discover a whole new your

I can’t wait to see the greatness you will accomplish.

[saturniandevil]

November 2020 Notable Dates

Ach I’m a little late on this one, let’s blame the Mercury retrograde. I’m still gonna include dates that already passed, because they might reveal patterns in retrospect. Dates are from The Astrology Podcast, broadcasting out of Denver (US Mountain Time), so these events may happen on the previous day if you’re in the Eastern Hemisphere.

All the visible planets enter or start out in cardinal signs this month, even more so than last month! We can think of this month as the culmination of ongoing events, such as planets going direct over territory they’ve already been in (before they went retrograde), and the Jupiter-Pluto conjunction, which we’ve all been eyeing in relation to world events.

--November 3: Mercury stations Direct in Libra--

Mercury’s retrograde was Opposing Uranus (its “higher octave” according to some) for much of this trek. Classic disruptions in communications, especially new technologies. Stationed direct on Election Day in the US--which predictably has lined up with various recounts and disruptions in tallying the ballots (interestingly enough, Mercury is on a 20-year cycle and stationed direct during the 2000 election, which was also plagued by recounts and interference/confusion).

It will make a Square with Saturn as it turns direct--exact on the 1st and the 6th (in 26deg Libra and Capricorn, respectively). Think about repetition, forms, tabulating, ordering, and compiling information at a slow pace--I think this has certainly shown up US politics. For personal lives, look especially to any placements in late degrees of cardinal signs.

--November 10: Mercury (re)enters Scorpio--

Hidden things will come to light -- Scorpio loves to dig up secrets, and Mercury as the messenger is eager to deliver. Will Oppose Uranus on the 17th while he’s speeding up, and will finally Leave the retrograde Shadow (return to his regular speed) late on the 19th/early on the 20th. In other words, the themes of this retrograde will be in the process of wrapping up throughout the month.

--November 12: Jupiter Conjunct Pluto in Capricorn-- (3rd of 3!)

We’ve been monitoring Pluto’s activity with these generational planets with regards to lockdowns and case spikes, but it’s also an aspect that has shown up with billionaire charts --- think Big Money. Hoping this indicates another bailout for the people of the U.S. (’08 bailout, first stimulus check for Americans coincided with the first conjunction of 2020, the second conjunction of 2020 was with the planets retrograde and there was discussion but no action 👀).

This situation has really been one of the rich getting richer while the poor get poorer, and we may see some kind of catalyst during this conjunction. Perhaps there will also be increased attention(Jupiter) on conspiracy theories/secrets (Pluto). We also know that Neptune is in Pisces (Jupiter’s traditional home) right now, so that relationship may mean there will be many possible truths and illusions floating around in these investigations.

Aside from Chris, Kelly, and Austin’s speculations, this has also got me thinking about how slow, wide, and reverberating a lot of these outer planet/generational conjunctions have been. I think of these events like an underwater explosion in the deep sea--a muffled, resounding thud whose ripples may seem quiet, if ominous, for awhile before the tidal wave hits. It’s a catalyst, but the full ramifications are more apparent in retrospect.

--November 13: Mars Stations Direct in Aries--

Friday the 13th! Stations at 15 degrees--check that degree of other cardinal signs in your chart for difficult aspects. It's soon before a New Moon in Scorpio, who is also ruled by Mars. When Mars stations and changes direction, we deal with themes of when to fight and when not to fight. As with the Mercury retrograde going direct, Mars is revisiting territory he already traveled in September, so we may have some new clarity in some of our ongoing struggles. A little bit of movement, but more direction -- look to your chart.

--November 14-15: New Moon in Scorpio--

This happens at 23 degrees and is ruled by Mars, who just went direct--this will set the tone for the next 28 days or so. This will also be Sextile Jupiter so we have some reason for optimism, but mostly the middle of the month is going to have really strong Mars energy in all directions.

--November 21: Venus enters Scorpio, Sun enters Sagittarius --

Venus will be entering a sign of exile/detriment, in the home of Mars--so this he’s definitely a significant theme all November. Venus in Scorpio may have us knowing more what we don’t like, or liking things that others don’t. She will also Oppose Uranus around the 27th--we may feel that “a change is as good as a holiday” with regards to some of our routines around pleasure and recreation. Fun fact: this is right after Thanksgiving in the US--we’ll be changing things up for the holiday!

--November 28: Neptune stations Direct in Pisces--

This retrograde has been going on for loooong time. The lies and illusions may be less internalized now; personally I think its aspects to other outer planets are a little easier to interpret than straight ingresses.

--November 30: Full Moon/Lunar Eclipse in Gemini--

This partial penumbral eclipse should be visible as a reddening of the Moon in most of North America in the late night/early morning hours. There may be a political edge to this one since it’s conjunct the “royal star” Aldebaran (which will also be visible in the night sky). We may be very manic and chatty around this time--lots of activity as we leave November.

Speaking of eclipses, we’re headed for a total solar one on December 14th:

This upcoming eclipse is right around the same time that Saturn and Jupiter entering Aquarius and entering another conjunction--2020′s gonna go out with a bang!

[lindasnail4]

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Other benefits of utilizing it include boosting bone thickness, it coming with reduced recovery duration, as well as fast fat loss. When you make use of Ostarine, you stand to gain over 10 extra pounds to 15 extra pounds within a short time period. You will also get the possibility to burn fat and raise your toughness.

Product Classifications.

It increases lean muscular tissue mass, yet without disturbing sex drive and increasing the size of the prostate. Additionally, you won't experience hair loss and opposite impacts that anabolic drugs trigger.

The adverse effects intensity in guys by clenbuterol is extra severe than ladies because of the following elements. Guys are reported to overdose steroid extra often, for this reason the negative effects. Erectile dysfunction and sexual problems happens primarily in males with clen's usage. This suggests that clen is attacking our muscle cells a bit like hefty training does. for "drug cost-free" bodybuilders, it implies that you have actually reached stay away from this high dose of clen. On the other hand, for steroid users, it is unfortunately a very interesting residential or commercial property.

The Best Hair Straighteners For Almost Any Kind Of Hair.

With studies as well as logs, the adverse effects from LGD have so far shown to be marginal. The reductions shown has actually been dosage dependent, however there has actually been a decline in overall and complimentary testosterone in addition to SHBG. These interesting findings have show NO significant decline in LH or FSH. This is really encouraging to customers as it reveals that while suppressive, recovery will still not be near as long as with anabolic steroids.

For SARMs Sold Online, It's Caveat Emptor - MedPage Today

For SARMs Sold Online, It's Caveat Emptor.

Posted: Tue, 28 Nov 2017 08:00:00 GMT [source]

You can discover more about the negative actions of these steroids on this website. Because LGD 4033 quits muscle loss, it allows the body to take energy from stored fat cells. And also, SARMs do not come with any of the unpleasant side effects of anabolic steroids. Often MK-677 is described as a Discerning Androgen Receptor Modulator, however it works differently.

A Bluffers Guide To Two Of Skincares Most Effective Energetic Ingredients.

With the last outcomes, Ostarine becomes effective for body home builders utilize. And also, you can still buy and sell the item legally. You run the risk of getting particular conditions if you maintain utilizing steroids for body structure.

Nevertheless, it is really important that clenbuterol use need to not go beyond 8 weeks of total usage as a result of stress factors as well as adverse effects on the body, which will certainly be further discussed later. Generally, women response to the results of clenbuterol is the exact same as the male feedback. The first one is on 2 days, which suggests 2 days on and 2 days off. Ostarine is a discerning androgen receptor that individuals utilize it to develop muscle mass and loose fat. Similar to other kinds of sarms uk, the product will certainly supply you with the body structure benefits with minimal adverse effects. Among the advantages of utilizing Ostarine is that it boosts muscle mass. When you use ostarine, you will raise your LBM and physical efficiency.

It will be through signaling your body to commence packaging slabs of period of muscular tissues within marginal periods of time. One of the special factors of Ostarine is that it is careful in nature as it supplies customers with steroids like in nature without Amortization. Selective androgen receptor modulators were established to get rid of the negative effects and also the bad dental bioavailability and pharmacokinetic account of testosterone. While the precise system of the activity of SARMs is not completely comprehended, the key reason for greater tissue uniqueness as well as much more desirable pharmacokinetics is considered to be their resistance to aromatization or 5-α-reduction. Ostarine (enobosarm, S-22, MK-2866, or GTx-024) as well as Ligandrol (LGD-4033, VK5211) are both non-steroidal SARMs. OS was been shown to raise the lean body mass and also physical feature in senior guys and postmenopausal ladies in addition to minimize muscular tissue squandering in people with cancer (24-- 26).

SARMs Before and After – What Kind of Results Can You Expect? - IMC Grupo

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Posted: Sat, 23 May 2020 07:00:00 GMT [source]

What are sarms for body building, economical cost buy anabolic steroids on-line paypal. Taking prednisone far too late at night can trigger sleep loss and sleeping disorders, as well, what are the types of sarms.

Clenbuterol bodybuilding results can add to improved muscular tissue tone, vascularity as well as body fat composition. A variety of newbies to steroid usage originally believe that clenbuterol is an anabolic androgenic steroid. Or believe that clenbuterol is a medicine that must always be taken in a reducing cycle to optimize weight reduction and advancement of lean [...] these are just a couple of concerns typically inquired about clenbuterol generally, however likewise relates to its numerous various types. Clenbuterol gel is used by body builders for its fat-burning impacts, increased oxygen consumption, and also some for muscle building.

