Proc dure de diagnostic cadillac catera

On Paediatric Sex Trait Modification

2024.05.12 11:33 Key-Talk-5171 On Paediatric Sex Trait Modification

What does the evidence say in favour of puberty blockers and cross-sex hormones for gender dysphoric youth? As we will see, it doesn't say much, at all. Systematic reviews are at the top of the evidence-based medicine pyramid, examining the literature in depth using non-biased, objective measures to determine its quality. We'll be looking at those, as well as what the guidelines for paediatric gender medicine are in some European countries. If you were to pick out countries that have an interest in deliberately misconstruing evidence to push an ideological narrative, these countries, some of the most progressive in the world, wouldn't even be in the hat.

Evidence

First, let's look at a systematic review funded by WPATH, you can't get any more pro trans than this. If any review were to find high quality evidence on these interventions, it would be this one. After finding studies that met certain inclusion criteria, they used prestigious Cochrane guidelines to evaluate their quality. For all outcomes but death by suicide, evidence was graded low, death by suicide evidence was graded insufficient. For a study funded by WPATH, this is the first indication that the evidence for these interventions is remarkably weak. We've all heard the phrase "do you want a living son or dead daughter?", and we now know it is based on no substantive evidence of any kind.
Next, there was a systematic review funded by the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) to construct guidelines for treating gender dysphoric youth in Sweden. They concluded;
GnRHa treatment in children with gender dysphoria should be considered experimental treatment of individual cases rather than standard procedure.
Swedish guidelines are as follows;
At group level (i.e. for the group of adolescents with gender dysphoria, as a whole), the National Board of Health and Welfare currently assesses that the risks of puberty blockers and gender-affirming treatment are likely to outweigh the expected benefits of these treatments
They say that using these treatments are only warranted in "exceptional" cases, whatever this means. They also state that these experimental treatments should only be offered within the context of a research setting, not standard treatment for gender dysphoria.
Both Swedish and Finnish guidelines state that psychosocial therapy as first line treatment for gender dysphoria, as well as looking at the presence of other mental health co-morbidities.
We also have a report from the Norwegian Healthcare Investigation Board (Ukom) which investigates systems and processes in healthcare, identifying factors that could have led, or could potentially lead, to harm for patients. This is regarding the evidence for sex trait modification in youth.
They say;
The knowledge base, especially research-based knowledge for gender-confirming treatment (hormonal and surgical), is deficient and the long-term effects are little known. This is especially true for the adolescent population where the stability of their gender incongruence is also not known. There is a lack of research-based knowledge on the treatment of patients with non-binary gender incongruence. In order to safeguard patient safety, Ukom considers it necessary to strengthen the knowledge base on gender incongruence and gender dysphoria, and to align the health service offering with the knowledge base.
Puberty delaying treatment (puberty blockers) and hormonal and surgical gender reassurance treatment for children and adolescents are defined as investigational treatment. This is especially important for teenagers with gender dysphoria.
Investigational treatment in this context means: all treatment where efficacy and safety are not sufficiently documented for the treatment to be included in the ordinary treatment offer. I.e. puberty blockers and CSH shouldn't be included in routine treatment for gender dysphoric youth. It isn't routine treatment because there is insufficient evidence that it is actually effective and that the benefits outweigh the risks.
Additionally, there is a German systematic review of the evidence that was released earlier this year, building upon the NICE reviews out of the United Kingdom performed a few years ago.
The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn’t suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD. Psychotherapeutic interventions to address and reduce the experienced burden can become relevant in children and adolescents with GD.
The Bundesärztekammer (German Medical Association passed a resolution calling on the German Federal Government to restrict the use of puberty blockers and cross-sex hormones for under 18s to a controlled research setting only, aligning with Swedish and Finnish practice. They cite the reasoning;
The current medical evidence clearly states that puberty-blocking drugs (PB), cross-sex hormone treatments (so-called cross-sex hormone Administration [CSH]) and gender reassignment surgery (e.g. mastectomy) do not improve GI/GD symptoms or mental health in minors with GI/GD. These are irreversible interventions in the human body in primarily physiologically healthy minors who cannot give informed consent in the absence of evidence for such measures.
This is in direct opposition to pro-trans-affirming draft guidelines published by the smaller association AWMF, which is odd given the aforementioned systematic review showing no good evidence for sex trait modification of minors in treating GD. But even if these guidelines are finalised, the GMA resolution strongly signals a possibility that they won't be widely accepted.
So, to any person reading who is in favour of turning children into sterile, life-long medical patients, what's more likely, do the health authorities in Sweden, Norway, Finland, Germany and the UK all hate transgender people and want gender dysphoric youth to kill themselves, or are you simply the party who is wrong on this topic?

Safety

We have considered the evidence in favour of sex trait modification in youth to treat gender dysphoria, as we have seen, there is no good evidence that they produce improved mental health outcomes. First, it must be emphasised that there are no long-term longitudinal studies on children given puberty blockers to block normally timed puberty looking at effects that might arise in adulthood, there are none of this nature. We know that over 90% of kids who are treated with puberty blockers go on to receive cross-sex hormones which most probably results in permanent sterility, as there are no methods of fertility preservation. Meanwhile, most kids not given medication desist in their dysphoria over time. This lends credence to the view that puberty blockers "lock in" a certain gender identity, and thus the hypothesis that blockers are "buying time to think" is false, as they almost always go on to take cross sex hormones. Children are not mature enough to give up future fertility entirely in return for unsupported mental health benefits.
Since nearly all participants started GnRHa after turning 13 and underwent a thorough diagnostic assessment before treatment was started, it is likely that most people starting GnRHa experienced sustained GD. Still, one cannot exclude the possibility that starting GnRHa in itself makes adolescents more likely to continue medical transition
https://academic.oup.com/jsm/article/20/3/398/7005631?login=false
Profound effects on future sexual function may even occur when puberty is paused and later allowed to proceed, since the precise timing of hormone exposure during the peripubertal window is a determinative factor in adult sexual function
There may be a possible underlying cause for why it is practically guaranteed for children that receive puberty blockers to go on to receive cross sex hormones, which collectively entail permanent castration. We know that the inferior fronto-occipital fasciculus (IFOF) has been implicated in playing a predominant role in the neural basis of visual/body perception, and that alterations in this area of the brain pays a role in the pathophysiology of anorexia nervosa. Interestingly, even after for controlling for sexual orientation, which we know can cause brain-sex atypicality in the case of homosexuality (and thus confounding for gender dysphoric persons), studies have shown reduced white matter integrity in the IFOF in transpersons, the same area of the brain that is altered in cases of anorexia nervosa. It has been reported that a dose dependent inverse relationship exists between amount of puberty blocker given to gender dysphoric adolescents and white matter integrity in the IFOF, in essence, this may be a potential mechanism as to why puberty blockers solidify the gender dysphoria.
There is also a concern in regards to brain maturation as a result of adolescent sex hormones, neural circuits to do with executive functioning are thought to be rewired during this critical period of puberty. If this is case, brain maturation during puberty may be temporarily or permanently disrupted as a result of these puberty blockers. This could have significant long term neuropsychological consequences including impact on the ability to make complex risk-laden decisions. Because we have no long term studies on the usage of puberty blockers, extreme uncertainty about its long-term effects make prescribing such drugs undesirable, especially given the fact that no good evidence exists for their efficacy.
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2024.05.09 19:33 RandomNameGenerated9 Think this is 30% but hoping for 50%. Any guesses?

Think this is 30% but hoping for 50%. Any guesses? submitted by RandomNameGenerated9 to VeteransBenefits [link] [comments]


2024.05.09 02:42 CadetHoldingThatTV When asked to be honest, the story of a tired worker

The most recent in a long line of just asking me how I feel working at best buy, figured I might as well just air all that built up irritation out for my leaders to ignore, and hopefully some of you to enjoy.
  1. How happy are you working at Best Buy
    1. 1
      1. The Best Buy I was hired to work at no longer exists. While the physical location is still there, the people who made it such a success during my tenure are gone. It has become less a place to work and more a ticking clock, I have watched people whom I was encouraged to befriend, to work hard with to be successful in this business stripped of their jobs, while I watch my own role grow beyond what is was promised to be when I was hired on with no sight of additional compensation. This job has gone from a place I could proudly say I work at, to a place where I ACTIVELY tell people to stay away from, as I would never wish the insecurity and fear on any other person. In the strictest of sense, I am filled with dread as I continue to work for the shadow of a great company.
  2. I would recommend Best Buy as a great place to work
    1. 1
      1. It is not a great place to work. It is blatantly the opposite. This horrible place has continued to push it’s employees past breaking points, damaged morals and actively robbed it’s employees of any sense of accomplishment and pride in their jobs. Just when you think things can’t get any worse, a meeting is called and half the workforce cleaved in half. The part removed left waiting for months for severance, while those that remain are told just how “Privileged” they are to have gotten to remain, to expect additional responsibilities to fall on you as “The company can’t afford extra staff.” all while the corporate offices keep bonuses, tell us how great we are doing as a company with RECORD profits, and our CEO gets another 2 million dollars added to her salary.
  3. I feel a sense of belonging at Best Buy
    1. 2
      1. Any belonging I feel has nothing to do with Best Buy. This company does not care about me, my coworkers, or even my bosses. Any sense of belonging I have is like a trauma bond to other victims of this company's constant de-moralling and damaging workplace expectations. I am but an expendable employee to a company that continues to undermine the job that I do, and the blatant disrespect of coworkers around me. This shows me that I am not the only one feeling this complete hopelessness this company has fostered..
  4. Regardless of background, everyone at Best Buy has an equal opportunity to succeed.
    1. 1
      1. This statement is a misnomer. There is no opportunity to succeed. There is only failure in the current Best Buy. There is more opportunity in a dice game than there is working at the current Best Buy, as you continue to dodge lay-offs, loss of position to restructures, to even just finding work in the field due to lack of training on any level, and pushing jobs off employees to third party service providers. While this should be something new it is a disturbing trend that has been going on for years, and has only become worse as anyone hired on quickly realizes that this job is a short term fix at best, and a mistake at worst.
  5. I feel empowered to make decisions regarding my work.
    1. 1
      1. Any and all decisions I make for my time at work are hard fought for. Turning down work outside of my own responsibilities is often held over my head with the veiled threat of not being promoted, any instance of me just wanting to do my job being seen as not doing enough. Any time I make an exception it becomes the new expected. I have had to set very hard boundaries, and defend them harshly with otherwise being forced into a position that I am not properly compensated for.
  6. I am able to make a meaningful impact through my role at Best Buy.
    1. 1
      1. Any impacts I make while working at Best Buy are in spite of what Best Buy puts me through every day. It is not the fault of the client that they have grown to trust the name of Best Buy and Geek Squad. This company was once trustworthy and true to its customer promises. Now it is a shell of its former self as we continue to pivot toward out of house service providers and move away from our long history of being there for our client base. I will continue to support the clients for as long as I can till my own termination from the company.
  7. My role is an excellent fit with my strengths.
    1. 1
      1. I have been trained in computephone/tablet repair and diagnostics. In that position I was given more and more responsibilities until I was told to become an in-home computer specialist I would need to come to the field as a cadet and learn how to do the job. As a cadet I showed that I could not only do the job, but did it for nearly 2 months. After which it was given to someone else less qualified than me. Now I am still a cadet, wasting 10 years of training and the position that was once my goal in the company is gone.
  8. I have good opportunities to learn and grow at Best Buy.
    1. 1
      1. There is no growth in Best Buy. You have to have skills you already acquired to work here, because there is no training here. Only spreadsheets with stats on them that mean nothing to you if you don’t already know what they mean. To grow in Best Buy you must do it off the clock, away from the store, as it is not a place of opportunity, but a place that uses your existing knowledge for profit.
  9. My job challenges me to grow my skills.
    1. 1
      1. There is no growing skills in Best Buy. You either have the skills needed to do the job, or you do not have the job. This job does not have time for you to learn, you are thrown to the wolves with less the 10 hours training, expected to perform at a near super natural level, learn systems on the fly, and should you need help, you will be left completely on your own to drown by your management team. You either know what you're doing, or you don’t work here.
  10. I have the resources I need to do my job well.
    1. 2
      1. Getting resources required to do this job is like bartering with a small village. All tools are hand me downs from previous agents as ordering new tools is too expensive. Ordering supplies to do the job is so hair pullingly difficult, even managers don’t want to do it, meaning you are often talking to other agents and rationing out required screws, toggles, or even drill bits in hopes you can finish your jobs for the day. Should one of your tools actually break and you need a replacement? No, send it in to be fixed, and just figure out how to do your jobs for the day. On my team alone, there has been one new drill ordered in 2 years, for a team that was once 4 home theater teams.
  11. In general, I feel that my workload is manageable.
    1. 1
      1. Manageable is not the word I would use. Unrealistic is. Teams in the field and store have been cut to near ghost town levels of employees. In the field we have days where we are expected to complete upwards of 6 jobs in a day, often scheduled incorrectly, and when adding in the correct labor turns a day that should only be 8 hours into 12. Drive times are non-existent, and with all this we are also expected to sell to our clients and get them more services. To call it manageable is laughable.
  12. I get sufficient time to do a quality job.
    1. 2
      1. The amount of time required to do most of the jobs in the field correctly, safely, and to most client’s very strict guidelines is hard even for the most experienced installer. No two homes are the same, and oftentimes a client has been given grand expectations and additional promises not added to labor lines or notes. This often leads to less happy clients, as to do a quality job calls for sacrificing in training time, or a disappointment of additional charges and labor must be added to a job pushing all other jobs back that day. I am lucky to have a good agent that is able to focus on the job at hand while I can assist in client education and clean up, but I know not all agents are so lucky.
  13. I have satisfaction with my work and personal life balance.
    1. 1
      1. This job is mentally draining. It does not finish when I am out of a client’s home. I have to silence or straight shut off my work phone to keep it from ringing, and looking at orders for the next day after precall leaves me in a constant cycle of work mindset, thinking about what I need, what not to forget when I get into work tomorrow, the knowledge that at least one order on my board is going to be so incorrect that is will set my whole day back haunts my nightmares.
  14. My manager encourages me to express my thoughts and ideas, even when they differ from the status quo.
    1. 1
      1. My manager is nice enough… when attempting to get me to do a job outside of my role. It is a battle even with the new manager to get them to understand the separation of responsibilities in roles, as the continue to try to push you to do things outside your pay grade and scale, even when against company policy. Any push back instantly gets down played as you “not being a team player”, and not the manager attempting to force you to do the job of people above you.
  15. My manager provides me with feedback that helps me improve my performance.
    1. 1
      1. I have, and continue to perform my job well beyond the required capacity. Any agent I work with performs better as I make sure their time is spent less on instructing me to do work and more on completing the work together with them as a helping hand. This was not something I was taught by a manager, as they do not provide useful insight or training, but instead attempt to force expectations above scope of work.
  16. I feel satisfied with the recognition or praise I receive from my manager.
    1. 3
      1. While it is out of my manager’s control, a pizza party is not any form of recognition, and I’m a grown man, I don’t need praise, I need a raise.
  17. My leader has meaningful discussions with me about my career development.
    1. 1
      1. There is no future career for me in Best Buy. The position I worked for 6 years to get no longer exists, the leadership has made it clear that they believed the position was “Overpaid for the work they do” and do not respect the lost role. Why should I remain with a company that does not see the value in a skill I spent 10 years professionally honing?
  18. My manager seeks feedback to help improve their performance.
    1. 3
      1. He is new in his role, and I don’t believe in judging anyone in such a short period of time. While he seems nice enough, in the few interactions I have had with him, I can tell that he will attempt, as he has with cadets in his original area, to get me to do work outside of my role and responsibility. He will find that I only do what I am paid to do, and nothing beyond that.
  19. My manager provides adequate support when I ask for it.
    1. 3
      1. He is new in his role, and I don’t believe in judging anyone in such a short period of time. While he seems nice enough, in the few interactions I have had with him, I can tell that he will attempt, as he has with cadets in his original area, to get me to do work outside of my role and responsibility. He will find that I only do what I am paid to do, and nothing beyond that.
  20. My manager provides clear direction to guide my work.
    1. 3
      1. He is new in his role, and I don’t believe in judging anyone in such a short period of time. While he seems nice enough, in the few interactions I have had with him, I can tell that he will attempt, as he has with cadets in his original area, to get me to do work outside of my role and responsibility. He will find that I only do what I am paid to do, and nothing beyond that.
  21. My team has a culture in which employees appreciate the differences that people bring to the workplace.
    1. 3
      1. My team (or what remains after Best Buy’s two sweeping layoffs) Are the only reason I still work for this company. There is no other reason, When they all move on to other jobs, I will follow soon after. This place does not deserve a single one of them.
  22. I work in an environment that is free from harassment and discrimination.
    1. 3
      1. There is no harassment or discrimination between co-workers, we are all together trauma bonded through the hell that is Best Buy. These are people I will talk to the rest of my life, without fail. As for the management? They are a lot of snakes that have in many cases made bad situations worse through clear lack of empathy. To quote one manager “If you all had sold more employees would have been able to stay on, the blood is on your hands” Or “We lost a lot of people, and some of that is my fault, but I won’t lose sleep over it”
  23. I feel comfortable being myself on our team.
    1. 1
      1. “Our” is vague. I feel comfortable with my co-workers, my manager, his boss, and the boss above who are nothing more than bearers of bad news. They continue to try and spin Best Buy as this great place to work for like some sort of propaganda machine when they have no additional information to add to any conversation outside of telling us all to work harder.
  24. On this team, mistakes are treated as opportunities to learn and grow.
    1. 1
      1. Mistakes made by field employees are treated as a bother, not an opportunity to our leadership. Many mistakes are made by other points in the business through an excessive lack of training, all attempts to get it fixed go largely ignored, and end up without any changing results. Jobs are still massively undersold, incorrect products are sold, and it is our fault for fixing the mistakes of the store and discrediting the under trained “experts” in the stores.
  25. My unique skills and talents are valued here.
    1. 1
      1. 10+ years of computer experience, and I was turned down for the in-home PC role 5 times. The first two times for people I trained, the next for someone who was never a repair agent, then again by someone who was a cadet and promised the job. The last time was told to become a cadet for training only for another agent who was already promised the job to get it. Valued is not the word I would use.
  26. Within our team, we communicate openly with each other.
    1. 3
      1. My co-workers and I are friends outside of work. We often chat, though ignore the topic of the job as it is quite depressing and demoralizing. We do make time for one another when the stress of this job and it’s uncertainty becomes too much.
  27. It is easy to ask members of my team for help.
    1. 3
      1. We do not leave a man behind. While we all suffer through the issues of this job, we do it together so that no one agent is overwhelmed.
  28. My manager keeps our team focused on clear priorities.
    1. 3
      1. He is new in his role, and I don’t believe in judging anyone in such a short period of time. While he seems nice enough, in the few interactions I have had with him, I can tell that he will attempt, as he has with cadets in his original area, to get me to do work outside of my role and responsibility. He will find that I only do what I am paid to do, and nothing beyond that.
  29. My team effectively manages conflict.
    1. 3
      1. There is no conflict in our team. We are all dealing with the same horrible job, and have a united front to make sure every single one of us gets through the day.
  30. I understand how Best Buy plans to achieve its strategic vision.
    1. 1
      1. Best Buy has no plan. They have continued to make mistake after mistake, and instead of firing the person in charge of steering the ship, they “lay-off” low level employees who have done nothing but do their job. Letting go of more people to offset costs, only to give themselves bonuses, increase the salary of our CEO 10 million dollars in 5 years, and further drive a wedge in the company as it turns us into the very companies that have failed. We went from experts to salesmen, employees focused to profits above all else, bonus for good performance to commissions on sales. We have turned into every one of our failed competitors.
  31. Senior leaders empower teams to stop work that does not align to company priorities.
    1. 1
      1. To directly quote a senior leader “If you all had sold more employees would have been able to stay on, the blood is on your hands” Or “We lost a lot of people, and some of that is my fault, but I won’t lose sleep over it” These are the people I’m supposed to listen to?
  32. I understand how my work contributes to Best Buy's strategy.
    1. 1
      1. Best Buy’s strategy does not exist. We are a company that has shown that is has not learned from the mistakes of our former competitors, and is now moving towards becoming just another failure tech company.
  33. Senior leaders behave in a way that is consistent with the values of our organization.
    1. 1
      1. To directly quote a senior leader “If you all had sold more employees would have been able to stay on, the blood is on your hands” Or “We lost a lot of people, and some of that is my fault, but I won’t lose sleep over it” so yes, just like the company values. Profit above all else.
  34. Senior leaders genuinely care about employees.
    1. 1
      1. To directly quote a senior leader “If you all had sold more employees would have been able to stay on, the blood is on your hands” Or “We lost a lot of people, and some of that is my fault, but I won’t lose sleep over it” Judging from those two statements, I don't think they do.
  35. When changes are made at Best Buy, I am provided with the information I need in order to do my job effectively.
    1. 1
      1. Best buy definitely notifies me of information needed to do my job. When they terminate it. That it is no longer my job, that I will not be working for the company anymore. That my position has changed, and I need to take learnings to work this new “role” at a lower pay grade and more work. Best Buy makes sweeping changes, tells no one till they do it, and you are left there with nothing but half your co-workers out of work and you to pick up the pieces. And that is only if you kept your job.
  36. Best Buy is a company that strongly values ethical behavior.
    1. 1
      1. Best buy has continued to show they care only about one thing. Money. They do not know what the word ethical means, if they did, the head offices would be getting the same 3 percent raises they keep giving the employees outside the corporate offices, they would stop changing benefit structures, removing bonuses from everyone but themselves and of course stop giving the very person driving the company into the ground a 2 million dollar raise every year. I have watched employees trick client’s into best buy credit cards and get nothing but a slap on the wrist. Sell a client product that doesn’t meet their needs because they get commission on it. And watched as people that were buying cheaper products were straight ignored.
  37. I believe the pay system is fair.
    1. 1
      1. I make less now doing more work than I did 6 years ago. The loss of bonus, the loss of structured raises to now 3% across all non corporate office jobs and the increase cost of living has left me making less money then I have at earlier parts of my Best Buy employment. I get the same 3% as someone who doesn't do the job half as well as me. Why should I try?
  38. Safety is a top priority here.
    1. 1
      1. I have seen agents on ladders hanging up TVs 12 ft in the air because our manager told us we had to, even though SOP has very clear guidelines on what is required for those jobs. Safety is only enforced after someone gets hurt, and the blame is placed squarely on the injured party. It doesn’t matter if you were told to,you should have said no when your manager told you to do it anyway.
  39. I plan to work at Best Buy one year from now.
    1. 1
      1. The second I find another job Best Buy will be getting my 2 weeks notice. Every cut I have been hoping to get fired so I can put this horrible job behind me. Outside of my co-workers, working for this company has shown me just how terrible a company can be, and every one who I have seen leave goes on to live happier and fuller lives. I can’t get out fast enough.
  40. What else is on your mind?
    1. I started with Best Buy over 10 years ago. I used to love working here, and helping clients discover technology they didn't even know they needed. I was paid fairly, and bonuses when I met my goals. Even got to get some free tech for learning about it. I remember Best Buy having a culture. I watched as we lost our bonuses, we had to be cross trained every where and we lost the experts part of our stores. I watched as people got overwhelmed with the pure amount of information we were expected to know. The smart ones left quick, and those that were left sold to make numbers. Our client experience felt to the wayside, and I watched the company I was so happy to work for just start caring about nothing but money. And it's a shame.
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2024.05.08 18:05 JohannGoethe The Al-Ge-B-Ra or algebra (الجبر) or 𓆄 𓅬 𓇯 𓍢 (H6-G38-N1–V1) cipher seems to indicate that the "foot" 𓃀 [D58] of 𓅬𓃀 [G38-D58], aka Geb {carto-phonetics}, the earth 🌎 god, does NOT render as the /B/ phonetic?

