I've mentioned the case of Heather Pressdee in this subreddit before. Heather Pressdee was a nurse in the US state of Pennsylvania prior to being charged with murdering a number of her elderly patients with insulin.
Local commentary around the announcement of her arrest was... markedly different than that surrounding Ms. Letby's trial: https://www.reddit.com/Pennsylvania/comments/17n9vig/former_nurse_heather_pressdee_now_linked_to_17/
https://www.reddit.com/medicine/comments/17nbov4/former_nurse_heather_pressdee_now_linked_to_17/
https://www.reddit.com/nursing/comments/17nmyq8/former_nurse_heather_pressdee_now_linked_to_17/
As it happens, Ms. Pressdee accepted a guilty plea less than two weeks ago: https://www.nbcnews.com/news/us-news/pennsylvania-nurse-pleads-guilty-killing-patients-lethal-doses-insulin-rcna150366
The Times wrote an article about Ms. Pressdee's crimes, and drew parallels to Lucy Letby: https://archive.ph/VHF1g

Last week Pressdee, 41, pleaded guilty to three charges of murder and was sentenced to life in prison, narrowly escaping the death penalty.
She is suspected of being behind the deaths of at least 14 others, aged 43 to 104, as well as attempting to kill five more. All were given insulin whether they needed it or not, quietly injected while others were not around to witness it.
If Pressdee has killed that many people, it would make her one of the most prolific serial killers in the US and certainly the biggest in the state of Pennsylvania.
Her case has parallels with that of Lucy Letby, the British paediatric nurse who in August was found guilty of seven counts of murder and seven of attempted murder, and Harold Shipman, the doctor based in Yorkshire who killed an estimated 250 of his patients, making him Britain’s most prolific serial killer.

The probable cause affadavit filed in May 2023 can be reviewed at this link: https://www.attorneygeneral.gov/wp-content/uploads/2023/11/2023-11-02-Heather-PRESSDEE-Criminal-Complaint.pdf
Included in the probable cause affadavit are facebook posts about the effects of insulin, texts found on Ms. Pressdee's phone where she repeatedly joked about killing people, a search for the obituary of a decedent (pages 20-21) Because of the US nature of at-will employment, Ms. Pressdee was able to be shuffled between several hospitals between 2018 and 2023, before the nursing board took action. Most chilling, the complaint ends with this paragraph (emphases mine):

The defendant has admitted to harming, with the intent to kill, all patients named in this Affidavit. Her conduct spanned approximately five years over the course of eleven facilities in Armstrong, Allegheny, Westmoreland and Butler Counties. Her criminal conduct exhibited a pattern of behavior. PRESSDEE would often work the medication cart, administer insulin during the night shift when staffing was lowest and the facilities were quiet. The victims would often remain undiscovered until morning. PRESSDEE often took steps to ensure her victims would expire prior to shift change so that they wouldn't be sent to the hospital where her scheme could be discovered through medical testing such as a C-peptide tests [sic]. If PRESSDEE sensed the victim would "pull through" there is a pattern of her taking additional measures to try to kill the victims before they could be sent to the hospital by either administering a second dose of insulin or the use of an air embolism to ensure death. Despite PRESSDEE's efforts to conceal her actions, the investigative team uncovered the evidence detailed above in this Affidavit. The evidence along with PRESSDEE's confessions demonstrate sufficient probably cause to support the issuance of attached criminal complaint.

While Lucy Letby was arrested prior to the beginning of Ms. Pressdee's crimes, the allegations of Letby having administered air injection and poisoning by insulin were not made public until the beginning of Letby's trial in October 2022, ruling out the possibility of her having operated as a copycat killer. Ms. Pressdee's confessions also support the validity of the charges against her, even though they weren't brought until Lucy Letby's case was already public knowledge in the UK.

Recently, kakaayos lang namin ng papeles for our platinum membership and thankfully, naapprove naman kami. However, I can't seem to understand bakit hindi ako makapaglogin sa site ng (notices.philgeps.gov.ph) and sinasabing invalid daw yung user id saka password ko, samantalang I can login just fine sa (philgeps.gov.ph). Ang hirap i-contact ng philgeps, and lahat ng mobile/telephone numbers ay hindi matawagan. Any help would be greatly appreciated. Thanks in advance.

I'm 30F I got this Credit Card early late 2018 or early 2019, and this was my first Credit Card.
I didn't apply for it they just sent it in the mail basically pre approved. My reasons for closing this Credit Card Account is that I don't have the savings account connected to it anymore and I don't use it that much. I have another CC BPI Rewards Master Card which still has annual fees and UB Platinum Rewards Visa that I am planning to acquire their no annual fee forever promo. I've emailed 3, called multiple times but still transferred to a team that doesn't pick up at all.
Emails sent at 1st was Tue, Feb 27, 9:46 PM
1st [callcenter@bdo.com.ph](mailto:callcenter@bdo.com.ph) replied an acknowledgement reference # 2nd was Sat, Mar 16, 1:10 PM 2nd [callcenter@bdo.com.ph](mailto:callcenter@bdo.com.ph) replied an acknowledgement reference # 3rd was Tue, May 14, 1:25 AM 3rd [callcenter@bdo.com.ph](mailto:callcenter@bdo.com.ph) replied an acknowledgement mail that suggest since my email is not about the FF:

For the concerns listed below, kindly expect a response from us within one (1) to two (2) days: Updating of registered online banking contact information while overseas Online banking enrollment while overseas Reporting of phishing attempts and/or data privacy issues

CC: [consumeraffairs@bsp.gov.ph](mailto:consumeraffairs@bsp.gov.ph) only a detail email on their services, but not anything they could help.
I tried calling their hotline but parang mamemorize ko na ang dialog ni Pia sa kaka hintay. I'm so tried of all of it.
So here's the best part kase gigil auntie nyo. I went to a branch close to me, when I got there, guess what they want me to do, CALL THEIR FRIGGEN HOTLINE!!!! ayoko na. pagod nako.
I was opting to just lock it forever and wait that they'll close it kase wla nang transactions. But I'm afraid na it would be an issue on my end sa credit score ko..
Please help. :(