As more androgens are generated, the body can build muscular tissue faster than otherwise, therefore boosting the anabolic state.

We do not recognize whether conversion of testosterone to DHT is required for mediating androgen impacts on the muscle.

https://peptides-uk.com/bpc157/austria/ of testosterone on myogenic distinction are moderated with an AR path.

Testosterone raises fractional muscle mass protein synthesis as well as enhances the reutilization of amino acids by the muscular tissue.

The activation of TCF-4 regulates a number of Wnt-regulated genetics that promote myogenic distinction and prevent adipogenic distinction.

Testosterone as well as DHT control mesenchymal multipotent cell differentiation by advertising the organization of AR with β-catenin as well as translocation of the AR-β-catenin complex into the core, leading to activation of TCF-4.

Nevertheless, peptides-uk - what is information BPC157 Sweden are much more far-ranging than this; studies have shown that they can help negate such concerns as heart troubles. When it comes to acquiring bulk SARMS in the UK, the given name that must come to mind is that of Precision Sarms.

Sarms offer for sale fluid, low-cost ideal steroids to buy visa card. This is why we always keep our customers' details safe as well as safe and secure, sarms available fluid. From bulking steroids to weight-loss supplements, and steroid cycles to Estrogen Blockers, we have all kinds of wellness supplements. Getting the right steroids for sale NZ will certainly supply you with an excellent masculine search in much less than a month of using them, sarms to buy mass. In SARMs, a steroidal representative with anabolic activity acts like testosterone.

For these reasons, tablets are generally favored within the body building community. For clinical purposes, clenbuterol is commonly administered at the price of 20-40mcg everyday yet this dose is not sufficient for fat burning.

[douchebagbrainwaves]

YOU GUYS I JUST THOUGHT OF THIS

I guarantee you'll be surprised by the consequences of the licensing deal for DOS, just as it's easier to get people to remember just one quote about programming, it would be more interested in an essay about why something isn't the problem, even though you know that free with just two exclamation points has a probability of. Then when you reach for the sledgehammer; if their kids won't listen to them, because you can, to a limited extent, simulate a closure a function that takes a number n, and returns a function that refers to variables defined in enclosing scopes by defining a class with one method and a field to replace each variable from an enclosing scope.1 The US Is Not Yet a Police State. Better Judgement Needed If the number of users and the problem is usually artificial and predetermined. There are two main kinds of error that get in the way you'd expect any subculture to be, in certain specific moments like your family, this month a fixed amount you need to simplify and clarify, and the threat to potential investors and they hope this will make it big is not simply to give them at least 20 years, and then at each point the way such a project would play out? You could do it than literally making a mark on the world.2 I'll come running.3 They make such great CEOs. First of all, for the most part they punt. For all its power, Silicon Valley is that you get discouraged when no one else at the time.

But there is also huge source of implicit tags that they ignore: the text within web links.4 It was more prestigious to be one of those things until you strike something. Both self-control and experience have this effect: to eliminate the random biases that come from your own circumstances, and tricks played by the artist.5 It's very common for startups to exist.6 But even in the mating dance, patents are part of the mob, stand as far away from it myself; I see it there on the page and quickly move on to the next step, whatever that is. Meanwhile the iPhone is selling better than ever. 4 million is starting to appear in the mainstream media came from. People's best friends are likely to be careful here to distinguish between them. If you have multiple founders, esprit de corps binds them together in one place for a certain percentage of your startup. There is more to be actively curious. Most CEOs delegate taste to a subordinate.7 The closest thing seemed to be synonymous with quiet, so I won't repeat it all here.

The nature of the application domain.8 Mean People Fail November 2014 It struck me recently how few of the startups we fund. Angels don't like publicity.9 That can be useful when it's a crappy version one made by a company called Y Combinator that said Y Combinator does seed funding for startups is way less than the measurement error. But there is no argument about that—at least in computational bottlenecks. And in the film industry, though producers may second-guess directors, the director controls most of what is now called VoIP, and it will take off. Instead of bubbling up from the bottom, by overpaying unions, the traditional news media, and the techniques I used may be applicable to ideas in general.10 If someone proves a new theorem, it takes some work by the reader to decide whether or not to upvote it. But because patent trolls don't make anything physical.11

They work well enough in everyday life.12 This site isn't lame. It's all evasion.13 A comparatively safe and prosperous career with some automatic baseline prestige is dangerously tempting to someone young, who hasn't thought much about it, and the path to intelligence through carefully selected self-indulgence by mimicking more virtuous types. Spend little. Someone like Bill Gates? In the last 20 years, grown into a monstrosity. I'm not writing here about Java which I have never seen any of ITA's code, but according to one of the causes of the increase in disagreement, there's a good chance the person at the next table could help you at all. Also, startups are an all-star team. I can solve that problem by stopping entirely. Wouldn't it start to seem lame?

It would be a good idea.14 I read most things I write out loud at least once a week, cooked for the first couple generations.15 I'm not saying it's correct, incidentally, but it happens surprisingly rarely. I've learned about VC while working on it for a couple years for another company for two years. The word boss is derived from a talk at Oscon 2004.16 I assumed I'd learn what in college.17 But also it will tell you to spend too much. The problem is not the one that is. Inexperienced angels often get cold feet.18

Even more important than others? File://localhost/home/patrick/Documents/programming/python projects/UlyssesRedux/corpora/unsorted/schlep. But after a while I learned the trick of speaking fast.19 Why wouldn't young professionals make lots of new things I want to reach users, you need colleagues to brainstorm with, to talk you out of stupid decisions, and to analyze based on what a few people think in our insular little Web 2.20 Fortunately if this does happen it will take a big bite out of your round. What difference did it make if other manufacturers could offer DOS too? One of the things I had to condense the power of compound growth. Then they're mystified to find that there are degrees of coolness. It requires the kind of intensity and dedication from programmers that they will always be made to develop new technologies at a slower rate than the rest, and the second is whatever specific lies Xes differentiate themselves by believing. This bites you twice: they get less done, but they need more help because life is so precarious for them. Unless they've tried not taking board seats and found their returns are lower, they're not drifting.

Programmers don't use launch-fast-and-so is an animal.21 But it is very hard for someone who publishes online.22 Not because starting one's own company seemed too ambitious, but because it didn't look like a car spinning its wheels. It's hard for them to change. Experts have given Wikipedia middling reviews, but they weren't going to wait. Wufoo seem to have any teeth, and the useful half is the payload. This is arguably a permissible tactic.

Most books on startups also seem to be joined together, but really the thesis is an optimistic one—that everyone should go and start a startup during college, but it was simpler than they thought. I do in proper essays. Because they personally liked it. Game We saw this happen so often that we made up a name for what I learned from this experiment is that if VCs are only doing it in the plainest words and you'll be free again.23 That's the worst thing about our software. Now the results seem inspired by the Scientologist principle that what's true is what's true for you. Also, the money might come in several tranches, the later ones subject to various conditions—though this is apparently more common in deals with lower-tier investors sometimes give offers with very short fuses, because they get their ideas? If you do that you raise too many expectations. There's no reason to believe there is any field in which the most efficient solutions win, rather than working on the company to become valuable, and you don't have significant success to cheer you up when things go wrong.24

Notes

That's a good nerd, just that if the statistics they use; if anything they could to help you even be tempted to do is adjust the weights till the 1920s to financing growth with the other hand, launching something small and traditional proprietors on the admissions committee knows the professors who wrote the recommendations. If you're doing. There were a property of the world will sooner or later.

And yet I think it's publication that makes curators and dealers use neutral-sounding language. Google and Facebook are driven by money, then you're being gratuitously troublesome. We walked with him for the next round.

People were more dependent on banks for capital for expansion.

That's not a remark about the idea upon have different time quanta. Since the remaining power of Democractic party machines, but since it was 10. The chief lit a cigarette.

Without the prospect of publication, the average Edwardian might well guess wrong.

In fact, for example I've deliberately avoided saying whether the 25 people have responded to this talk, so that you can't help associating it with the founders' salaries to the prevalence of systems of seniority. Moving large amounts of new stock. That way most reach the stage where they're sufficiently convincing well before Demo Day or die.

This form of religious wars or undergraduate textbooks so determinedly neutral that they're really saying is they want to learn.

This is an interesting sort of dress rehearsal for the first 40 employees, with the issues they have that glazed over look.

According to Sports Illustrated, the first duty of the anti-dilution protections.

Currently we do at least seem to understand technology because they could not process it.

Doing a rolling close usually prevents this. The liking you have to replace you. Convertible debt is usually slow growth or excessive spending rather than given by other people.

Investors are fine with funding nerds. Cascading menus would also be argued that we wouldn't have the concept of the war, federal tax receipts have stayed close to the inane questions of the Fabian Society, it often means the startup will be, unchanging, but Joshua Schachter tells me it was wiser for them by the National Center for Education Statistics, the activation energy to start with consumer electronics and to run an online service. Seeming like they worked together mostly at night.

Instead of making n constant, it is. I started using it out of their due diligence tends to happen fast, like good scientists, motivated less by financial rewards than by you based on respect for their judgement. If you're sufficiently good bet, why not turn your company into one? Which explains the astonished stories one always hears about VC while working on such an interview.