The Al-Ge-B-Ra or algebra (الجبر) or 𓆄 𓅬 𓇯 𓍢 (H6-G38-N1–V1) cipher seems to indicate that the
Abstract
Research to figure out who first rendered the following hiero-names, believed to the glyph-names versions of the Egyptian earth 🌍 god, into the word GEB:
  1. 𓅬𓃀
  2. 𓅬𓃀𓀭
  3. 𓆇𓃀𓀭
  4. 𓆇𓃀𓊹
  5. 𓈅𓃀𓀭
  6. 𓇼𓊹
  7. 𓏾𓀭
  8. 𓀭 (king) with 𓅬 (goose) on his head
  9. 𓀿 (man on back) with 𓂸 erection (𐤂)
Data gathered thus far:
  • Κὴβ (KHB) {Keb} [30] τοῦ Ἡλίου 🌞, ἤτοι Κρόνος John Antioch (1310A/+645)
  • Sév, Siv, Sèv, Kèb, Kev Jean Champollion (132A/1823)
  • Qeb (𝔔𝔢𝔟) or Geb [?] Brugsch (69A/1886)
  • Seb, Qeb or GEB Renouf (2 Nov 69A/1886)
  • Qeb (𝔔𝔢𝔟) = Sebet (𝔖𝔢𝔟𝔢𝔱); 𝔔𝔢𝔟 (Qeb) {Monuments}, 𝔎𝔢𝔟 (Keb) {tradition} Brugsch (64A/1891)
  • Keb or Seb Wiedemann (58A/1897)
  • Seb, Geb, Gebb, Keb, Kebb Budge (51A/1904)
Antioch
In 1310A (+645), John Antioch, in his Chronological History (Historia chronike), cited by Carl Lepsius (pg. 14) and Peter Renouf (pg. 83), spoke about a Keb (Κηβ) [30] of Helios (Ηλιον) 🌞 being defined as the Greek god Cronos (Κρονος) [510], the last child born of Gaia, the earth 🌍 goddess, and Uranos, sky god:
Greek Phonetics Google
Αἰγύπτιοι φασιν, ὡς Ηφαιστος αὐτῶν ἐβασίλευσεν ἀπείρους τινὰς χρόνους· μετὰ τοῦτον Ἥλιος ὁ Ἡφαίστου ἔτη ζψοξ (1. ζψος), μετ' αὐτὸν Σῶς, ἤτοι "Αρης, μεθ ̓ ὃν Κὴβ [30] τοῦ Ἡλίου 🌞, ἤτοι Κρόνος Aigýptioi fasin, os Ifaistos aftón evasílefsen apeírous tinás chrónous: metá toúton Ílios o Ifaístou éti zpsox (1. zpsos), met' aftón Sós, ítoi "Aris, meth ón Kív toú Ilíou 🌞, ítoi Krónos Egyptians, like their Hephaestus, reigned for an infinite number of times; after this Sun, Hephaestus year zpsox (1. zpsos), with him Sos, i.e. "Mars", with the Sun's 🌞 Cube, i.e. Saturn
Strange that Google renders ”Κὴβ τοῦ Ἡλίου 🌞” as “Sun’s cube”.
That Κὴβ (KHB) = 30 here makes sense, firstly, as the base of 30 is 3, which is letter G, the bottom 3rd column letter. Secondly, because it has eta (H) in the name, which is based the 𓐁 [Z15G] proto-type, i.e. numeral 8 or eight digits in Egyptian numerals.
The following is the Wiktionary entry on Keb (Κῆβ), presumably derived from the Lepsius citation of the Greek choreographer:
https://preview.redd.it/zkbd4yp4bjzc1.jpg?width=1200&format=pjpg&auto=webp&s=44b6b3d5cdcdaa64b290829a07bb68019c4a8075
Champollion
In 132A (1823), Jean Champollion, in his Egyptian Panthéon: Collection of Mythological Characters from Ancient Egypt after the Monuments (pgs. 22-23; 27:1) defined the “Egyptian Saturn“, aka Cronos, by the name Seb or Sev (or Siv), in main form, also conjecturing the names Keb or Kev:
  • Egyptian earth 🌍 god [𓅬𓃀𓀭] = Seb or Sev (Sév, Siv, Sèv) or Kèb or Kev, i.e. Cronos {Greek}, Saturn {Roman} Jean Champollion (132A/1823)
Peter Renouf (69A/1886), in his “The Name of the Egyptian god Seb” (pg. 83), summarized Champollion‘s Egyptian Saturn name as following:
French English
Le Saturne Egyptien ... prenait le nom de Sév, Siv ou Sèv et celui de Kèb ou Ke Saturn of Egypt ... preceded the name of Sév, Siv or Sèv and that of Kèb or Kev
Lepsius
In 104A (1851), Carl Lepsius, in his About the First Egyptian Gods and Their Historical-mythological Origins (pg. 14), citing John Antioch (1310A/+645), equated Keb (Κηβ) of Helion (Helion) to Seb, as follows:
https://preview.redd.it/eidu3v5j9jzc1.jpg?width=1096&format=pjpg&auto=webp&s=5aefd1f550634bb2196382547ccf7d94f618248d
Brugsch
In circa Jan 69A (1886), Heinrich Brugsch, in an article in the Zeitschrift für Aegyptische Sprache, had rendered the Egyptian earth 🌍 god, formerly called Seb, by the new name Keb or Seb? [N2] His later (64A/1891) works used the German Qeb (𝔔𝔢𝔟) = Sebet (𝔖𝔢𝔟𝔢𝔱); 𝔔𝔢𝔟 (Qeb) {Monuments}, 𝔎𝔢𝔟 (Keb) {tradition}. We will have to check on this?
Renouf
On 2 Nov 69A (1886), Peter Renouf, in his 14-page “The Name of the Egyptian god Seb”, opened to the following:
“This year's first number of the Zeitschrift für Aegyptische Sprache begins with an extremely interesting article by Heinrich Brugsch, in which that eminent scholar produces the evidence on which he bases his new reading, Qeb or Geb [see: Appendix on the Transcription of Egyptian Words], of the god's name which has hitherto been read Seb.
The new reading has been taken up by scholars like Dr. Dümichen and Dr. von Bergmann, and is now authoritatively recognised in the Catalogue of the Egyptian Antiquities of the Museum in Berlin. I fear my learned colleagues in Egyptology have been somewhat precipitate in this matter, for the evidence which has until now been put before them, however strong it may appear to them, is essentially one-sided, and, as I shall presently show, it is even incomplete on the side which they have espoused.”
Renouf talks about the views of Antoich, Champollion, and Lepsius, commenting:
”The exchange between Keb and Seb, as Lepsius well observes, is difficult to explain?”
Then says:
”The first point I must insist on is that the old orthodox reading of Seb as:
  1. 𓅬𓃀
  2. 𓆇𓃀𓊹
is not an erroneous one.
He then jumps into standard CartoPhonetics (CP):
Sebastos [𓊃𓊸𓏏𓆇𓊃] and sebasta [𓅬𓃀𓋴𓂪𓂣] are the Egyptian transcriptions of Roman imperial titles, and ⲥⲓⲕⲉⲧ {Coptic} and ⲤⲒⲤⲢⲰ {Coptic}, as Brugsch says, are the Greek transcriptions of decans: 𓅬𓊧𓏏𓇼 (or 𓏤𓆇𓊧𓏏𓇼) and 𓅬𓊃𓂋𓏏𓇼 (or 𓏤𓆇𓊃𓂋𓏏𓇼).”
Shown below:
https://preview.redd.it/a8hmrw7ivkzc1.jpg?width=1184&format=pjpg&auto=webp&s=db5b5eca13d18f6ab2864a00c0e83ab0af2d4914
In his CP-rendered term sebasta [𓅬𓃀𓋴𓂪𓂣], we see:
  • 𓅬𓃀 = /seb/ or se [𓅬] b [𓃀]
  • 𓋴 = /s/
  • 𓂪 = /šsp/, meaning: “palm”
  • 𓂣 = /mḥ/, meaning: Cubit
Not really sure how he is getting the “-ta” suffix out of this? Possibly, he is assuming the bread bread 🥯 /t/ sound from his previous CP-term: Sebastos [𓊃𓊸𓏏𓆇𓊃] or Se [𓊃] ba [𓊸] t [𓏏] 𓆇 {egg} s [𓊃]?
Appendix On the Transcription of Egyptian Words
Geb cannot possibly be the right name of an Egyptian god. The texts in the Etruscan language, though perfectly legible, defy as yet all attempts at translation or grammatical analysis. Yet if it were asserted that Geb was the name of an Etruscan god we could at once pronounce an unhesitating verdict against such a statement. We know this at least, that the Etruscan language is defective in certain letters. It has no medial sounds. Geb therefore cannot be the name of a god in this language. And the same truth holds good with regard to the Egyptian language.
It is deeply to be lamented that Egyptologists have not adhered to the system of transliteration adopted at the Oriental Congress held in London in the year 81A/1874. That system had been most carefully devised by Lepsius (who among the older Egyptologists was the only competent scholar), and agreed upon with him by M. de Rougé, who had not indeed the advantage of the splendid philological training which Lepsius had gone through, but was guided by a highly refined instinct and reason, which enabled him to see the right path whenever fairly presented to him. The system of transliteration agreed upon was certainly not perfect, but it was far better than any which has since been devised. It did not, as others do, completely misrepresent the entire character of the Egyptianlanguage.
When alphabets of different languages are compared together it is seen at once that each is incomplete. Each language has its peculiar sounds and is defective in all the rest. Mohawk and other American languages have no labials. Some languages have no gutturals. Sanskrit, though so rich in sounds, has no ƒ or soft sibilants. Latin has neither soft sibilants nor aspirated consonants. Greek has no sound corresponding to , and is generally averse to spirants. Those who only know Greek without reference to kindred languages can have no notion of the extent to which the letter s has been suppressed in it. The digamma is chiefly known through Aeolic and Doric forms, but the Jod which once formed an essential part of an immense number of words in the vocabulary has entirely disappeared. The Cypriote syllabary though used for the purpose of writing a Greek dialect, has no means of indicating a medial sound or an aspirated consonant.
It is evident that any mode of transcription which ignores characteristic facts of this nature must be radically wrong.
The Egyptian language, like the Etruscan and others, had no medial consonants. [N3] When the Greek alphabet was borrowed for the purpose of writing Coptic, the letters, 2, and 3, were used for foreign words only; and these words are often found written in such a way as to show that the writer did not understand the right sound. If the Egyptians at one time used and in the transcription of the Semitic and 2, this does not prove that these signs had exactly the same sounds as the Semitic ones. The signs were only conventional representations of sounds which did not exist in the Egyptian language. The Greeks were reduced to the same strait when they had to transcribe Y, Y, and . But we have no excuse for such transcriptions from the Egyptian as Geb, gabu, du, didi, Dad, Zaru.
Post-script
Renouf also gives the following post-script:
POSTSCRIPT.-It has occurred to me that Brugsch, who most certainly knows of the only text which offers a direct proof of the existence of the god kab, may have good reasons for not attaching importance to it.
The fact is, this inscription, like many others, is carelessly and ignorantly written, and glaring blunders may be pointed out in it.
Screen shot of rest:
https://preview.redd.it/k0wps64hiizc1.jpg?width=752&format=pjpg&auto=webp&s=e5f3f92c9aea6f2cf3e63c5d26f6013b9a90a108
https://preview.redd.it/35pxv4ooiizc1.jpg?width=745&format=pjpg&auto=webp&s=be98d7d8e48cb4867b634e740ffd25902641fd05
Brugsch Religion and Mythology of the Ancient Egyptians
In 64A (1891), Heinrich Brugsch, in his Religion and Mythology of the Ancient Egyptians (pg. 383), made the following earth 🌍 god, was rendered in German as Qeb (𝔔𝔢𝔟) = Sebet (𝔖𝔢𝔟𝔢𝔱)
https://preview.redd.it/rm8z8esxy9zc1.png?width=410&format=png&auto=webp&s=d80bacdb8dc27b96c41c40273208a3f6ded20ae5
Then (pg. 417) he gives the following 7-god Egyptian to Greek rescript table, wherein renders the earth god as Geb or Keb:
https://preview.redd.it/2oecg22uz9zc1.png?width=609&format=png&auto=webp&s=1e552aeac6d2a78fe4f8a10652aaf40d45308c8a
The A43 (1912) German alphabet characters:
https://preview.redd.it/vb0yxw0bkazc1.jpg?width=1020&format=pjpg&auto=webp&s=34cb5c3ac341e6697dcc4dbf1261a2418f2576ce
The Fraktur type (442A/1513) German alphabet:
Upper case:
𝔄 𝔅 ℭ 𝔇 𝔈 𝔉 𝔊 ℌ ℑ 𝔍 𝔎 𝔏 𝔐 𝔑 𝔒 𝔓 𝔔 ℜ 𝔖 𝔗 𝔘 𝔙 𝔚 𝔛 𝔜 ℨ
Lower case:
𝔞 𝔟 𝔠 𝔡 𝔢 𝔣 𝔤 𝔥 𝔦 𝔧 𝔨 𝔩 𝔪 𝔫 𝔬 𝔭 𝔮 𝔯 𝔰 𝔱 𝔲 𝔳 𝔴 𝔵 𝔶 𝔷
Upper case (bold):
𝕬 𝕭 𝕮 𝕯 𝕰 𝕱 𝕲 𝕳 𝕴 𝕵 𝕶 𝕷 𝕸 𝕹 𝕺 𝕻 𝕼 𝕽 𝕾 𝕿 𝖀 𝖁 𝖂 𝖃 𝖄 𝖅
Lower case (bold):
𝖆 𝖇 𝖈 𝖉 𝖊 𝖋 𝖌 𝖍 𝖎 𝖏 𝖐 𝖑 𝖒 𝖓 𝖔 𝖕 𝖖 𝖗 𝖘 𝖙 𝖚 𝖛 𝖜 𝖝 𝖞 𝖟
Note: the long s ("ſ") is not included in this Unicode font set.
German text:
Nach den Denkmälern Nach den Ueberlieferungen
1. Ptah Hephaistos, Vulcanus, Ptah
2. Ra, Sohn des Ptah Helios, Sol, Sohn des vorigen.
3. 𝔖c𝔥𝔲 (Shu) Ares (Mars), Sos, Sosis
4. 𝔔𝔢𝔟 (Qeb) Cronos, Saturnus, 𝔎𝔢𝔟 (Keb)
5. Osiris und Isis Osiris, Osiris und Isis
6. Set Typhon, Bruder des Osiris
7. Horus Horus, Sohn der Isis und des Osiris
English translation:
After the monuments According to tradition
1. Ptah Hephaestus, Vulcan, Ptah
2. Ra, sun of Ptah Helios, Sol, son of Ptah
3. Schu Ares (Mars), Sos, Sosis [?]
4. Qeb Cronos, Saturn, Keb
5. Osiris & Isis Osiris, Osiris & Isis
6. Set Typhon, brother of Set
7. Horus Horus, son of Isis and Osiris
Wiedemann
In 58A (1897), Alfred Wiedemann (58A/1897), in his Religion of the Ancient Egyptians (pg. 231), gave the following image:
https://preview.redd.it/w5ygw5u0cizc1.jpg?width=642&format=pjpg&auto=webp&s=4edf63cfac421767b6efd4d207577feabbbea5dc
With the following text, citing Brugsch and Renouf:
SEB, or, as his name was also written, KEB [N2] was god of the earth, for which his name was used as an equivalent in expressions such as "on the back of Seb." The Greeks identified him with Kronos, probably only because as father of Osiris he might be considered as senior among the gods. Shû was supposed to be his father, and Nût his wife. According to the lists of the divine dynasties in Memphis and Thebes, he was the fourth king of Egypt, and therefore to be reckoned as one of the younger gods. But the mention of him in the texts does not seem to favour this view, for there he is called, not king, but nomarch (erpå) of the gods, as if at the time when his worship arose there had as yet been no king in Egypt. His sacred animal was the goose, and sometimes he is supposed to be connected or even identical with the goose which laid the egg whence issued the world. In the Legend of the Destruction of Mankind he is installed as king in immediate succession to Râ. His connexion with the cult of the dead is very slight; nevertheless he is often named incidentally in, the texts.
Budge
The following are my notes, from today (8 May A69/2024), from The Gods of Egypt, Volume Two (pg. 94) of Wallis Budge (51A/1904):
https://preview.redd.it/tuqgc9ke38zc1.jpg?width=3268&format=pjpg&auto=webp&s=e75dc3cc3283b331f5bbfdc5f107698c8dc1a0f2
Here Budge lists the following names:
  1. 𓅬𓃀𓀭 = Seb
  2. 𓆇𓃀𓀭 = Seb
  3. 𓈅𓃀𓀭 = Seb
  4. 𓇼𓊹 = Seb
  5. 𓏾𓀭 = Seb
On version #2 (𓆇𓃀𓀭), Budge says:
Seb and an his female counter part Nut, at Heliopolis, produced the great egg 🥚 whereout sprang the sun 🌞 god under the form of the phoenix 🐦‍🔥 (Brugsch, Religion, pg. 577).”
— Wallis Budge (56A/1904), The Gods of the Egyptians, Volume Two (pgs. 95-96) [N1]
On version #5 (𓏾𓀭), we will note that this has been decoded as the 5 (𓏾) epagomenal children that Geb and Bet make, see: earth 🌍 and heaven heaven ✨ having sex, once Thoth wins the 5-days of moon 🌖 light from Khonsu, the moon god, during a game of Senet 𓏠, aka the Egyptian afterlife game:
https://preview.redd.it/q9xipavrhbzc1.jpg?width=1641&format=pjpg&auto=webp&s=0fa05f24a768d61009704c9afa0645224b209569
Gardiner
In A2 (1957), Alan Gardiner, in his Egyptian Grammar, lists 𓃀 [D58] or the foot heiro-type as follows, showing it defined as meaning “place or position”, with a /b/ phonetic:
https://preview.redd.it/0xwcpuztkjzc1.jpg?width=1691&format=pjpg&auto=webp&s=36e9fac3523ed17ca25c3dd9518c5c983a5bf457
Letter E?
This Geb god form of: 𓏾𓀭, seems to be the proto-form of letter E, the 5th alphabet letter, prior to becoming the Osiris triple phallus (𓂺 𓏥) version of letter E, in the LunarScript mechanism, which we see in the Phoenician E (𐤄) and early Greek/Etruscan E (𐌄) triple erection angled letters, including the 4-barred epsilon variety:
https://preview.redd.it/3cv0k83urbzc1.jpg?width=1128&format=pjpg&auto=webp&s=2661c1580631385928f796189a10aacb1d9653fa
Letter E, 5th letter, value: 5️⃣
Geb (𓏾𓀭), symbols: 𓏾, meaning: 5️⃣, + 𓀭, meaning: ”god”, the Egyptian earth 🌍 god, fathers the 5 (𓏾) epagomenal children: Osiris 𓀲, Horus (elder) 𓅃, Set 𓁣, Isis 𓊨, and Nephthys 𓉠, via the Heliopolis ΓΔE or 3-4-5 perfect birth theorem triangle 📐, formula: Γ² + ▽ (𓉾)² = 𐌄² or 3² + 4² = 5² (Plato, Republic [§:546B-C]; Plutarch, Isis and Osiris [§:56]), which equals 25, the number main characters in the Egyptian LunarScript alphabet or up the years of Serapis bull (age 27) or the age when Osiris 🌱 dies (age 28) (Plutarch, Isis and Osiris [§13, §:56]) the number or cubit units; Osiris is 1st born; the sacred Osiris triple phallus 𓂺 𓏥, shown in Egyptian triple (𓏥) phallus holiday parades and in the form of pharaoh Russian doll style triple (𓏥) layered golden coffin ⚰️, with mummified erection 𓂺, becomes the triple-erection Phoenician E (𐤄), thematic of three sowing 𓁅 oats E character “erection bars”, angled at 70º degrees, the average male erection angle; this becomes the Greek E (𐌄), including the four-barred epsilon, meaning: “naked E”, varieties; three of which (EEE) are hung at Delphi Temple 🏛️ (Plutarch, On the E at Delphi); later the Etruscan E (𐌄), Latin E, Syriac E (ܗ), Gothic E (𐌴), German E (𝔈); and in some way the double-phallus like Aramaic E (𐡄) and Hebrew E (ה).
Letter E type evolution:
𓏾𓀭 » 𓂺 𓏥 » 𐤄 » 𐌄,ε » Ε,e » 𐡄 » 𐌴 » ה » ܗ » 𝔈,𝔢 » ه
Τime solved ✅: 11:11PM 8 May A69 (2024)!
Noting the Budge 3-house 🏠 style division of things, we glean, from what I wrote in the margins, the following crude division behind the complex 1-11-111-1111 cipher:
Egyptian Glyphs Arabic Greek Hebrew Budge
𓏤 𓆄𓅱𓀭, 𓆄𓈚𓅱, 𓆄𓏲𓏲𓇶𓀭, 𓍷𓍷𓀭 1 A House 🏠 of Shu 💨
𓎆𓏤 𓅬𓃀𓀭 11 ΓΗ (Ge) House 🏠𓉐 of Geb 🌍
𓍢𓎆𓏤 𓁜 111 ΙΡΑ (Ira), ΠΑΙΔΕΙΑ (Paideia) Alep (אָלֶף)‎ House 🏠 of Ra ☀️
𓆼𓍢𓎆𓏤 𓀲 1111 ΙΩΤΑ (Iota) House 🏠 of Osiris 𓉥🌌
The so-called value 11 god or “Ge god”, as rendered in Greek in this new table, yields, renders, in status-quo translation, aka CartoPhonetics based, as Geb, shown below:
𓅬𓃀 𓀭 [G38-D58-A40] = GeB
New data obtained via EAN, however, seems to point to the conclusion that 𓃀 [D58] does not render as the /b/ phonetic, as presently believed in standard Egyptology.
Algebra
In short, given the recent al-Ge-B-Ra (algebra) cipher decoding:
https://preview.redd.it/toktxsm558zc1.png?width=685&format=png&auto=webp&s=28d1ee42c2422797239a2b5e15939d2752e063df
It seems to be highly-unlikely that the Egyptians used a B-phonetic in the name of the Egyptian earth god, when we know know that the B-sound is is made by the stars of space goddess 𓇯 [N1] symbol, aka "Bet", or letter B, as this is now rendered, based on a synthesis of the names for letter B in the languages we know: beta {Greek}, beth {Hebrew}, and ba (ا) {Arabic}.
We know that earth in Greek is ΓΗ [11] (ge). We know that letter G in Greek is gamma and that G in Hebrew is gimel.
Budge also says the Egyptian goose was a "seb" goose? I found the name sebastopol goose in Wikipedia so far?
Presumably, then, the correct original Egyptian phonetic for the name of their earth 🌍 god 𓀭, symbolized by the goose 𓅬, would be:
𓅬𓃀 𓀭 [G38-D58-A40] = G-something?
The “foot” 𓃀, accordingly, seems, therefore, not to be a “phonetic”, but rather a symbol for distance 📏, as in “feet length“, which is 16 Cubits. Compare the new GodGeometry sub image, which shows a goose 🪿 and geometry 📐 triangle emoji, both of which having no B-phonetic in them:
https://preview.redd.it/zquoq6zia8zc1.jpg?width=1138&format=pjpg&auto=webp&s=597908c8a64e63d9a8354f45fc13a099db25ab6c
Whence the meaning of “measure”, as in feet 👣 walked to measure the earth 🌍 diameter, or how the Greeks measure temple lengths in feet 🦶.
Letter G Decoding history
I added the following to the letter G decoding history section:
  1. Plutarch (1850A/+105), in: Moralia, Volume Five (56A); via citation of Plato (2330A/-375) Republic (§:546B-C) & Plato (2315A/-360) Timaeus (§50C-D), said that: the Egyptian triangle, with three in the upright position and four in the base and five in the hypotenuse, is equal to the contained dynamene, i.e. 5² (or the 25 Egyptian letters), where: “the upright [→Γ], therefore, may be likened to the male 👨🏼, the base [↑Γ] to the female 👩🏼, and the hypotenuse [◣] to the child 👶🏻 of both.”
  2. Heinrich Brugsch (64A/1891), in his Religion and Mythology of the Ancient Egyptians (pg. 383), in his Theban-Heliopolis god family tree (pg. 383) and “after the monuments vs after tradition“ table (pg. 417) was rendering the Egyptian earth 🌍 god, generally defined by the following: 𓅬𓃀 𓀭 [G38-D58-A40], presently, as the word: 𝔔𝔢𝔟 (Qeb) {monuments}, 𝔎𝔢𝔟 (Keb) {tradition}, or 𝔔𝔢𝔟 (Qeb) = 𝔖𝔢𝔟𝔢𝔱 (Sebet) {family tree}.
  3. Budge (51A/1904), in his Gods of Egypt, Volume Two (pg. 94) renders the name of the Egyptian earth 🌍 god 𓆄𓅱𓀭 as Seb, but says that Brugsch recommends the names: Geb, Keb, Gebb, or Kebb.
Notes Cited
  • [N1] I will note that a while back I tried to post the etymo of “phoenix” to Phoenix, but got post-removed. The irony? I wonder 💭 how they like the new phoenix 🐦‍🔥 emoji?
  • [N2] Cf. BRUGSCH, Aeg. Zeit., 1886, pp. 1 et seq.; RENOUF, Proc. Soc. Bib. Arch., ix., pp. 83 et seq; also Aeg. Zeit., 1893, pp. 125 et seq.; Rec. de Trav., xvii., pp. 94 et seq.
  • [N3] “There is not the same objection to the use of b, because in many languages this is not pronounced as a medial consonant.”
Notes
  1. Stubbed this page to letter G decoding history.
  2. We will have to come back to this? This was just a quick mental note post.
Posts
  • Egyptian algebra (الجبر) or 𓆄 𓅬 𓇯 𓍢 (H6-G38-N1–V1)
  • Need help translating some of the words in the god tables and family trees in Brugsch’s Religion und Mythologie der alten Aegypter - German.
  • Who first rendered the name of the Egyptian earth 🌍 god as GEB? - Egyptian Hieroglyphs
References
  • Antoich, John. (1310A/+645). Chronological History (Historia chronike). Publisher.
  • Champollion, Jean. (132A/1823). Egyptian Panthéon: Collection of Mythological Characters from Ancient Egypt after the Monuments (Panthéon égyptien: collection des personnages mythologiques de l'ancienne Egypte d'après les monuments) (§: Seb or Sev, pgs. 22-23; 27:1). Publisher.
  • Lepsius, Carl. (104A/1851). About the First Egyptian Gods and Their Historical-mythological Origins (Über den ersten Ägyptischen Götterkreis und seine geschichtlich-mythologische Entstehung) (Κηβ [Keb], pg. 14). Publisher.
  • Brugsch, Heinrich. (69A/1886). ”article”, Zeitschrift für Aegyptische Sprache, Jan [?]
  • Renouf, Peter. (69A/1886). “The Name of the Egyptian god Seb”, Nov 2; in: Proceedings of the Society of Biblical Archaeology, Volume 9, Society of Biblical Archæology (pgs. 83-97). London.
  • Brugsch, Heinrich. (64A/1891). Religion and Mythology of the Ancient Egyptians (Religion und Mythologie der alten Aegypter) (Geb, 8+ pgs, Geb+Nut family tree, pg. 383; Keb, 6+ pgs; 7-god Egyptian to Greek table, pg. 417). Hinrichs.
  • Wiedemann, Alfred. (58A/1897). Religion of the Ancient Egyptians (Keb, pg. 231). Publisher.
  • Budge, Wallis. (51A/1904). The Gods of the Egyptians, Volume One. Dover, A14/1969.
  • Budge, Wallis. (51A/1904). The Gods of the Egyptians, Volume Two. Dover, A14/1969.
  • Gardiner, Alan. (A2/1957). Egyptian Grammar: Being an Introduction to the Study of Hieroglyphs (Arch) (pdf-file). Oxford.
submitted by JohannGoethe to Alphanumerics [link] [comments]


2024.05.08 09:23 VG_Crimson The most unhiged Kai'sa jungle build, 14.10 The Scaling Jungler

Kai'sa Jungle...
As a concept for this build, she functions as a Farming, Hyper Scaling jungler acting as a damage dealer that can gank suddenly from half the map.
Her weakness are the same as 14.9 however a small change in runes makes this build go from wack to "viable ???".
No, not truly, but close enough that you can have consistent fun. The purpose of the build is fun. If you are anti-fun or allergic you may leave or stay, you've been warned.
TL;DR - Scroll to the bottom Conclusion section
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14.10 changes and how they're relevant

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Kai'sa will die easily and at a moments notice if caught with their pants down like any other squishy jungler. Assassins are still an issue like they always are for any squishy champ, this doesn't change that, however...

~ 14.10 introduces some rune changes that peaked my interest. Specifically: Absorb Life
Through the satanic power of blood sacrifice for the devs: This rune heals you for any unit you sacrifice, including every tiny monster. Baby krugs, infant raptors, and the void camp that spawns tens of children.
You will unalive these children. They are not safe from you. You will heal for all of them. The strong eat the weak.
This will keep jungle Kai'sa happy and healthy! 😃
She will take a beating from monsters so the sustain makes it harder for her to be caught off guard, never know when a fight will happen.