Philippines
Up to this point, I’ve travelled to most countries in SE Asia (except for Brunei & Timor-Leste), and am returning from the Philippines. I wanted to give some insight, thoughts, and tips for travel.
1. It is relatively more expensive to travel compared to other southeast asian countries. My average was close to $50/day, including accommodation. What I felt made it a little more expensive is the island-nature, meaning flights and ferries tend to add up in cost, say compared to Laos of Vietnam. Secondly, I found it difficult to find the sweet spot of local food that also didn’t feel risky. Many times, my choices were fast food, super local canteen options, or nice western-style restaurants. Consequently, I ended up eating at fast food restaurants mostly, which felt more mid-range (150-250 php/meal).
2. SIM Cards. There are two companies, SMART and GLOBE. Don’t buy from the airport, they are ridiculously overpriced. I’d recommend buying at a local store inside a shopping mall. GLOBE had errors when I tried to install it on my phone & app glitches. SIM cards are a pain, considering to register them you need proof of onward travel and hotel reservations. Don’t do this alone, have a phone rep help you complete this step.
3. Get out of Manila. It may be obvious, the natural beauty of the Philippines lies on the coast and the many islands. But also, I personally found Manila to be a particularly depressing city. The traffic, the un-walkability, the heat, and inconvenience of getting around made me want to leave rather quickly. 1-2 days should be enough. The coffee & food seemed so overpriced. Nothing felt too charming, compared to other SEA capitals. In contrast, I enjoyed Bangkok and Saigon immensely.
4. Most pristine nature in SE Asia. The only place in my mind that can rival the beauty of the islands here would be Indonesia, in my humble opinion.. The beaches, turquoise & clear water, and many waterfalls are stunning. Each place is more beautiful than the next, and it's easy to get off the beaten track with so many islands and waterfalls.
5. Everything moves VERY slowly, take this into account for planning. I was only here for 8 days and barely touched the surface of 2 islands. One month , maybe two months would give a nice introduction to what the Philippines has to offer. Getting around by bus, ferry, and boats takes a long time. Bus’s stop frequently to pick up cargo and passengers. The ferries do not leave on time. Even simple things, such as waiting in line for food or coffee, will take much longer than you may be used to. Entrance and Exit immigration, also, can be hours of waiting at the airport. But this can be good for relaxation too.
6. Flights and Ferries are expensive. I’ve already touched on this, but domestic flights in the Philippines can rival long-haul international flights in the rest of the world. For example, the other day I saw flights going from Cebu-Manila for nearly 12,000 php ($207.44), which is a 1.5 hour domestic flight. The ferries I took ranged from 800-100 php ($13-$18). For domestic flights, purchase well in advance can mitigate these costs.
7. Proficiency of English is very high. The removal of the language barrier for most makes this a great destination. I’d say the only other place in Southeast Asia that can rival the level of English proficiency in the Philippines would be Malaysia/Singapore. I was surprised that even the locals talk to each other in English. For tourism, the fact that English is so ubiquitous means ease of travel for most solo travellers that have a strong command of English.
8. Strong Points: Natural Beauty & Politeness. Throughout the SEA, I’d say the Philippines has some of the most pristine beaches and waterfalls. Additionally, the locals are very polite to tourists. You may get some taxi men pestering you, but they are easy to avoid if you let them know you’re not interested. I never felt in danger, but some of the spots in the cities felt a bit seedier than I am used to.
9. Weak Points: Coffee & Food. I tried the delicacies the Philippines is known for, and at least to my palate, I didn’t think it was too special. Adobo, Chicken and rice, as well as lechon (pork) tend to be popular dishes. Same for coffee, the coffee in the Philippines for most places I have tried was overly sweet and weak for espresso-based drinks. Not the worst coffee in SEA, but pretty low on the list. Additionally, food and coffee was more expensive than most other southeast asian countries.
10. Download these apps. Grab for cars, Move In (owned by Grab) for motorbike taxis, JoyRide also for motorbike taxis, SMART for sim card registration, and eGov pH for entrance into the Philippines as you will be required to fill out the entrance declaration on the app. Last note is ATMs, international ATMS are relatively uncommon. But ask around, and you can find them in each city or island you are travelling to.

Dr. Sean M. Kirkpatrick
Director, All-domain Anomaly Resolution Office (AARO)
Dr. Kirkpatrick was asked by USD(I&S) to stand-up and lead AARO in early 2022. Known as Dr. K to his staff and team, he brings over two decades of experience and a significant depth of expertise in scientific and technical intelligence (S&TI), S&TI and space policy, research and development, acquisitions, and operations, specializing in space/counterspace mission areas.
Dr. Kirkpatrick was born in Columbus, GA to an Army family. He grew up in the Atlanta area, where he attended the University of Georgia as an undergraduate, to study physics. Dr. Kirkpatrick finished his Ph.D. work in nonlinear and nonequilibrium phonon dynamics of rare earth doped fluoride crystals also at the University of Georgia, and is currently an adjunct professor at UGA.
Dr. Kirkpatrick began his career in Defense and Intelligence related science and technology immediately out of graduate school. After receiving his Ph.D. in Physics in 1995, he subsequently took a postdoctoral position at the University of Illinois, Urbana-Champaign, investigating laser-induced molecular vibrations of high explosives under an AFOSR program. In 1996, he was offered a National Research Council Fellowship at the U.S. Naval Research Laboratory in Washington D.C. investigating novel solid-state lasers for the Department of the Navy. In 1997, he was recruited by the Air Force Research Laboratory to build an Ultrafast Laser Physics Lab to investigate nonlinear optics, novel ultrafast spectroscopic methods, and nonlinear micro/nano-fabrication techniques for the Air Force. In 2003 he was offered a program manager position in the National Reconnaissance Office, and converted to CIA in 2005. In 2007, he was assigned as Chief Technology Officer in a joint CIA-DIA program office, where he later became division chief as a DIA officer. In 2010 he was asked to serve as the space control portfolio manager for the Deputy Assistant Secretary of Defense, Space and Intelligence, Office of the Secretary ofDefense.
In 2012 he returned to DIA, and served as the Defense Intelligence Officer for Scientific and Technical Intelligence, serving as the Department of Defense’s counterpart to the National Intelligence Manager for Science and Technology until 2016. Towards the end of his tenure as DIO/S&TI, Dr. Kirkpatrick served on special assignment to the Principal Deputy Director National Intelligence leading the Intelligence Community’s support to the Joint Interagency Combined Space Operations Center.
From 2016 to his current assignment, Dr. Kirkpatrick served in a variety of no-fail roles including Deputy Director of Intelligence, US Strategic Command; Director, National Security Strategy, National Security Council; Deputy Director of Intelligence and the DNI Representative for USSPACECOM. The USSPACECOM Intelligence Enterprise was the fifth organization he has been the IC lead for establishment. His most recent assignment was as Chief Scientist at DIA’s Missile and Space Intelligence Center.
Dr. Kirkpatrick is the recipient of several scientific and intelligence awards. These include the National Intelligence Exceptional Achievement Medal, four National Intelligence Collaboration medallions, the NRO Innovation and Achievement Award, the Cleary Award for Scientific Excellence, and the DIA Director’s Award for Excellence. Dr. Kirkpatrick holds 2 open patents and has contributed to several scientific books on nonlinear phenomena as well as written multiple strategies for the National and Defense Intelligence Communities. He was appointed to the Senior Service in 2012.
https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://media.defense.gov/2022/Jul/20/2003039076/-1/-1/1/DR-SEAN-M-KIRKPATRICK-BIOGRAPHY.PDF&ved=2ahUKEwjJ1Zf10oyGAxV9LkQIHSnSCKoQFnoECCEQAQ&usg=AOvVaw3R8GHHkCVxkjZBwYMWJfyK