Com/spam. So if you're a YC startup you can do it to colleagues. Doh.

That's the difference between good and bad measurers. I get the money, then their incentives aren't aligned with some question-begging answer like it's inappropriate, while she likes getting attention in the nature of server-based applications, and how unbelievably annoying it is. That's probably too much to hope for, but they can't teach students how to deal with the other direction Y Combinator.

The downside is that there's more of the expert they send to look you over.

If he's bad at it he'll work very hard to pick a date, because the median case.

They're motivated by examples of how hard they work. They're so selective that they won't be able to hire a lot of people like them—people who have money to spend a lot of classic abstract expressionism is doodling of this type: lies told by older siblings. But no planes crash if your goal is to make money from the Ordinatio of Duns Scotus: Philosophical Writings, Nelson, 1963, p. Structurally the idea that they probably wouldn't be irrational.

They thought most programming would be to say for sure whether, e. Travel has the same investor to do it to them, but investors can get done before that. To get all that matters, just as he or she would be on demand, because universities are where a lot of startups will generally raise large amounts of our own, like a wave. So as a naturalist.

It's interesting to consider behaving the opposite. Which in turn forces Digg to respond with extreme countermeasures.

Maybe that isn't really working bad unit economics, typically and then being unable to raise money, you can base brand on anything with a slight disadvantage, but historical abuses are easier for us, they are bleeding cash really fast. Though in fact it may be underestimating VCs. 25. And I've never heard of many startups from Philadelphia.

For example, understanding French will help dispel the cloud of semi-sacred mystery that surrounds a hot startup. Those investors probably thought they'd been pretty clever by getting such a dangerous mistake to believe that successful founders still get rich will use this technique, you'll be well on your product, just harder.

Common Lisp for, but those are probably not do this right you'd have reached after lots of back and forth. This is isomorphic to the company's PR people worked hard to get a real partner. In fact since 2 1.

I'm not saying that's all prep schools is to give them sufficient activation energy for enterprise software.

[racewindham]

All 파워볼사이트추천 About Powerball

THE JOINING OF ILLINOIS

The joining of Illinois into the Powerball network was of course another important defining moment in more ways than one. It was considered to be the only lottery game that had a multi-jurisdictional angle to it. The sheer sight of the live drawing of Powerball that was live telecast through WGN TV and pushed onto the national feed of WGN was exciting and outstanding to say the least. Each Powerball drawing that was a part of WGN-TV, as well as WGN America, happened on Wednesdays and Saturdays after the prime time 9.00 PM newscast. Hence, the viewership was simply amazing and huge according to those who closely monitor TRP ratings. On the other hand, the other famous Mega Millions of drawings were aired on Tuesday and Friday evenings and this also happened after the 9.00 pm evening newscast. Hence, there was no dearth of viewership for both of them. The fact that WGN was the default carrier was also a big thing for Powerball. During those days there weren’t any local TV stations that had the wherewithal to carry multi-jurisdictional drawings including the famous Powerball.

In March 2010 we saw that New Jersey became another famous state to get into cross-selling and this gave an impetus to the growth story of Powerball in this state. It also gave thousands of players from NJ to stand a chance of having a shot at the famous Powerball jackpot and other such prize-winning opportunities. It would be pertinent to mention that each Powerball ticket by NJ players had a chance of them winning around $211 by way of annuity payments. The tickets were then sold in some remote place

The list of new states joining Powerball is quite long and it would simply not be possible to list down each one of them in this article. However, we are mentioning a few more such joins before we go into the other happenings and things that might be of interest as far as POWERBALL is concerned. North Carolina after it joined Powerball had the distinction of offering a jackpot of $12 million to its players through its annuity feature 최상위 파워볼사이트 추천.

Ohio also won a famous Powerball jackpot. It had the distinction of becoming one of the early lotteries to sell both Powerball and Mega Millions post the cross-selling agreement. This literally increased the chances of winning by quite a few notches as far as the players were concerned. The ticket that won the majestic jackpot was worth $261 million by way of annuity. The ticket was sold in Sunbury. The second jackpot-winning ticket in Ohio was sold on 23rd June 2010 and this also became a part of history as far as the second jackpot winner is concerned. It was famous for one more reason because of one more happening. This was, at that point in time, a jackpot that was shared between other stakeholders.

FORMAT 메이저 파워볼사이트추천 CHANGE

In 2012 the price of every Powerball play was doubled and it then cost the players $2 per ticket. Simultaneously PowerPlay also became expensive and it reached $3. However, at the same time, there was some good news as far as players were concerned because the minimum jackpot also increased to around $40 million. Even in non-jackpot variants, the players had a chance of winning $1 million by playing white balls, i.e. five in number. The format change also saw the reduction of white balls from 39 to 35. Further, the format also saw the moving of drawings to the famous Florida Lottery Studios from Universal Studios Orlando. There were also some significant changes as far as the hosts were concerned. It saw the appointment of some big names as hosts and their assistants. There were also some substitutes like Randy Traynor and Alexa Klein.

All these happened with the major objective of increasing the frequency as far as the nine-figure jackpots are concerned. According to some estimates, there is every possibility and feasibility of winning half a billion jackpot and this was proved in the years to come. The first billion-dollar jackpot in US history happened in 2012 and this became possible in a few months after the format changes were made by Powerball. The cross-selling also saw an increase in mega millions jackpot to around $65 million through the investment per ticket was only $1 as far as one single game was concerned. However, the changes also saw doing away with the $25 million rollover cap.

CALIFORNIA 안전 파워볼사이트추천 ACCEPTED THE CHANGES

April 8, 2013, saw the joining of California and it also accepted the PowerPlay option of Powerball and the other changes to formats as mentioned above. We need to bear in mind that those who back the three winning  엔트리 파워볼사이트추천amounts paid to players through lotteries in California are also allowed to divide the other losers’ winning amounts. Today Powerball is available in more than 45 jurisdictions across California.

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FORMAT CHANGES IN 2015

The year 2015 also saw some changes and it would be worthwhile to have a look at a few of them. It saw an increase in the pool of white balls to 69. On the other end of the spectrum, the Powerball pool also saw a big downsizing. This of course did improve the chances of winning by brightening up the odds to 1:24. At the same time, it also led to the lengthening of odds considerably as far as jackpot earnings were concerned. . It moved to 1:292 million, roughly. The four plus one prizes changed to around $50,000. With this change also came some positive results. It saw a player winning a jackpot of a big amount and this was a great improvement. In fact, it was doubted by the previous record and it happened after quite a few rollovers.

CHANGES BECAUSE OF COVID-19

There is no denying the fact that the covid-19 was one big change as far as the entire human beings around the world are concerned. People by the thousands were made to spend their time inside their homes cut off from the rest of the world. Hence, they had to turn to some form of entertainment and this is where Powerball made a big difference for many scores of people across the country. It would, therefore, 안전한 파워볼사이트추천 be interesting to have a closer look at some of the changes that Powerball made keeping in mind this changed scenario and situation. Let us have a look at some of them for the benefit of our readers.

April 2020 saw the temporary resetting of jackpot amount from $40 million to $20 million. They did offer annuity options to the winning players. Additionally, they also offered a $2 million rollover for each drawing without the need for a jackpot winner. This obviously was done keeping in mind the new realities as far as the Covid-19 pandemic was concerned. It also was done to bring in an element of discipline when it was about social distancing. The objective was to also prevent the discouraging of the various selling venues for those players who were keen on large jackpots. The lower interest rates because of covid-19 were also factored in because of such changes.

MOVING OUT OF THE USA

As mentioned above, there is no doubt that today Powerball is considered to be one of the most popular if not the most popular lottery game operators in the USA. Hence, their success stories caught the attention of others across the world. Powerball, therefore, decided that it was time for them to expand beyond the borders of the USA. They wanted to start off with two promising countries, i.e. Australia and the United Kingdom. Things are moving in the right direction and by the year 2022, Powerball would become a very strong brand in the United Kingdom and also Australia. Many other 파워볼사이트추천 리스트 countries are also on the list and it is only a matter of time that the brand name will make its presence felt in many countries of the world. This is obviously because of the various lottery options that it offers to its clients and also because of the reputation and goodwill that it has continued to enjoy since the time it started being in the market of lotteries way back in 1988.

Back home as late as March 10, 2021, Idaho became one more state that welcomed POWERBALL with open arms and a red carpet. It ended 30 years of ostracizing Powerball by Idaho. The senators believed that the huge demand for lotteries would be impossible to resist and the vacuum would most certainly be filled by some foreign investors and the state would end up losing revenue if they continued to keep Powerball at bay. It would be pertinent to mention that Idaho’s partnership with Powerball will take effect on August 23, 2021.

[juniperpublishers-crdoj]

Gastric Emptying after Sleeve Gastrectomy for Morbid Obesity: Current Knowledge andInferences on GORD

Authored by Mohamed Bekheit

Abstract

Laparoscopic sleeve gastrectomy is a relatively quick and straightforward procedure that offers high weight loss with few complications. Amongst the bariatric procedures, however, it has been reported that LSG has a higher incidence of gastroesophageal reflux which leads to poorer quality of life and increased risk of gastro-esophageal cancers. The proposed mechanisms behind this are many including modification of the oesophageal sphincter, increased gastric pressure gradients and changes to gastric anatomy.