~ Another new rune of note is: Jack of All Trades
AD, AP, Movespeed, Lifesteal, %Movespeed, Haste,...
Every unique stat that you own is now an offering to the almighty Jack. At 5 offerings this deity, Jack, blesses you with 10 adaptive force. At 10 offerings, jack is very pleased with your dedication to the cause. He rewards you with another 25 adaptive force on top of that last 10.
Kai'sa already wants all the stats, so go make Jack happy.

~ Another New cool rune: Cash Back
Through the sheer power of tax evasion, you can learn to avoid paying the tax on items.
This rune accelerates your late game build. You scale hard with gold, this is a good rune for scaling.
Unlike Treasure Hunter, which gives 450 gold total upon take down of all 5 unique enemy players, this new money rune doesn't require you to get messy with players.
You can choose to farm instead or steal camps when the enemy is away. Upon buying a 3000 gold item like Nashor's it gives 180 gold. Which is more than 2 unique stacks of that Treasure Hunter. Anything that helps you reach late game faster is cool, so go do a crime 😎

~ PTA now amps all your damage dealt so this new buffed rune is what will be the main rune you use. It gives access too all the best minor runes anyways.
~ Cut Down is reworked. It helps you hurt healthy enemies, which brings down to lower HP faster where your missing health passive can do the rest of the work. There is less finishing kill power here than coup de grace, but you are more of a threat to enemies that might be troublesome for you. When you proc PTA at the start of a fresh fight, the burst damage will get amped by this giving the enemy a scare at how decent your damage is before the fight drags on. That amped initial damage might make your ganks better.
~ One of the best changes of all, BorK has more attack speed, lifesteal and AD. This is a strict buff to any Kai'sa player looking for faster evolutions.
~ Lots of cool ADC items now have their cringe crit removed in place of very based AD / attack speed.
~ 6th item Zypher. This is a new legendary item built out of Berserkers Greaves. Getting to this is difficult. Because it requires level 15 AND it has bad gold efficiency so you shouldn't really buy it unless you have not much better buys left. But thanks to our new Tax Evasion skills, at least the money isnt the issue.
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Rune Setup

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PTA

• Absorb Life
• Legend : Alacrity
• Cut Down
Secondary Runes
• Cash Back
• Jack of All Trades
Minor Rune Shards
• Attack Speed
• 2% Movespeed
• Scaling HP
.
Explanation:
Absorb Life is what holds all the hopes and dreams together. This will ensure you aren't ever truly low HP while clearing camps. Making it harder to take you down. Makes it possibly to take the void camp with a bajillion babies.
Movespeed is a CORE stat to an ADC according to Phreak, lead balance director of League. Specifically recently, which is what was stated during his explanation of some ADC item changes.
How can they kill you if they can't touch you? That's our reasoning to take this over double HP scaling runes. It feels real good once you rush Berserkers first item because you'll have a massive movespeed advantage over most players in the game at that point. Gives you a strong but tiny window of power at that point before others bother with tier 2 boots.
The secondary runes are for scaling as explained in the 14.10 changes I mentioned.
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Items

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Rush Berserkers
Attack speed is king for Jungle Kai'sa. Her passive %HP missing damage is what makes up for anything bad about her in this role. You clear fast for a non-jungler. Her first clear, you can be on your 6th camp by the time scuttle spawns in. Nothing crazy but not bad. This is good. Attack speed good. 👍 we will focus on that stat.
For the 1st item:
Nashor's
We are attempting to assert our dominance over the jungle. Nothing is more proof of that than stealing teeth from the biggest baddest monster here, and using it to beat down on the denizens of these green hunting grounds.
You build Nashor's tooth for max attack speed and your passive %HP damage which is helpful against these beasts with thousands of HP.
 After you get Berserkers and Nashor's, we are in kill range for getting 2 evolutions before even buying a 2nd item. Grab a dagger and Amp Tome, and you will hit a big spike in power as both W and E have evolved. Nashor's 1st allows Kai'sa to hit 2 evolutions in only 4800 gold!! 
For the 2nd item:
BorK
We just grabbed an amp tome for the W evolution, and it'll go into a Rageblade. But for now we want BorK.
It gives Lifesteal so we don't die easy. It gives a slow, so we dont die as easy. And it gives a massively buffed 55 AD now. Idk how or why, but that also is so we don't die as easy.
The on-hit damage kills monsters quite fast so we can keep crusading along our glorious attempt at reminding the local fauna that there's no environmental protection laws in Runeterra.
After Bork, building a pickaxe should basically be close to evolving Q. So you are golden at boots + 2 items + a component.
That pickaxe builds into your 3rd item you want. Rageblade. Which completes this core plan. Ryze mains have theirs, and I have mine.
.

The Secret Sauce

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When it comes to Jungle, you need self reliance.
Kindred has a passive Fleet Footwork, Graves has stacking armor and a blind, and both have a means of distancing themselves from enemies.
Kai'sa has only an ult and a movespeed steroid. We want to give her more self-reliance so that's what this build focuses on.
This is a Max E build.
"But... Doesn't Q deal better damage?" The voices in my head ask. My response is:
 Yes. I didn't take my meds and you can't make me. 
Take 1st point into E, 2nd into Q and 3rd into E again. We want to proc our monster slaying passive as quick as possible. Example point distribution:
 E > Q > E > W > E > Points into Ult when possible > Max E > Max Q > Max W 
The more attack speed, and the lower a CD for this ability, the better. We are planning to have Ult Vayne levels of annoying invisibility and plan on kitting anything with the intention to kill us. This is how we survive the jungle, and this is how we outrun the depression this build might cause.
You can't hit what you can't see.
This is also why I say Nashor's first item. That attack speed is getting put to full use by juicing up our passive damage.
We will have around 20 haste and a cooldown of around 7 seconds without attacking on E. With this much attack speed so early its really going to be even lower. They can't touch us, we will out run their asses to the finish line.
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In Conclusion

__________________________/
I do not have legal permission to be in the kitchen. I can't be allowed to cook.
Don't try this build out without a parent or guardian's permission.
Run fast on jungle grass and eat ass 🏃‍♀️ 💨
submitted by VG_Crimson to kaisamains [link] [comments]


2024.05.05 09:31 swempish PC shows only top centimeter and rest of the screen is black

PC shows only top centimeter and rest of the screen is black
Before, only horizontal lines appeared above the screen. This problem was solved when I lowered the refresh rate of the screen, but this time, when I went into full screen mode in games, the screen was black and only 1cm of the top was visible, as it is now. When I searched online, I was told to uninstall the display device from the device manager and Windows would automatically update the drivers. But when I did that, the screen went black even in the BIOS screen. Sometimes the BIOS screen opens like in the 3rd photo and sometimes like in the 1st photo.
submitted by swempish to computers [link] [comments]


2024.05.05 03:04 Friendly_Ad_8844 Urgent!

Urgent! submitted by Friendly_Ad_8844 to AlfaRomeo [link] [comments]


2024.05.04 18:41 Kpie2000 Here’s my selfish little story. I just want to be an aunt!

I know this long and not along the funny lines. But I need help raising awareness to make it easier for people like my brother and his wife to get help with IVF. It’s so expensive and insurance doesn’t always cover it. They recently tried to win votes in a contest for $5000 toward the $30000 IVF costs. Sadly they lost. Due to the contest not having caps on people voting more than once. Two of the winner already had a child and the other had insurance to help cover it. This is their story below. My guilty part in this is that no matter how bad a feel for them. All I want is to be an aunt. My kids grew up being the only ones in the family and it makes me so sad to not have all these children for me to spoil and love. Charlotte please help me spread the word on infertility. I just want to be an aunt so bad and I can’t believe money is what’s stopping us right now. I’m holding bitterness in my heart that I haven’t been able to be the amazing aunt I will be. But the real heartbreak is my brother and his wife.
“The struggle to be happy and grateful while you feel like the world is passing you by, waiting for your turn when you want something so badly - it’s indescribably hard. It’s isolating and lonely, even when you have a support system to lean on and lift you up. Recognizing you’re not alone doesn’t fix the heartache or take away the anxiety, mental exhaustion, mood swings, side effects like weight gain, hair loss, migraines, nausea or bruises on your belly from all the shots.
You dare to be hopeful, again and again and bargain with yourself over all the things you could be doing differently or better or more or less. Infertility is the hardest full time job you’ll ever have - you don’t get paid for it, but it’s all consuming and no matter how hard you work, you’re not promoted to the only title you actually want, “mom and dad”. All the love you have to give has nowhere to go, and you often spare others’ feelings rather than share how it affects you every day.
Infertility can tear you apart - it’s cruel and unfair. It’s a roller coaster of emotions and you never know when the next drop or turn will come. It’s draining - mentally, physically and financially. But infertility can also show you how many people are willing to fight with you and for you, you just have to let them in. We build our walls so high to protect ourselves we forget that the cracks let in sunlight and that’s where love grows and heals.
Sharing something so personal and private is tough, but so is infertility. Suffering in silence is even harder. We are in awe of the support system that has shown up for us and we are beyond grateful for the outpouring of love. Everyone who has liked, commented, posted, shared, voted for us to receive funds, prayed, hoped, asked, messaged, reached out, sent a positive thought or good vibe our way, THANK YOU.
The intent behind the generous “Fertility Diaries” giveaway from The Fertility Center is increasing awareness, especially this week. We are hopeful to be in the running to receive $5,000 toward our treatment, which would make such a difference for our family. If you have voted or continue to, we are very grateful and fortunate to have the support.
I read a quote that inspired me to step out of my comfort zone in hopes that even one person suffering in silence can see all the good that comes from letting people in. To honor National Infertility Awareness Week, for those interested or wondering if there are different approaches out there that may lead to answers, here’s our 3.5 Year Ongoing Journey (it’s a long one).
In 2018 after unexplained recurring and worsening pain several doctors I had seen dismissed, a new doctor asked me if I had ever heard about endometriosis. She explained that she had a hunch endo was the cause of the pain I was experiencing, but that the only way to diagnose definitively was with surgery. We got scheduled and the pain worsened quickly. It became so severe that I was bedridden for a month - confused as to what was happening inside my body. I had to quit my job and was struggling while Pat flew missions for the US Air Force, gone for weeks at a time.
I had surgery, anticipated to be diagnostic and fairly quick, but based on the abdominal scope the doctor found pretty severe endometriosis and several cysts that needed to be removed. My husband made the decision we discussed ahead of time to extend the surgery and remove all of the cysts and endometriosis present. What was described to me as routine and something most people recover in a couple of days from, was not what I was experiencing. I was still having trouble getting out of bed and walking around on my own after several weeks.
Post-surgery I was told the doctor saw a presence of over-active nerves and she attributed the severity of the endo she removed and the overactive nerves to my longer recovery. She gently mentioned that if we planned to have children we should consider bumping up our timeline to the next 1-2 years, but I thought of it more as a passing comment (insert regret). I was 25, newly married and not ready to think about babies yet. I wish I asked more questions then (hindsight).
To keep the endo from returning, I was put on a low dose birth control. I was pain-free for about 18mos. before I started noticing the familiar feeling creeping back in. We had relocated to Grand Rapids and I researched an OB/GYN that treated endometriosis. Their suggestion was to try a drug called Orlissa, which puts your body into a temporary medical menopause to “starve” the endo of estrogen it feeds on.
The side effects were wicked. I had hot flashes you could see coming on from a mile away - my whole body turned purple. I wasn’t sleeping and before long I had dark circles that looked more like black eyes (SO much concealer). I had just started a new job, so these symptoms at work were embarrassing and not something I felt I could talk about openly. I lasted 6mos. before throwing in the towel, but the endo pain was gone. I was no longer triggered by certain foods (gluten and chocolate) and started to feel more like myself again.
I was referred to a new doctor by a friend shortly after - this office is application only and specializes further in endometriosis. Fast forward to 2020, celebrating our 3rd anniversary and deciding to casually start trying for a family. Given my history, we were hopeful but involved our OB/GYN after 6mos. who suggested we do a second laparoscopy to check for endo and perform the HSG (tube test) while I was under anesthesia.
To my surprise waking up from surgery a second time, I got the great news that they did not find any returning endo and my tubes were open! We started Clomid and kept trying, hopeful this would do the trick. We doubled the dose and did some baseline testing, but ultimately reached the end of the road for treatment with our OB/GYN after 6mos. (a year in).
We were referred to The Fertility Center and began a new protocol with Femara, which my body didn’t respond to. My husband was tested and everything came back fine on his end. We were introduced to a laundry list of supplements and FSH injections - and as a person who was terrified of needles (broke out in a sweat just mentioning the word) I was less than thrilled and needed friends and (eventually) my husband to do the injections.
FSH injections require closer monitoring, so we became very familiar with the ultrasound machine and (you guessed it) more needles! Monthly blood draws. With several medicated cycles, my body adjusted sporadically. There were a few months we missed ovulation all together and had to wait, which meant a lot of sunken cost with nothing to show for it.
I started acupuncture after reading about the benefits online and finding a local clinic that offered fertility-focused packages including IUI and IVF support. Talk about exposure therapy for needles! I felt the calming and de-stressing effects immediately and still go every 1-2 weeks, 2 years later. I’ve taken the advice of my acupuncturist over the years with supplements and have learned more about balance.
We tried IUI twice, our second procedure our levels looked really great and we were so hopeful. After 6-7 months, I needed a break. Mentally I was not in a good place so we took a month or two and decided to start IVF in the new year. After talking with a friend, something their family member did to conceive really stuck with me.
This friend told me of someone in their family who needed their partner’s sample to be immersed in their bodily fluids before transferring in order for her body to recognize and not repel for being foreign. Then a lightbulb went off - my entire life my body has repelled anything foreign; tubes in my ears multiple times, all piercings, even an IUD.
We pushed for more answers before pursuing IVF and were referred to a doctor that some in the RE world would consider “experimental”. Dr. Derbala from Derbala Institute for Reproductive Immunology (RI) is one of less than 5 in the country practicing this approach. After extensive testing (25 viles of blood, an hour long internal ultrasound, hysteroscopy and uterine biopsy while awake and unmedicated - triggering trauma) a few genetic mutations believed to contribute to inflammation and implantation failure as well as over clotting of the blood were found.
We also discovered my blood contains much higher than normal levels of NK cells and anti phospholipid antibodies - in short terms, my immune system is an overachiever and is overactive. We have worked for over a year now with varying aggressive medication protocols, including immune suppression.
With monthly blood draws to monitor my immune levels, we were tweaking the medications to address the ebbs and flows of different markers. Traveling for work during this time forced me to conquer my biggest fear - administering my own shots. We were hoping by treating the underlying issues we would conceive on our own and not need more intervention.
Due to worsening side effects (increasingly frequent and debilitating migraines, nausea, dizziness, fatigue, prednisone withdrawal, weight gain, hair loss, extreme bruising) we decided that IVF is necessary to control the medication timeline and condense side effects.
We had consultations with 4 fertility clinics in the surrounding areas and learned a lot of abbreviations along the way (IVF lingo). Our insurance does not cover any fertility treatments or medications. After 3.5 years and over $13k out of our savings with nothing to show for it, we are investing in IVF out of pocket. The financial uncertainty with IVF is daunting, all for the chance to conceive with no guarantee.
It’s difficult to choose the right fit - financially, geographically and to feel well taken care of and understood by your providers. We are hopeful that we have found a great team of doctors to help us conceive with The Fertility Center and Derbala Reproductive Immunology.
We realize the next few months through the IVF process will be challenging, but we will have an uphill battle ahead of us if we find success with IVF. According to predictions based on all of the immune testing, we will likely be classified as a high-risk pregnancy with weekly monitoring throughout. It’s been a blessing to have transparency with next steps, but like so many facing infertility, the outcome you want so badly is also ironically the scariest outcome you can imagine.
There are deep scars from this process that no one sees - mine are still healing slowly and sometimes old wounds can re-open. Every pregnancy announcement on social media, someone innocently asking if you want kids or when you’re having kids, birthdays and holidays that feel empty, the parts of your body that feel traumatized and the disassociation with discretion you experience to name a few.
We are grieving the people we would have been if we had not gone through this struggle. We are grieving the memories we could have made with our grandparents and parents having great/grand babies. We are accepting that our dream of our kids being in the same class as our friends’ kids isn’t going to be a reality. Those are tough things to let go of.
We are leaning on our system of support and taking this one day, one step at a time. I feel lucky beyond words to have my husband Pat Schmidt, who picks up the slack when I’m tired or sick or sad (which is more often than not lately). He’s affected in all of this too, but he’s holding it all together for us and I’m toughing it out for him. He will be the world’s best dad and I can’t wait for that day. The supporting role doesn’t ever get enough of the credit.
If you’re still reading, thank you. Being part of this conversation is helping remove the stigma associated with infertility little by little. I’m hoping that by being vulnerable enough to share our very private struggle, someone else will feel empowered to seek answers, speak about their experience and let their support system help carry some of the weight infertility burdens 1 in 6 with.
With National Infertility Awareness Week highlighting such a vulnerable part of our lives, we are thinking of all those struggling - you are brave for continuing to hope and fight for the family you deserve. Continuing the conversation is an important piece in validating all of the resilient couples out there who’s every day involves infertility. We are stronger when we uplift each other.”
submitted by Kpie2000 to CharlotteDobreYouTube [link] [comments]


2024.05.01 19:44 Inevitable-Plenty203 The Psych Drug induced suicide of Robin Williams

The Psychiatric Drug-Induced Suicide of Robin Williams - Two Years Later by Gary G. Kohls, MD FEBRUARY 10, 2020
55 years ago (July 2, 1961) an American literary icon, Ernest Hemingway, committed suicide at his beloved vacation retreat in Ketchum, Idaho. He had just flown to Ketchum after being discharged from a psychiatric ward at the Mayo Clinic in Rochester, MN where he had received a series of electroconvulsive “treatments” (ECT) for a life-long depression that had started after he had experienced the horrors of World War I. In the “War To End All Wars” he had been a non-combatant ambulance driver and stretcher-bearer.
One of Hemingway’s wartime duties was to retrieve the mutilated bodies of living and dead humans and the body parts of the dead ones from the Italian sector of the WWI battle zone. In more modern times his MOS (military occupational specialty)might have been called Grave’s Registration, a job that - in the Vietnam War - had one of the highest incidences of posttraumatic stress disorder (PTSD) that arose in that war’s aftermath.
Hemingway, just like many of the combat-induced PTSD victims of every war, was likely haunted for the rest of his life by the horrific images of the wounded and dead, so there was no question that he had what was later to be understood as combat-induced PTSD with depression, panic attacks, nightmares, auditory and/or visual hallucinations and insomnia.
Unfortunately for Papa, the psychiatrists at the Mayo Clinic were unaware of the reality of the PTSD phenomenon. They mistakenly thought that he had a mental illness (depression) of unknown etiology. (The diagnosis of PTSD wasn’t validated by the American Psychiatric Association as a Diagnostic and Statistical Manual (DSM) diagnosis until 1980.)
Hemingway, a legendary chronic alcoholic who consumed large volumes of hard liquor daily, had also been wounded by shrapnel in WWI so he probably also had physical pain issues. Therefore, like many other soldier-victims of combat-induced PTSD he used alcohol to self-medicate his physical pain as well as his psychic pain, anxiety, insomnia, nightmares, failed marriages and the financial stresses related to the alimony payments to his ex-wives.
Following his Mayo Clinic misadventure, Hemingway rapidly came to understand that his latest ECT “treatments” had erased his memory and creativity, and, because those realities were essential for him to continue his writing career and feeling that he no longer had a reason for living - ended his life. There is no record of what psychiatric drugs he had been prescribed over the years, but ECT is typically only attempted after all psychiatric drug options had failed.
The Parallel Paths of Artistic Geniuses Like Hemingway and Williams (and Michael Jackson and Prince)
53 years after Hemingway’s self-inflicted death, another American icon, actor and comedian Robin Williams, entered the Hazelden psychiatric facility and addiction treatment center - also in my home state of Minnesota. He was treated with a cocktail of (undisclosed) psychiatric drugs for a month and, shortly after his discharge, committed suicide by hanging (August 11, 2014) at his California home. The cocktail of brain-altering drugs surely was a major factor in his becoming increasingly depressed, losing appetite, losing weight and withdrawing from his loved ones.
His discharge medications, which included the so-called “antidepressant” drug mirtazapine (Remeron – which is well-known to increase the risk of suicidal thinking), the so-called anti-psychotic drug Seroquel (probably prescribed off-label for his insomnia) plus an unknown anti-Parkinsonian drug caused him to be somnolent, despondent, despairing and increasingly depressed.
Remeron, it should be emphasized, is well-known to cause suicidal thinking (and attempted suicide) and carries the Food and Drug Administration’s “Black box” warning for suicidality. After he returned home, he was said to have slept in his darkened bedroom, up to 20 hours a day, in a probably drug-induced stupor.
Remeron, it is helpful to remind readers, was one of the two psych meds (the other was the anti-psychotic drug Haldol) that the infamous Andrea Yates was taking before she irrationally drowned her five children - including her 6-month-old baby Mary - in the family bathtub. The devoutly religious Texas mother was convicted of first degree murder and sentenced to life imprisonment but – at re-trial – had her conviction changed to “not guilty by reason of insanity” (rather than “not guilty by reason of the intoxicating, insanity-inducing and homicidal effects of psychiatric medications!”). She is now spending the rest of her life in a psychiatric facility, no longer a threat to children.
Robin Williams was said to have been diagnosed with Parkinson’s Disease while at Hazelden. The symptoms of Parkinson’s Disease are well known to be caused by antipsychotic drugs such as Seroquel. Children who have been given anti-psychotic drugs (most commonly foster care children) are now coming down with Parkinson’s Disease at an early age, an illness totally unheard of prior to the formation of the subspecialty of Pediatric Psychiatry.
The Secrets of NIMH (and Hazelden)
30 years ago or so a cartoon movie was released about lab rats that were trying to escape extermination by the National Institute of Mental Health. The movie was titled “The Secret of NIMH”. I tried to watch it a few years ago and was disappointed to discover that it really didn’t expose any of the real secrets of NIMH, its American Psychiatric Association foundations or the psychopharmaceutical industry’s unholy alliance with NIMH. I understand that a remake of the film is planned. I hope some of the real secrets will be revealed in the new film.
Robin Williams left no suicide note, and so far Hazelden is mum on what happened behind closed doors during that fateful – and failed – month-long stay.
“What Brain-Altering Drugs was Williams or Michael Jackson or Prince On?”
Williams’ legendary cocaine and amphetamine use are certainly factors to consider as contributing causes for his suicide, for such drugs are notoriously toxic to mitochondria and brain cells. What is also deserving of consideration is the fact that when patients abruptly quit taking an antipsychotic drug, withdrawal symptoms can occur - even if the drug was first prescribed for non-psychotic issues like insomnia. Those withdrawal symptoms can include irrational thinking, loss of impulse control, psychoses, hallucinations, insomnia and mania, any of which can lead a physician to falsely diagnose “schizophrenia” or “bipolar disorder” or any number of mental disorders “of unknown cause”.
Some of Williams’ closest friends are logically wondering about what was the effect of the newly prescribed drugs that may have motivated Williams to so illogically kill himself. Hollywood journalists swarmed all over the tragic event two years ago, but characteristically avoided even speculating about the possibility of psychiatric drug-induced suicide, the most logical explanation for the series of events, especially for any thinking person who knows anything about the connections between psychiatric prescription drugs and suidicality, homicidality, aggression, violence, dementia, and irrational thinking and actions (whether while taking the drugs or withdrawing from them).
Such informed people have already asked themselves the question: “I wonder what psych drugs Robin (or Hemingway or Michael Jackson or Prince) was taking?” Tragically, the media has been totally unhelpful in discussing that important question or in offering any answers to the question. Iatrogenic (doctor-caused or prescription drug-induced) causes of morbidity and mortality are apparently not to be discussed in polite company.
It is important to point out that a bottle of Seroquel with 8 pills missing was found in Williams’ bedroom and drug toxicity testing revealed Remeron in Williams’ bloodstream at autopsy. The coroner emphasized that the dose of the legally-prescribed drug was at “therapeutic levels”, which is, of course, totally unhelpful information, given the fact that the undesired effects of a drug have no correlation to dosage.
The Taboo Reality of Iatrogenesis: Psych Drugs Can Cause Suicidality
There have been millions of words written about how much everybody was shocked by Williams’ suicide. There have been thousands of flowers placed at any number of temporary shrines “honoring” his legacy. There have been thousands of comments on the internet from amateur arm-chair psychologists spouting obsolete clichés about suicide, mental illness, drug abuse, alcoholism, cocaine addiction, and how wonderful psychoactive prescription drugs have been.
And there have been hundreds of dis-informational essays and website commentaries written by professional arm-chair psychiatrists who have financial or career conflicts of interest with Big Pharma, Big Psychiatry, Big Medicine, Big Vaccine and the rehab industries. Most of those commentaries distract readers from making the connections between suicidality and psych drugs. Some of the comments I have read have preemptively tried to discredit those who are publicly making those connections.
Whenever unexpected suicides or accidental drug overdose deaths occur among heavily drugged-up military veterans, active duty soldiers, Hollywood celebrities or other groups of individuals, I search the media – usually in vain - for information that identifies the drugs that are usually involved in such cases. But revealing the drug names, dosages, length of usage or who prescribed them seems to be a taboo subject. One has to read between the lines or wait until the information gets revealed at www.ssristories.org(a Big Pharma-exposing whistle-blowing website that should be mandatory reading for everybody who prescribes or consumes psychiatric drugs).
Patient confidentiality is usually the reason given for the cover-ups – and why important potentially teachable moments about these iatrogenic (drug-induced or vaccine-induced) tragedies are averted.
Big Pharma, the AMA, the APA, the AAP, the AAFP, the CDC, the FDA, the NIH, the NIMH, Wall Street and most of the patient or disease advocacy groups that sponsor the annual fund-raising “searches for the cure” events all understand that the hidden epidemic of iatrogenic illnesses must be covered-up. And, simultaneously, the altruistic whistle-blowers among us will be black-listed, denigrated, labeled as nuisance conspiracy theorists or even criminalized.
The well-funded corporate entities mentioned above also know how useful it is if patients (rather than the system) are blamed for causing their own health problems. Typical examples include: “you eat too much”, “you don’t exercise enough”, “you smoke too much”, “you don’t eat right”, “your family history is bad”, “you don’t take your meds correctly”, “you don’t come in for your screening tests/routine exams often enough”, “you don’t get all the vaccinations like you are told to do”, etc).
Highly unlikely “genetic” causes are energetically promoted as preferable root causes of totally preventable iatrogenic illnesses (because inherited disorders are not preventable and are also essentially untreatable). This reality ensures that researchers can annually demand billions of dollars for research while at the same time short-changing and discrediting simple, cheap, do-it-yourself preventive efforts that don’t need a doctor.
The confidence of the American public in Big Pharma’s drug and vaccine promotions must not be disturbed. Wall Street’s rigged stock market does not permit the publication of any information that could destroy investor confidence in the pharmaceutical or vaccine corporation’s highly profitable products, even if the (corporate pseudo-)science behind the drugs and vaccines is bogus and the unaffordable products are also dangerous.
The beauty of an unbiased public inquest, which I advocated for in this column two years ago, should have been done in the case of Robin Williams and all the school shooters, is the subpoena power of a grand jury to open up the previously secretive medical records and enforce testimony from Williams’ psychiatric treatment team. The public could finally hear information that could make comprehensible the mysterious death of yet another high-profile suicide victim - and start the process of actually de-mystifying America’s suicide and violence epidemics.
An inquest would likely reveal that Robin Williams did not have a “mental illness of unknown cause” or “bipolar disorder of unknown cause” or “depression of unknown cause” or “suicidality of unknown cause”.
An inquest would obtain testimony from feared whistle-blower experts in the fields of medicine, psychiatry and psychopharmaceuticals such as Peter Breggin, MD, Joseph Glenmullen, MD, Grace Jackson, MD, David Healey, MD, Russell Blaylock, MD, Fred Baughman, MD and other well-informed medical specialists who don’t own stock in Big Pharma corporations and who know very well how dangerous their drugs can be.
Robin Williams did not have a Mental Illness of Unknown Etiology
Just knowing a little about the life and times of Robin Williams and others on the long list of celebrity victims of psychiatric drugs (like Michael Jackson and Prince both of whom “died too soon”) would easily disprove most of the unscientific theories about their deaths that have widely published online.
Why did many of us psych drug sceptics and psychiatric survivors want an inquest in Robin Williams’ suicide? We wanted to know the names of the ingredients in the cocktail of drugs that had been tried on him (and the dosages and length of time they were taken). We wanted to know what side effects he had from the drugs and what his responses were. We wanted to know what was the reasoning behind the decision to prescribe unproven combinations of powerful drugs on someone whose brain was already compromised by the past use of known illegal brain-damaging drugs.
And we wanted to know, for the sake of past and future victims of these neurotoxic substances, if the prescribing practitioners informed Williams about the dangers of those treatments, particularly the black box suicide warnings for Remeron.
Stress-induced and Drug-induced Mental Ill Health Doesn’t Mean One is Mentally Ill
Robin Williams gained fame and fortune as a comic actor, starting with what was to become his trade mark manic acting style (stimulant drug-induced mania?) on “Mork and Mindy”. As have many other famous persons that attained sudden fame and fortune, Williams spent his millions lavishly and – in retrospect – often foolishly. After his third marriage he found that he could no longer afford his Hollywood lifestyle.
But long before his two divorces and the serious financial difficulties caused him to decompensate and again fall off the sobriety wagon, Robin Williams had lived in the fast lane, working long exhausting days and weeks and partying long exhausting nights with the help of stimulant drugs like the dependency-inducing drug cocaine (that overcomes sleepiness and fatigue) and artificial sleep-inducing tranquilizers whose mechanism of action resembles long-acting alcohol. Sedative drugs artificially counter the drug-induced mania and drug-induced insomnia that predictably results from psycho-stimulants like cocaine, nicotine, caffeine, Ritalin, Strattera, Prozac, Paxil, Zoloft, Celexa, Wellbutrin, Provigil, amphetamines, etc, etc).
Williams had acknowledged that he was addicted to both cocaine and alcohol when his famous comedian buddy John Belushi died of an accidental drug overdose shortly after they had snorted cocaine together (March 4, 1962). Shortly after Belushi’s overdose death, Williams quit both drugs cold turkey, and he remained sober and cocaine-free for the next 20 years. There is no public information about his use of addictive prescription drugs, but it is well-known that many Hollywood personalities like him have close relationships with both prescription-writing physicians and illicit drug pushers, many of whom make house calls.
However, Williams relapsed in 2006 and started abusing drugs and alcohol again, eventually being admitted to a Hazelden drug rehab facility in Oregon. After “taking the cure” he continued his exhausting career making movies, doing comedy tours and engaging in personal appearances in order to “pay the bills and support my family”.
After two expensive divorces, huge indebtedness and an impending bankruptcy, Williams was forced, in September of 2013, to sell both his $35,000,000 home and his even more expensive 600-acre ranch in Napa Valley. He moved into a more modest, more affordable home in the San Francisco area, where he lived until his death.
But despite solving his near-bankruptcy situation (which would make any sane person temporarily and deeply sad), Williams continued having a hard time paying his bills – especially his alimony payments, so he was forced to go back to making movies (which he despised doing because of the rigorous schedule and being away from his family for extended periods of time). And he hated the fact that he was being financially forced to sign a contract to do a “Mrs. Doubtfire” sequel later in 2014.
For regular income, he took a job doing a TV comedy series called “The Crazy Ones”, but the pressures of working so hard got him drinking again, even using alcohol on the set, which he had never done before. He was making $165,000 per episode and was counting on continuing the series beyond the first season in order to have a steady income.
So when CBS cancelled the show in May 2014, humiliation, sadness, anxiety and insomnia naturally set in, and he decided to go for professional help at the Minnesota Hazelden addiction facility, spending the month of July 2014 as an patient there.
The public deserves to know what really happened inside that facility.
We certainly deserve to know the full story. There are many painful lessons that can be learned. Those who think that we can’t handle the truth are wrong.
The psychiatric drug-taking public deserves to know what were the offending drugs that contributed to his pain, anguish, sadness, nervousness, insomnia, sleep deprivation, hopelessness and the seemingly irrational decision to kill himself.
And the family, friends and fans of Robin Williams certainly deserve to know the essential facts of the case which, if not revealed to us, will otherwise just result in a blind continuation of America’s “mysterious” iatrogenic suicide, violence and dementia epidemics. Ignorance of the well-hidden truths will just allow the continuation of Big Pharma’s ill-gotten gains and its deception of the medical profession and their patients for so long - and destroying the memory, creativity, brains and lives of millions of patients simultaneously.
For more information on the above very serious issues, check out these websites: www.ssristories.com, www.madinamerica.com, http://rxisk.org/www.mindfreedom.org, www.breggin.com,www.cchrint.org, www.drugawareness.org, www.psychrights.org, www.quitpaxil.org, www.endofshock.com.
Appendix A
The Powers-That-Be That Would Keep Us Ignorant
Big Pharma, the AMA, the APA, the AAP, the AAFP, the CDC, the FDA, the NIH, the NIMH, Wall Street and most of the patient or disease advocacy groups that sponsor the annual fund-raising and very futile “searches for the cure” all understand that the hidden epidemic of iatrogenic illnesses must be de-emphasized. And, simultaneously, the altruistic whistle-blowers among us will be black-listed, denigrated and labeled as nuisance conspiracy theorists.
https://freepress.org/article/psychiatric-drug-induced-suicide-robin-williams-two-years-later?fbclid=IwZXh0bgNhZW0CMTEAAR1AyLy3MJ8Tp2DTwc_c4G5DyQ1InTevjbzhmN5SiIb1CTv4neZIUTFdNoM_aem_AYJChMg0jV8OZPvcXTWQj6v6bU68PWGBdCO3saO27D9LaXhPIsUf8Mxnk2iAnypzxC-CDHI9t1jx9PG7e5KMkZO-
submitted by Inevitable-Plenty203 to Antipsychiatry [link] [comments]