References

• Vincent, Brandi (November 30, 2023). "Pentagon's UAP investigation chief to depart Dec. 1". DefenseScoop. Retrieved December 3, 2023.
• Seligman, Lara (November 7, 2023). "Pentagon UFO boss to step down next month". POLITICO. Retrieved November 12, 2023.
• Degges, Ireland (November 8, 2023). "AARO Shakes Up Executive Team With 2 New Leadership Changes; Kathleen Hicks Quoted". Retrieved November 14, 2023.
• https://www.politico.com/news/magazine/2023/11/12/sean-kirkpatrick-ufos-pentagon-00126214
• "USD(I&S) Ronald Moultrie and Dr. Sean Kirkpatrick Media Roundtable on the All-domain Anoma". U.S. Department of Defense. Retrieved April 22, 2023.
• "Sean Kirkpatrick, Adjunct Assistant Professor of Physics". University of Georgia.
• "Dr. Sean M. Kirkpatrick Deputy Director of Intelligence and DNI Representative, USSPACECOM" (PDF).
• "Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)" (PDF)
• Archived (PDF) from the original on May 13, 2023. Retrieved June 9, 2023.ReferencesVincent, Brandi (November 30, 2023). "Pentagon's UAP investigation chief to depart Dec. 1".
• DefenseScoop. Retrieved December 3, 2023. Seligman, Lara (November 7, 2023).
• "Pentagon UFO boss to step down next month". POLITICO. Retrieved November 12, 2023.
• Degges, Ireland (November 8, 2023). "AARO Shakes Up Executive Team With 2 New Leadership Changes; Kathleen Hicks Quoted". Retrieved November 14, 2023.
• https://www.politico.com/news/magazine/2023/11/12/sean-kirkpatrick-ufos-pentagon-00126214 "USD(I&S) Ronald Moultrie and Dr. Sean Kirkpatrick Media Roundtable on the All-domain Anoma".
• U.S. Department of Defense. Retrieved April 22, 2023.
• "Sean Kirkpatrick, Adjunct Assistant Professor of Physics". University of Georgia.
• "Dr. Sean M. Kirkpatrick Deputy Director of Intelligence and DNI Representative, USSPACECOM" (PDF).
• "Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)" (PDF).
• Archived (PDF) from the original on May 13, 2023. Retrieved June 9, 2023.

Dr. Sean M. Kirkpatrick
Director, All-domain Anomaly Resolution Office (AARO)
Dr. Kirkpatrick was asked by USD(I&S) to stand-up and lead AARO in early 2022. Known as Dr. K to his staff and team, he brings over two decades of experience and a significant depth of expertise in scientific and technical intelligence (S&TI), S&TI and space policy, research and development, acquisitions, and operations, specializing in space/counterspace mission areas.
Dr. Kirkpatrick was born in Columbus, GA to an Army family. He grew up in the Atlanta area, where he attended the University of Georgia as an undergraduate, to study physics. Dr. Kirkpatrick finished his Ph.D. work in nonlinear and nonequilibrium phonon dynamics of rare earth doped fluoride crystals also at the University of Georgia, and is currently an adjunct professor at UGA.
Dr. Kirkpatrick began his career in Defense and Intelligence related science and technology immediately out of graduate school. After receiving his Ph.D. in Physics in 1995, he subsequently took a postdoctoral position at the University of Illinois, Urbana-Champaign, investigating laser-induced molecular vibrations of high explosives under an AFOSR program. In 1996, he was offered a National Research Council Fellowship at the U.S. Naval Research Laboratory in Washington D.C. investigating novel solid-state lasers for the Department of the Navy. In 1997, he was recruited by the Air Force Research Laboratory to build an Ultrafast Laser Physics Lab to investigate nonlinear optics, novel ultrafast spectroscopic methods, and nonlinear micro/nano-fabrication techniques for the Air Force. In 2003 he was offered a program manager position in the National Reconnaissance Office, and converted to CIA in 2005. In 2007, he was assigned as Chief Technology Officer in a joint CIA-DIA program office, where he later became division chief as a DIA officer. In 2010 he was asked to serve as the space control portfolio manager for the Deputy Assistant Secretary of Defense, Space and Intelligence, Office of the Secretary of Defense.
In 2012 he returned to DIA, and served as the Defense Intelligence Officer for Scientific and Technical Intelligence, serving as the Department of Defense’s counterpart to the National Intelligence Manager for Science and Technology until 2016. Towards the end of his tenure as DIO/S&TI, Dr. Kirkpatrick served on special assignment to the Principal Deputy Director National Intelligence leading the Intelligence Community’s support to the Joint Interagency Combined Space Operations Center.
From 2016 to his current assignment, Dr. Kirkpatrick served in a variety of no-fail roles including Deputy Director of Intelligence, US Strategic Command; Director, National Security Strategy, National Security Council; Deputy Director of Intelligence and the DNI Representative for USSPACECOM. The USSPACECOM Intelligence Enterprise was the fifth organization he has been the IC lead for establishment. His most recent assignment was as Chief Scientist at DIA’s Missile and Space Intelligence Center.
Dr. Kirkpatrick is the recipient of several scientific and intelligence awards. These include the National Intelligence Exceptional Achievement Medal, four National Intelligence Collaboration medallions, the NRO Innovation and Achievement Award, the Cleary Award for Scientific Excellence, and the DIA Director’s Award for Excellence. Dr. Kirkpatrick holds 2 open patents and has contributed to several scientific books on nonlinear phenomena as well as written multiple strategies for the National and Defense Intelligence Communities. He was appointed to the Senior Service in 2012.
https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://media.defense.gov/2022/Jul/20/2003039076/-1/-1/1/DR-SEAN-M-KIRKPATRICK-BIOGRAPHY.PDF&ved=2ahUKEwjJ1Zf10oyGAxV9LkQIHSnSCKoQFnoECCEQAQ&usg=AOvVaw3R8GHHkCVxkjZBwYMWJfyK