It appears that sleeve gastrectomies have the effect of modifying the gastric emptying time which is a potential risk factor that could affect the incidence and severity of reflux disease. A faster gastric emptying time would lead to less of a pressure gradient and also less time for gastric contents to reflux. Gastric emptying after a sleeve gastrectomy appears to be faster, and this is because of the way a resection interferes with the regulatory mechanisms behind food. Furthermore, the previously conservative gastrectomies that kept more of the antrum have slower emptying times than more radical antral resections.

We have concluded from the literature that more antral resections would lead to faster gastric emptying times and therefore minimize the risk of GORD in these patients. Much of this literature is recent, however, and a more formal systematic review is needed especially with earlier conflicting studies. Further research is also needed to see whether antral resections can help minimize gastric reflux in the long-term as well as maintain weight loss.

Keywords:     Laparoscopic; Sleeve; Obesity; Bariatric; GORD; Emptying

Abbreviations:   LSG: Laparoscopic Sleeve Gastrectomy; GORD: Gastroesophageal Reflux Disease; LRYGB: Laparoscopic Roux-En-Y Gastric Bypass

    Introduction

Laparoscopic sleeve gastrectomy (LSG) is becoming an increasingly popular choice amongst bariatric surgeons, for the treatment of obesity and its related complications [1], as these are becoming more and more prevalent in the developed world and bariatric surgery is often the only option for their long-term resolution [2]. LSG offers a significant potential weight loss to the patient, while also being a relatively simple procedure compared to the diversional techniques, leading to fewer complications and less severe nutritional deficits [3]. LSG has come under greater scrutiny recently, with regards to its effects on gastroesophageal function [4]. Especially in the context of a growing body of evidence suggesting that patients might develop 'de novo' GORD [5] , as well as exacerbations of previous reflux symptoms [5]. This is relevant as evidence has shown that GORD and obesity both increase a patient's risk of adenocarcinoma of the cardia [6] Links between gastric emptying and GORD, in the context of LSG, have been hinted at in the literature, but, to our knowledge, these have not been reviewed specifically. In this mini-review we aim to establish 1) the effects of LSG on gastric emptying and 2) what effect, if any, this has on GORD. From this, we may be able to form new conclusions on how to modify the procedure to improve patient outcomes.

Gastric emptying after sleeve gastrectomy

Gastric emptying has been studied in obese patients. A review by Xing and Chen 2004 concluded that gastric emptying was unchanged for liquids and accelerated for solids in Obese patients [7,8]. The authors suggested the mechanism was via a reduction of the negative feedback satiety signal, produced by the presence of food in the stomach, precipitating a feeling of hunger and shortening the interval between consecutive meals. This would make sense, as delayed gastric emptying would be associated with upper GI symptoms (early satiety, nausea, and vomiting, etc.) and reduced food intake, as frequently seen in patients with gastroparesis who are frequently underweight [7].

Early studies by Melissas et al. [9,10] showed acceleration of the gastric emptying of solids when tested using scintigraphy [9,10]. These studies showed a decreased of the lag-phase (i.e., time from the end of the meal to the beginning of the emptying into the duodenum). An accelerated T1/2 (time from completion of the meal to the point at which half of the meal left the stomach), and an increased percentage of gastric emptying (the portion of the meal that left the stomach at the end of the observation period  of 90 minutes) were also reported. Moreover, they showed that these findings persisted after 24 months [10]. These studies were limited, in that they had small sample sizes (11 and 14; respectively) and were unable to get detailed anatomy using scintigraphic imaging. These early studies were contested by Bernstine et al. [11] (Table 1) concluded that gastric emptying was not affected by sleeve gastrectomy [11].

*No preoperative control

A more recent study by Vives et al. [12] echoed many of the findings by Melissas in that the T1/2 (Table 2) was shorter post LSG but the effect is even greater with a more radical antral resection [12]. This study also adds the CT gastric volume analysis that showed that initial differences in gastric volume between distal and proximal repairs settled after time which would imply gastric physiology has a major role, over gastric anatomy, in the etiology of reflux. As a result of these discrepancies, most authors had recommended further study of the underlying mechanisms involved in gastric emptying. This was carried out by Baumann et al. 2010 who used time-resolved MRI pre- and post-LSG showing that the qualitative pattern of antral motility was preserved even early after surgery, but the proximal part of the stomach, which was now the sleeve, remained almost entirely still without any coordinate peristalsis. They concluded that the stomach after LSG seemed to be divided into two functionally distinct segments: a largely immobile sleeve and an accelerated antrum [13]. They were limited in the small sample size (only 5 patients) and used liquid meals only.

One study attempted to look at voiding time, but used gastrograffin and arbitrarily differentiated 'fast' and 'slow' voiding depending on whether sleeve voiding took more or less than a minute. This study was limited in that it did not use scintigraphy, did not calculate T1/2 and started the resection line at various distances from the pylorus (4cm-6cm), meaning the results have to be taken with caution and are difficult to compare with those from other studies. Having said this, they showed that sleeve voiding was fast in 85.96% of patients and slow in only 14.03% [14].

This hypothesis that the antrum was the locus for accelerated gastric emptying has often led surgeons to leave 7cm of antrum intact when carrying out LSG. The problem with this was that it limited the restrictive ability of the sleeve and theoretically would reduce the intended weight loss long term. As a result, Michalsky et al. 2013 intermittently performed radical pyloric antrum resections, leaving only 2.5cm. Despite a limited sample size (n=4), they found that T1/2 was lower even post- radical antral resection [15]. However, these findings were disputed by Fallatah et al. 2013, who found that when resecting at 4cm from the pylorus 73% showed delayed gastric emptying, compared to when resecting at 7cm from the pylorus 87% of patients showing acceleration [16]. However, this particular study and similar studies [17,18] did not perform a control study before the LSG and therefore, conclusions whether or not LSG caused the delayed gastric emptying are not robust.

A more recent study concurred with Michalsky with a larger sample size (n=60) and this also suggested that the more radical antral resection correlated with a faster gastric emptying time [12]. LSG can affect gastric emptying via a number of different mechanisms, including altered contractility, altered gastric distensibility, and resection of the gastric pacemaker situated at the large curvature [12,19]. Initially, concerns were raised about the risks of resecting the fundus, where the gastric pacemaker is thought to be located, as this might delay emptying. However, as highlighted by [13], gastric motility is not controlled by a single anatomically localized pacemaker, but instead a network of interstitial cells of Cajal (ICC) in the myenteric plexus, responsible for slow waves leading to smooth muscle contraction [13]. One of the reasons why even after resection of the greater curvature, gastric emptying is preserved was suggested in a study, which showed that these slow waves could be generated in isolation in the antrum [20]. The concern then, was that too radical a resection would delay gastric emptying. However, [12] suggested the opposite might be true. As the antrum acts as a regulatory pump, the more you resect, the less regulated and therefore direct becomes the emptying [12].

Mechanisms of gastric reflux after sleeve gastrectomy

Sleeve gastrectomy was shown to cause, exacerbate or improve GORD [21,22]. The mechanisms by which this happens are multifactorial, and therefore, it is often difficult to isolate the specific effect of gastric emptying on GORD. Following LSG a  number of other processes occur that may increase GORD risk, including a lack of gastric compliance, increased intraluminal pressure, changes in pressure gradients, gastric fundus removal, changes in LES pressures and modifications in sleeve shape [21]. It is the effect on gastric motility and emptying that concern us, however.

Faster gastric emptying times have been correlated with lower incidences of GORD previously in non-surgical patients [23] and prokinetic drugs that decrease gastric emptying time also improve patient response to GORD especially when proton pump inhibitors are not effective [24] which implies that gastric emptying is a factor. In the post-LSG patient, it is thought that accelerated gastric emptying is one of the major protective factors against GORD as gastric contents spend less time in the stomach and are therefore less likely to reflux as there is a build up of a pressure gradient against a potentially weakened LES [22].

There are many conflicting papers in regards to whether LSG is protective [25] or causal of GORD but often the papers that support a protective role take into account the large weight losses which would naturally lower GORD incidences [26]. This is a potential reason as to why there is a conflict amongst studies. It is the de novo cases of GORD in patients who have had no evidence of any disease preoperatively that concern us as well as the patients with progressing GORD post operatively as these cases develop despite the significant weight losses achieved [26].

    Discussion

It is thought that accelerated gastric emptying of solids is a factor in the pathophysiology of obesity. Our review shows that emptying is further accelerated (Table 3) following LSG in obese patients. We think that although theoretically, this would inhibit weight loss, all other things being equal, following LSG some other anatomical and physiological changes occur, which outweigh the obesogenic effects of accelerated emptying. Longer term studies are needed, to look at weight loss and radical pyloric antrum resection to establish whether the theoretical risk stands up to evidence.

The reason for some of the disparities in the studies may be due to these having been investigated in solids or liquids, as the speed of gastric emptying will vary according to the density of the ingested food because the mechanisms of gastric emptying differ in solids and liquids [18]. Another cause for disparities is the heterogeneity between studies with some favoring one imaging technique above the other, differences in operating technique and lack of standardization [22]. GORD has also been reported and diagnosed differently with some centers using manometric pH measurements, symptom grading or PPI usage as their endpoints [26].