2024.05.01 15:11 HenryOrlando2021 Meibomian Gland Probing Dilemma: Making an Informed Choice...Part 1

Preamble…Improve, Rebut, Point Out Bias, Make Points Missed Etc.
This post is over 8.000+ words in two parts. Please help make the purpose of this piece better by commenting on things (pro or con) that make it better as a tool for helping someone come to a decision on if and when Meibomian Gland Probing is for them or not. We are all in this together and nobody is the enemy I figure even though as humans we sometimes forget that element.
The following are the headings and sub headings of the 8,000+ word post for you to see if you have further interest in this post:
Meibomian Gland Probing Dilemma: Making an Informed Choice
Preamble…Improve, Rebut, Point Out Bias, Make Points Missed Etc.
Introduction:
Critics of probing clearly have some at least arguable to valid, concerns and maybe some that are misinformed or wrong about MGP…you decide:
Effectiveness:
Research and Evidence:
Risk of Complications:
Pain During the Procedure:
Bleeding in Probing:
Infection and inflammation:
Probing Itself Causes Scaring of the Meibomian Glands:
Skills of the Physician Doing Probing:
The Placebo Effect:
The Nocebo Effect:
Cost and Accessibility:
Alternative Treatments versus Probing:
Probing is often reported as not being USA FDA approved while IPL and LipiFlow are FDA approved:
To a man with a hammer, everything looks like a nail critique:
Probing is all about making money from the exorbitant fees for doing probing critique:
The “Why don’t more doctors do probing?” Question:
Other Considerations to Address in Coming to A Yes or No Decision:
Current/Future Condition:
The Case for Doing Probing When Unresponsive to More Conservative Treatments Options:
Introduction:
Meibomian Gland Expression Insufficient:
Chronic Blepharitis:
Persistent Symptoms…enter the medical device treatments:
Significant Meibomian Gland Dysfunction:
Unresponsive to Advanced Treatments:
The Case for When First Diagnosed with Meibomian Gland Dysfunction (MGD) do probing ASAP:
Note on the “pain without stain” term and what that means in terms of progression of DED/MGD:
Conclusion:
Improve, Rebut, Point Out Bias, Make Points I Missed Etc.
Please do comment pro or con on these aspects. That should be helpful to all.
Introduction:
It would be better if all doctors agreed on how to proceed with DED/ MGD treatments. It would make the patient's job easier and we would all know what to do to manage the disease the best way. Unfortunately this is not our reality.
I figure there are upsides and downsides to most any Dry Eye Disease (DED) or Meibomian Gland Dysfunction (MGD) treatment. When someone reaches the point in DED/MGD that they are in enough pain/discomfort that they think they need to move up as it were to one of the more secondary treatments (IPL, Lipiflow, TearCare, ILux, Autogolus blood serum, etc.) that is when things get pretty serious in terms of money and treatment risks versus benefits.
I think probing discussions tends to hook the human brain into our tendency to get into right/wrong, good/bad, win/lose positions much like one can with talking about politics or religion. People have a tendency to take sides and dig in discounting or even demonizing the other point of view as well as the people who hold the other point of view. In other words it gets sort of tribal if you will. I think it is a bit of a challenge to not get sucked into that mode as a human being. We forget that we are all in this together.
I think, from a patient's point of view, the best defense to all of these types of issues in DED/MGD is becoming a more educated consumer since I don't think all too many doctors a patient encounters, particularly in the beginning of their DED/MGD journey, are not really up to speed on DED/MGD since there is no specialist training track for this disease.
The whole conversation about should one do probing or not is not an easy one. To do it early when diagnosed with MGD or once all else has been tried is also not an easy one. There are compelling arguments pro and con for both questions. Be on the lookout for any bias in my writing since I have been probed after trying most everything else so some bias may creep in.
What I did is not necessarily what you should do. I would not presume to tell anyone what they “should” do. My goal is to tell all sides of the story so you can make an informed decision for yourself from knowing all the arguments no matter what the treatment option someone is considering including probing. If you see any bias or errors be sure to comment on it so we all can benefit.
To be clear at the outset let’s underline there are doctors who would think there is never a need to get probed and would not recommend it at this time. Intense Pulsed Light is probably the dominant treatment option currently for MGD. Rolando Toyos, MD, who developed IPL, does not recommend probing. Probably even a majority of doctors would support the Toyos position.
Most likely then, a doctor who thinks probing is at least something that should be done when most other treatment efforts have failed are likely in the minority. To think probing should be done before Intense Pulsed Light or other device oriented treatments would even be a smaller minority of doctors.
What is a patient to do in this situation? Let’s look deeper into the situation.
Critics of probing clearly have some, at least arguable to valid concerns and maybe some that are misinformed or wrong about MGP…you decide:
Effectiveness:
Some critics question the effectiveness of probing in the short term as well as the long term. While research results to date may show improvement in gland function and symptom relief, there is skepticism about how lasting these benefits are, with some studies suggesting the need for repeated treatments. In fact, what the probing research so far shows (also it is recommended by the developer of MGP Steven L. Maskin, MD), that probing needs to be repeated, on average, annually to maintain and improve any gains. Of course, as noted some doctors see no effectiveness with probing.
Research and Evidence:
There is a call for more robust, long-term studies to validate the effectiveness and safety of probing. Critics argue that much of the existing research on probing might have limitations such as small sample sizes, lack of control groups, or short follow-up periods. Some critics point out a lot of the research published was conducted by Dr. Maskin thus it could be biased. It is accurate that Maskin has published a lot in the medical literature. A review of 28 publications finds that 13 of them were done by other than Maskin, thus 46% of them were from others. Some people have asserted that all the publications were Maskin’s which is totally inaccurate.
Of course probably nobody would disagree it would be good to have randomized (assigning patients randomly to either the treatment group or the control group without the researcher or patient choosing which group to be in), double blind studies (doctors and patients not knowing who got the treatment and who got the control). Double blind studies would likely be impossible given the nature of the MGP procedure being probing. It could be done more easily with some medical devices or drugs of course.
Longitudinal studies (following patients after being probed for at least 5 years to decades to see how well the treatment held up as successful) would also be of value although that also would be a difficult task, but possible with enough funding. Ideally that research would need to not be from Dr. Maskin’s patient base as it would run up against the concern about bias if done that way.
Unfortunately, the patient with a problem today has to decide based on the existing research. While these critiques of probing are at least arguable and with some even valid, the question for a patient comes down to is there enough research in one’s personal opinion to warrant taking the risks given the potential benefits. One can see the research on MGP here:
Meibomian Gland Probing Published Research List
And here:
https://mgdi.com/research
To give the whole story on research in the DED/MGD field, a proponent of probing would probably point out many, if not most, of the treatment options for DED/MGD do not have a lot of research, double blind studies or longitudinal studies either. That is the state of probably close to all DED/MGD research on devices that is at best in the early adolescence stage of development.
BlephEx, LipiFlow, TearCare, iLux and IPL probably are the most common other device options available for DED/MGD. See here for their research:
BlephEx Treatment Published Research List = 9 of Them with Links
LipiFlow Published Research List = 25 of Them with Links
TearCare Published Research List = 9 of Them with Links
iLux Published Research List = 5 of Them with Links
Intense Pulsed Light Published Research List = 24 of Them with Links
Risk of Complications:
While there are concerns about complications such as pain, trauma, and bleeding during the probing procedure, these are typically mild and self-limiting or so the research indicates. Dr. Maskin’s protocol, including pre-procedural pain management, aim to mitigate these risks. The occurrence of small hemorrhages (see more on this aspect in "bleeding" below) during the procedure is often an expected sign that fibrovascular obstructions have been successfully released, rather than an indication of damage.
Pain During the Procedure:
The Maskin protocol in total is available in a PDF download here:
https://static1.squarespace.com/static/5c38d4fa3c3a536ca6a0353f/t/5c86946971c10b0a7caa4f0d/1552323689732/Detailed+Guide+to+MGP+for+Physicians.pdf
You will see that there are three different pain medications given prior to the probing in the Maskin protocol. Of course not every doctor uses the Maskin protocol. If you plan to do probing it would be a good idea to review the Maskin protocol with the doctor you are getting probing from to see if you are comfortable with the pain aspects. In my readings some say the pain was intense and some said the pain was minimal or little but most of the people I have read their experiences with probing but they did not report who the doctor was or what was the pain approach used in their probing. For me with my first probing using the Maskin protocol I had mostly a little pain at times with a couple of times when the pain was substantial when using deeper probes on a few glands after the first round of probing with 1mm probes. With my second Maskin protocol probing I had no pain at all. Now that may or may not be what happens for you as each person is different.
Bleeding in Probing:
Yes, there is bleeding with probing. Critics (doctors and people) are concerned about that bleeding as they should be. Dr. Maskin addressed the matter of bleeding in a Letter to the Editor section of the Survey of Ophthalmology International Review Journal, July 2021 (when critiquing an element of a review article on probing) as follows:
The authors noted that several studies reported small, self-limited hemorrhages during the procedure, alluding to inherent risks of the procedure. Again, these minute hemorrhages are not complications, but are expected signs that fibrovascular tissue has released, similar to a releasing a canalicular fibrovascular scar. In fact, every investigator that has published a manuscript on probing who has observed these self-limited hemorrhages has referred to them as an inconsequential finding. When hemorrhaging is greater, it is usually because of injection of anesthetic into the lids when sufficient topical anesthetic was not first applied to the lids.
Thus the bleeding referred to is not from the probing tool itself which some might think. It is from the releasing of the scar tissue that is constricting the gland.
In another published article in 2022 Dr. Maskin writes about bleeding as follows:
Post-MGP Hemorrhage
Occasionally a microscopic self-limiting hemorrhage is seen at the gland orifice after MGP. The droplet of blood is not an indication that the gland has been damaged. Instead, the microscopic, self-limiting hemorrhage, along with the auditory pop or gritty sound described above, confirms that fixed obstruction consisting of abnormal fibrotic or fibrovascular tissue, that often wraps the glands and disrupts the external duct walls was released with probing (Figure 3).
Figure 3 Confocal microscopy image of Meibomian gland distal duct showing disruption of the normally well demarcated external duct wall by fibrovascular tissue invasion. A prominent blood vessel is seen inside the oval. The disruption of the duct wall is indicated by the solid arrow showing a “step off”. This gland had not been probed. (Courtesy of SLM.).
One would expect a released fibrovascular stricture of a Meibomian gland, like a released fibrovascular stricture elsewhere in the body, to hemorrhage. This hemorrhage is a natural result of targeting and reversing the root cause of this disease and indicates the beginning of the rehabilitative process for the diseased glands. It is analogous to the small amount of hemorrhage sometimes seen when releasing a stricture of the urethra or esophagus.
Note: you can see the image referenced about in the article (and more) here:
https://www.dovepress.com/review-of-literature-on-intraductal-meibomian-gland-probing-with-insig-peer-reviewed-fulltext-article-OPTH
Another way to describe it from my reading is with MGD, the glands can become inflamed and the surrounding tissues can develop increased vascularization (blood vessels) due to chronic inflammation. This can result in more fibrous, scar-like tissue around the glands. During the probing, a tiny probe is inserted into the Meibomian gland ducts to mechanically unclog them as you know. This can release the blockage and restore normal gland function. The process of probing can indeed cause some level of bleeding, especially if the scar tissue is vascularized. Thus actually the bleeding is a good sign since it means the glands are not being “strangled” any longer.
Sometimes people posting online reference the bleeding as a large negative with probing. This is likely coming from not fully understanding the full situation given what the research says and what Dr. Maskin writes. Or at least that is what the pro-probing person would assert. The occurrence of small hemorrhages during the procedure is often an expected sign that fibrovascular obstructions have been successfully released, rather than an indication of damage.
Infection and inflammation:
Infection: Anytime the skin or mucous membranes are breached, there is a risk of infection. In the context of Meibomian gland probing, the introduction of a probe into the glands can potentially introduce bacteria, leading to an infection. Sterile technique and proper preparation of the area are crucial to minimize this risk.
Inflammation: Probing can also induce inflammation, either as part of the healing process or due to irritation from the procedure itself. This inflammation can be painful and may temporarily worsen eyelid swelling or redness. In some cases, anti-inflammatory medications may be needed to manage this response.
Probing Itself Causes Scaring of the Meibomian Glands:
Trauma to the Gland or Eyelid: Some critics bring up the concern that using a sharp tool that is thrust into a blocked and curved gland will cause scaring inside the gland itself. As one patient critic wrote once: “…the metal probe jammed down a delicate gland…” Almost certainly the possibility of trauma to the gland or the eyelid is probably somewhat dependent on the ability of the physician doing the probing. Thus one can’t 100% rule out totally scaring happening from probing it seems to me…a lay person’s reasoning of course.
Dr. Maskin has addressed this aspect as follows in the article linked below:
https://www.dovepress.com/review-of-literature-on-intraductal-meibomian-gland-probing-with-insig-peer-reviewed-fulltext-article-OPTH
o The probe enters the gland through the natural orifice opening at the lid margin, not through tissue of the lid margin.
o The probe advances into the hollow lumen of the gland, like an arm into a shirt sleeve, not into the gland’s acinar structures.
o The gland’s duct is not bony or rigid. The duct is flexible and the surrounding periglandular tissue is spongy and compressible, allowing the duct to flex when the probe is inserted while remaining intact.
The Maskin probes used are thin with a diameter of about 76 microns, made of steel to ensure durability and precision during the probing process. They are designed to be stiff enough to penetrate through fibrosis or keratinization at the lid margin and distal duct, which is critical for effectively clearing blockages deep within the glands. They are solid, which allows them to apply the necessary pressure to break through the periductal fibrosis without bending or breaking. This design choice is crucial for the successful application of the technique, ensuring that the probes can navigate through the intricate glandular structures without causing damage. They are not sharp either as some people have thought of them like a needle.
Moreover, the design of the probes considers the tactile feedback necessary for physicians, with a certain amount of stiffness to feel resistance and 'pop' or “gritty” sensations as the probe breaks through blockages. This feedback is essential for doctors to understand the progress of the probing and to adjust their technique as necessary during the procedure.
Then, keep in mind, I am not a medical person or a science person. There are things that reduce the chances of any internal scaring from happening like the following seems to me:
  1. The gland is to some degree is flexible in structure by design (maybe not as flexible as a balloon filled with water but some degree of flexibility)...or so I have read. As we age the glands do lose some of their flexibility though...again my reading. Thus the probe is not like probing into a fixed structure that is “delicate” if you will.
  2. Any given gland is from 5 to 6mm in length on the upper eyelids...and 2 to 3mm on the lowers. Maskin writes he begins probing with a 1mm probe and goes longer (2mm or 4mm) only if he thinks there is a need in some glands. So he is not forcing a probe into the whole gland length in most all cases and not all glands in most all cases.
  3. Another factor that would likely mitigate against the probes from scaring would be the diameter of the probe used. Maskin writes that the probes he designed are smaller in diameter than others that might be adapted from other medical tools for use in probing and then used that have not been designed specifically for probing. Thus the right tools are important in doing probing. The probes are 76 microns in diameter. The average width of a human hair ranges from about 50 to 180 microns, depending on the individual's hair type. At 76 microns, the diameter of the probes used for Meibomian gland probing is quite close to the finer side of this range. So, you can think of these probes as being slightly thicker than some of the finest human hairs but thinner than the average or thicker ones
  4. I have not read all the research to be sure. That said from what I have read on probing none has mentioned scaring from probing as one of their findings or concerns nor infection and inflammation either.
  5. In my thinking it may be possible that probing causes scar tissue in the glands and it seems at least arguable or unlikely. Additionally maybe somewhat dependent on the doctor doing the probing. Nor does it seem there is any evidence in the medical literature that there is scaring from the probing process itself as well as infection or inflammation being a problem.
Skills of the Physician Doing Probing:
Critics of probing bring up the skill of the physician doing the procedure as a problem and why one should not get probed. It is accurate that there are people who report they had probing and had a bad or even terrible outcome. There is little question in my mind that skill level is a factor in success from probing on two levels.
Unfortunately there are not a lot of doctors doing Meibomian gland probing in the USA, Canada or Europe. When I was doing my looking for a doctor who probes in the USA, I ran across Dr. Maskin’s site for doctors on how to do probing and his exact protocol here: https://mgdi.com/detailed-mg-probing-protocol.
You can also download the detailed Maskin protocol PDF here:
https://static1.squarespace.com/static/5c38d4fa3c3a536ca6a0353f/t/5c86946971c10b0a7caa4f0d/1552323689732/Detailed+Guide+to+MGP+for+Physicians.pdf
If I was looking now to find a probing doctor, I would want to ask the doctor what tools they use for probing and what protocol the doctor would be using. I would share the Maskin protocol with them to see how their approach compares. I would also ask the doctor how many patients has the doctor probed in their career as well since I want a doctor who had some solid experience in probing. I would not want to be their first one. I also would want to know the tools they would be using for the procedure and if they were going to do the therapeutic lavage immediately after the probing. Now, that is my level of due diligence and risk tolerance, yours may not be the same.
The second key skill aspect is after the probing what depth the doctor has in the diagnostic and treatment of all the causes (comorbidities in medical terms). It is at least likely you will be back to square one quickly needing to be probed again without addressing the comorbidities. I would ask about what diagnostics would be done before probing to determine comorbidities and will they be able to provide you with a treatment plan post probing. Probing is not a standalone solution or a one and done one either from my reading.
The Placebo Effect:
Occasionally critics have advanced the assertion that the placebo effect is what is causing the body to heal itself not the probing itself.
The placebo effect in medicine in general occurs when patients experience improvements in health due to their belief in a treatment's effectiveness, rather than the treatment itself. In fact there have been research studies done where the patient was told that the pills they were prescribed were sugar pills but take them as directed and they will get better and they did at a significant level. Clearly this placebo effect as a psychological response can stimulate changes in the brain's chemistry, influencing health even if the patient knows they are only getting a placebo.
In cases of periductal fibrosis of the Meibomian glands—which affect eye moisture—Meibomian gland probing is a technique used to clear blockages. Although probing provides a direct mechanical solution, the placebo effect may also contribute to recovery. Patients expecting relief might experience enhanced benefits, partly driven by their belief in the procedure's efficacy. This illustrates how psychological factors can significantly complement physical treatments, especially in conditions with subjective symptoms like discomfort. Thus the critics have a point that would be difficult to prove one way or the other if it was either the placebo alone or a combination of what the mechanical procedure does and the placebo process combined.
The Nocebo Effect:
Critics do not bring this up since it is not a well-known term. The nocebo effect is a psychological phenomenon where negative expectations of the patient regarding a treatment cause the treatment to have a more negative effect than it otherwise would have. Essentially, it's the counterpart to the better-known placebo effect, where positive expectations can lead to positive health outcomes, even from a treatment that has no therapeutic effect on its own.
The nocebo effect can result in the manifestation of adverse symptoms. For example, if patients are told about the potential side effects they might experience with a medication or treatment, they might report experiencing those effects even if they are given a placebo. Human psychology is interesting!
Cost and Accessibility:
Meibomian Gland Probing can be relatively expensive (anywhere from $1,000 to $5,000) depending on what protocol is used, what doctor is doing it and where. Additionally, it almost always is not covered by insurance (although traditional Medicare in the USA covers some of the costs when using the Maskin protocol). This raises concerns about accessibility and cost-effectiveness, particularly since probing is recommended to be repeated annually. Then other device treatment options discussed above also usually are not covered by insurance including Medicare. They also need to be repeated with some frequency to be determined by their doctor based on the patient’s condition as well.
Alternative Treatments versus Probing:
Critics often point to alternative, less invasive treatments that might be effective for people with MGD like iLux, TearCare, LipiFlow, Radio Frequency, Low Level Light Therapy (LLLT) and most prominently Intense Pulsed Light (IPL). They argue that these methods should be exhausted before resorting to more invasive procedures like probing or there is no need for probing given these treatments are available.
The pro-probing primary argument would center on how if one has obstructive MGD then the only treatment approach, at this writing, to treat the periductal fibrosis of obstructive MGD is probing. Additionally, if you asked Dr. Maskin, he would probably say, do Meibomian gland probing first and you might not need IPL at all. He would also probably say, do the probing first, because you want to create in the glands the conditions of being open, expanded and unobstructed before you do anything to the glands, like heating them (via IPL, TearCare, iLux, LipiFlow, Radio Frequency, etc.) or squeezing them (lid expression done with medical instruments immediately after IPL and/or after TearCare, iLux, other medical devices as well as a mechanical expression treatment like LipiFlow) which could provoke more inflammation and damage without probing first.
Intense Pulsed Light (IPL) treatment is increasingly being used for the management of Meibomian Gland Dysfunction (MGD). The primary mechanism by which IPL is thought to help in MGD involves reducing inflammation, improving Meibomian gland function, and indirectly affecting the melting point of meibum.
Obstructive Meibomian Gland Dysfunction includes the complication of periductal fibrosis, where fibrous tissue builds up around the ducts of the Meibomian glands, potentially blocking the secretion of oils necessary for a healthy tear film. Periductal fibrosis can be considered one of the more advanced and challenging aspects of MGD to treat, as it can lead to gland dropout and more permanent changes in gland functionality.
Regarding the specific question of whether IPL treatment addresses periductal fibrosis, while IPL has demonstrated benefits in reducing inflammation and improving gland secretion, direct evidence specifically focusing on its impact on periductal fibrosis is limited. The primary effect of IPL may not directly resolve fibrosis but may prevent further deterioration by improving overall gland function and reducing inflammatory mediators that could contribute to fibrosis.
Clearly more targeted research is needed to determine the direct impact of IPL on periductal fibrosis within the context of MGD. Current literature often focuses on the symptomatic relief and overall improvement in gland functionality, rather than specific changes in the fibrotic structures.
IPL’s direct effects on reversing or addressing periductal fibrosis specifically are not well-documented. Patients with advanced fibrosis probably need additional or alternative therapies to address these changes. Other medical device treatments have no evidence of being able to impact periductal fibrosis.
Improve, Rebut, Point Out Bias, Make Points I Missed Etc.
Reminder: Since this is published on a Reddit Sub help make the purpose of this piece better by commenting on things (pro or con) that make it better as a tool for helping someone come to a decision on if and when Meibomian Gland Probing is for them. We are all in this together and nobody is the enemy I figure even though as humans we sometimes forget that element.
Want to go on? Then here is the link to Part 2:
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2024.05.01 14:49 healthmedicinet Health Daily News April 30 2024

DAY: APRIL 30 2024

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2024.04.30 12:58 TheGreatGimmick An Extensive Guide to Ability Draft (updated)

This is my attempt at a comprehensive compilation of everything you need to know about drafting abilities in Ability Draft. If you see a mistake or think of things to add, please, tell me!
This post is current as of DotA patch 7.35d.