References

• Vincent, Brandi (November 30, 2023). "Pentagon's UAP investigation chief to depart Dec. 1". DefenseScoop. Retrieved December 3, 2023.
• Seligman, Lara (November 7, 2023). "Pentagon UFO boss to step down next month". POLITICO. Retrieved November 12, 2023.
• Degges, Ireland (November 8, 2023). "AARO Shakes Up Executive Team With 2 New Leadership Changes; Kathleen Hicks Quoted". Retrieved November 14, 2023.
• https://www.politico.com/news/magazine/2023/11/12/sean-kirkpatrick-ufos-pentagon-00126214
• "USD(I&S) Ronald Moultrie and Dr. Sean Kirkpatrick Media Roundtable on the All-domain Anoma". U.S. Department of Defense. Retrieved April 22, 2023.
• "Sean Kirkpatrick, Adjunct Assistant Professor of Physics". University of Georgia.
• "Dr. Sean M. Kirkpatrick Deputy Director of Intelligence and DNI Representative, USSPACECOM" (PDF).
• "Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)" (PDF)
• Archived (PDF) from the original on May 13, 2023. Retrieved June 9, 2023.ReferencesVincent, Brandi (November 30, 2023). "Pentagon's UAP investigation chief to depart Dec. 1".
• DefenseScoop. Retrieved December 3, 2023. Seligman, Lara (November 7, 2023).
• "Pentagon UFO boss to step down next month". POLITICO. Retrieved November 12, 2023.
• Degges, Ireland (November 8, 2023). "AARO Shakes Up Executive Team With 2 New Leadership Changes; Kathleen Hicks Quoted". Retrieved November 14, 2023.
• https://www.politico.com/news/magazine/2023/11/12/sean-kirkpatrick-ufos-pentagon-00126214 "USD(I&S) Ronald Moultrie and Dr. Sean Kirkpatrick Media Roundtable on the All-domain Anoma".
• U.S. Department of Defense. Retrieved April 22, 2023.
• "Sean Kirkpatrick, Adjunct Assistant Professor of Physics". University of Georgia.
• "Dr. Sean M. Kirkpatrick Deputy Director of Intelligence and DNI Representative, USSPACECOM" (PDF).
• "Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)" (PDF).
• Archived (PDF) from the original on May 13, 2023. Retrieved June 9, 2023.
• Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)Dr. Kirkpatrick was asked by USD(I&S) to stand-up and lead AARO in early 2022. Known as Dr. K to his staff and team, he brings over two decades of experience and a significant depth of expertise in scientific and technical intelligence (S&TI), S&TI and space policy, research and development, acquisitions, and operations, specializing in space/counterspace mission areas.Dr. Kirkpatrick was born in Columbus, GA to an Army family. He grew up in the Atlanta area, where he attended the University of Georgia as an undergraduate, to study physics. Dr. Kirkpatrick finished his Ph.D. work in nonlinear and nonequilibrium phonon dynamics of rare earth doped fluoride crystals also at the University of Georgia, and is currently an adjunct professor at UGA.Dr. Kirkpatrick began his career in Defense and Intelligence related science and technology immediately out of graduate school.
• After receiving his Ph.D. in Physics in 1995, he subsequently took a postdoctoral position at the University of Illinois, Urbana-Champaign, investigating laser-induced molecular vibrations of high explosives under an AFOSR program. In 1996, he was offered a National Research Council Fellowship at the U.S. Naval Research Laboratory in Washington D.C. investigating novel solid-state lasers for the Department of the Navy. In 1997, he was recruited by the Air Force Research Laboratory to build an Ultrafast Laser Physics Lab to investigate nonlinear optics, novel ultrafast spectroscopic methods, and nonlinear micro/nano-fabrication techniques for the Air Force. In 2003 he was offered a program manager position in the National Reconnaissance Office, and converted to CIA in 2005.
• In 2007, he was assigned as Chief Technology Officer in a joint CIA-DIA program office, where he later became division chief as a DIA officer. In 2010 he was asked to serve as the space control portfolio manager for the Deputy Assistant Secretary of Defense, Space and Intelligence, Office of the Secretary of Defense.
• In 2012 he returned to DIA, and served as the Defense Intelligence Officer for Scientific and Technical Intelligence, serving as the Department of Defense’s counterpart to the National Intelligence Manager for Science and Technology until 2016. Towards the end of his tenure as DIO/S&TI, Dr. Kirkpatrick served on special assignment to the Principal Deputy Director National Intelligence leading the Intelligence Community’s support to the Joint Interagency Combined Space Operations Center.From 2016 to his current assignment, Dr. Kirkpatrick served in a variety of no-fail roles including Deputy Director of Intelligence, US Strategic Command; Director, National Security Strategy, National Security Council; Deputy Director of Intelligence and the DNI Representative for USSPACECOM. The USSPACECOM Intelligence Enterprise was the fifth organization he has been the IC lead for establishment. His most recent assignment was as Chief Scientist at DIA’s Missile and Space Intelligence Center.Dr. Kirkpatrick is the recipient of several scientific and intelligence awards. These include the National Intelligence Exceptional Achievement Medal, four National Intelligence Collaboration medallions, the NRO Innovation and Achievement Award, the Cleary Award for Scientific Excellence, and the DIA Director’s Award for Excellence. Dr. Kirkpatrick holds 2 open patents and has contributed to several scientific books on nonlinear phenomena as well as written multiple strategies for the National and Defense Intelligence Communities. He was appointed to the Senior Service in 2012.
• https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://media.defense.gov/2022/Jul/20/2003039076/-1/-1/1/DR-SEAN-M-KIRKPATRICK-BIOGRAPHY.PDF&ved=2ahUKEwjJ1Zf10oyGAxV9LkQIHSnSCKoQFnoECCEQAQ&usg=AOvVaw3R8GHHkCVxkjZBwYMWJfyKReferencesVincent, Brandi (November 30, 2023).
• "Pentagon's UAP investigation chief to depart Dec. 1". DefenseScoop.
• Retrieved December 3, 2023. Seligman, Lara (November 7, 2023).
• "Pentagon UFO boss to step down next month". POLITICO. Retrieved November 12, 2023.
• Degges, Ireland (November 8, 2023).
• "AARO Shakes Up Executive Team With 2 New Leadership Changes; Kathleen Hicks Quoted". Retrieved November 14, 2023. https://www.politico.com/news/magazine/2023/11/12/sean-kirkpatrick-ufos-pentagon-00126214
• "USD(I&S) Ronald Moultrie and Dr. Sean Kirkpatrick Media Roundtable on the All-domain Anoma". U.S. Department of Defense. Retrieved April 22, 2023.
• "Sean Kirkpatrick, Adjunct Assistant Professor of Physics". University of Georgia. "Dr. Sean M. Kirkpatrick Deputy Director of Intelligence and DNI Representative, USSPACECOM" (PDF). "Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)" (PDF) Archived (PDF) from the original on May 13, 2023.
• Retrieved June 9, 2023.ReferencesVincent, Brandi (November 30, 2023). "Pentagon's UAP investigation chief to depart Dec. 1". DefenseScoop. Retrieved December 3, 2023. Seligman, Lara (November 7, 2023). "Pentagon UFO boss to step down next month". POLITICO.
• Retrieved November 12, 2023.
• Degges, Ireland (November 8, 2023). "AARO Shakes Up Executive Team With 2 New Leadership Changes; Kathleen Hicks Quoted". Retrieved November 14, 2023.
• https://www.politico.com/news/magazine/2023/11/12/sean-kirkpatrick-ufos-pentagon-00126214 "USD(I&S) Ronald Moultrie and Dr. Sean Kirkpatrick Media Roundtable on the All-domain Anoma". U.S. Department of Defense. Retrieved April 22, 2023.
• "Sean Kirkpatrick, Adjunct Assistant Professor of Physics". University of Georgia.
• "Dr. Sean M. Kirkpatrick Deputy Director of Intelligence and DNI Representative, USSPACECOM" (PDF).
• "Dr. Sean M. Kirkpatrick Director, All-domain Anomaly Resolution Office (AARO)" (PDF).
• Archived (PDF) from the original on May 13, 2023. Retrieved June 9, 2023.