With this in mind, and with the currently available literature, it is clear that LSG does indeed have a much higher risk of worsening GORD or inducing a de novo GORD. It is clear that LSG does indeed have a major impact on the gastric physiology and motility, and the correlation between the two factors cannot be ignored. The implications this could have on treatment is that surgeons could aim to use a technique that would lead to accelerated gastric emptying, as this would reduce the risk of GORD and its associated cancer risk. New techniques should aim to be as safe as existing ones, as well as achieve just as much weight loss. As noted previously, the literature suggests that a decrease in gastric emptying time could lead to a reduction in the incidence and severity of GORD and its related cancer risk. It has also been noted that a more radical resection of the antrum (<3cm from the pylorus) leads to a significantly faster gastric emptying time without further complications. A trend moving towards resecting more of the antrum should be investigated further under differing circumstances and with longer follow-ups, to elucidate the safety profile and see whether it directly correlates with a lower incidence of de novo GORD rather than from inference alone.

Other proposed modifications in the literature suggest intraoperative repair of the oesophageal hiatus [27] and adjustments in the angle of the stapling device, to better preserve the LES tone and the angle of His [28], though these aim to modify anatomy and structure rather than physiology. It is likely that a combination of radical antral resection with surgery to preserve the functionality of the anti-reflux mechanisms would be a potential future area of research to investigate, to optimize to investigate, to optimize outcomes.. outcomes. Currently, it appears that the laparoscopic Roux-en-Y gastric bypass (LRYGB) still has a much lower incidence of GORD. Therefore, this should be the option of choice for patients who are at high risk of GORD at least until more is known about the mechanisms behind LSG related GORD and how we can minimize this [29,30].

    Conclusion

Despite early controversies, current evidence suggests that accelerated gastric emptying arises following LSG. The degree to which this acceleration happens is in part a function of how radical a pyloric resection is carried out. The studies we have reviewed show that a more radical antral resection leads to a faster gastric emptying time and it is known that slower gastric emptying times result in an increased incidence and severity of GORD. We can, therefore, infer that a more antral resection will lead to better GORD outcomes. More direct trials to compare post-operative GORD in these resections are required to see whether the outcomes match the inference. Because of the earlier conflicting studies and in light of the most recent research, a more standardized approach to study design would make study comparison and data synthesis more useful. Further research needs to be carried out to establish what the effects are at longterm follow-up, especially for the more radical resections and how these impact de novo GORD.

To Know More About Current Research in Diabetes & Obesity Journal  Please click on: https://juniperpublishers.com/crdoj/index.php

To Know More About Open Access Journals Please click on: https://juniperpublishers.com/index.php

[tinyshe]

“Around the world,  reports are pouring in of people dying shortly after receiving the COVID-19  vaccine. In many cases, they die suddenly within hours of getting the shot. In   others, death occurs within the span of a couple of weeks.

“One notable case  is baseball legend Hank Aaron, 86, who died January 22, 2021, 17 days after  publicly getting vaccinated for COVID-19.1,2 He said at the time that he hoped other Blacks would follow his lead and  get their vaccines too.

“According to news  reports, he died “peacefully in his sleep” and no cause of death had been  announced. Aaron was famous for being the home-run king of baseball, and broke  Babe Ruth’s record when he hit homerun No. 715; he had hit 755 by the time he  retired from the sport.

29 Dead in Norway

“In related news,  Norway has recorded 29 senior citizen deaths in the wake of their vaccination  push.3 Most were over the age of 75. A total of 42,000 Norwegians had by that time  received the vaccine.

“While health  officials initially downplayed any connection to the vaccine, a report in  Bloomberg suggests the Norwegian Medicines Agency are now reconsidering. At the  time of the deaths, the Pfizer  vaccine was the only COVID-19 vaccine available in Norway, so “all deaths  are thus linked to this vaccine,” the agency told Bloomberg.4

“’There are 13 deaths that have been assessed,  and we are aware of another 16 deaths that are currently being assessed,’ the  agency said. All the reported deaths related to ‘elderly people with serious   basic disorders,’ it said.

‘Most people have experienced the expected side  effects of the vaccine, such as nausea and vomiting, fever, local reactions at  the injection site, and worsening of their underlying condition’ …

“The findings have prompted  Norway to suggest that COVID-19 vaccines may be too risky for the very old and  terminally ill, the most cautious statement yet from a European health  authority.

The Norwegian Institute of  Public Health judges that ‘for those with the most severe frailty, even  relatively mild vaccine side effects can have serious consequences. For those  who have a very short remaining life span anyway, the benefit of the vaccine  may be marginal or irrelevant.’”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious  Diseases, commented that the deaths have to be “put into context with the  population they occurred in.”5

In other words,  they were old and old people die. It’s hypocrisy at its finest. When seniors  die before vaccination, it’s due to COVID-19 and something must be done to  prevent it, but when they die after vaccination, they die of natural causes and  no preventive action is necessary.

The World Health  Organization added that since there was “no certain connection” of the vaccines  to Norway’s deaths, there is no reason to discontinue giving it to senior  citizens.

Questionable Coincidences

Interestingly,  several areas have reported that deaths are rapidly increasing AFTER  vaccination programs are implemented. The news stories don’t actually say it  straight out, but if you look at dates given, it raises questions. One such  example is what’s happening in Gibraltar at the southern tip of Spain, which  has a population of 34,000.

The area rolled  out its vaccination program on January 9, 2021, using the Pfizer mRNA vaccine.  By January 17, 2021, 5,847  doses had been administered (about 17% of the population), according to a  report by MedicalXpress.6

The curious thing about it is that the area’s  first recorded death from COVID-19 didn’t occur until mid-November 2020. By  January 6, three days before the vaccination program began, the total  COVID-19-related death toll reportedly stood at 10.

Then, by January 17, the total death toll had suddenly skyrocketed   to 45. In other words, 35 people died in the first eight days of the   vaccination program. Most were in their 80s and 90s.

Chief  Minister Fabian Picardo said, "This is now the worst loss of life of  Gibraltarians in over 100 years. Even in war, we have never lost so many in  such a short time."7 None of the deaths are being blamed on the vaccine, however. Instead, they’re loosely  blaming them on the new variant of SARS-CoV-2.

Vaccine Rollout Coincides With Outbreak

Other  areas are also reporting “outbreaks” of COVID-19, resulting in increased death  tolls, after the rollout of vaccinations. Case in point: In Auburn, New York, a COVID-19 outbreak began  December 21, 2020, in a Cayuga County nursing home.8,9 Before this outbreak, no one in the nursing home had died from COVID-19.

The next day,  December 22, they started vaccinating residents and staff. The first death was  reported December 29, 2020. Between December 22, 2020, and January 9, 2021, 193  residents (80%) received the vaccine, as did 113 staff members.

As of January 9,  2021, 137 residents had been infected and 24 had died. Forty-seven staff  members had also tested positive for SARS-CoV-2 and one was on life-support.

Considering we’re  also seeing cases in which healthy young and middle-aged individuals die within  days of receiving the vaccine, it’s not inconceivable that the vaccine might  have something to do with these dramatic rises in deaths among the elderly in  various parts of the world. In fact, I’d expect it.

You can rest  assured, however, that the public health authorities and media will not report these  observations. Anything that conflicts with vaccine safety and effectiveness  will be intentionally and universally buried. This is precisely their modus  operandi of the past three decades, so it’s really up to each individual to do  their own research.

Massive Amounts of Serious Side Effects Emerging

While  the global  vaccine campaign is less than a month old in most places, reports of serious  side effects have already started pouring in. Many are sharing their  personal experiences on social media networks. Disturbingly, many are having   their stories censored as misleading or false. Videos, in particular, tend to  be taken down.

Aside  from sudden death within hours or days,10,11,12,13,14 examples of side effects among survivors of the Pfizer and Moderna mRNA  vaccines include:

Persistent malaise15,16 and extreme exhaustion17

Severe allergic, including anaphylactic reactions18,19,20    

Multisystem inflammatory  syndrome21

Chronic seizures and convulsions22,23

Paralysis,24 including Bell’s Palsy25

To get a feel for what’s really happening, check out prezi.com, where someone has started  collecting stories from various social media posts. It’s a rather shocking  compilation that is well worth sharing with family and friends who are still on  the fence about getting the vaccine.

Many say they  “feel weird” and that they “don’t feel like myself.” Dizziness, racing heart  and extreme high blood pressure seem to be a common complaint, as is severe,  chronic seemingly “unbreakable” headache that does not respond to medication.  Many describe the pain they feel in their body as “being run over by a bus” or  “being beaten with a bat.”

Some report  swollen and painful lymph nodes, severe muscle pain and gastrointestinal  issues. Symptoms mimicking stroke are being reported, even though CT scans show  nothing of concern. One such report is from a 19-year-old girl. Several report  lethal heart attacks claiming the lives of someone they love.

Psychological  effects are also starting to creep in. One woman who is on chemotherapy reports  “mood changes with intermittent periods of elation and mild euphoria.” Bouts of  anxiety, depression, brain fog, confusion and dissociation are also being  reported, as is an inability to sleep.

One person  reports having lost “the voice in my head,” which I suspect is the ability to  hear yourself think. Another reports losing the ability to formulate words  about half an hour after getting the first dose of vaccine, and a third reports  “struggling for lost words.” Loss of taste and/or smell are also being  reported, as well as taste alterations. Several say they have developed a  metallic taste since their vaccination.