General Drafting Tips

  • Your hero's base stats heavily affect the viability of many builds. Additionally, Talents should be considered when drafting abilities, although they are usually far from the most important factor. Stats can be found here, while Talents can be found here. You can also just hover over your hero in the drafting screen.
  • Carefully consider the pick order when choosing which abilities to draft. The earlier you pick, the more likely you are to get an overpowered stand-alone ability, while picking later raises the chances that you can complete a combination of abilities. If you see an overpowered combo in the draft, but are first-pick, tell your team what you see but pick one of the powerful stand-alone abilities instead, because it is unlikely the second half of the combo will make it all the way back to you. Some heroes are also far more likely to pick certain abilities than others (e.g., Warlock and Chaotic Offering) which can also affect your assessment of whether you can get away with a combo or not.
  • Ruining your own build can sometimes be worth denying an enemy build. For example, Arcane Orb is generally a grief pick unless you draft Essence Flux first, but sometimes it is actually the correct play to deny-pick Orb if the enemy has Essence Flux and, say, Swashbuckle already. The very last person in the pick order is the only hero that drafts two abilities back-to-back (in the first round of drafting), so if you pick earlier be on the lookout for which abilities you need to pick to deny them a broken combo.
  • Sometimes your own team will pick abilities you needed for a combo. Communicate in the chat, but do not assume everyone will play along. Try to get confirmation from your team that they understand not to draft the ability you want. If you are met with negatives or even just silence, assume they may draft your desired ability.

Gameplay Differences

  • Ability Draft often lags behind the main game in terms of patch updates. For a while after a patch, new ability changes may or may not have taken effect, and entirely new abilities (e.g., from Aghanim's Shard changes) are often missing entirely. Conversely, removed parts of the game may still linger in Ability Draft. They've gotten better about updating AD, but this is still something to keep in mind for weeks or months after a major patch.
  • If your hero's normal Talent option(s) pertain to an ability that you did not draft, you are offered Gold instead. I know free Gold is tempting, but if you have the option, it is almost always better to take a Talent that actually does something over the free Gold.
  • You must be flexible in your item builds, because you are essentially playing an entirely new hero each game of Ability Draft. Ask yourself what your abilities need to succeed, then build that, no matter how silly such an item build might seem out of context. Sometimes item builds that are ill-advised in the regular game work exceedingly well in Ability Draft.
  • A corollary to the above point is that supports in Ability Draft tend to be greedier than in the regular game. Sometimes this is even justifiable; if their build achieves perma-stun with an Octarine, is it really better to get traditional items like Glimmer Cape instead? Well, yes, it probably still is, but the argument is there at least.
  • The mid lane usually hosts one of three kinds of builds: The build that is completely useless before 6 but comes online once they can use their ultimate (e.g., Ancient Seal + Decrepify + Ice Vortex + Finger of Death), the build that completely dominates a 1v1 (the most 'vanilla' style of mid-laner, amplified further by custom builds), or simply the strongest build on your team (the broken combo). The point is, you may sometimes see a player who should have been a clear safelane carry or durable offlaner go mid instead, and that may not be a bad thing, simply because if they have a very powerful build they just need to outlevel everyone else and roll over them. In summary, often you will see builds that do not fit the archetype for a traditional midlaner nonetheless going mid in Ability Draft. Whoever needs levels the most generally goes.
  • The strength of various builds on a team often makes Ability Draft a more polarized game in terms of target priorities. Identify whether there is someone on the enemy team that is worth losing 3+ of your own heroes to take out, and if so, do that. This is occasionally the case in the regular game as well (e.g., going all-in on the enemy carry), but it happens more often in Ability Draft.

Special Cases / Tips

  • Unique sources of Bash that do not normally stack will fully stack in Ability Draft.
  • Geminate Attack stacks with Echo Sabre, resulting in 3 attacks at once for melee heroes.
  • Melee heroes can attack with the full attack range of attack modifiers (e.g. Frost Arrows) only if they have a source of True Strike. Otherwise the attacks will miss if distance exceeds 350 units. Ranged heroes can always use the full distance, but may suffer the reverse problem: Short-ranged modifiers (e.g., Infernal Blade) should not be manually cast, since you must autocast them to use your base hero's range.
  • For most effects that refresh cooldowns (e.g., Rearm, Blur's Aghanim's Scepter upgrade, etc.), charge-based abilities will only receive 1 charge back, not be fully replenished like Refresher Orb.
  • Dismember cannot be used while you have eaten someone with its Aghanim's Shard effect.
  • Several abilities have been altered to work in Ability Draft, but the most drastic of these changes is Poof, which can now target any allied unit within 2000 range. Although I still would not recommend picking Poof, it is not as useless as one might think.
  • Only Meepo can be globally targeted by an allied Poof from anywhere on the map and have them appear at his location.
  • Only Monkey King can become trees with Mischief (which is tied to the Wukong's Command ability). Other heroes can still turn into other things.
  • Bane can freely damage targets under the effects of Nightmare, even if he does not have Nightmare.
  • Faceless Void can move inside anyone's Chronosphere.
  • At one time, Batrider used to gain unobstructed vision whenever he had free pathing, which was easy to abuse with abilities like Spin Webs and Arctic Burn. However, I am not sure if this is the case any longer now that, in the vanilla game, Firefly was changed to be ground vision.

You can also find a helpful list of the current bugs here. Some of them are gamebreaking!

Dependent Abilities

Most interdependent interactions are now included in the tooltips provided by Ability Draft, so this section is less necessary than in ye olden days. I'm including some key interactions here for completion's sake, however.
  • Any time another ability is directly referenced in the description of an ability or its upgrade (e.g., Scepter, Shard, or Talent), that effect requires both abilities to function. The prime example of this is Eclipse requiring Lucent Beam. Don't be that guy. Another notable example is Bristleback needing Quill Spray to fully function.
  • Geomagnetic Grip, unlike Rolling Boulder or Boulder Smash, is entirely dependent on Stone Remnants (and thus Magnetize) to do anything.
  • Arcane Orb needs Essence Flux to be fully viable, though it can deal decent damage on the first use if at full mana.
  • Neither Charge of Darkness nor Nether Strike will inflict their Greater Bash components if the caster does not have Greater Bash.
  • Natural Order does not lower Magic Resistance if Astral Spirit is not drafted.
  • Requiem of Souls requires souls, and thus Necromastery.
Less Drastic Improvements Include :
  • Astral Spirit and Echo Stomp, while decent abilities on their own, are heavily interconnected in terms of how they were intended to be used.
  • Shuriken Toss can only bounce if Track is also on your team, though two different heroes can own the abilities!
  • Avalanche, Toss, and Grow are all interconnected.
  • Familiars from Summon Familiars are very fragile without Gravekeeper's Cloak.
  • Rolling Boulder and Boulder Smash are best used with Stone Remnants (and thus Magnetize).
  • Relocate can be useful on its own, but half the point of the spell is to take an ally with you, necessitating Tether.
  • Summon Wolves are usually underwhelming without support from both Feral Impulse and Shapeshift.
  • Many other abilities (Plague Wards + Poison Sting, Dragon Tail + Elder Dragon Form, Spawn Spiderlings + Spin Webs, etc.) use other abilities as part of their normal function.

Notable Talents

Multiple Talents :
  • Luna, Dark Seer, Lone Druid, Puck, Primal Beast, Tidehunter, and Undying each have at least one Talent per Talent tier (4 or more Talents) for Lucent Beam, Ion Shell, Summon Spirit Bear, Waning Rift, Trample, Anchor Smash, or Tombstone, respectively.
  • Engima's Eidolons can be heavily improved by his Talents.
  • Many heroes have multiple early Talents for certain abilities (e.g., Underlord with Firestorm) that can be potent to stack up, but don't get baited into planning for level 25, because it usually doesn't happen.
  • Snapfire can transform into a devastating lategame carry with her relevant Lil' Shredder Talents if the game does end up going long enough, though level 25 is a long time to wait.
Single Talents :
  • Ancient Apparition gains +300 Chilling Touch range at level 10, making already-strong Aghs builds even stronger.
  • Jakiro gains +200 attack range at level 10, making abilities like Arctic Burn, Take Aim, Elder Dragon Form, and especially Impetus more desirable.
  • Techies gets a casual 20% magic resistance at level 10 (Timbersaw gets this at level 20).
  • Crystal Maiden's level 20 Talent grants +225 Attack Speed, which can be quite potent with certain modifiers like Scepter Chilling Touch or Bash of the Deep.
  • Warlock's level 20 Golem On Death Talent makes Chaotic Offering very attractive on the hero, and he gets further Talents for his Golems at 25.
  • Of course, many level 25 Talents can be incredible and change how your build functions... provided the game even lasts that long.
Niche Talents :
  • Some heroes have Talents that provide auras for the "AFK Infest/Dismember" builds (see the below Ally-Dependent Builds section), such as Beastmaster's level 15 +20 MS aura, Doom's level 15 Devour Ancients for auras, Underlord's level 25 Allies gain 50% Atrophy Aura, or Centaur's level 25 Retaliate Aura.
  • Tinker's level 20 Defense Matrix Grants 25% CDR Talent could allow some Aftershock builds to achieve permastun (see the below Aftershock section).
  • Skywrath Mage's Global Concussive Shot at level 20 could be highly amusing with Rearm. Perhaps add Rocket Flare into the mix as well.
  • With a sufficiently tanky build (especially with Kraken Shell to dispel stuns), Terrorblade's 10-second Sunder at level 25 would be incredibly difficult to deal with.
  • Tiny with Rupture combined with the level 20/25 Toss Talents (to remove the need for a target and grant more charges) could be devastating and hilarious.
  • Tusk and Ogre Magi both have level 25 Talents that, with enough attack speed, can result in permastun and ridiculous damage. This requires Walrus Punch / Fireblast, respectively.
Of course, many other Talents can be potent as well; be sure to know your hero's Talents before constructing your draft.

Ally-Dependent Builds

Later sections of this guide will go over how you can combine your own abilities together, but some builds require that the synergistic abilities be drafted on two different heroes. Most such builds involve one hero going AFK inside of an ally, as described below.
  • Infest with Tether, Rot, Scepter-upgraded Spirits, Voodoo Restoration, Scepter-upgraded Heartstopper Aura, or (less potently) any AoE passive (e.g. Atrophy Aura, Warcry's Shard upgrade, Inner Beast, etc.) can make for an AFK build where one hero sits inside an ally all game but still contributes significantly. This requires that the AFK hero has a viable ally 'host', of course.
  • An ally with Dismember and an Aghanim's Shard can accomplish the same effect (however, the Tether combo does not work). This version has the additional requirement of not only needing a viable 'host', but also needing a host that doesn't require an ultimate ability (because they wasted it on Dismember to eat the afk hero).
  • If using the Dismember version, the interior hero can also contribute their ult (since they don't need Infest), opening up builds like Blood Mist (Scepter-upgraded Rupture) constantly burning enemies down, Reincarnation contributing its aura to the exterior ally, or Shard-upgraded Epicenter pulsing occasionally.
  • Special mention goes to Vengeance Aura with Dismember, since the Scepter illusion can re-eat your hidden ally once your actual hero dies.
  • Bulwark's Scepter upgrade still works in this situation despite being disabled by stuns/disarms normally.
  • When using the Dismember version, Glimmer Cape can be used on the host by the interior ("afk") hero without emerging from the host.
If the ally that is being Infested or eating their teammate with Dismember is durable, reasonably mobile, and covers whatever weakness the hidden ally does not (e.g., you need damage for the Tether build, but not for the Rot build since Rot deals so much damage anyway), these can be some of the most potent builds in Ability Draft due to the combined chimera essentially functioning as two heroes in one.
The Rot builds are very strong, Heartstopper with Infest is broken, and Tether with Infest is one of the most broken possible builds in the mode, easily turning into 800+ heal per second.
If going for this type of combo, one ally should draft to be a durable meat shield (Flesh Heap, Dispersion, etc.) that would be useless on their own, while the other goes for their 'hidden ally' combo (to buff the meat shield vessel).
Other ally-dependent builds are also possible, such as one hero having an extremely mobile Flaming Lasso build (Icarus Dive, Scepter-upgraded Pounce, etc.) and really wishing they could have also drafted Rupture. If an ally has Rupture... that's -1 enemy hero.

Common Build Archetypes

Often, it can be beneficial to simply get several of the same type of ability, maximizing one strength. Here is a list of common variants of this kind of build:
Always Useful :
  • All-stun builds are never bad. However, they can often lack in their own damage. This is not necessarily a problem, since if the enemy can't move, your allies should be able to kill them. The more AoE stuns, the better. Example: Hoof Stomp + Slithreen Crush + Echo Stomp + Reverse Polarity
  • Aghanim's Scepter / Shard Abilities: It is almost never a bad idea to just cram your build full of as many Aghanim's Scepter or Aghanim's Shard - upgraded abilities as possible. Note that despite this being in the "Always Useful" section, it is still technically possible to make a bad build, just unlikely. You can view all available ScepteShard abilities in the current draft by pressing CTRL+ALT. Example: Resonant Pulse + Laser + Gush + Shapeshift
Usefully Useful :
  • All-nuke builds are hard to do wrong. If used correctly one can often win fights by deleting a key enemy early on. Example: Lightning Bolt + Brain Sap + Soul Assumption + Laguna Blade
  • All-right-click builds are often difficult to implement due to lacking control, mobility, or defense. However, with proper support (or poor opponents), they can be devastating. Example: Searing Arrows + Metamorphosis + Gunslinger + Grow.
  • All-long-cast-range builds, or "Artillery" builds as I like to call them, are some of the most fun one can have in Ability Draft barring an OP combo. Just hang back and fire away! However, without good aim for the skillshots, these can obviously become underwhelming. Example: Powershot + Heat-Seeking Missiles + Sacred Arrow + Assassinate
Sometimes Useful:
  • Pure defensive builds can work, don't get me wrong. However, they are often a burden to their team. The wielder must have a way to punish the enemy for ignoring them, because otherwise, the enemy will, of course, ignore them. This may be as simple as a good Radiance timing, or be more direct like having sustain for their allies. Example: Nature's Attendants + Dispersion + Counterspell + Reincarnation
  • Pure mobility builds are usually a great way to end the game with triple 0s in your KDA, and that's not a good thing. If you have an abundance of mobility, be sure to also have a low-cooldown disable or damage option to complement it. Example: Slithreen Crush, Time Walk, Blink (QoP), Fire Remnant
  • All-summon builds are usually just food for the enemy. Have a clear gameplan (and preferably a coordinated stack for a team) before trying this. Example: Demonic Conversion + Nature's Call + Summon Wolves + Chaotic Offering

Aftershock Builds

Abilities that result in permastun until the caster runs out of mana:
  • Ball Lightning
  • Rearm (level 3)
  • This list used to be much longer before the 7.33 stun reduction nerfs :(
Abilities that are almost permastun but don't quite get there even with Octarine:
  • Arc Lightning
  • Arcane Bolt
  • Viscous Nasal Goo
  • Purifying Flames is part of this group with Oracle's relevant Talent.
Abilities that can be used for many stuns:
  • Any ability with a cooldown less than or equal to about 5 or 6 (there are several) are great for frequent stun output. e.g., Counterspell, Static Remnant, Quill Spray
  • Charge-based abilities (e.g., Soul Siphon, Spin Webs, Shrapnel, Fire Remnant, etc.) allow for a burst of multiple stuns, but take a long time to recharge fully.
  • Some abilities that involve multiple casts (e.g., X-Marks-the-Spot) get multiple uses out of Aftershock. In general, anything that gives a Magic Stick charge will also trigger Aftershock.
Abilities that make good use of Aftershock for setup:
  • Kinetic Field, Light Strike Array, Torrent, and other delayed skills appreciate Aftershock holding foes in place for them to land.
  • Mystic Flare or (less potently) any other AoE-based damage over time skill makes great use of foes being stunned for the first second or so of their duration. One of the better combos in the mode is Aftershock + Ancient Seal + Mystic Flare for incredible early-to-mid-game damage (before the Pipes start coming out).
  • Sharpshooter allows other skills to be cast and appreciates the setup for its long charging period, not to mention that point-blank shots while they are permastunned by your combo are hilarious.
Proximity Mines are both charge-based and need time to arm, making them almost ideal for Aftershock and one of the most powerful combos in Ability Draft.

Attack Modifier Builds

Many abilities can make use of attack modifiers to great effect. Here we are talking about things like Poison Attack, Mana Break, Frost Arrows, Curse of Avernus, Searing Arrows, and so on. Some abilities that interact with attack modifiers include:
  • Tricks of the Trade
  • Starbreaker
  • Wukong's Command (terms and conditions apply)
  • Swashbuckle
  • Anchor Smash
  • Stifling Dagger
  • Phase Shift's Aghanim's Shard upgrade
  • Split Shot when upgraded by Medusa's Level 25 Talent
  • Assassinate
That list is not comprehensive, it is just meant to get you thinking about potential applications.
Note that when multiple attacks are done 'at once' (e.g., Anchor Smash, God's Rebuke, etc.) only one target gets the effects of a single-use attack modifier like Enchant Totem or Bash of the Deep.

First-Pick Abilities

These abilities are so good that they are usually worth picking up first, before trying to get a combo / synergy. Some of these are mainly first-pick because you probably don't want the enemy to have them, while others are good regardless of your base hero or the current ability pool.
This list is in alphabetical order, not order of priority.
First-picks that are often essentially 'mandatory' include :
  • Arctic Burn (OP range, slow, and scaling damage)
  • Bash of the Deep (great on ranged, good even on melee, often a deny-pick vs a scary enemy)
  • Chemical Rage (now includes Greevil's Greed, making it OP)
  • Glaives of Wisdom (even if you aren't an INT hero, someone on the enemy team probably is)
  • Heartstopper Aura (very high winrate)
  • Reincarnation (second-highest winrate)
  • Shadow Realm (arguably the top priority in most drafts despite mediocre winrate)
  • Shukuchi (invisibility and high mobility)
  • Unleash (depending on the enemy heroes you may be required to deny-pick this)
Strong first-picks that nonetheless usually aren't really 'mandatory' include :
  • Arc Lightning (very strong Shard)
  • Atrophy Aura (DAMAGE... and damage mitigation too, I guess)
  • Either variation of Blink (Never a bad option for any build)
  • Borrowed Time (poor man's Reincarnation)
  • Burrowstrike (solid AoE stun and mobility in one)
  • Cloak and Dagger (most people don't like buying a lot of detection in a fun mode like AD)
  • Dispersion (very high winrate, preferably on tanky hero)
  • Fury Swipes (very strong on ranged heroes or with certain abilities)
  • Storm Hammer (just a solid stun with an Aghs upgrade option)
  • Thirst (personally I think Thirst doesn't stand up to the rest of this list, but statistics disagree)
  • Time Walk (powerful heal and mobility, and the Shard opens many combo options)
  • Vengeance Aura (the Aghs is OP with many abilities)
You can check out this site for a list of the highest-winrate abilities, though be warned that you'll be flamed if you pass up, say, Shadow Realm in favor of Corrosive Skin just because it has a higher winrate! Stats can be helpful but shouldn't be your sole consideration.