Hi! I saw a tiktok na pwedeng magka-valid ID thru orus.bir.gov.ph
I'm 19 and I want to have a valid ID because I'm planning to freelance but I don't have any idea what ID to obtain and what's the easiest to obtain
please respect my post kasi wala talaga akong idea, I live in a province din so hindi ko alam kanino magtatanong, thank you

Hi! I saw a tiktok na pwedeng magka-valid ID thru orus.bir.gov.ph
I'm 19 and I want to have a valid ID because I'm planning to freelance but I don't have any idea what ID to obtain and what's the easiest to obtain
please respect my post kasi wala talaga akong idea, I live in a province din so hindi ko alam kanino magtatanong, thank you

I emailed the following address requesting help regarding my CENOMAR -- maybe some here have encountered this situation before, I would be very interested to hear from you. I got the address from the Philippine Embassy site out of Washington DC.
cc: crs.qvu1@psa.gov.ph, crs.qvu2@psa.gov.ph, crs.qvu3@psa.gov.ph, info2@psaserbilis.com.ph
Hello and Good afternoon po,
Requesting help and guidance. I currently live in North Carolina.
I was married in the Philippines years ago.
I left the Philippines and became a US Citizen, then I was able to petition my then wife to the US.
We got divorced in the US and the divorce is now Final. I have Official Paperwork from California of the Divorce Papers
When I checked my Philippines Cenomar, it states that I am still Married.
I intend to Marry a Filipina Citizen, but it appears that my Cenomar is preventing me.
My now EX-Wife appears to be a US Citizen and she is already living with someone else in Sacramento California. They have two children of their own.
I am requesting assistance in what is the best way I can marry my Filipina Fiancé so we can get on with our lives together.
Very Sincerely,

TLDR: Can I find m/Q ratios of unknowns using AMDIS??
Hi friends! I'm a biology PhD student who has been given a stack of GC-MS data completed on a machine that is older than time and asked to analyse it using AMDIS (which is also older than time but literally the only option). Long story short someone majorly goofed and the samples and alkane standards are very messy, some are entirely unusable. To try to salvage something, I've been told by a chemistry prof to find the m/Q ratios for my unknowns, except that has proven to be an impossible task. I can't find it anywhere in the manual for AMDIS and its not anywhere that I can find in the program itself (either that or I just don't know what I am doing which is highly possible/likely). So people of reddit, please lend me your expertise and help a confused student out.

Hi guys, so… yes! this is another post about “thinking about transitioning to PM” but with a little particularities:
I’m finishing my PhD in biology (a mix of entomology - biological control - mycology). I also have some background in agriculture and environmental topics.
I’m from Spain, and it seems (?) that Pm2 methodologies (from the European Union) are gaining relevance, contrary to the more international certifications like pmp.
So, the thing is:
Is it common for such a “technical” profile to jump for this career change?
Is it somehow considered positive? Or on the contrary, companies prefer more “pure” and PM/administrator profiles?
Should i apply for pm2 certifications? Or you think they’re not that useful?
Thank you!🙏🏻
———— Extra info:
I’m DONE for good with the academia and all the $^+~ it implies… and i’ve discovered that i like working in ideas that (ACTUALLY) are going to be applied in real life and have an impact.
I’m 31, is it doable reaching a good job before 40?
Experience: -Some short courses (willing to apply for more). Although i want to avoid doing another master (already got 2). -few “not formal structured” projects: research projects in academia and services in my own company, plus i’m directing my own thesis). -1 project based on pm2 stil pending evaluation from local goverment. -1 project rejected form national gov. (Did it yeara ago when i had zero knowledge about pm and still got a decent qualification).
Skills:
researching, critical thinking, realistic, practical and “global view” of things lots of exp. In communication including clients managed and mentorized other people. some interest in leadership. Confortable with other languages
Weak spot: imposter syndrome & numbers.🙃
Pm is interesting for public and private organizations and I really think that i got the potential, but I’m a bit unsure if my scientific background and some exp/certi. would be enough for a company to choose me 🥲
Any insights? ❤️

Wanna share thjs post about "adulting" based on personal research. I added links from.government or legitimate sites for your personal review. Hope this helps for those like me who are now trying to prepare for their career foundations after graduation.

1. SSS. Different people have different contributions based on salary. For the case of us mostly being future employees the rate is 4.5% of our income, and will be matched by our employers with 9% of our income - doubling them. If your salary exceeds 20k, you will be automatically enrolled in the WISP program, increasing your monthly contributions.

Link: https://www.sss.gov.ph/sss/appmanagepages.jsp?page=scheduleofcontribution

1. Pag-Ibig. When you are employed, you are guaranteed to be a part of their Regular Savings with a recorded interest of 6.55% last 2023, and you are obligated to deposit 100 from your monthly income, and another 100 from the employer are deposit within your account monthly, although this may change to 200 for each side since February. Really neat.

Link: https://www.pagibigfund.gov.ph/Membership_RegularSavings.html

1. Pag-Ibig MP2 Savings. A voluntary and specialized savings program that has a higher divident yield per year with a 7.05% interest last 2023. The dividends are tax-free although the savings matures in 5 years so you cant touch it during that duration with a few exceptions.

Link: https://www.pagibigfund.gov.ph/Membership_ModifiedPagIBIG2.html
4.PhilHealth. Every month, with the new rule for the years 2024 and 2025, 5% of your monthly income is deducted to pay for it as contribution, capping to 5,000 pesos. It's a good chunk of your income. It has a lot of medical benefits you can utilize, though.
Link: https://www.philhealth.gov.ph/partners/employers/ContributionTable_v2.pdf

1. Income Tax. As a citizen of the Philippines we are legally obligated to pay our taxes and I would highly argue that the best patriotic thing you can do to care and love your country is simply paying your taxes and voting every elections. Income tax works by annual income brackets with those earning not more than 250k annualy not required to pay income taxes. Rules apply differently if you are self-employed or in any other income groups.

Link: https://www.bir.gov.ph/index.php/tax-information/income-tax.html#it_rates

1. Government IDs. Nothing symbolizes a fully-independent and budding young adult than a leather wallet filled with a full set of government IDs - postal ID, PhilSys ID, driver's license, pasaporte, PhilHealth ID, UMID ID, and TIN ID. Each IDs are acquired differently and their official websites provide scheduling features or online registrations, take advantage of those for your convenience. Beware of "trash" websites mimicking legitimate government websites to get your personal information.
   
2. eGovPH. As an IT student and a software developer myself, I am guilty of amusing myself with the level of quality of a few government websites (NBI Clearance/Police Clearance websites are with all due respects feels and looks like it was built by senior high school ICT interns). eGovPH (and LTO Portal) is.. a different one as it feels polished albeit lacking in features. It centralizes government functions and other things. Take a look to know more in Play Store.
   
3. Credit Score. It is a centralized score calculated and stored by the Credit Information Corporation managed by the government and is used to assess how trustworthy you are in borrowing money. Credit score affects how low - or high - interest rates for loans you take from banks. It is an important thing to consider if in long-term you wish to take a large loan from banks for a business, a house, or land lots and you wish to acquire the lowest interest rate. Useful also for financing motorcycles and cars and other things through banks. In short, higer credit score meant you can borrow larger funds with lower interests from banks. Credit score are not applied in many other lending organizations - usually those where borrowing is "easier" - but they charge high interests (mobile lending applucation, salary loans).
   

Links: https://www.creditinfo.gov.ph/about-your-cic-credit-report

1. Credit Cards. The "black card". It is a financial instrument that allows you to borrow money from a bank you applied with for your purchases. Irresponsible use meant hell and a buttload of problems as not paying for your debts meant additional fees. Despite this, credit card - to responsible users - will improve your credit score and allow you to earn points for use in travels, food, groceries, gasoline and many more which means free money. Paying your debt before the end of the monthly cycle means no interest added. Better read more about these to know and understabd more about this.