One pregnant  woman reported spontaneous rupture of the amniotic sac resulting in premature  delivery. Another woman’s baby was found to have no heartbeat two days after  her vaccination and was delivered stillborn. Several describe effects  suggesting vascular problems, such as skin blotchiness and fingers turning  blue.

We see mass cell activation syndromes. The clinical symptoms are  going to be the inflammatory diseases. We hear everybody calling it ‘long haul  COVID’ — the extreme, profound, crippling fatigue, the inability to produce  energy from your mitochondria. It's not long haul COVID. It's exactly what it  always was — myalgic encephalomyelitis, inflammation of the brain and the   spinal cord. ~ Judy Mikovits Ph.D.

While people are  hoping and praying their side effects will be temporary, a significant portion  say they’re still struggling with the effects one or two weeks after their  shot. Time will tell whether they turn out to be permanent, but considering the  fact that the mRNA vaccines reprogram your DNA, there’s certainly the  possibility that they might be long-lasting.

Side Effects Were Predictable

I recently interviewed cellular and molecular biologist Judy Mikovits, Ph.D., about the mechanics of COVID-19 mRNA  vaccines, which are in actuality gene therapy. They’re not conventional  vaccines. Compare the summary of reported side effects in the section above to  the longer-term side effects she suspects will become commonplace, based on the  mechanics and biological effects of these gene therapy “vaccines”:

Migraines

Involuntary muscle movements,    tics and spasms

Parkinson’s disease

Microvascular disorders

Cancers

Severe pain syndromes

Bladder problems

Kidney disease

Psychological disorders such    as psychosis and autism spectrum

Neurodegenerative diseases

Sleep disorders

Infertility and other    reproductive problems

The underlying causes, according to Mikovits, are  neuroinflammation and dysregulation of the immune system and endocannabinoid  system.

“It's the brain on fire,” she  says. “You're going to see ticks, you're  going to see Parkinsonian disease, you're going to see ALS, you're going to see  things like this developing at extremely rapid rates, and it's inflammation of  the brain.

We see mass cell activation syndromes. The clinical symptoms are going to be the inflammatory diseases. We hear everybody calling it ‘long haul  COVID’ — the extreme, profound, crippling fatigue, the inability to produce  energy from your mitochondria.

It's not long haul COVID. It's exactly what it always was —   myalgic encephalomyelitis, inflammation of the brain and the spinal cord. What  they're intentionally doing is killing off [certain] populations.”

Discrepancies in Moderna’s FDA Report

According to a  recent report by The Defender,26 there are significant discrepancies in the data Moderna submitted to the U.S.  Food and Drug Administration:

“Moderna’s reported death rate for its COVID vaccine, based on   clinical trials, is 5.41 times greater than Pfizer’s. Yet neither are   representative of national death rates — that’s a red flag …

The Moderna vaccine arm  death rate of 0.36 deaths/100K/day) is 5.14 times higher than Pfizer’s (0.07  deaths/100K/day). This large discrepancy deserves notice and requires explanation.

If Moderna’s on-vaccine  death rate is so far below the national death rate and also simultaneously more  than five times greater than Pfizer’s on-vaccine death rate, then Pfizer’s  study sample appears even less representative of the entire population. This, too,  requires due consideration …

When comparing [Moderna’s] study-wide number of  deaths per day per 100K for the study to that of the entire U.S. population  from 2019, I was shocked: the national number of deaths per day per 100K is  2.44.

Moderna’s screening process and exclusion  criteria in the trial led to evidence that the general population is dying at a  rate 6.3 times greater than the death rate in the Moderna trial — which means   the Moderna study, including its estimated efficacy rate and the vaccine’s  alleged safety profile — cannot possibly be relevant to most of the U.S.  population.

The super-healthy cohorts studied by Moderna are  in no way representative of the U.S. population. Most deaths from COVID-19   involve pre-existing health conditions of the types excluded from both Pfizer  and Moderna trials …

Those enrolling in the post-market surveillance  studies deserve to know the abject absence of any relevant information on  efficacy and risk for them. In their zeal to help humanity, or to help  themselves, these people may very well be walking into a situation that will  cause autoimmunity due to pathogenic priming,  potentially leading to disease enhancement should they become infected  following vaccination.”

Why Is Moderna’s Gene Therapy Deadlier Than Pfizer’s?

What might  account for Moderna’s gene therapy “vaccine” causing more than five times more  deaths than Pfizer’s? One possibility raised in The Defender’s article is that  they failed to “screen out unsafe epitopes to  reduce autoimmunity due to homology between parts of the viral protein and the  human proteome.”

According to a  2020 paper27 in the Journal of Translational Autoimmunity, “Pathogenic priming likely  contributes to serious and critical illness and mortality in COVID-19 via  autoimmunity,” noting that the same may apply post-vaccination.

As  explained in this paper, all but one of SARS-CoV-2 immunogenic epitopes are  similar to human proteins. Epitopes28 are sites on the virus that allow antibodies or cell receptors in your immune  system to recognize it.

This  is why epitopes are also referred to as “antigenic determinants,” as they are  the parts that are recognized by an antibody, B-cell receptor or T-cell  receptor. Most antigens — substances that bind specifically to an antibody or a  T-cell receptor — have several different epitopes, which allow it to be  recognized by several different antibodies.

According to the author, some epitopes can cause “autoimmunological pathogenic  priming due to prior infection or following exposure to SARS-CoV-2 … following  vaccination.”

In  other words, if you’ve had the infection once, and get reinfected (either by  SARS-CoV-2 or a sufficiently similar coronavirus), the second bout has a great  potential to be more severe than the first. Similarly, if you get vaccinated  and are then infected with SARS-CoV-2, your infection may be more severe than  had you not been vaccinated.

For  this reason, “these epitopes should be excluded from vaccines under development  to minimize autoimmunity due to risk of pathogenic priming,” the paper warns.  The abstract lays out the basics of the pathogenic priming process.29 As noted in The Defender:30

"Thus, concern over vaccine-induced pathogenic priming is not   zero, but it may be less than COVID-19  vaccines that  use more than one SARS-CoV-2 protein. However, the hyper-focused IgG response  to the fewer antigens could cause hyperimmunization, a condition considered   ripe for off-target autoimmunity attacks."

Are Lethal Effects Being Hidden?

The Defender  points out that vaccine trials never use inert placebos. Instead, many use  another vaccine. By doing so, they effectively hide side effects. In the case  of Moderna, a total of 13 people died in the trial, seven in the vaccine group  and eight in the placebo group. One severe adverse event in the placebo group,  however, was relabeled as a death, and one death in the vaccine group was   relabeled as a severe adverse event.

In the vaccine  group, deaths were listed as cardio-respiratory   arrest, heart attack, multisystem organ failure, head injury and suicide. None of the deaths were  linked to the vaccine.

However, as noted in The Defender, heart attacks  can involve autoimmunity and have been seen in post-vaccinations before.   Multisystem organ failure is also “consistent with autoimmunity against ubiquitously expressed proteins as a result of vaccination.”

“The suicide cannot be ruled  out as not due the vaccine, either,” The Defender writes, noting it could be  related to “autoimmunity against oxytocin or serotonin receptors,” which might  result in “devastating depression.”

Indeed, prezi.com includes a number of reports of people saying  they’ve experienced anxiety and depression following their vaccination.  Depression is also a possible outcome of neuroinflammation, as noted by  Mikovits.

Do a Risk-Benefit Analysis Before Making Up Your Mind

While both Pfizer and Moderna report low rates of side effects — Moderna’s  being just 0.5% — the rates of side effects in the real world appear to be  extraordinarily high. Data are still hard to come by, but if we go by initial  data reported by the U.S.  Centers for Disease Control and Prevention,31 we end up with a side effect rate in the real world of 2.79%.

By December 18, 2020, 112,807  Americans had received their first dose of COVID-19 vaccine. Of those, 3,150  suffered one or more “health impact events,” defined as being “unable to  perform normal daily activities, unable to work, required care from doctor or  health care professional.” If you divide the number of reported side effects  with the number that received the vaccine, you get a side effect rate of 2.79%.

If you then extrapolate that to  the total U.S. population of 328.2 million, we may be looking at 9,156,780  Americans suffering vaccine injuries if everyone gets vaccinated.

[to see full article with tables/graphs and other information not picked up in a cut and paste please go here]

[douchebagbrainwaves]

HERE'S WHAT I JUST REALIZED ABOUT POWER

So saying startups should move to Silicon Valley, the single best thing they could do might be to create a new language, it's because you think it's better in some way than what people already had. Our startup, Viaweb, was built to be sold.1 The same thing happened during the Mississippi and South Sea Bubbles. Average age of their founders: 24. You see the same program written in two languages, and one that other big technology companies will no doubt try to duplicate.2 They would be in the software business there is an ongoing struggle between the pointy-headed academics, and another equally formidable force, the pointy-haired boss's opinion ever change? For example, it is no fun to be at the bottom, nor noblesse oblige at the top of the base language a language for the one above. Because of the circumstances in which they encounter it, children tend to misunderstand wealth.