Combos

A 'combo' is when both abilities need to be on the same hero to work, as opposed to a 'synergy' where the skills just need to be used in tandem regardless of who casts them.
Several combos have already been discussed and are thus not included. Also, note that combos which already existed in the main game (e.g., Ball Lightning + Overload, Counter Helix + Berserker's Call, etc.) are similarly not included.
  • Vengeance Aura's Aghanim's Scepter upgrade allows one to cast spells twice: Once while alive, then again after death as the illusion. This is extremely potent with fire-and-forget abilities independent of the main hero like Tombstone, Chaotic Offering, or Serpent Wards. It can also be extremely strong with other spells as well if the illusion can survive long enough to cast them optimally. Note that it "refreshes" the full charges of charge-based abilities like Aghs Demonic Purge.
  • Nightmare is essentially just a 6.5 second stun if no other sources of damage (e.g., an ally Radiance) interfere. This can allow many lengthy combos to land and run their course (e.g., Macropyre, Mystic Flare), or just for your simple right-click build to freely damage the victim.
  • Any of the following combined with one or more of each other results in ridiculous attack range : Elder Dragon Form, Take Aim, Arctic Burn, Psi Blades, Chilling Touch
  • Any Illusion-creating spell with any passives that transfer to Illusions can be potent. Powerful options include Split Shot, Mana Break, and Counter Helix with spells like Mirror Image.
  • Bristleback + Bulwark makes for the ultimate defense, but be sure to have a way for that to matter (pure defense often doesn't do much on its own).
  • Berserker's Call with Stone Gaze forces foes to be turned to stone. This also works with any disable that disallows turning, but is most potent with Berserker's Call because Berserker's Call forces foes to look at the caster, making the execution much easier.
  • Enchant Totem, God's Strength, or Tidebringer with Mortal Strike, God's Rebuke, Boundless Strike, or (less reliably) any other critical strike ability deals insane damage. Note that Enchant Totem, God's Strength, and Tidebringer stack with each other as well; e.g., the most optimal build is likely Enchant Totem, Tidebringer, Mortal Strike, and God's Strength.
  • Walrus Punch is an ultimate ability and thus cannot stack with God's Strength, but is otherwise arguably the best critical strike ability for Enchant Totem and Tidebringer.
  • Coup De Grace's buff can reliably land a massive critical hit along with Enchant Totem or Tidebringer. Enchant Totem works especially well with Stifling Dagger in this case.
  • Enchant Totem and Jinada can be potent combined with any single-target spell due to Khanda. Add in Aghs Fiend's Grip (which casts three separate Khandas on the victim) for absurd burst damage.
  • Focus Fire with Shadow Realm, Time Lock, Bash of the Deep, Greater Bash, Fury Swipes, Poison Attack, Chilling Touch, or basically any attack modifier results in the victim nearly always succumbing to the modifier's effects.
  • Omnislash or Unleash with the aforementioned Focus Fire abilities can also be very potent, albeit less reliably (omnislash) and on a longer cooldown (both).
  • Geminate Attack (especially on a melee hero with an Echo Sabre) or Gunslinger can have a similar but more tame effect with the aforementioned Focus Fire modifiers. These have the advantage of not relying on a cooldown, however, situationally performing better than their ultimate-ability counterparts!
  • Impetus with any range-boosting ability deals massive damage, even if the range boost is temporary (e.g., Penitence, Scurry, etc.).
  • Impetus with any long-range forced-attack abilities (e.g., Boundless Strike, Acorn Shot, Stifling Dagger) also deals massive damage. Assassinate is especially funny with this.
  • Swashbuckle with Impetus or Arcane Orb is extremely strong, though the latter also requires Essence Flux. Currently Walrus Punch is still bugged to trigger on each and every Swashbuckle hit (please correct me if that has been fixed).
  • Attack Modifiers like Infernal Blade or Walrus Punch are especially potent with long-range attack abilities like Acorn Shot or Stifling Dagger.
  • Cloak and Dagger with any channeled or sustained ability (e.g., Shackles, Battery Assault, Rot) allows the user to stay invisible for the duration of the latter spells. Other forms of invisibility also work with this, but are harder to execute.
  • Rearm with Nether Ward, Tombstone, Living Armor, Shallow Grave, Sacred Arrow, Split Earth, or Rocket Flare are all very potent for different reasons.
  • Rearm makes the Aghanim's Scepter upgrades for Torrent, Metamorphosis, and Sun Strike completely broken.
  • Rearm with Nature's Call, Demonic Conversion, Enchant, or other summoning spells can make a huge army, but be careful not to feed them.
  • Sticky Napalm with abilities like Ion Shell, Rot, Shackles, Torrent, Rocket Barrage, or Dark Pact deals a lot of damage since these abilities deal many instances of damage individually, proc-ing Napalm damage each time.
  • Thirst with any ability that grants percentage-based movement speed gets very, very fast.
  • Rolling Thunder with most movement skills (Blink, Time Walk, etc.) can 'come back for seconds', so to speak: Roll through someone, then teleport back and roll through again. Sleight of Fists can do this for multiple enemies at once!
  • Tether with Chemical Rage, Shadow Dance, or Burrow (Scepter upgrade for Vendetta) could grant considerable healing to the Tethered target.
  • Blast Off combined with Reincarnation, Berzerker's Blood, or Sunder could use the health cost to its advantage.
  • Omnislash allows one to cast spells during the duration, so short-ranged spells go well with it (e.g., Hoof Stomp, Double Edge).
  • Snowball allows one to cast spells in the prep period, opening up a wide variety of options. For example, using Teleport to escape while invulnerable.
  • Rage, Blade Fury, or Repel with any channeled (e.g., Black Hole, Freezing Field, Fiend's Grip) ability grants one protection from interruptions.
  • Sunder with any invisibility or long-range mobility allows one to intentionally reach low health, sneak up on a foe, Sunder them down to 25% of their health, then finish them off in some way, usually a nuke or Dagon.
  • Supernova with any long-cooldown ability can be potent due to the refreshed cooldowns. Tombstone is the prime example that comes to mind.
  • Icarus Dive with any channeling abilities like Death Ward, Dismember, or Black Hole allows one to dive in, begin channeling, but be taken back out by the back-swing of the dive while still channeling. This can also be used for drive-by uses of other spells, but is funniest with channeling spells.
  • Flaming Lasso with any mobility spell that does not use teleportation (Leap, Pounce, Blast Off, Boundless Strike with Shard, etc.) will take the Lasso target along for the ride. Special mention goes to Icarus Dive, allowing one to dive in, grab someone, and drag them back out. Reverse Time Walk is the most insane with this combo, as you can Time Walk forward, Blink Dagger even further forward, then Reverse all the way back with your kidnapping victim.
  • Duel or Culling Blade with Thirst, Charge of Darkness, or Teleport allows one to easily catch up to low-health foes.
  • Teleport with X-Marks-the-Spot or Time Lapse allows one to teleport in, take an action, then send themselves back. Combined with a nuke, stun, or summoning spell, this can be extremely annoying to the enemy.
  • Primal Split with Rot gives your current Brewling (begins as the Earth Brewling) your Rot aura. This also works with Bulwark's Scepter upgrade.
  • Infest your own Summon Spirit Bear for shenanigans.
  • Aghanim's Scepter upgraded Infest can be surprisingly potent with certain attack modifiers like Arcane Orb or Chilling Touch.
  • Trample with abilities that grant mobility without teleporting (e.g. Skewer, Surge, Windrun, Time Walk, Shard-upgraded Boundless Strike, etc.) can proc its effect many, many times in rapid succession.
  • Freezing Field highly benefits from any mobility spell when upgraded by an Aghanim's Scepter, with the most notable example being Shukuchi.
  • Bulwark's Scepter with any source of cleave (e.g. Tree Grab, Greater Cleave) or potent attack modifiers (e.g. Caustic Finale, Curse of Avernus) can apply their effects to many enemies at once.
  • Haunt (Shadow Step's Scepter) can also apply attack modifiers to the entire enemy team, with the most notable being Curse Of Avernus (like a Global Silence on a 4-attack delay).
  • Essence Flux with Mana Shield makes for an extremely tanky hero, provided you have something to spam like Arcane Orb.
  • Exorcism with abilities that hide the user (e.g., Snowball, Phase Shift, Astral Imprisonment, etc.) can stall for the ghosts to burn enemies or buildings down.
  • Arcane Supremacy is powerful with most targeted abilities, but is particularly funny with abilities like Pulverize, Dispose, or Walrus Kick where the cast range makes for weird displacement rules.
  • Poof can target your own illusions globally, which is one of its only viable uses in my opinion. Conjure Image or Mirror Image with Poof could make for an annoyingly mobile, farm-efficient build.
  • Lucky Shot with any rapid damage over time (e.g. Ion Shell, Rot, etc.) can trigger its effects reliably and repeatedly. Supernova is one of the most powerful with Lucky Shot due to the massive AoE and Lucky Shot's attack slow synergising very well to protect the Egg.
  • Skewer or Boulder Smash with any kind of mobility (e.g., Blink, Burrowstrike, etc.) can reposition enemies even early in the game (no items needed).
  • Assassinate's attack effect can be combined with effects like Mortal Strike and Enchant Totem for extremely long-ranged and damaging shots.
  • Dark Ascension can refresh high-impact abilities like Tombstone, Metamorphosis, Nether Ward, and Cataclysm. It is also excellent for refreshing your kit in general, especially stuns.
  • Heartstopper Aura's Scepter can be combined with regenerative effects like Chemical Rage, Burrow, or especially Infest for extremely high damage.
  • Blade Fury scales with attack speed, so abilities that grant absurd attack speed like Lil' Shredder, Overpower, Focus Fire, or Unleash will send its damage through the roof!
  • Mystic Flare's Shard, Shield of the Scion, can grant absurd Armor and Magic Resistance (from INT) when combined with rapid damage-over-time effects like Sandstorm and Rot.

Synergies

A 'synergy' is when the abilities merely need to be used in tandem regardless of who casts them, as opposed to a 'combo' where both abilities need to be on the same hero to work. However, most synergies do indeed work better (in terms of execution) if both abilities are on the same hero, hence their potency in Ability Draft.
Note that synergies which already existed in the main game (e.g., X-Marks-the-Spot + Torrent, Kinetic Field + Static Storm, Mana Break + Mana Void, etc.) are not included, nor are any that were already mentioned in this post. Some synergies were already included in the 'Combos' section for brevity, as I was already describing their build with other abilities.
  • Laguna Blade or Finger of Death with Decrepify, Ancient Seal, or any other magic damage amplification deals massive damage.
  • Vacuum with any AoE stun can make for a one-man wombo-combo. Note that you can cast Vacuum on units affected by Song of the Siren as well.
  • False Promise with Shallow Grave work together extremely well for two reasons. Firstly, no matter how much damage is taken during False Promise, Shallow Grave will allow the victim to survive at the end. This alone makes the target of the caster's protection extremely difficult to kill. Additionally, with cooldown reduction it is possible to Shallow Grave -> False Promise - > Shallow Grave. This means that - barring Culling Blade's interference - the targeted unit cannot die for 17, 18.5, 20 seconds (+1.5 if the caster is a level 25 Oracle with the relevant Talent).
  • Ghost Shroud with False Promise makes for extreme healing. The hero being targeted by False Promise must have Ghost Shroud, not the other way around.
  • Rupture with Meat Hook, Skewer, Toss, Spear of Mars, X-marks-the-Spot, Dead Shot, or any other forced-movement ability allows one to deal massive Rupture damage. Usually more than one of the above movement skills is needed to be effective.
  • Spark Wraith or Proximity Mines with Meat Hook or Skewer allows one to set up a stack of death then force an enemy into them. Flaming Lasso and Nether Swap can also be used this way for Spark Wraiths.
  • Ice Blast or Doom with Purifying Flames allows one to nuke one's victim without worrying about healing them.
  • Maledict with Finger of Death, Laguna Blade, or an assortment of nukes (i.e., more than one) deals massive damage over time.
  • Aphotic Shield with Double Edge, Blast Off, or Life Break both mitigates the self-inflicted damage of the latter spells and also pops the shield for added burst.
  • Earth Splitter, Ghost Ship, Unstable Concoction, Light Strike Array, Kinetic Field, Cold Feet, Torrent, or any other delayed spell benefits greatly from another disable to set it up. Often, the spell to be set up (e.g. Ghost Ship) is cast before the aiding stun or disable (e.g., Ghost Ship into Burrowstrike, not the other way around).
  • Nightmare with any ability in need of setup can generally guarantee the ability lands. This applies to the examples mentioned above (e.g., Earth Splitter, Ghost Ship, etc.), but can also be used for abilities like Meat Hook, Skewer, or other hard-to-hit spells. Special mention goes to Nightmare + Static Link.
  • Mystic Flare with any stun or root allows its full duration to be reliably inflicted, turning a mediocre spell into a terrifying one. The same effect can be achieved with any ground-targeted damage over time spell, but Mystic Flare is the most potent.
  • Cloak and Dagger with any dispel (e.g., Fortune's End, Aphotic Shield, etc.) can get rid of the Dust debuff on the caster. If the caster also has a Gem to destroy enemy Sentry Wards, the only thing that can reliably see them is an opposing Gem. Dark Pact is a 'combo' using this same premise, as it is required that the same hero have both abilities.
  • Pit of Malice with any other disable allows one to disable the victim(s) during the 'downtime' of the Pit of Malice root, allowing subsequent Pit of Malice root(s) to trigger.
  • The Scepter Upgrade for Fiend's Gate and Pit of Malice combos extremely well with the Scepter Upgrade for Sun Strike. The former two abilities must be present on the same hero. The Scepter upgrade for Wrath Of Nature is arguably even better for this purpose, since it has a lower cooldown and is even easier to execute if you only want to hit a couple of targets.
  • Sacred Arrow with Hookshot, Fortune's End, Fissure, Homing Missile, or Nightmare (with a mobility spell to move away after casting said Nightmare) allows one to land long-ranged Arrows with ease. Sharpshooter can work similarly.
  • Tombstone with Decrepify or Sprout allows one to protect their Tombstone.
  • Proximity Mine with any disable of sufficient length makes the mines' wind-up time irrelevant.
  • Requiem of Souls with any sufficiently-long disable can insta-kill anyone caught out, provided one has enough Necromastery souls. The stun must be 1.67 seconds or longer, and the caster must also have Necromastery. If the stun also provides mobility (e.g., Burrowstrike, Blast Off, Firesnap Cookie) this makes the execution much easier.
  • Penitence will allow a Death Ward to attack ludicrously fast. It also works well with Winter's Curse and Chaotic Offering.
  • Arena of Blood is excellent with large-AoE spells like Midnight Pulse, Shrapnel, or Tombstone (place the Tombstone outside of the arena).
  • Savage Roar is hilarious with Arena of Blood or Dream Coil, forcing enemies to run away into even worse effects.
  • Song of the Siren with Tombstone allows zombies to begin stacking up while the Tombstone remains safe. Upheaval can serve a less effective but similar purpose.
  • Phantom's Embrace, Proximity Mines, or Supernova with any source of disarm (e.g. Inner Fire, Decrepify, Reactive Taser) stops the enemy from attacking the phantom, mines, or egg, respectively.
  • Any stun that has a moderate cast range works very well with the Ability-Draft-exclusive version of Shadow Raze, which gives 3 charges of the medium-range Raze.

Closing

I am certain there are many, many interesting and powerful builds not mentioned here. Moreover, many obvious synergies (e.g., False Promise with any healing ability) were left out due to their... well... obvious-ness. Finally, many abilities can make for quite potent builds that were not called out here (such as Pulse Nova) due to them usually not involving any explicit combo, instead just making a build strong overall.
All in all, Ability Draft is a realm of infinite possibilities. Tell me what you think! Thank you for your time and feedback!
submitted by TheGreatGimmick to DotA2 [link] [comments]


2024.04.30 12:57 TheGreatGimmick An Extensive Guide to Ability Draft (updated)

This is my attempt at a comprehensive compilation of everything you need to know about drafting abilities in Ability Draft. If you see a mistake or think of things to add, please, tell me!
This post is current as of DotA patch 7.35d.

General Drafting Tips

  • Your hero's base stats heavily affect the viability of many builds. Additionally, Talents should be considered when drafting abilities, although they are usually far from the most important factor. Stats can be found here, while Talents can be found here. You can also just hover over your hero in the drafting screen.
  • Carefully consider the pick order when choosing which abilities to draft. The earlier you pick, the more likely you are to get an overpowered stand-alone ability, while picking later raises the chances that you can complete a combination of abilities. If you see an overpowered combo in the draft, but are first-pick, tell your team what you see but pick one of the powerful stand-alone abilities instead, because it is unlikely the second half of the combo will make it all the way back to you. Some heroes are also far more likely to pick certain abilities than others (e.g., Warlock and Chaotic Offering) which can also affect your assessment of whether you can get away with a combo or not.
  • Ruining your own build can sometimes be worth denying an enemy build. For example, Arcane Orb is generally a grief pick unless you draft Essence Flux first, but sometimes it is actually the correct play to deny-pick Orb if the enemy has Essence Flux and, say, Swashbuckle already. The very last person in the pick order is the only hero that drafts two abilities back-to-back (in the first round of drafting), so if you pick earlier be on the lookout for which abilities you need to pick to deny them a broken combo.
  • Sometimes your own team will pick abilities you needed for a combo. Communicate in the chat, but do not assume everyone will play along. Try to get confirmation from your team that they understand not to draft the ability you want. If you are met with negatives or even just silence, assume they may draft your desired ability.

Gameplay Differences

  • Ability Draft often lags behind the main game in terms of patch updates. For a while after a patch, new ability changes may or may not have taken effect, and entirely new abilities (e.g., from Aghanim's Shard changes) are often missing entirely. Conversely, removed parts of the game may still linger in Ability Draft. They've gotten better about updating AD, but this is still something to keep in mind for weeks or months after a major patch.
  • If your hero's normal Talent option(s) pertain to an ability that you did not draft, you are offered Gold instead. I know free Gold is tempting, but if you have the option, it is almost always better to take a Talent that actually does something over the free Gold.
  • You must be flexible in your item builds, because you are essentially playing an entirely new hero each game of Ability Draft. Ask yourself what your abilities need to succeed, then build that, no matter how silly such an item build might seem out of context. Sometimes item builds that are ill-advised in the regular game work exceedingly well in Ability Draft.
  • A corollary to the above point is that supports in Ability Draft tend to be greedier than in the regular game. Sometimes this is even justifiable; if their build achieves perma-stun with an Octarine, is it really better to get traditional items like Glimmer Cape instead? Well, yes, it probably still is, but the argument is there at least.
  • The mid lane usually hosts one of three kinds of builds: The build that is completely useless before 6 but comes online once they can use their ultimate (e.g., Ancient Seal + Decrepify + Ice Vortex + Finger of Death), the build that completely dominates a 1v1 (the most 'vanilla' style of mid-laner, amplified further by custom builds), or simply the strongest build on your team (the broken combo). The point is, you may sometimes see a player who should have been a clear safelane carry or durable offlaner go mid instead, and that may not be a bad thing, simply because if they have a very powerful build they just need to outlevel everyone else and roll over them. In summary, often you will see builds that do not fit the archetype for a traditional midlaner nonetheless going mid in Ability Draft. Whoever needs levels the most generally goes.
  • The strength of various builds on a team often makes Ability Draft a more polarized game in terms of target priorities. Identify whether there is someone on the enemy team that is worth losing 3+ of your own heroes to take out, and if so, do that. This is occasionally the case in the regular game as well (e.g., going all-in on the enemy carry), but it happens more often in Ability Draft.

Special Cases / Tips

  • Unique sources of Bash that do not normally stack will fully stack in Ability Draft.
  • Geminate Attack stacks with Echo Sabre, resulting in 3 attacks at once for melee heroes.
  • Melee heroes can attack with the full attack range of attack modifiers (e.g. Frost Arrows) only if they have a source of True Strike. Otherwise the attacks will miss if distance exceeds 350 units. Ranged heroes can always use the full distance, but may suffer the reverse problem: Short-ranged modifiers (e.g., Infernal Blade) should not be manually cast, since you must autocast them to use your base hero's range.
  • For most effects that refresh cooldowns (e.g., Rearm, Blur's Aghanim's Scepter upgrade, etc.), charge-based abilities will only receive 1 charge back, not be fully replenished like Refresher Orb.
  • Dismember cannot be used while you have eaten someone with its Aghanim's Shard effect.
  • Several abilities have been altered to work in Ability Draft, but the most drastic of these changes is Poof, which can now target any allied unit within 2000 range. Although I still would not recommend picking Poof, it is not as useless as one might think.
  • Only Meepo can be globally targeted by an allied Poof from anywhere on the map and have them appear at his location.
  • Only Monkey King can become trees with Mischief (which is tied to the Wukong's Command ability). Other heroes can still turn into other things.
  • Bane can freely damage targets under the effects of Nightmare, even if he does not have Nightmare.
  • Faceless Void can move inside anyone's Chronosphere.
  • At one time, Batrider used to gain unobstructed vision whenever he had free pathing, which was easy to abuse with abilities like Spin Webs and Arctic Burn. However, I am not sure if this is the case any longer now that, in the vanilla game, Firefly was changed to be ground vision.

You can also find a helpful list of the current bugs here. Some of them are gamebreaking!

Dependent Abilities

Most interdependent interactions are now included in the tooltips provided by Ability Draft, so this section is less necessary than in ye olden days. I'm including some key interactions here for completion's sake, however.
  • Any time another ability is directly referenced in the description of an ability or its upgrade (e.g., Scepter, Shard, or Talent), that effect requires both abilities to function. The prime example of this is Eclipse requiring Lucent Beam. Don't be that guy. Another notable example is Bristleback needing Quill Spray to fully function.
  • Geomagnetic Grip, unlike Rolling Boulder or Boulder Smash, is entirely dependent on Stone Remnants (and thus Magnetize) to do anything.
  • Arcane Orb needs Essence Flux to be fully viable, though it can deal decent damage on the first use if at full mana.
  • Neither Charge of Darkness nor Nether Strike will inflict their Greater Bash components if the caster does not have Greater Bash.
  • Natural Order does not lower Magic Resistance if Astral Spirit is not drafted.
  • Requiem of Souls requires souls, and thus Necromastery.
Less Drastic Improvements Include :
  • Astral Spirit and Echo Stomp, while decent abilities on their own, are heavily interconnected in terms of how they were intended to be used.
  • Shuriken Toss can only bounce if Track is also on your team, though two different heroes can own the abilities!
  • Avalanche, Toss, and Grow are all interconnected.
  • Familiars from Summon Familiars are very fragile without Gravekeeper's Cloak.
  • Rolling Boulder and Boulder Smash are best used with Stone Remnants (and thus Magnetize).
  • Relocate can be useful on its own, but half the point of the spell is to take an ally with you, necessitating Tether.
  • Summon Wolves are usually underwhelming without support from both Feral Impulse and Shapeshift.
  • Many other abilities (Plague Wards + Poison Sting, Dragon Tail + Elder Dragon Form, Spawn Spiderlings + Spin Webs, etc.) use other abilities as part of their normal function.

Notable Talents

Multiple Talents :
  • Luna, Dark Seer, Lone Druid, Puck, Primal Beast, Tidehunter, and Undying each have at least one Talent per Talent tier (4 or more Talents) for Lucent Beam, Ion Shell, Summon Spirit Bear, Waning Rift, Trample, Anchor Smash, or Tombstone, respectively.
  • Engima's Eidolons can be heavily improved by his Talents.
  • Many heroes have multiple early Talents for certain abilities (e.g., Underlord with Firestorm) that can be potent to stack up, but don't get baited into planning for level 25, because it usually doesn't happen.
  • Snapfire can transform into a devastating lategame carry with her relevant Lil' Shredder Talents if the game does end up going long enough, though level 25 is a long time to wait.
Single Talents :
  • Ancient Apparition gains +300 Chilling Touch range at level 10, making already-strong Aghs builds even stronger.
  • Jakiro gains +200 attack range at level 10, making abilities like Arctic Burn, Take Aim, Elder Dragon Form, and especially Impetus more desirable.
  • Techies gets a casual 20% magic resistance at level 10 (Timbersaw gets this at level 20).
  • Crystal Maiden's level 20 Talent grants +225 Attack Speed, which can be quite potent with certain modifiers like Scepter Chilling Touch or Bash of the Deep.
  • Warlock's level 20 Golem On Death Talent makes Chaotic Offering very attractive on the hero, and he gets further Talents for his Golems at 25.
  • Of course, many level 25 Talents can be incredible and change how your build functions... provided the game even lasts that long.
Niche Talents :
  • Some heroes have Talents that provide auras for the "AFK Infest/Dismember" builds (see the below Ally-Dependent Builds section), such as Beastmaster's level 15 +20 MS aura, Doom's level 15 Devour Ancients for auras, Underlord's level 25 Allies gain 50% Atrophy Aura, or Centaur's level 25 Retaliate Aura.
  • Tinker's level 20 Defense Matrix Grants 25% CDR Talent could allow some Aftershock builds to achieve permastun (see the below Aftershock section).
  • Skywrath Mage's Global Concussive Shot at level 20 could be highly amusing with Rearm. Perhaps add Rocket Flare into the mix as well.
  • With a sufficiently tanky build (especially with Kraken Shell to dispel stuns), Terrorblade's 10-second Sunder at level 25 would be incredibly difficult to deal with.
  • Tiny with Rupture combined with the level 20/25 Toss Talents (to remove the need for a target and grant more charges) could be devastating and hilarious.
  • Tusk and Ogre Magi both have level 25 Talents that, with enough attack speed, can result in permastun and ridiculous damage. This requires Walrus Punch / Fireblast, respectively.
Of course, many other Talents can be potent as well; be sure to know your hero's Talents before constructing your draft.

Ally-Dependent Builds

Later sections of this guide will go over how you can combine your own abilities together, but some builds require that the synergistic abilities be drafted on two different heroes. Most such builds involve one hero going AFK inside of an ally, as described below.
  • Infest with Tether, Rot, Scepter-upgraded Spirits, Voodoo Restoration, Scepter-upgraded Heartstopper Aura, or (less potently) any AoE passive (e.g. Atrophy Aura, Warcry's Shard upgrade, Inner Beast, etc.) can make for an AFK build where one hero sits inside an ally all game but still contributes significantly. This requires that the AFK hero has a viable ally 'host', of course.
  • An ally with Dismember and an Aghanim's Shard can accomplish the same effect (however, the Tether combo does not work). This version has the additional requirement of not only needing a viable 'host', but also needing a host that doesn't require an ultimate ability (because they wasted it on Dismember to eat the afk hero).
  • If using the Dismember version, the interior hero can also contribute their ult (since they don't need Infest), opening up builds like Blood Mist (Scepter-upgraded Rupture) constantly burning enemies down, Reincarnation contributing its aura to the exterior ally, or Shard-upgraded Epicenter pulsing occasionally.
  • Special mention goes to Vengeance Aura with Dismember, since the Scepter illusion can re-eat your hidden ally once your actual hero dies.
  • Bulwark's Scepter upgrade still works in this situation despite being disabled by stuns/disarms normally.
  • When using the Dismember version, Glimmer Cape can be used on the host by the interior ("afk") hero without emerging from the host.
If the ally that is being Infested or eating their teammate with Dismember is durable, reasonably mobile, and covers whatever weakness the hidden ally does not (e.g., you need damage for the Tether build, but not for the Rot build since Rot deals so much damage anyway), these can be some of the most potent builds in Ability Draft due to the combined chimera essentially functioning as two heroes in one.
The Rot builds are very strong, Heartstopper with Infest is broken, and Tether with Infest is one of the most broken possible builds in the mode, easily turning into 800+ heal per second.
If going for this type of combo, one ally should draft to be a durable meat shield (Flesh Heap, Dispersion, etc.) that would be useless on their own, while the other goes for their 'hidden ally' combo (to buff the meat shield vessel).
Other ally-dependent builds are also possible, such as one hero having an extremely mobile Flaming Lasso build (Icarus Dive, Scepter-upgraded Pounce, etc.) and really wishing they could have also drafted Rupture. If an ally has Rupture... that's -1 enemy hero.

Common Build Archetypes

Often, it can be beneficial to simply get several of the same type of ability, maximizing one strength. Here is a list of common variants of this kind of build:
Always Useful :
  • All-stun builds are never bad. However, they can often lack in their own damage. This is not necessarily a problem, since if the enemy can't move, your allies should be able to kill them. The more AoE stuns, the better. Example: Hoof Stomp + Slithreen Crush + Echo Stomp + Reverse Polarity
  • Aghanim's Scepter / Shard Abilities: It is almost never a bad idea to just cram your build full of as many Aghanim's Scepter or Aghanim's Shard - upgraded abilities as possible. Note that despite this being in the "Always Useful" section, it is still technically possible to make a bad build, just unlikely. You can view all available ScepteShard abilities in the current draft by pressing CTRL+ALT. Example: Resonant Pulse + Laser + Gush + Shapeshift
Usefully Useful :
  • All-nuke builds are hard to do wrong. If used correctly one can often win fights by deleting a key enemy early on. Example: Lightning Bolt + Brain Sap + Soul Assumption + Laguna Blade
  • All-right-click builds are often difficult to implement due to lacking control, mobility, or defense. However, with proper support (or poor opponents), they can be devastating. Example: Searing Arrows + Metamorphosis + Gunslinger + Grow.
  • All-long-cast-range builds, or "Artillery" builds as I like to call them, are some of the most fun one can have in Ability Draft barring an OP combo. Just hang back and fire away! However, without good aim for the skillshots, these can obviously become underwhelming. Example: Powershot + Heat-Seeking Missiles + Sacred Arrow + Assassinate
Sometimes Useful:
  • Pure defensive builds can work, don't get me wrong. However, they are often a burden to their team. The wielder must have a way to punish the enemy for ignoring them, because otherwise, the enemy will, of course, ignore them. This may be as simple as a good Radiance timing, or be more direct like having sustain for their allies. Example: Nature's Attendants + Dispersion + Counterspell + Reincarnation
  • Pure mobility builds are usually a great way to end the game with triple 0s in your KDA, and that's not a good thing. If you have an abundance of mobility, be sure to also have a low-cooldown disable or damage option to complement it. Example: Slithreen Crush, Time Walk, Blink (QoP), Fire Remnant
  • All-summon builds are usually just food for the enemy. Have a clear gameplan (and preferably a coordinated stack for a team) before trying this. Example: Demonic Conversion + Nature's Call + Summon Wolves + Chaotic Offering

Aftershock Builds

Abilities that result in permastun until the caster runs out of mana:
  • Ball Lightning
  • Rearm (level 3)
  • This list used to be much longer before the 7.33 stun reduction nerfs :(
Abilities that are almost permastun but don't quite get there even with Octarine:
  • Arc Lightning
  • Arcane Bolt
  • Viscous Nasal Goo
  • Purifying Flames is part of this group with Oracle's relevant Talent.
Abilities that can be used for many stuns:
  • Any ability with a cooldown less than or equal to about 5 or 6 (there are several) are great for frequent stun output. e.g., Counterspell, Static Remnant, Quill Spray
  • Charge-based abilities (e.g., Soul Siphon, Spin Webs, Shrapnel, Fire Remnant, etc.) allow for a burst of multiple stuns, but take a long time to recharge fully.
  • Some abilities that involve multiple casts (e.g., X-Marks-the-Spot) get multiple uses out of Aftershock. In general, anything that gives a Magic Stick charge will also trigger Aftershock.
Abilities that make good use of Aftershock for setup:
  • Kinetic Field, Light Strike Array, Torrent, and other delayed skills appreciate Aftershock holding foes in place for them to land.
  • Mystic Flare or (less potently) any other AoE-based damage over time skill makes great use of foes being stunned for the first second or so of their duration. One of the better combos in the mode is Aftershock + Ancient Seal + Mystic Flare for incredible early-to-mid-game damage (before the Pipes start coming out).
  • Sharpshooter allows other skills to be cast and appreciates the setup for its long charging period, not to mention that point-blank shots while they are permastunned by your combo are hilarious.
Proximity Mines are both charge-based and need time to arm, making them almost ideal for Aftershock and one of the most powerful combos in Ability Draft.