Links: https://www.moneymax.ph/credit-card/articles/credit-card-interest-rate https://www.moneymax.ph/credit-card/articles/best-credit-cards-philippines

1. Insurance. This is a kind of security that supports you and your family for unexpected events - death, illnesses, accidents, house fire, and other - you can avail and pay periodically. Personally, I am not a fan of life insurances and VULs promoted by financial advisors but that's my take. I would rather avail for a health insurance or HMO with a wide coverage for me and my family since a serious illness, no matter how much money you have, will seriously put a large dent and devastate your finances in a matter of days or months. Issue here is unlike government institutions, insurances are provided by private institutions and businesses that definitely operates for profit and may not issue money in some cases (based on what I read, this really happens although rare in well-established ones). Some on the other hand issue financial support for a lot of cases that they operate with a loss, resulting in unpaid claims and health providers like hospitals not honoring insurance claims. Definitely something you must research on your own in depth.

That is all. 😁

I'm sorry if my grammar won't be perfect, I am dealing with a lot of problems right now and I don't want to think anymore, so please be nice.
I (28F) am half Japanese and half Filipino, born in Japan but I grew up in the Philippines and still living in the Philippines as of the moment; My dad is Japanese and my mom is a Filipina. My parents are separated and I don't have contact with my dad anymore.
I needed to submit some documents for a job in Europe and one of the documents needed is Passport, ofcourse. I have my old passport here (Non E-passport, expired year 2009) and I just needed to renew it.
When I was about to renew my passport, they asked for my PSA Birth Certificate, which I don't have and I don't have any idea that I CAN get PSA because ever since, no one asked me for my PSA. Government offices such as SSS, BIR, PRC accepted my Koseki Tohon (Family Registry / Birth Certificate in Japan).
Asked my mom if she knew about this, she said our relative is the one who processed my documents when I was born. She called her and remembered that they didn't continue passing the requirements at DFA because at that time, my dad doesn't want to give some of the needed documents. So they just decided to not declare my birth and forgot about it.
Since PSA is required, they told me to check the requirements on DFA site for me to process my report of birth. I checked the requirements and I already have all the documents needed to submit, so here's one of the problems.
I called them two times already and they said walk-ins are not allowed and I needed to send the scanned documents via email for the "pre-evaluation" then they will reply for the appointment date. I sent the email last month, and been sending email everyday since then. I didn't receive a single reply from them. The email address is also correct, asked the staff at DFA and PSA and also checked on site incase someone will say that maybe I am sending it on the wrong email.
Here are the email addresses: [oca.crd-aspac@dfa.gov.ph](mailto:oca.crd-aspac@dfa.gov.ph) and [oca.crd@dfa.gov.ph](mailto:oca.crd@dfa.gov.ph)
I only have until next month to submit the requirements I needed for work which is sad because I am supposed to leave with my friends, but I know I won't be able to go with them anymore. Mind you, it is also one of my dreams to work in Europe. And even if I can't go, I really need to fix this problem.
I literally just need a reply from DFA. What should I do?
PS. Again, please be nice, I have anxiety and I can't even eat anymore and can't do the things I used to love because of this. I hope no one will comment something rude/mean.
Will appreciate the help/replies. Thank you.
Update: DFA replied to my email this morning but didn't send me an appointment date. They asked me to submit additional documents, now I need to wait for their reply again which will take more than a month again? Lol

𝐓𝐨 our 𝐟𝐞𝐥𝐥𝐨𝐰 𝐛𝐫𝐨𝐤𝐞𝐫𝐬: 𝐏𝐥𝐞𝐚𝐬𝐞 𝐛𝐞𝐰𝐚𝐫𝐞 𝐨𝐟 𝐚𝐧 𝐨𝐧-𝐠𝐨𝐢𝐧𝐠 𝐌𝐨𝐧𝐞𝐲 𝐋𝐚𝐮𝐧𝐝𝐞𝐫𝐢𝐧𝐠 𝐬𝐜𝐡𝐞𝐦𝐞 𝐛𝐲 𝐅𝐨𝐫𝐞𝐢𝐠𝐧 𝐧𝐚𝐭𝐢𝐨𝐧𝐚𝐥𝐬.

1. They will contact you with the intent to buy the property you're selling using Chinese Yuan.
   
2. Once you decline, they will ask for your help to convert their Yuan to Peso thru black market exchanges.
   

Don't fall for their trap.
𝐍𝐨𝐭𝐞: 𝐑𝐞𝐚𝐥 𝐄𝐬𝐭𝐚𝐭𝐞 𝐁𝐫𝐨𝐤𝐞𝐫𝐬 𝐚𝐫𝐞 𝐧𝐨𝐰 𝐜𝐨𝐯𝐞𝐫𝐞𝐝 𝐩𝐞𝐫𝐬𝐨𝐧𝐬 𝐮𝐧𝐝𝐞𝐫 𝐀𝐌𝐋𝐀.
Source: http://www.amlc.gov.ph/publications/16-news-and-announcements/257-advisory-for-real-estate-developers-real-estate-brokers-offshore-gaming-operators-ogo-and-ogo-service-providers#:~:text=Pursuant%20to%20the%20Anti%2DMoney,SPs)%20are%20now%20covered%20persons.)
𝐏𝐞𝐧𝐚𝐥𝐭𝐲 𝐟𝐨𝐫 𝐌𝐨𝐧𝐞𝐲 𝐋𝐚𝐮𝐧𝐝𝐞𝐫𝐢𝐧𝐠 𝐮𝐧𝐝𝐞𝐫 𝐑𝐀 𝟗𝟏𝟔𝟎:
SEC. 14. Penal Provisions. — (a) Penalties for the Crime of Money Laundering. The penalty of imprisonment ranging from seven (7) to fourteen (14) years and a fine of not less than Three million Philippine pesos (Php3,000,000.00) but not more than twice the value of the monetary instrument or property involved in the offense, shall be imposed upon a person convicted under Section 4(a) of this Act.
Source: http://www.amlc.gov.ph/laws/money-laundering/2015-10-16-02-50-56/republic-act-9160