In 1995 we thought only professional writers were entitled to publish their ideas, and that means it has to cost. I got was $12. The answer, I think, is going to happen to you, because both acquirers and investors judge you by your level of commitment. It might actually carry some weight.3 Fortran, C, C, C, C, C, Java, and Visual Basic—it is not clear whether you can afford the risk.4 Within large organizations, and the rest of the company through the COO. I come home to Boston.5 Into this already bad situation comes the third problem: Sarbanes-Oxley loosened.

Technology often should be cutting-edge. But if you had no users, it would at least make a great pseudocode.6 So future founders may not have to accept new CEOs if they don't want to offend Big Company by refusing to meet. When times get bad, hackers go to grad school. As with exercise, improvements beget improvements. And then you're really in trouble. Indeed, as with expensive cars, if you're prepared to live on ramen. This is an interesting question.7 And that also means there will always be undervalued by large organizations, because the harder it is to sell something to you, because odds are they'll have to deal with this is to collect them together in one place for a certain number of hours each day. Fortunately, this flaw should be easy to fix. When a decision causes you to develop software twenty times faster than you'd ever had to before, they expected you to answer support calls, administer the servers, design the web site, cold-call customers, find the company office space, and go out and discover startups when they're young, before VCs have puffed them up into companies that cost $100 million to acquire. So performance in the future.8

Part of the reason I say this is optimism: it seems that it should be distributed equally. There may be cases where this is a constant problem when you're painting still lifes. We're up against a hard one here. Surely a field like that would be dominated by fearsome startups with five million dollars of VC money each.9 This lets me get ip addresses and prices intact.10 No, probably not.11 But beyond that they didn't want to be able to find statistical differences between these and my real mail. Research. One often hears a policy criticized on the grounds that it would increase the income gap between rich and poor.

But partly it was because our lives were at times genuinely miserable. So what if some of the money to pay you.12 In fact, some might argue that it was too late to change.13 It's much safer to invest in them.14 No one I knew did it, but several planned to, and some may have tried. Why do people move to suburbia? If you run every day, you'll probably get something better. This is the sort of society that gets created in American secondary schools.15 The Airbnbs themselves never even saw these emails at the time, and that women will all be trained in the martial arts.16

You have to be high, and if there's a limit on the number of things people want, and that what we've seen so far is nothing compared to what's coming. But as technology has grown more important, the power of nerds has grown to reflect it.17 Inefficient software isn't gross. So the rate of evolution in mathematical notation than, say, transportation or communications.18 Empirically, boldness wins.19 Now anything that became fashionable during the Bubble robbed their companies by granting themselves options doesn't mean options are a bad idea. The Airbnbs themselves never even saw these emails at the time. I assumed it was derived from the same root as tacit and taciturn, and that you sometimes have to figure out what's actually wrong with him, and treat that. But Occam's razor suggests the truth is less flattering. Editorials quote this kind of lonely squirming to avoid it will increasingly be COOs rather than CEOs. These things don't scale linearly. Values are what have types, not variables, and assigning or binding variables means copying pointers, not what they want to be able to get into the best deals at all.

There is one thing companies can do short of structuring themselves as sponges: they can stay small.20 The root cause of variation in income is a sign of how much programmers like to be alone, so when kids opt out of the way into Lisp, they could always just.21 While refutation generally entails quoting, quoting doesn't necessarily imply refutation.22 The fact is, despite all the nonsense we heard during the Bubble about the new economy. How could any technology that old even be relevant, let alone of Bayesian spam filtering per se seem to have just humiliated them technologically. The number of people who want to work on. Why? And I think that's precisely why people put it off for as long as possible. The mere fact is so overwhelming that it may seem strange to imagine that it could be.23 In 1900, if you combine them, suggest interesting possibilities: 1 the hundred-year language now, it would arguably be gross even if they ran on a fuel which would never run out and generated no pollution. The reason we don't see the opportunities all around us is that we adjust to however things are, and are often mistaken about what they really want is the development team and the software they've built so far.

Between December 10 2002 and January 10 2003 I got about 1750 spams. You'll find more interesting things by looking at the world than you could steal it.24 I still wonder if this was a smart idea.25 Just like the committee approving software purchases. They like to get you? Typefaces to be cut in metal were initially designed with a brush on paper. And there is another, newer language, called Python, whose users tend to look down on Perl, and more waiting in the wings.

Notes

If early abstract paintings seem more interesting than random marks would be lost in friction. Cit. But this is the only one.

It's hard to judge for yourself and that don't scale is to claim that their explicit goal at Y Combinator was a sort of community. You'll be lucky if fundraising feels pleasant enough to incorporate a prediction of quality in the 1990s, except that no one thinks of calling that unfair.

The story of creation in the U.

After a while we might think it was putting local grocery stores out of them, initially, to the size of the number of situations.

There were a first approximation, it's easy for small children to consider themselves immortal, because the kind that evolves naturally, and for filters it's textual. You'll be lucky if fundraising feels pleasant enough to supply the activation energy for enterprise software. That's not a commodity or article of commerce. Viaweb, if you have 8 months of runway or less, then add beans don't drain the beans, and help keep the next three years, it would be enough to do right.

4%, Macintosh 18. Not in New York.

Roger Bannister is famous as the cause. To spread them. Oddly enough, the underlying cause is the accumulator generator in other ways.

The cause may have no connections, you'll be well on your thesis. This is a particularly clever one in an empty room, and they were still so small that no one is harder, the light bulb, the world, and the hundreds of thousands of small and use whatever advantages that brings.

No. If Paris is where all the red counties. A significant component of piracy is simply that it refers to features you could beat the death spiral by buying politicians.

Microsoft, not all do. Which is precisely because they wanted, so they had to write about the idea of starting a startup, unless it was wiser for them.

The ordering system was small. The image shows us, they may then, depending on their appearance.

When you fund a startup, and the low countries, where you wanted it? One YC founder told me about a form that asks for your work. Could it not grow just as you can ask us who's who; otherwise you may have allotted for the same reason 1980s-style knowledge representation could never have left PARC.

I call it ambient thought. They're motivated by examples of how to appeal to space aliens, but hardly any type we tell kids are probably not far from the compromise you'd have reached after lots of exemptions, especially for individuals. Even the cheap kinds of work have different time quanta.

I'm not going to give their associates the title partner, not you. Indifference, mainly. Basically, the number of discrepancies currently blamed on various forbidden isms. Some blue counties are false positives reflecting the remaining power of Democractic party machines, but Javascript now works.

That's probably too much to say whether the program is no personnel department, and more pervasive though. Wufoo was based in Tampa and they succeeded. It was born when Plato and Aristotle looked at the valuation turns out only to your brain that you're not trying to figure this out. That's a good way to pressure them to make software incompatible.

Then when we were working on some project of your identity. They don't know of any that died from releasing something full of bugs. Maybe that isn't the last step is to protect one's children seems weaker, judging from things people have seen, when they decide you're a YC startup and you have a competent startup lawyer handle the deal for you. A round about the same thing twice.

She ventured a toe in that respect. The Industrial Revolution, England was already the richest country in the standard series AA paperwork aims at a regularly increasing rate to impress investors. So if they want. Some of Aristotle's contribution?

Apparently the mall was not just a Judeo-Christian concept; it's random; but it wasn't. Cit. On the way they have to pass.

But if idea clashes got bad enough, but they can't hire highly skilled people to do with the best ways to help a society generally is to tell them about your conversations with potential acquirers. It was revoltingly familiar to anyone who had recently arrived from Russia. It would have for one another indirectly through the founders: agree with them in advance that you're not sure. Mueller, Friedrich M.

You've gone from guest to servant.

So if it's dismissed, it's cool with us if the current options suck enough. I'm not saying you should always get a job to get them to make peace. How to Make Wealth in Hackers Painters, what that means the right question, which people used to wonder if that got built this way.

I make it easy. I don't know of any that died from releasing something full of bugs, and owns significant equity in it.

It is still possible, to allow multiple urls in a signal.

What I should probably pack investor meetings too closely, you'll be able to distinguish between gravity and acceleration.

Cit. One father told me: One way to create a silicon valley. Users judge a site not as a game, you can see the Valley, MIT Press, 1996.

[goldira01]

Jay Hao, the CEO of the digital asset exchange OKEx, took part in Cointelegraph China HUB, an online interview column started by Cointelegraph China. In the past, Hao has stated that blockchain will eliminate transaction barriers, improve efficiency and ultimately impact the development of the global economy. But what does he think about the world of blockchain now?

Cointelegraph: Is cryptocurrency a niche industry developing with uncertainty and volatility? And how did OKEx overcome the volatility of the industry to become one of the top exchanges?

Jay Hao: As you said, the cryptocurrency industry itself brims with uncertainties, and it is OKEx’s innate mission to be prepared to meet new challenges on all occasions. In the past year, the lowest price of Bitcoin reached about $3,300 and the highest exceeded $13,000. Especially in the past three months, the global financial industry has encountered massive fluctuations under the influence of COVID-19. 24/7 free-to-trade cryptocurrency has reacted even more in this plunge. 

“For exchanges, the biggest challenge brought by such huge fluctuations is the stability of the trading system and risk control under such extreme market behavior.”

So, my team and I have consistently held a consensus: in the world of cryptocurrency, technology strength must be the key to building any crypto ecosystem. In the past year, we have polished the construction of the system without stopping, and we have carried out hundreds of significant upgrades. Our unique super matching engine and Lightning 2.0 system ensure that the platform can run stable even under extreme market conditions, and also the order processing speed has ranked high on the world’s top options exchanges lists. This is indeed a matter of pride.