Attack Modifier Builds

Many abilities can make use of attack modifiers to great effect. Here we are talking about things like Poison Attack, Mana Break, Frost Arrows, Curse of Avernus, Searing Arrows, and so on. Some abilities that interact with attack modifiers include:
  • Tricks of the Trade
  • Starbreaker
  • Wukong's Command (terms and conditions apply)
  • Swashbuckle
  • Anchor Smash
  • Stifling Dagger
  • Phase Shift's Aghanim's Shard upgrade
  • Split Shot when upgraded by Medusa's Level 25 Talent
  • Assassinate
That list is not comprehensive, it is just meant to get you thinking about potential applications.
Note that when multiple attacks are done 'at once' (e.g., Anchor Smash, God's Rebuke, etc.) only one target gets the effects of a single-use attack modifier like Enchant Totem or Bash of the Deep.

First-Pick Abilities

These abilities are so good that they are usually worth picking up first, before trying to get a combo / synergy. Some of these are mainly first-pick because you probably don't want the enemy to have them, while others are good regardless of your base hero or the current ability pool.
This list is in alphabetical order, not order of priority.
First-picks that are often essentially 'mandatory' include :
  • Arctic Burn (OP range, slow, and scaling damage)
  • Bash of the Deep (great on ranged, good even on melee, often a deny-pick vs a scary enemy)
  • Chemical Rage (now includes Greevil's Greed, making it OP)
  • Glaives of Wisdom (even if you aren't an INT hero, someone on the enemy team probably is)
  • Heartstopper Aura (very high winrate)
  • Reincarnation (second-highest winrate)
  • Shadow Realm (arguably the top priority in most drafts despite mediocre winrate)
  • Shukuchi (invisibility and high mobility)
  • Unleash (depending on the enemy heroes you may be required to deny-pick this)
Strong first-picks that nonetheless usually aren't really 'mandatory' include :
  • Arc Lightning (very strong Shard)
  • Atrophy Aura (DAMAGE... and damage mitigation too, I guess)
  • Either variation of Blink (Never a bad option for any build)
  • Borrowed Time (poor man's Reincarnation)
  • Burrowstrike (solid AoE stun and mobility in one)
  • Cloak and Dagger (most people don't like buying a lot of detection in a fun mode like AD)
  • Dispersion (very high winrate, preferably on tanky hero)
  • Fury Swipes (very strong on ranged heroes or with certain abilities)
  • Storm Hammer (just a solid stun with an Aghs upgrade option)
  • Thirst (personally I think Thirst doesn't stand up to the rest of this list, but statistics disagree)
  • Time Walk (powerful heal and mobility, and the Shard opens many combo options)
  • Vengeance Aura (the Aghs is OP with many abilities)
You can check out this site for a list of the highest-winrate abilities, though be warned that you'll be flamed if you pass up, say, Shadow Realm in favor of Corrosive Skin just because it has a higher winrate! Stats can be helpful but shouldn't be your sole consideration.

Combos

A 'combo' is when both abilities need to be on the same hero to work, as opposed to a 'synergy' where the skills just need to be used in tandem regardless of who casts them.
Several combos have already been discussed and are thus not included. Also, note that combos which already existed in the main game (e.g., Ball Lightning + Overload, Counter Helix + Berserker's Call, etc.) are similarly not included.
  • Vengeance Aura's Aghanim's Scepter upgrade allows one to cast spells twice: Once while alive, then again after death as the illusion. This is extremely potent with fire-and-forget abilities independent of the main hero like Tombstone, Chaotic Offering, or Serpent Wards. It can also be extremely strong with other spells as well if the illusion can survive long enough to cast them optimally. Note that it "refreshes" the full charges of charge-based abilities like Aghs Demonic Purge.
  • Nightmare is essentially just a 6.5 second stun if no other sources of damage (e.g., an ally Radiance) interfere. This can allow many lengthy combos to land and run their course (e.g., Macropyre, Mystic Flare), or just for your simple right-click build to freely damage the victim.
  • Any of the following combined with one or more of each other results in ridiculous attack range : Elder Dragon Form, Take Aim, Arctic Burn, Psi Blades, Chilling Touch
  • Any Illusion-creating spell with any passives that transfer to Illusions can be potent. Powerful options include Split Shot, Mana Break, and Counter Helix with spells like Mirror Image.
  • Bristleback + Bulwark makes for the ultimate defense, but be sure to have a way for that to matter (pure defense often doesn't do much on its own).
  • Berserker's Call with Stone Gaze forces foes to be turned to stone. This also works with any disable that disallows turning, but is most potent with Berserker's Call because Berserker's Call forces foes to look at the caster, making the execution much easier.
  • Enchant Totem, God's Strength, or Tidebringer with Mortal Strike, God's Rebuke, Boundless Strike, or (less reliably) any other critical strike ability deals insane damage. Note that Enchant Totem, God's Strength, and Tidebringer stack with each other as well; e.g., the most optimal build is likely Enchant Totem, Tidebringer, Mortal Strike, and God's Strength.
  • Walrus Punch is an ultimate ability and thus cannot stack with God's Strength, but is otherwise arguably the best critical strike ability for Enchant Totem and Tidebringer.
  • Coup De Grace's buff can reliably land a massive critical hit along with Enchant Totem or Tidebringer. Enchant Totem works especially well with Stifling Dagger in this case.
  • Enchant Totem and Jinada can be potent combined with any single-target spell due to Khanda. Add in Aghs Fiend's Grip (which casts three separate Khandas on the victim) for absurd burst damage.
  • Focus Fire with Shadow Realm, Time Lock, Bash of the Deep, Greater Bash, Fury Swipes, Poison Attack, Chilling Touch, or basically any attack modifier results in the victim nearly always succumbing to the modifier's effects.
  • Omnislash or Unleash with the aforementioned Focus Fire abilities can also be very potent, albeit less reliably (omnislash) and on a longer cooldown (both).
  • Geminate Attack (especially on a melee hero with an Echo Sabre) or Gunslinger can have a similar but more tame effect with the aforementioned Focus Fire modifiers. These have the advantage of not relying on a cooldown, however, situationally performing better than their ultimate-ability counterparts!
  • Impetus with any range-boosting ability deals massive damage, even if the range boost is temporary (e.g., Penitence, Scurry, etc.).
  • Impetus with any long-range forced-attack abilities (e.g., Boundless Strike, Acorn Shot, Stifling Dagger) also deals massive damage. Assassinate is especially funny with this.
  • Swashbuckle with Impetus or Arcane Orb is extremely strong, though the latter also requires Essence Flux. Currently Walrus Punch is still bugged to trigger on each and every Swashbuckle hit (please correct me if that has been fixed).
  • Attack Modifiers like Infernal Blade or Walrus Punch are especially potent with long-range attack abilities like Acorn Shot or Stifling Dagger.
  • Cloak and Dagger with any channeled or sustained ability (e.g., Shackles, Battery Assault, Rot) allows the user to stay invisible for the duration of the latter spells. Other forms of invisibility also work with this, but are harder to execute.
  • Rearm with Nether Ward, Tombstone, Living Armor, Shallow Grave, Sacred Arrow, Split Earth, or Rocket Flare are all very potent for different reasons.
  • Rearm makes the Aghanim's Scepter upgrades for Torrent, Metamorphosis, and Sun Strike completely broken.
  • Rearm with Nature's Call, Demonic Conversion, Enchant, or other summoning spells can make a huge army, but be careful not to feed them.
  • Sticky Napalm with abilities like Ion Shell, Rot, Shackles, Torrent, Rocket Barrage, or Dark Pact deals a lot of damage since these abilities deal many instances of damage individually, proc-ing Napalm damage each time.
  • Thirst with any ability that grants percentage-based movement speed gets very, very fast.
  • Rolling Thunder with most movement skills (Blink, Time Walk, etc.) can 'come back for seconds', so to speak: Roll through someone, then teleport back and roll through again. Sleight of Fists can do this for multiple enemies at once!
  • Tether with Chemical Rage, Shadow Dance, or Burrow (Scepter upgrade for Vendetta) could grant considerable healing to the Tethered target.
  • Blast Off combined with Reincarnation, Berzerker's Blood, or Sunder could use the health cost to its advantage.
  • Omnislash allows one to cast spells during the duration, so short-ranged spells go well with it (e.g., Hoof Stomp, Double Edge).
  • Snowball allows one to cast spells in the prep period, opening up a wide variety of options. For example, using Teleport to escape while invulnerable.
  • Rage, Blade Fury, or Repel with any channeled (e.g., Black Hole, Freezing Field, Fiend's Grip) ability grants one protection from interruptions.
  • Sunder with any invisibility or long-range mobility allows one to intentionally reach low health, sneak up on a foe, Sunder them down to 25% of their health, then finish them off in some way, usually a nuke or Dagon.
  • Supernova with any long-cooldown ability can be potent due to the refreshed cooldowns. Tombstone is the prime example that comes to mind.
  • Icarus Dive with any channeling abilities like Death Ward, Dismember, or Black Hole allows one to dive in, begin channeling, but be taken back out by the back-swing of the dive while still channeling. This can also be used for drive-by uses of other spells, but is funniest with channeling spells.
  • Flaming Lasso with any mobility spell that does not use teleportation (Leap, Pounce, Blast Off, Boundless Strike with Shard, etc.) will take the Lasso target along for the ride. Special mention goes to Icarus Dive, allowing one to dive in, grab someone, and drag them back out. Reverse Time Walk is the most insane with this combo, as you can Time Walk forward, Blink Dagger even further forward, then Reverse all the way back with your kidnapping victim.
  • Duel or Culling Blade with Thirst, Charge of Darkness, or Teleport allows one to easily catch up to low-health foes.
  • Teleport with X-Marks-the-Spot or Time Lapse allows one to teleport in, take an action, then send themselves back. Combined with a nuke, stun, or summoning spell, this can be extremely annoying to the enemy.
  • Primal Split with Rot gives your current Brewling (begins as the Earth Brewling) your Rot aura. This also works with Bulwark's Scepter upgrade.
  • Infest your own Summon Spirit Bear for shenanigans.
  • Aghanim's Scepter upgraded Infest can be surprisingly potent with certain attack modifiers like Arcane Orb or Chilling Touch.
  • Trample with abilities that grant mobility without teleporting (e.g. Skewer, Surge, Windrun, Time Walk, Shard-upgraded Boundless Strike, etc.) can proc its effect many, many times in rapid succession.
  • Freezing Field highly benefits from any mobility spell when upgraded by an Aghanim's Scepter, with the most notable example being Shukuchi.
  • Bulwark's Scepter with any source of cleave (e.g. Tree Grab, Greater Cleave) or potent attack modifiers (e.g. Caustic Finale, Curse of Avernus) can apply their effects to many enemies at once.
  • Haunt (Shadow Step's Scepter) can also apply attack modifiers to the entire enemy team, with the most notable being Curse Of Avernus (like a Global Silence on a 4-attack delay).
  • Essence Flux with Mana Shield makes for an extremely tanky hero, provided you have something to spam like Arcane Orb.
  • Exorcism with abilities that hide the user (e.g., Snowball, Phase Shift, Astral Imprisonment, etc.) can stall for the ghosts to burn enemies or buildings down.
  • Arcane Supremacy is powerful with most targeted abilities, but is particularly funny with abilities like Pulverize, Dispose, or Walrus Kick where the cast range makes for weird displacement rules.
  • Poof can target your own illusions globally, which is one of its only viable uses in my opinion. Conjure Image or Mirror Image with Poof could make for an annoyingly mobile, farm-efficient build.
  • Lucky Shot with any rapid damage over time (e.g. Ion Shell, Rot, etc.) can trigger its effects reliably and repeatedly. Supernova is one of the most powerful with Lucky Shot due to the massive AoE and Lucky Shot's attack slow synergising very well to protect the Egg.
  • Skewer or Boulder Smash with any kind of mobility (e.g., Blink, Burrowstrike, etc.) can reposition enemies even early in the game (no items needed).
  • Assassinate's attack effect can be combined with effects like Mortal Strike and Enchant Totem for extremely long-ranged and damaging shots.
  • Dark Ascension can refresh high-impact abilities like Tombstone, Metamorphosis, Nether Ward, and Cataclysm. It is also excellent for refreshing your kit in general, especially stuns.
  • Heartstopper Aura's Scepter can be combined with regenerative effects like Chemical Rage, Burrow, or especially Infest for extremely high damage.
  • Blade Fury scales with attack speed, so abilities that grant absurd attack speed like Lil' Shredder, Overpower, Focus Fire, or Unleash will send its damage through the roof!
  • Mystic Flare's Shard, Shield of the Scion, can grant absurd Armor and Magic Resistance (from INT) when combined with rapid damage-over-time effects like Sandstorm and Rot.

Synergies

A 'synergy' is when the abilities merely need to be used in tandem regardless of who casts them, as opposed to a 'combo' where both abilities need to be on the same hero to work. However, most synergies do indeed work better (in terms of execution) if both abilities are on the same hero, hence their potency in Ability Draft.
Note that synergies which already existed in the main game (e.g., X-Marks-the-Spot + Torrent, Kinetic Field + Static Storm, Mana Break + Mana Void, etc.) are not included, nor are any that were already mentioned in this post. Some synergies were already included in the 'Combos' section for brevity, as I was already describing their build with other abilities.
  • Laguna Blade or Finger of Death with Decrepify, Ancient Seal, or any other magic damage amplification deals massive damage.
  • Vacuum with any AoE stun can make for a one-man wombo-combo. Note that you can cast Vacuum on units affected by Song of the Siren as well.
  • False Promise with Shallow Grave work together extremely well for two reasons. Firstly, no matter how much damage is taken during False Promise, Shallow Grave will allow the victim to survive at the end. This alone makes the target of the caster's protection extremely difficult to kill. Additionally, with cooldown reduction it is possible to Shallow Grave -> False Promise - > Shallow Grave. This means that - barring Culling Blade's interference - the targeted unit cannot die for 17, 18.5, 20 seconds (+1.5 if the caster is a level 25 Oracle with the relevant Talent).
  • Ghost Shroud with False Promise makes for extreme healing. The hero being targeted by False Promise must have Ghost Shroud, not the other way around.
  • Rupture with Meat Hook, Skewer, Toss, Spear of Mars, X-marks-the-Spot, Dead Shot, or any other forced-movement ability allows one to deal massive Rupture damage. Usually more than one of the above movement skills is needed to be effective.
  • Spark Wraith or Proximity Mines with Meat Hook or Skewer allows one to set up a stack of death then force an enemy into them. Flaming Lasso and Nether Swap can also be used this way for Spark Wraiths.
  • Ice Blast or Doom with Purifying Flames allows one to nuke one's victim without worrying about healing them.
  • Maledict with Finger of Death, Laguna Blade, or an assortment of nukes (i.e., more than one) deals massive damage over time.
  • Aphotic Shield with Double Edge, Blast Off, or Life Break both mitigates the self-inflicted damage of the latter spells and also pops the shield for added burst.
  • Earth Splitter, Ghost Ship, Unstable Concoction, Light Strike Array, Kinetic Field, Cold Feet, Torrent, or any other delayed spell benefits greatly from another disable to set it up. Often, the spell to be set up (e.g. Ghost Ship) is cast before the aiding stun or disable (e.g., Ghost Ship into Burrowstrike, not the other way around).
  • Nightmare with any ability in need of setup can generally guarantee the ability lands. This applies to the examples mentioned above (e.g., Earth Splitter, Ghost Ship, etc.), but can also be used for abilities like Meat Hook, Skewer, or other hard-to-hit spells. Special mention goes to Nightmare + Static Link.
  • Mystic Flare with any stun or root allows its full duration to be reliably inflicted, turning a mediocre spell into a terrifying one. The same effect can be achieved with any ground-targeted damage over time spell, but Mystic Flare is the most potent.
  • Cloak and Dagger with any dispel (e.g., Fortune's End, Aphotic Shield, etc.) can get rid of the Dust debuff on the caster. If the caster also has a Gem to destroy enemy Sentry Wards, the only thing that can reliably see them is an opposing Gem. Dark Pact is a 'combo' using this same premise, as it is required that the same hero have both abilities.
  • Pit of Malice with any other disable allows one to disable the victim(s) during the 'downtime' of the Pit of Malice root, allowing subsequent Pit of Malice root(s) to trigger.
  • The Scepter Upgrade for Fiend's Gate and Pit of Malice combos extremely well with the Scepter Upgrade for Sun Strike. The former two abilities must be present on the same hero. The Scepter upgrade for Wrath Of Nature is arguably even better for this purpose, since it has a lower cooldown and is even easier to execute if you only want to hit a couple of targets.
  • Sacred Arrow with Hookshot, Fortune's End, Fissure, Homing Missile, or Nightmare (with a mobility spell to move away after casting said Nightmare) allows one to land long-ranged Arrows with ease. Sharpshooter can work similarly.
  • Tombstone with Decrepify or Sprout allows one to protect their Tombstone.
  • Proximity Mine with any disable of sufficient length makes the mines' wind-up time irrelevant.
  • Requiem of Souls with any sufficiently-long disable can insta-kill anyone caught out, provided one has enough Necromastery souls. The stun must be 1.67 seconds or longer, and the caster must also have Necromastery. If the stun also provides mobility (e.g., Burrowstrike, Blast Off, Firesnap Cookie) this makes the execution much easier.
  • Penitence will allow a Death Ward to attack ludicrously fast. It also works well with Winter's Curse and Chaotic Offering.
  • Arena of Blood is excellent with large-AoE spells like Midnight Pulse, Shrapnel, or Tombstone (place the Tombstone outside of the arena).
  • Savage Roar is hilarious with Arena of Blood or Dream Coil, forcing enemies to run away into even worse effects.
  • Song of the Siren with Tombstone allows zombies to begin stacking up while the Tombstone remains safe. Upheaval can serve a less effective but similar purpose.
  • Phantom's Embrace, Proximity Mines, or Supernova with any source of disarm (e.g. Inner Fire, Decrepify, Reactive Taser) stops the enemy from attacking the phantom, mines, or egg, respectively.
  • Any stun that has a moderate cast range works very well with the Ability-Draft-exclusive version of Shadow Raze, which gives 3 charges of the medium-range Raze.

Closing

I am certain there are many, many interesting and powerful builds not mentioned here. Moreover, many obvious synergies (e.g., False Promise with any healing ability) were left out due to their... well... obvious-ness. Finally, many abilities can make for quite potent builds that were not called out here (such as Pulse Nova) due to them usually not involving any explicit combo, instead just making a build strong overall.
All in all, Ability Draft is a realm of infinite possibilities. Tell me what you think! Thank you for your time and feedback!
submitted by TheGreatGimmick to Abilitydraft [link] [comments]


2024.04.30 12:56 TheGreatGimmick An Extensive Guide to Ability Draft (updated)

This is my attempt at a comprehensive compilation of everything you need to know about drafting abilities in Ability Draft. If you see a mistake or think of things to add, please, tell me!
This post is current as of DotA patch 7.35d.

General Drafting Tips

  • Your hero's base stats heavily affect the viability of many builds. Additionally, Talents should be considered when drafting abilities, although they are usually far from the most important factor. Stats can be found here, while Talents can be found here. You can also just hover over your hero in the drafting screen.
  • Carefully consider the pick order when choosing which abilities to draft. The earlier you pick, the more likely you are to get an overpowered stand-alone ability, while picking later raises the chances that you can complete a combination of abilities. If you see an overpowered combo in the draft, but are first-pick, tell your team what you see but pick one of the powerful stand-alone abilities instead, because it is unlikely the second half of the combo will make it all the way back to you. Some heroes are also far more likely to pick certain abilities than others (e.g., Warlock and Chaotic Offering) which can also affect your assessment of whether you can get away with a combo or not.
  • Ruining your own build can sometimes be worth denying an enemy build. For example, Arcane Orb is generally a grief pick unless you draft Essence Flux first, but sometimes it is actually the correct play to deny-pick Orb if the enemy has Essence Flux and, say, Swashbuckle already. The very last person in the pick order is the only hero that drafts two abilities back-to-back (in the first round of drafting), so if you pick earlier be on the lookout for which abilities you need to pick to deny them a broken combo.
  • Sometimes your own team will pick abilities you needed for a combo. Communicate in the chat, but do not assume everyone will play along. Try to get confirmation from your team that they understand not to draft the ability you want. If you are met with negatives or even just silence, assume they may draft your desired ability.

Gameplay Differences

  • Ability Draft often lags behind the main game in terms of patch updates. For a while after a patch, new ability changes may or may not have taken effect, and entirely new abilities (e.g., from Aghanim's Shard changes) are often missing entirely. Conversely, removed parts of the game may still linger in Ability Draft. They've gotten better about updating AD, but this is still something to keep in mind for weeks or months after a major patch.
  • If your hero's normal Talent option(s) pertain to an ability that you did not draft, you are offered Gold instead. I know free Gold is tempting, but if you have the option, it is almost always better to take a Talent that actually does something over the free Gold.
  • You must be flexible in your item builds, because you are essentially playing an entirely new hero each game of Ability Draft. Ask yourself what your abilities need to succeed, then build that, no matter how silly such an item build might seem out of context. Sometimes item builds that are ill-advised in the regular game work exceedingly well in Ability Draft.
  • A corollary to the above point is that supports in Ability Draft tend to be greedier than in the regular game. Sometimes this is even justifiable; if their build achieves perma-stun with an Octarine, is it really better to get traditional items like Glimmer Cape instead? Well, yes, it probably still is, but the argument is there at least.
  • The mid lane usually hosts one of three kinds of builds: The build that is completely useless before 6 but comes online once they can use their ultimate (e.g., Ancient Seal + Decrepify + Ice Vortex + Finger of Death), the build that completely dominates a 1v1 (the most 'vanilla' style of mid-laner, amplified further by custom builds), or simply the strongest build on your team (the broken combo). The point is, you may sometimes see a player who should have been a clear safelane carry or durable offlaner go mid instead, and that may not be a bad thing, simply because if they have a very powerful build they just need to outlevel everyone else and roll over them. In summary, often you will see builds that do not fit the archetype for a traditional midlaner nonetheless going mid in Ability Draft. Whoever needs levels the most generally goes.
  • The strength of various builds on a team often makes Ability Draft a more polarized game in terms of target priorities. Identify whether there is someone on the enemy team that is worth losing 3+ of your own heroes to take out, and if so, do that. This is occasionally the case in the regular game as well (e.g., going all-in on the enemy carry), but it happens more often in Ability Draft.

Special Cases / Tips

  • Unique sources of Bash that do not normally stack will fully stack in Ability Draft.
  • Geminate Attack stacks with Echo Sabre, resulting in 3 attacks at once for melee heroes.
  • Melee heroes can attack with the full attack range of attack modifiers (e.g. Frost Arrows) only if they have a source of True Strike. Otherwise the attacks will miss if distance exceeds 350 units. Ranged heroes can always use the full distance, but may suffer the reverse problem: Short-ranged modifiers (e.g., Infernal Blade) should not be manually cast, since you must autocast them to use your base hero's range.
  • For most effects that refresh cooldowns (e.g., Rearm, Blur's Aghanim's Scepter upgrade, etc.), charge-based abilities will only receive 1 charge back, not be fully replenished like Refresher Orb.
  • Dismember cannot be used while you have eaten someone with its Aghanim's Shard effect.
  • Several abilities have been altered to work in Ability Draft, but the most drastic of these changes is Poof, which can now target any allied unit within 2000 range. Although I still would not recommend picking Poof, it is not as useless as one might think.
  • Only Meepo can be globally targeted by an allied Poof from anywhere on the map and have them appear at his location.
  • Only Monkey King can become trees with Mischief (which is tied to the Wukong's Command ability). Other heroes can still turn into other things.
  • Bane can freely damage targets under the effects of Nightmare, even if he does not have Nightmare.
  • Faceless Void can move inside anyone's Chronosphere.
  • At one time, Batrider used to gain unobstructed vision whenever he had free pathing, which was easy to abuse with abilities like Spin Webs and Arctic Burn. However, I am not sure if this is the case any longer now that, in the vanilla game, Firefly was changed to be ground vision.

You can also find a helpful list of the current bugs here. Some of them are gamebreaking!