I have been battling SIBO/an intestinal infection for over a year now. Have been in and out of the ER, and doctors found constipation on my right side every time. Frustrated with my doctors and the lack of adequate care that I received, I began doing my research and ordered a stool test and sent that in and found out that I have various levels of pathogenic bacteria in my colon - some of which are associated with hydrogen sulfide SIBO, ulcerative colitis, and Chrons disease. Did a TRIO smart breath test, and that also confirmed hydrogen sulfide SIBO.
Hydrogen sulfide bacteria are notoriously known for creating copious amounts of biofilm (biofilms are mucus layers that bacteria use to protect themselves - they supply these layers with everything from nutrients to heavy metals), that, in turn, can cause constipation. This may be why I end up constipated on my right side every time. A lot of biofilm production ends up near the cecum, and ileum, the valve that connects the small and large intestine together.
I am currently on antibiotics, and I have seen some improvement in my condition. However, I am still trying to break open the biofilms that are causing my illness.
I know these are frowned upon here and elsewhere in the medical community, but I have been getting colonics and have been getting relief from those. This is NOT medical advice, just my own personal experience with them. I have passed all sorts of things like parasites, biofilms/mucus, etc, that initially made me so ill. Biofilms are connected with the development of cancer, for example.
I AM AWARE of the risks associated with colonics. I have done my research on them and determined that the benefits outweigh the risks for me.
The gist of my post is --- there could be an underlying cause of your constipation - whether it is something genetic, bacterial/parasite/candida-related, or even a weak pelvic floor.
Please explore your cause!!!!
Sources:
Biofilms/cancer connection: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436866/
Hydrogen sulfide/inflammatory bowel disease connection:
https://pubmed.ncbi.nlm.nih.gov/37627565/#:~:text=H2S%20has%20been,and%20ulcerative%20colitis%20(UC).
Subreddit dedicated to biofilms:
biofilms
Pictures of biofilms found in ulcerative colitis/Chrons patients:
https://pubmed.ncbi.nlm.nih.gov/34146566/#&gid=article-figures&pid=supplementary-figure-1-uid-4
Dr. Ghannoum, PhD, discovered that pathogenic fungi/bacteria hide behind biofilms in 2016:
https://www.reddit.com/biofilms/s/2WVyGEIzYW
Biofilms can prevent antibiotics from working properly (i.e., antibiotics can't penetrate the biofilms to target the necessary bacteria):
https://asm.org/articles/2023/march/the-role-of-bacterial-biofilms-in-antimicrobial-re#:~:text=Various%20components%20work%20in%20tandem,a%20phenomenon%20known%20as%20recalcitrance.
Locations of biofilms throughout the intestinal tract:
https://ibb.co/586Rq2R
Biofilms may impede nutrient absorption:
https://www.longdom.org/open-access/the-probiotic-biohm-improves-nutrient-absorption-by-disrupting-gastrointestinal-biofilms-44470.html?fbclid=IwZXh0bgNhZW0CMTEAAR1obVKB115csrtff4HM_BEm0P69eWHPpYwLYdSckwsubtCw2Z7JkSN-6xc_aem_AV_eKTeXJ_mqwwsF55HUvyKodl7FeT_c1lR_jUYELPs8YrNbtHd46oX55nqoj4G4Idbn4I7B604FY2XCRAAPuOrC#:~:text=By%20forming%20a%20thick%20layer,nutritional%20source%20for%20their%20survival
Biofilms may be linked to leaky gut (intestinal permeability):
https://oc-integrative-medicine.com/biofilms-in-the-gut-microbiome/?fbclid=IwZXh0bgNhZW0CMTEAAR0WDj4iphWkZVk53GIfBMrzYI46N9AtUi30QZgaN5PiudDtqEGFzP54olk_aem_AV-sWaxR-ZNeQsJjMKJDcTYEEMsdfCnuDib6UY-VWuR5QzGT-YuphEBFIu_GC2M0RiPCUnvPChSQTbUroSW4nx_T

Yung mga nababasa ko and nababalitaan about mga sleeper cell kuno and silent invasion ng chi sobrang nakakabother. Knowing kung ano yung military leverage ng chi tapos di hamak na andami na talaga dito mga chinese. Idagdag mo pa yung mga nababalitaan na mga pogo near military bases. Ako lang ba or parang sobrang nakakabahala dagdag mo pa yung thought na ang incompetent ng gov ngayon lalo sa pag harap sa ganitong issue. Nasa isip ko na if aabot ba ako ng 30s na buo pa rin ang Ph or what huhu naiiyak ako oa na kug oa pero nakakatakot sobra.

I tried to copy paste and reformat it but references didn't work so sorry about that, just go to the link.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2818193

Dental diseases and procedures are common, troublesome, and expensive, exceeding spending on other major health conditions, such as diabetes, ischemic heart disease, hypertension, dementias, and breast cancer, in the US. Dental issues are relevant for internists because unmet dental care needs can be painful for patients. Excluding teeth from medical health care is arbitrary.
Evidence-based medicine, a movement that gained prominence in the 1990s, has profoundly affected the practice of medicine. Unfortunately, little progress has been made on using data from clinical trials to determine best practices for dental care. Instead, most dental care relies on practice patterns influenced by the economic pressures of running a dental practice, dentists’ professional training and opinions, and patients’ expectations, all of which tend to favor excessive diagnoses and interventions. The result is that while many people who have low income go without any dental care, those who can pay are subjected to overdiagnosis and overtreatment.
Overdiagnosis
Overdiagnosis occurs when conditions that will never cause harm are identified. Unnecessary treatments resulting from overdiagnosis subject patients to potential harm and waste valuable resources that could be used for necessary and effective treatments.
For example, dentists may treat early noncavitated caries lesions, aiming to prevent more advanced lesions, such as dentine cavities. A noncavitated caries lesion is a demineralized enamel spot (white spot lesion) without evidence of cavitation. The majority of white spot lesions will not progress,1 and there is no evidence that early treatment, except with fissure sealants, is generally more effective than no treatment in preventing dentine cavities.2 Paradoxically, these sealants are frequently overlooked or underused by dentists. Dental cavities are routinely filled in children, despite evidence that dental pain and infection rates due to dental cavities in primary teeth are similar (about 40%) in children who are randomized to teeth being filled or not being filled.3
Decline in Caries and the Impact on Dentists’ Workload
In the 1970s, there was an unexpected, extraordinary decline in the number of cavitated caries lesions seen in dental patients.4 This decline in the number of patients’ cavitated caries lesions affected dentists’ workload and has played a role in overdiagnosis and treatment in dentistry so that dentists can support their practices. This financial need led to more recommendations for regular 6-month visits.5 Two randomized clinical trials failed to demonstrate that 6-month intervals between dental checkups result in better oral health compared with longer intervals (up to 24 months), which led the authors of a Cochrane review to conclude: “Whether adults see their dentist for a check-up every 6 months or at personalized intervals based on their dentist’s assessment of their risk of dental disease does not affect tooth decay, gum disease, or quality of life. Longer intervals (up to 24 months) between checkups may not negatively affect these outcomes.”6 Nonetheless, the standard for dental visits remains every 6 months.
Scaling and Polishing
Another commonly performed procedure is scaling and polishing to prevent periodontitis, a common condition in middle-aged persons. Scaling removes plaque and calculus from the crown and root surfaces of the teeth and is performed using hand or ultrasonic scalers. Polishing, which entails the mechanical removal of extrinsic stains and deposits, is typically done using a rubber cup or bristle brush loaded with a prophylaxis paste.
The assumption has been that scaling and polishing can prevent gingivitis and periodontitis, thus potentially preventing tooth loss, pain, and mobility. However, to our knowledge there are no published clinical trials assessing these outcomes.7 The existing evidence only evaluates short-term surrogate outcomes. It suggests that treating periodontitis, specifically through root planing, leads to a slight enhancement in the gum-to-tooth attachment level among individuals with moderate to severe periodontitis.8 However, there does not appear to be any advantage to scaling and polishing for adults without periodontitis.9
Changing Financial Incentives
The prevailing dental economic model based on fee-for-service creates an environment of dental overdiagnosis and overtreatment. At the same time, many persons who do not have dental insurance cannot afford to pay out of pocket for dental care, creating a situation where people with low income or who are part of a racial and ethnic minority group are often underdiagnosed and undertreated. A value-based model, in which dentists are paid to maintain oral health rather than to deliver treatments like fillings, cleanings, and fluoride applications, could be more positive for oral health. A study conducted in Rio de Janeiro (and coauthored by one of us [P.N.]) found that, among patients without treatment indications, an average of 2 teeth were treated during a 6-month follow-up period. This number increased to 3.6 teeth if the patient had changed dentists.10 A clear need exists for trials to compare different methods of paying dentists to assess the impact on oral health and on overtreatment and undertreatment.
What Is the Way Forward?
We do not want to give the impression that dental care is not important. On the contrary, dental pain, oral abscesses, broken teeth, and inflamed tissues surrounding the teeth are common presentations to medical professionals, especially those working in urgent care settings. Similarly, good dentition is nutritionally important for eating a full diet and psychologically essential to a person’s sense of appearance. However, dental procedures should be based on effectiveness and safety.
It is true that many important dental outcomes (eg, tooth loss) may take a long time to assess. On the other hand, the human mouth offers an easy trial design in which some procedures, such as filling a tooth, could be determined by randomization when there is more than 1 tooth in the mouth with a cavity. Other common abnormalities can impact adjacent teeth (eg, periodontitis) and require a refined design (eg, randomization to quadrants or sextants).
Identifying which dental procedures are beneficial and ensuring that relevant dental associations update their guidelines accordingly provide an opportunity to allocate resources to those who need them the most. The aim is to reduce overdiagnosis and overtreatment while increasing necessary treatment.
Corresponding Author: Paulo Nadanovsky, DDS, PhD, Oswaldo Cruz Foundation, FIOCRUZ, Brazil, Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil ([paulo.nadanovsky@gmail.com](mailto:paulo.nadanovsky@gmail.com)).
Published Online: May 6, 2024. doi:10.1001/jamainternmed.2024.0222
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank Steven Woloshin, MD, MS, The Center for Medicine and the Media, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, and The Lisa Schwartz Foundation for Truth in Medicine, for his invaluable intellectual contributions to the development, writing, and critical revision of this paper. Dr Woloshin was not compensated for his contributions.