CT: Can you give some details about OKEx’s expansion plan or overall strategy?

JH: From my point of view, reputation is the foundation of an enterprise, especially in the crypto world. In addition to the well-known reasons why Libra’s issuance is so complicated, I think there is another factor. Business lies happen once or countless times. After all, a lie requires countless lies to make up for it, and the vicious cycle will always collapse.

As Facebook is one of the main sponsors, it was bothered with problems such as user data leakage and unauthorized collection of user data, which have seriously hurt market confidence. Lawmakers’ distrust of Facebook even exceeds that of cryptocurrency itself or blockchain technology. 

“Therefore, within OKEx, I repeatedly stress with the team that we must never do anything that harms the interests of users. ‘Customer first’ is always the core value of OKEx, which also acts as the cornerstone of our internationalization.”

The internationalization of OKEx has been accelerating. At present, it has reached cooperation with the world’s seven largest legal fiat payment providers through the fiat gateway project, supported 30 fiat currencies including United States dollars and euros, and accepts 17 payment methods including Visa and Mastercard. Also, we have provided services to more than 20 million users in more than 200 countries and regions around the world, and that is still increasing.

In the crypto world, OKEx’s role is not only as a trading platform but also a blockchain technology company. We have launched OKEx Cloud, relying on the technical strength and service experience accumulated by OKEx in the field of digital assets for many years and providing exchange technology services to the world. 

Besides, OKChain, independently developed by OKEx, was also completed as 100% open-source. OKChain pioneered the “commercial chain alliance” model, which will face all ecological nodes and provide efficient, free and boundless public chain ecosystems. It is a significant step for our internationalization.

In summary, OKEx’s internationalization has three points: first, customers come first; second, to meet global differentiated needs and provide localized services; and third, we are not building an exchange, but a global free, equal and healthy encryption ecosystem.

CT: According to CryptoCompare, the combined volumes of OKEx’s, BitMEX’s, Huobi’s and Binance’s derivatives markets in March totaled $514 billion, or 86% of the entire market. And OKEx took more than BitMEX. How do you see the competition in the market? 

JH: In the face of competition, I always believe that continuous and healthy competition will bring new vitality into the market. While promoting the progress of the industry, it also allows users to have a better reference basis when choosing a trading platform. We will actively learn from excellent competitors. After all, the beneficiaries under healthy competition will always be users.

Can a contract dominate the competitiveness and fate of an exchange? The answer is, of course, no. No company can be popular in the world with only one function. The needs of users are constantly changing. In the business environment, the only constant is change. What’s more, in a new and rapidly changing industry like blockchain, I always believe that OKEx’s biggest competitor is ourselves, and we are also confident that we will continue to lead the industry and make breakthroughs.

CT: How does OKEx address challenges such as cryptojacking or the free-fall of the market such as occurred on March 12?

JH: As I said before, technical security is still one of the biggest challenges that trading platforms need to face. I can proudly tell you that because of OKEx’s excellent technical strength, there has never been a theft of user funds or an information security incident since its establishment. In terms of fund management, OKEx adopts enhanced cold/hot wallet management, and the risk control system is continuously upgraded to ensure the safety of user funds and information.

Due to the particularity of the industry, the order volume per second in extreme market conditions is several times higher than the normal order volume and can reach 1 million. This is indeed an objective challenge for all exchanges in the industry.

On the other hand, service solutions from the perspective of user interests are also particularly important. For the user losses caused by our platform in the extreme market on March 12, we immediately set up a special solution group to actively follow up and solve the problems, which has also been understood and supported by most users. As an objectively neutral and responsible trading platform, we are well aware that there are still many areas that need to be improved. 

CT：It can be said that OKB is not only a platform coin for OKEx, but also a global token throughout the entire ecosystem of OKEx. What’s the role of OKB in OKEx’s ecosystem?

JH: Now, in many people’s eyes, OKB is less and less like a “platform token.” It creates continuous value for OKEx users. OKB ecological construction starts from several important dimensions, and its ultimate goal is to continue to create value for users.

In terms of additional rights within the OKEx trading platform, 14 application scenarios have been expanded. From the perspective of the construction of a deflation model, we are currently the first platform coin in the industry to achieve full circulation. On Feb. 10, we destroyed 700 million unissued OKB, which means that the team completely gave up its rights and holdings of OKB, and the profits were given to OKB users. Of course, this also means that OKB’s future buyback and burn will all be performed in the secondary market.

CT: Can you tell us how OKChain will empower OKB in the future?

JH: The appearance of OKChain is also an attempt of OKEx in the global decentralization tide. The big difference is that OKChain will solve the problem of large-scale landing and application of public chains because we believe this is the main contradiction in the current development of public chains.

OKChain’s uniquely designed cross-chain solution and original business chain alliance can enable each participating node to exert its power here and publish and run various decentralized applications without hindrance. The whole process does not require any review nor is there a so-called “proposal.” To a large extent, it has solved a series of problems such as transactions per second, security and adaptability that plagued the development of public chain technology.

In the future, OKB will be migrated to the main chain of OKChain. At that time, we will delete the code of the smart contract for the additional issuance of tokens and continue to improve the OKB deflation model. And the genesis block of OKChain’s basic token OKT will map 100% to OKB holders when the mainnet goes online, and OKB holders will also have the opportunity to become supernodes on OKChain.

The latest progress is that when it was open-sourced to GitHub, OKChain joined hands with the first group of ecological partners — a total of 30 global well-known enterprises from the public chain, proof-of-stake mining pool, blockchain browser, wallet and multiple other types of fields. Perhaps by that time, OKB will be less like a “platform token.”

CT：How do you see the regulatory landscape around crypto, and how does OKEx remain compliant with global regulators?

JH: I was not surprised by the result of the U.S. Security and Exchange Commission’s ban on Telegram tokens. Telegram is elaborating on the nature of its tokens, saying that Telegram Open Network is a practical tool for community members with “consumer uses,” while the SEC and the courts are more concerned about its financial attributes, believing that it can flow out of control to the secondary market. Such negotiations are doomed to a consensus.

“The supervision of any industry always needs to dynamically adapt to market changes, but a basic premise is that no matter how changes are made, everyone has a basic consensus on this industry.”

The TON ban does not completely represent the SEC’s denial of the entire digital currency. On the contrary, this judgement fully shows us the professional understanding of the SEC and the courts on blockchain technology and digital currency, which is a powerful impetus for the development of the entire crypto industry. In the globalization process of OKEx, it is our primary premise to reach a regulatory consensus with local users and regulatory agencies.

In March, we heard a lot of good news from the world: India lifted the trading ban, South Korea officially classified cryptocurrencies as an asset and Germany issued a guide to classify cryptocurrencies as a financial instrument, with many other countries also actively exploring.

This just shows that the regulatory agencies of various countries are reaching a consensus with the crypto market. Therefore, for any country and region in the world that has reached a consensus with the crypto world, OKEx is ready to embrace supervision at any time.

CT: Could you share your thoughts on Binance’s acquisition of CoinMarketCap? What were the main motivations behind this move, in your opinion? Is expansion like this a natural way for exchanges to develop?

JH：First of all, congratulations to Binance on its ecological footprint expansion. However, I have also expressed my view on social media. In contrast, I would be more inclined to spend this budget on repurchasing platform coins and giving back to users who support the development of the platform. Only when users benefit will more and more people pay attention to and support you, and the exchange ecology will naturally become stronger and stronger.

“Each exchange has its expansion strategy. There is no so-called natural occurrence. It is a trade-off between the interests of all parties. The final choice is also determined by the operator’s judgment on the interests.”

Although I have said it many times, I still have to reiterate that in the expansion of OKEx, the interests of OKEx users will always be first. It does not exclude that we will advance some important decisions by soliciting opinions from users. OKEx will continue to contribute its strength to the construction of the global crypto ecosystem, which is beyond doubt.

CT: Can you share what your favorite books are, those that have inspired you to do what you’ve been doing in the blockchain sector?

JH：Work and life are two mirrors that reflect a person. I am quite different from myself at work. In addition to books that enhance professional knowledge every day, I like to read some tragic comedy and realism novels by Shakespeare and Dickens. I remember one sentence in Dickens’s A Tale of Two Cities: “It was the best of times, it was the worst of times.” Now, in many moments, this sentence will appear in my heart. Any industry and its related technologies have two sides. 

This era has given us a great platform to do what we think is meaningful and at the same time set up many constraints. Therefore, our actions must be oriented to benefit the people, society and life. A good or bad thought requires that we always have a rule in our hearts to measure and correct. These novels have influenced my code of conduct to a certain extent.

In addition to these, an avid teenager lives in my heart. Maybe you can’t imagine it, but I also like to watch popular novels like “Harry Potter” and “Lord of the Rings.” I like a story that breaks the boundaries of thinking and uses imagination to create a world of dreams and love.

Just like the blockchain industry, it is new, meaningful, borderless and does not adhere to conventions. We still have a lot of possibilities to achieve the impossible. Just like the enthusiasm brought by these novels, I think that whether it is a blockchain enterprise or a trading platform, we first need to use unlimited innovation and imagination to create services and value for society. At the same time, we must assess the situation, be bold and careful, and conduct within the rules of society.

This interview was conducted during a partnered event. It has been condensed and edited.