REFERENCES
1.Ferreira Zandoná A, Santiago E, Eckert GJ, et al. The natural history of dental caries lesions: a 4-year observational study.  J Dent Res. 2012;91(9):841-846. doi:10.1177/0022034512455030PubMedGoogle ScholarCrossref2.Bomfim AR. O Tratamento da Lesão de Cárie Dentária Não Cavitada é Efetivo? Uma Revisão Sistemática. Dissertation. Universidade do Estado do Rio de Janeiro; 2022. Accessed April 1, 2024. https://www.bdtd.uerj.br:8443/handle/1/186113.Innes NP, Clarkson JE, Douglas GVA, et al. Child caries management: a randomized controlled trial in dental practice.  J Dent Res. 2020;99(1):36-43. doi:10.1177/0022034519888882PubMedGoogle ScholarCrossref4.Nadanovsky P, Sheiham A. Relative contribution of dental services to the changes in caries levels of 12-year-old children in 18 industrialized countries in the 1970s and early 1980s.  Community Dent Oral Epidemiol. 1995;23(6):331-339. doi:10.1111/j.1600-0528.1995.tb00258.xPubMedGoogle ScholarCrossref5.Sheiham A. Is there a scientific basis for six-monthly dental examinations?  Lancet. 1977;2(8035):442-444. doi:10.1016/S0140-6736(77)90620-190620-1)PubMedGoogle ScholarCrossref90620-1)6.Fee PA, Riley P, Worthington HV, Clarkson JE, Boyers D, Beirne PV. Recall intervals for oral health in primary care patients.  Cochrane Database Syst Rev. 2020;10(10):CD004346.PubMedGoogle Scholar7.Hujoel PP. Endpoints in periodontal trials: the need for an evidence-based research approach.  Periodontol 2000. 2004;36:196-204. doi:10.1111/j.1600-0757.2004.03681.xPubMedGoogle ScholarCrossref8.Jervøe-Storm PM, Eberhard J, Needleman I, Worthington HV, Jepsen S. Full-mouth treatment modalities (within 24 hours) for periodontitis in adults.  Cochrane Database Syst Rev. 2022;6(6):CD004622.PubMedGoogle Scholar9.Lamont T, Worthington HV, Clarkson JE, Beirne PV. Routine scale and polish for periodontal health in adults.  Cochrane Database Syst Rev. 2018;12(12):CD004625. doi:10.1002/14651858.CD004625.pub5PubMedGoogle ScholarCrossref10.Naegele ER, Cunha-Cruz J, Nadanovsky P. Disparity between dental needs and dental treatment provided.  J Dent Res. 2010;89(9):975-979. doi:10.1177/0022034510369994PubMedGoogle ScholarCrossref

I recently re-introduced L-Arginine to my army of amino acids I take on a daily basis for health reasons but more specifically for oral health and it has left my mouth feeling cleaner than clean.
I suffer from tooth enamel erosion and it is supposed to aid in re-mineralizarion and a correction of the PH of the mouth which is also super important bc this enables the right balance of good to bad bacteria to thrive apart from keeping our teeth from essentially melting way and getting decayed from acidification.
I add a TINY bit of the powder to my brushes and have brushed my teeth and tongue with it for a couple of days and it has wiped out any biofilm on my teeth and they all feel like they are made of polished pearls.
BUT if taken too much the effect of it breaking down the protein barriers of the biofilm is also what leads it to break down the molecular layer of protein that hides the herpes simplex virus in remission and even shingles leading to outbreaks in some cases (yikes!) . This can be remedied by taking extra Lysine which is the Amino Acid that balances Arginine and what some people take when they get cold sores.
I once took it a couple years ago in large amounts and it led to tingling and ultimately got a small cold sore which I got under control after I stopped taking the Arginine...this time around I'm taking a minuscule amount in comparison and havent had an issue yet but boy is my mouth feeling/looking/smelling better.
So despite the worst case scenario side effect being a tad scary the effects on the oral biome are nothing short of amazing. Check out these medical magazine articles:
https://www.rdhmag.com/patient-care/article/16408932/arginine-and-oral-health-its-affect-on-oral-microbial-diseases
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802732/
Also, I was surprised to see that even Colgate (which is a huge mainstream commercial company) adds it to some products in certain countries.
https://www.colgateprofessional.com/dentist-resources/caries/arginine-a-new-and-exciting-approach-to-oral-care

My wife (Filipina) and I (American) are traveling to Ph to visit family. We normally bring small gifts, mostly clothing, so never had any issues . This year we are planning to buy iPads for the kids and bring over. Would these need to be declared? If so, what am I looking at in taxes.
I’ve seen on the ph.gov customs page there was a 10k limit on gifts but it was very vague in details and what taxes would be involved.
TIA !