Dependent Abilities

Most interdependent interactions are now included in the tooltips provided by Ability Draft, so this section is less necessary than in ye olden days. I'm including some key interactions here for completion's sake, however.
  • Any time another ability is directly referenced in the description of an ability or its upgrade (e.g., Scepter, Shard, or Talent), that effect requires both abilities to function. The prime example of this is Eclipse requiring Lucent Beam. Don't be that guy. Another notable example is Bristleback needing Quill Spray to fully function.
  • Geomagnetic Grip, unlike Rolling Boulder or Boulder Smash, is entirely dependent on Stone Remnants (and thus Magnetize) to do anything.
  • Arcane Orb needs Essence Flux to be fully viable, though it can deal decent damage on the first use if at full mana.
  • Neither Charge of Darkness nor Nether Strike will inflict their Greater Bash components if the caster does not have Greater Bash.
  • Natural Order does not lower Magic Resistance if Astral Spirit is not drafted.
  • Requiem of Souls requires souls, and thus Necromastery.
Less Drastic Improvements Include :
  • Astral Spirit and Echo Stomp, while decent abilities on their own, are heavily interconnected in terms of how they were intended to be used.
  • Shuriken Toss can only bounce if Track is also on your team, though two different heroes can own the abilities!
  • Avalanche, Toss, and Grow are all interconnected.
  • Familiars from Summon Familiars are very fragile without Gravekeeper's Cloak.
  • Rolling Boulder and Boulder Smash are best used with Stone Remnants (and thus Magnetize).
  • Relocate can be useful on its own, but half the point of the spell is to take an ally with you, necessitating Tether.
  • Summon Wolves are usually underwhelming without support from both Feral Impulse and Shapeshift.
  • Many other abilities (Plague Wards + Poison Sting, Dragon Tail + Elder Dragon Form, Spawn Spiderlings + Spin Webs, etc.) use other abilities as part of their normal function.

Notable Talents

Multiple Talents :
  • Luna, Dark Seer, Lone Druid, Puck, Primal Beast, Tidehunter, and Undying each have at least one Talent per Talent tier (4 or more Talents) for Lucent Beam, Ion Shell, Summon Spirit Bear, Waning Rift, Trample, Anchor Smash, or Tombstone, respectively.
  • Engima's Eidolons can be heavily improved by his Talents.
  • Many heroes have multiple early Talents for certain abilities (e.g., Underlord with Firestorm) that can be potent to stack up, but don't get baited into planning for level 25, because it usually doesn't happen.
  • Snapfire can transform into a devastating lategame carry with her relevant Lil' Shredder Talents if the game does end up going long enough, though level 25 is a long time to wait.
Single Talents :
  • Ancient Apparition gains +300 Chilling Touch range at level 10, making already-strong Aghs builds even stronger.
  • Jakiro gains +200 attack range at level 10, making abilities like Arctic Burn, Take Aim, Elder Dragon Form, and especially Impetus more desirable.
  • Techies gets a casual 20% magic resistance at level 10 (Timbersaw gets this at level 20).
  • Crystal Maiden's level 20 Talent grants +225 Attack Speed, which can be quite potent with certain modifiers like Scepter Chilling Touch or Bash of the Deep.
  • Warlock's level 20 Golem On Death Talent makes Chaotic Offering very attractive on the hero, and he gets further Talents for his Golems at 25.
  • Of course, many level 25 Talents can be incredible and change how your build functions... provided the game even lasts that long.
Niche Talents :
  • Some heroes have Talents that provide auras for the "AFK Infest/Dismember" builds (see the below Ally-Dependent Builds section), such as Beastmaster's level 15 +20 MS aura, Doom's level 15 Devour Ancients for auras, Underlord's level 25 Allies gain 50% Atrophy Aura, or Centaur's level 25 Retaliate Aura.
  • Tinker's level 20 Defense Matrix Grants 25% CDR Talent could allow some Aftershock builds to achieve permastun (see the below Aftershock section).
  • Skywrath Mage's Global Concussive Shot at level 20 could be highly amusing with Rearm. Perhaps add Rocket Flare into the mix as well.
  • With a sufficiently tanky build (especially with Kraken Shell to dispel stuns), Terrorblade's 10-second Sunder at level 25 would be incredibly difficult to deal with.
  • Tiny with Rupture combined with the level 20/25 Toss Talents (to remove the need for a target and grant more charges) could be devastating and hilarious.
  • Tusk and Ogre Magi both have level 25 Talents that, with enough attack speed, can result in permastun and ridiculous damage. This requires Walrus Punch / Fireblast, respectively.
Of course, many other Talents can be potent as well; be sure to know your hero's Talents before constructing your draft.

Ally-Dependent Builds

Later sections of this guide will go over how you can combine your own abilities together, but some builds require that the synergistic abilities be drafted on two different heroes. Most such builds involve one hero going AFK inside of an ally, as described below.
  • Infest with Tether, Rot, Scepter-upgraded Spirits, Voodoo Restoration, Scepter-upgraded Heartstopper Aura, or (less potently) any AoE passive (e.g. Atrophy Aura, Warcry's Shard upgrade, Inner Beast, etc.) can make for an AFK build where one hero sits inside an ally all game but still contributes significantly. This requires that the AFK hero has a viable ally 'host', of course.
  • An ally with Dismember and an Aghanim's Shard can accomplish the same effect (however, the Tether combo does not work). This version has the additional requirement of not only needing a viable 'host', but also needing a host that doesn't require an ultimate ability (because they wasted it on Dismember to eat the afk hero).
  • If using the Dismember version, the interior hero can also contribute their ult (since they don't need Infest), opening up builds like Blood Mist (Scepter-upgraded Rupture) constantly burning enemies down, Reincarnation contributing its aura to the exterior ally, or Shard-upgraded Epicenter pulsing occasionally.
  • Special mention goes to Vengeance Aura with Dismember, since the Scepter illusion can re-eat your hidden ally once your actual hero dies.
  • Bulwark's Scepter upgrade still works in this situation despite being disabled by stuns/disarms normally.
  • When using the Dismember version, Glimmer Cape can be used on the host by the interior ("afk") hero without emerging from the host.
If the ally that is being Infested or eating their teammate with Dismember is durable, reasonably mobile, and covers whatever weakness the hidden ally does not (e.g., you need damage for the Tether build, but not for the Rot build since Rot deals so much damage anyway), these can be some of the most potent builds in Ability Draft due to the combined chimera essentially functioning as two heroes in one.
The Rot builds are very strong, Heartstopper with Infest is broken, and Tether with Infest is one of the most broken possible builds in the mode, easily turning into 800+ heal per second.
If going for this type of combo, one ally should draft to be a durable meat shield (Flesh Heap, Dispersion, etc.) that would be useless on their own, while the other goes for their 'hidden ally' combo (to buff the meat shield vessel).
Other ally-dependent builds are also possible, such as one hero having an extremely mobile Flaming Lasso build (Icarus Dive, Scepter-upgraded Pounce, etc.) and really wishing they could have also drafted Rupture. If an ally has Rupture... that's -1 enemy hero.

Common Build Archetypes

Often, it can be beneficial to simply get several of the same type of ability, maximizing one strength. Here is a list of common variants of this kind of build:
Always Useful :
  • All-stun builds are never bad. However, they can often lack in their own damage. This is not necessarily a problem, since if the enemy can't move, your allies should be able to kill them. The more AoE stuns, the better. Example: Hoof Stomp + Slithreen Crush + Echo Stomp + Reverse Polarity
  • Aghanim's Scepter / Shard Abilities: It is almost never a bad idea to just cram your build full of as many Aghanim's Scepter or Aghanim's Shard - upgraded abilities as possible. Note that despite this being in the "Always Useful" section, it is still technically possible to make a bad build, just unlikely. You can view all available ScepteShard abilities in the current draft by pressing CTRL+ALT. Example: Resonant Pulse + Laser + Gush + Shapeshift
Usefully Useful :
  • All-nuke builds are hard to do wrong. If used correctly one can often win fights by deleting a key enemy early on. Example: Lightning Bolt + Brain Sap + Soul Assumption + Laguna Blade
  • All-right-click builds are often difficult to implement due to lacking control, mobility, or defense. However, with proper support (or poor opponents), they can be devastating. Example: Searing Arrows + Metamorphosis + Gunslinger + Grow.
  • All-long-cast-range builds, or "Artillery" builds as I like to call them, are some of the most fun one can have in Ability Draft barring an OP combo. Just hang back and fire away! However, without good aim for the skillshots, these can obviously become underwhelming. Example: Powershot + Heat-Seeking Missiles + Sacred Arrow + Assassinate
Sometimes Useful:
  • Pure defensive builds can work, don't get me wrong. However, they are often a burden to their team. The wielder must have a way to punish the enemy for ignoring them, because otherwise, the enemy will, of course, ignore them. This may be as simple as a good Radiance timing, or be more direct like having sustain for their allies. Example: Nature's Attendants + Dispersion + Counterspell + Reincarnation
  • Pure mobility builds are usually a great way to end the game with triple 0s in your KDA, and that's not a good thing. If you have an abundance of mobility, be sure to also have a low-cooldown disable or damage option to complement it. Example: Slithreen Crush, Time Walk, Blink (QoP), Fire Remnant
  • All-summon builds are usually just food for the enemy. Have a clear gameplan (and preferably a coordinated stack for a team) before trying this. Example: Demonic Conversion + Nature's Call + Summon Wolves + Chaotic Offering

Aftershock Builds

Abilities that result in permastun until the caster runs out of mana:
  • Ball Lightning
  • Rearm (level 3)
  • This list used to be much longer before the 7.33 stun reduction nerfs :(
Abilities that are almost permastun but don't quite get there even with Octarine:
  • Arc Lightning
  • Arcane Bolt
  • Viscous Nasal Goo
  • Purifying Flames is part of this group with Oracle's relevant Talent.
Abilities that can be used for many stuns:
  • Any ability with a cooldown less than or equal to about 5 or 6 (there are several) are great for frequent stun output. e.g., Counterspell, Static Remnant, Quill Spray
  • Charge-based abilities (e.g., Soul Siphon, Spin Webs, Shrapnel, Fire Remnant, etc.) allow for a burst of multiple stuns, but take a long time to recharge fully.
  • Some abilities that involve multiple casts (e.g., X-Marks-the-Spot) get multiple uses out of Aftershock. In general, anything that gives a Magic Stick charge will also trigger Aftershock.
Abilities that make good use of Aftershock for setup:
  • Kinetic Field, Light Strike Array, Torrent, and other delayed skills appreciate Aftershock holding foes in place for them to land.
  • Mystic Flare or (less potently) any other AoE-based damage over time skill makes great use of foes being stunned for the first second or so of their duration. One of the better combos in the mode is Aftershock + Ancient Seal + Mystic Flare for incredible early-to-mid-game damage (before the Pipes start coming out).
  • Sharpshooter allows other skills to be cast and appreciates the setup for its long charging period, not to mention that point-blank shots while they are permastunned by your combo are hilarious.
Proximity Mines are both charge-based and need time to arm, making them almost ideal for Aftershock and one of the most powerful combos in Ability Draft.

Attack Modifier Builds

Many abilities can make use of attack modifiers to great effect. Here we are talking about things like Poison Attack, Mana Break, Frost Arrows, Curse of Avernus, Searing Arrows, and so on. Some abilities that interact with attack modifiers include:
  • Tricks of the Trade
  • Starbreaker
  • Wukong's Command (terms and conditions apply)
  • Swashbuckle
  • Anchor Smash
  • Stifling Dagger
  • Phase Shift's Aghanim's Shard upgrade
  • Split Shot when upgraded by Medusa's Level 25 Talent
  • Assassinate
That list is not comprehensive, it is just meant to get you thinking about potential applications.
Note that when multiple attacks are done 'at once' (e.g., Anchor Smash, God's Rebuke, etc.) only one target gets the effects of a single-use attack modifier like Enchant Totem or Bash of the Deep.

First-Pick Abilities

These abilities are so good that they are usually worth picking up first, before trying to get a combo / synergy. Some of these are mainly first-pick because you probably don't want the enemy to have them, while others are good regardless of your base hero or the current ability pool.
This list is in alphabetical order, not order of priority.
First-picks that are often essentially 'mandatory' include :
  • Arctic Burn (OP range, slow, and scaling damage)
  • Bash of the Deep (great on ranged, good even on melee, often a deny-pick vs a scary enemy)
  • Chemical Rage (now includes Greevil's Greed, making it OP)
  • Glaives of Wisdom (even if you aren't an INT hero, someone on the enemy team probably is)
  • Heartstopper Aura (very high winrate)
  • Reincarnation (second-highest winrate)
  • Shadow Realm (arguably the top priority in most drafts despite mediocre winrate)
  • Shukuchi (invisibility and high mobility)
  • Unleash (depending on the enemy heroes you may be required to deny-pick this)
Strong first-picks that nonetheless usually aren't really 'mandatory' include :
  • Arc Lightning (very strong Shard)
  • Atrophy Aura (DAMAGE... and damage mitigation too, I guess)
  • Either variation of Blink (Never a bad option for any build)
  • Borrowed Time (poor man's Reincarnation)
  • Burrowstrike (solid AoE stun and mobility in one)
  • Cloak and Dagger (most people don't like buying a lot of detection in a fun mode like AD)
  • Dispersion (very high winrate, preferably on tanky hero)
  • Fury Swipes (very strong on ranged heroes or with certain abilities)
  • Storm Hammer (just a solid stun with an Aghs upgrade option)
  • Thirst (personally I think Thirst doesn't stand up to the rest of this list, but statistics disagree)
  • Time Walk (powerful heal and mobility, and the Shard opens many combo options)
  • Vengeance Aura (the Aghs is OP with many abilities)
You can check out this site for a list of the highest-winrate abilities, though be warned that you'll be flamed if you pass up, say, Shadow Realm in favor of Corrosive Skin just because it has a higher winrate! Stats can be helpful but shouldn't be your sole consideration.

Combos

A 'combo' is when both abilities need to be on the same hero to work, as opposed to a 'synergy' where the skills just need to be used in tandem regardless of who casts them.
Several combos have already been discussed and are thus not included. Also, note that combos which already existed in the main game (e.g., Ball Lightning + Overload, Counter Helix + Berserker's Call, etc.) are similarly not included.
  • Vengeance Aura's Aghanim's Scepter upgrade allows one to cast spells twice: Once while alive, then again after death as the illusion. This is extremely potent with fire-and-forget abilities independent of the main hero like Tombstone, Chaotic Offering, or Serpent Wards. It can also be extremely strong with other spells as well if the illusion can survive long enough to cast them optimally. Note that it "refreshes" the full charges of charge-based abilities like Aghs Demonic Purge.
  • Nightmare is essentially just a 6.5 second stun if no other sources of damage (e.g., an ally Radiance) interfere. This can allow many lengthy combos to land and run their course (e.g., Macropyre, Mystic Flare), or just for your simple right-click build to freely damage the victim.
  • Any of the following combined with one or more of each other results in ridiculous attack range : Elder Dragon Form, Take Aim, Arctic Burn, Psi Blades, Chilling Touch
  • Any Illusion-creating spell with any passives that transfer to Illusions can be potent. Powerful options include Split Shot, Mana Break, and Counter Helix with spells like Mirror Image.
  • Bristleback + Bulwark makes for the ultimate defense, but be sure to have a way for that to matter (pure defense often doesn't do much on its own).
  • Berserker's Call with Stone Gaze forces foes to be turned to stone. This also works with any disable that disallows turning, but is most potent with Berserker's Call because Berserker's Call forces foes to look at the caster, making the execution much easier.
  • Enchant Totem, God's Strength, or Tidebringer with Mortal Strike, God's Rebuke, Boundless Strike, or (less reliably) any other critical strike ability deals insane damage. Note that Enchant Totem, God's Strength, and Tidebringer stack with each other as well; e.g., the most optimal build is likely Enchant Totem, Tidebringer, Mortal Strike, and God's Strength.
  • Walrus Punch is an ultimate ability and thus cannot stack with God's Strength, but is otherwise arguably the best critical strike ability for Enchant Totem and Tidebringer.
  • Coup De Grace's buff can reliably land a massive critical hit along with Enchant Totem or Tidebringer. Enchant Totem works especially well with Stifling Dagger in this case.
  • Enchant Totem and Jinada can be potent combined with any single-target spell due to Khanda. Add in Aghs Fiend's Grip (which casts three separate Khandas on the victim) for absurd burst damage.
  • Focus Fire with Shadow Realm, Time Lock, Bash of the Deep, Greater Bash, Fury Swipes, Poison Attack, Chilling Touch, or basically any attack modifier results in the victim nearly always succumbing to the modifier's effects.
  • Omnislash or Unleash with the aforementioned Focus Fire abilities can also be very potent, albeit less reliably (omnislash) and on a longer cooldown (both).
  • Geminate Attack (especially on a melee hero with an Echo Sabre) or Gunslinger can have a similar but more tame effect with the aforementioned Focus Fire modifiers. These have the advantage of not relying on a cooldown, however, situationally performing better than their ultimate-ability counterparts!
  • Impetus with any range-boosting ability deals massive damage, even if the range boost is temporary (e.g., Penitence, Scurry, etc.).
  • Impetus with any long-range forced-attack abilities (e.g., Boundless Strike, Acorn Shot, Stifling Dagger) also deals massive damage. Assassinate is especially funny with this.
  • Swashbuckle with Impetus or Arcane Orb is extremely strong, though the latter also requires Essence Flux. Currently Walrus Punch is still bugged to trigger on each and every Swashbuckle hit (please correct me if that has been fixed).
  • Attack Modifiers like Infernal Blade or Walrus Punch are especially potent with long-range attack abilities like Acorn Shot or Stifling Dagger.
  • Cloak and Dagger with any channeled or sustained ability (e.g., Shackles, Battery Assault, Rot) allows the user to stay invisible for the duration of the latter spells. Other forms of invisibility also work with this, but are harder to execute.
  • Rearm with Nether Ward, Tombstone, Living Armor, Shallow Grave, Sacred Arrow, Split Earth, or Rocket Flare are all very potent for different reasons.
  • Rearm makes the Aghanim's Scepter upgrades for Torrent, Metamorphosis, and Sun Strike completely broken.
  • Rearm with Nature's Call, Demonic Conversion, Enchant, or other summoning spells can make a huge army, but be careful not to feed them.
  • Sticky Napalm with abilities like Ion Shell, Rot, Shackles, Torrent, Rocket Barrage, or Dark Pact deals a lot of damage since these abilities deal many instances of damage individually, proc-ing Napalm damage each time.
  • Thirst with any ability that grants percentage-based movement speed gets very, very fast.
  • Rolling Thunder with most movement skills (Blink, Time Walk, etc.) can 'come back for seconds', so to speak: Roll through someone, then teleport back and roll through again. Sleight of Fists can do this for multiple enemies at once!
  • Tether with Chemical Rage, Shadow Dance, or Burrow (Scepter upgrade for Vendetta) could grant considerable healing to the Tethered target.
  • Blast Off combined with Reincarnation, Berzerker's Blood, or Sunder could use the health cost to its advantage.
  • Omnislash allows one to cast spells during the duration, so short-ranged spells go well with it (e.g., Hoof Stomp, Double Edge).
  • Snowball allows one to cast spells in the prep period, opening up a wide variety of options. For example, using Teleport to escape while invulnerable.
  • Rage, Blade Fury, or Repel with any channeled (e.g., Black Hole, Freezing Field, Fiend's Grip) ability grants one protection from interruptions.
  • Sunder with any invisibility or long-range mobility allows one to intentionally reach low health, sneak up on a foe, Sunder them down to 25% of their health, then finish them off in some way, usually a nuke or Dagon.
  • Supernova with any long-cooldown ability can be potent due to the refreshed cooldowns. Tombstone is the prime example that comes to mind.
  • Icarus Dive with any channeling abilities like Death Ward, Dismember, or Black Hole allows one to dive in, begin channeling, but be taken back out by the back-swing of the dive while still channeling. This can also be used for drive-by uses of other spells, but is funniest with channeling spells.
  • Flaming Lasso with any mobility spell that does not use teleportation (Leap, Pounce, Blast Off, Boundless Strike with Shard, etc.) will take the Lasso target along for the ride. Special mention goes to Icarus Dive, allowing one to dive in, grab someone, and drag them back out. Reverse Time Walk is the most insane with this combo, as you can Time Walk forward, Blink Dagger even further forward, then Reverse all the way back with your kidnapping victim.
  • Duel or Culling Blade with Thirst, Charge of Darkness, or Teleport allows one to easily catch up to low-health foes.
  • Teleport with X-Marks-the-Spot or Time Lapse allows one to teleport in, take an action, then send themselves back. Combined with a nuke, stun, or summoning spell, this can be extremely annoying to the enemy.
  • Primal Split with Rot gives your current Brewling (begins as the Earth Brewling) your Rot aura. This also works with Bulwark's Scepter upgrade.
  • Infest your own Summon Spirit Bear for shenanigans.
  • Aghanim's Scepter upgraded Infest can be surprisingly potent with certain attack modifiers like Arcane Orb or Chilling Touch.
  • Trample with abilities that grant mobility without teleporting (e.g. Skewer, Surge, Windrun, Time Walk, Shard-upgraded Boundless Strike, etc.) can proc its effect many, many times in rapid succession.
  • Freezing Field highly benefits from any mobility spell when upgraded by an Aghanim's Scepter, with the most notable example being Shukuchi.
  • Bulwark's Scepter with any source of cleave (e.g. Tree Grab, Greater Cleave) or potent attack modifiers (e.g. Caustic Finale, Curse of Avernus) can apply their effects to many enemies at once.
  • Haunt (Shadow Step's Scepter) can also apply attack modifiers to the entire enemy team, with the most notable being Curse Of Avernus (like a Global Silence on a 4-attack delay).
  • Essence Flux with Mana Shield makes for an extremely tanky hero, provided you have something to spam like Arcane Orb.
  • Exorcism with abilities that hide the user (e.g., Snowball, Phase Shift, Astral Imprisonment, etc.) can stall for the ghosts to burn enemies or buildings down.
  • Arcane Supremacy is powerful with most targeted abilities, but is particularly funny with abilities like Pulverize, Dispose, or Walrus Kick where the cast range makes for weird displacement rules.
  • Poof can target your own illusions globally, which is one of its only viable uses in my opinion. Conjure Image or Mirror Image with Poof could make for an annoyingly mobile, farm-efficient build.
  • Lucky Shot with any rapid damage over time (e.g. Ion Shell, Rot, etc.) can trigger its effects reliably and repeatedly. Supernova is one of the most powerful with Lucky Shot due to the massive AoE and Lucky Shot's attack slow synergising very well to protect the Egg.
  • Skewer or Boulder Smash with any kind of mobility (e.g., Blink, Burrowstrike, etc.) can reposition enemies even early in the game (no items needed).
  • Assassinate's attack effect can be combined with effects like Mortal Strike and Enchant Totem for extremely long-ranged and damaging shots.
  • Dark Ascension can refresh high-impact abilities like Tombstone, Metamorphosis, Nether Ward, and Cataclysm. It is also excellent for refreshing your kit in general, especially stuns.
  • Heartstopper Aura's Scepter can be combined with regenerative effects like Chemical Rage, Burrow, or especially Infest for extremely high damage.
  • Blade Fury scales with attack speed, so abilities that grant absurd attack speed like Lil' Shredder, Overpower, Focus Fire, or Unleash will send its damage through the roof!
  • Mystic Flare's Shard, Shield of the Scion, can grant absurd Armor and Magic Resistance (from INT) when combined with rapid damage-over-time effects like Sandstorm and Rot.

Synergies

A 'synergy' is when the abilities merely need to be used in tandem regardless of who casts them, as opposed to a 'combo' where both abilities need to be on the same hero to work. However, most synergies do indeed work better (in terms of execution) if both abilities are on the same hero, hence their potency in Ability Draft.
Note that synergies which already existed in the main game (e.g., X-Marks-the-Spot + Torrent, Kinetic Field + Static Storm, Mana Break + Mana Void, etc.) are not included, nor are any that were already mentioned in this post. Some synergies were already included in the 'Combos' section for brevity, as I was already describing their build with other abilities.
  • Laguna Blade or Finger of Death with Decrepify, Ancient Seal, or any other magic damage amplification deals massive damage.
  • Vacuum with any AoE stun can make for a one-man wombo-combo. Note that you can cast Vacuum on units affected by Song of the Siren as well.
  • False Promise with Shallow Grave work together extremely well for two reasons. Firstly, no matter how much damage is taken during False Promise, Shallow Grave will allow the victim to survive at the end. This alone makes the target of the caster's protection extremely difficult to kill. Additionally, with cooldown reduction it is possible to Shallow Grave -> False Promise - > Shallow Grave. This means that - barring Culling Blade's interference - the targeted unit cannot die for 17, 18.5, 20 seconds (+1.5 if the caster is a level 25 Oracle with the relevant Talent).
  • Ghost Shroud with False Promise makes for extreme healing. The hero being targeted by False Promise must have Ghost Shroud, not the other way around.
  • Rupture with Meat Hook, Skewer, Toss, Spear of Mars, X-marks-the-Spot, Dead Shot, or any other forced-movement ability allows one to deal massive Rupture damage. Usually more than one of the above movement skills is needed to be effective.
  • Spark Wraith or Proximity Mines with Meat Hook or Skewer allows one to set up a stack of death then force an enemy into them. Flaming Lasso and Nether Swap can also be used this way for Spark Wraiths.
  • Ice Blast or Doom with Purifying Flames allows one to nuke one's victim without worrying about healing them.
  • Maledict with Finger of Death, Laguna Blade, or an assortment of nukes (i.e., more than one) deals massive damage over time.
  • Aphotic Shield with Double Edge, Blast Off, or Life Break both mitigates the self-inflicted damage of the latter spells and also pops the shield for added burst.
  • Earth Splitter, Ghost Ship, Unstable Concoction, Light Strike Array, Kinetic Field, Cold Feet, Torrent, or any other delayed spell benefits greatly from another disable to set it up. Often, the spell to be set up (e.g. Ghost Ship) is cast before the aiding stun or disable (e.g., Ghost Ship into Burrowstrike, not the other way around).
  • Nightmare with any ability in need of setup can generally guarantee the ability lands. This applies to the examples mentioned above (e.g., Earth Splitter, Ghost Ship, etc.), but can also be used for abilities like Meat Hook, Skewer, or other hard-to-hit spells. Special mention goes to Nightmare + Static Link.
  • Mystic Flare with any stun or root allows its full duration to be reliably inflicted, turning a mediocre spell into a terrifying one. The same effect can be achieved with any ground-targeted damage over time spell, but Mystic Flare is the most potent.
  • Cloak and Dagger with any dispel (e.g., Fortune's End, Aphotic Shield, etc.) can get rid of the Dust debuff on the caster. If the caster also has a Gem to destroy enemy Sentry Wards, the only thing that can reliably see them is an opposing Gem. Dark Pact is a 'combo' using this same premise, as it is required that the same hero have both abilities.
  • Pit of Malice with any other disable allows one to disable the victim(s) during the 'downtime' of the Pit of Malice root, allowing subsequent Pit of Malice root(s) to trigger.
  • The Scepter Upgrade for Fiend's Gate and Pit of Malice combos extremely well with the Scepter Upgrade for Sun Strike. The former two abilities must be present on the same hero. The Scepter upgrade for Wrath Of Nature is arguably even better for this purpose, since it has a lower cooldown and is even easier to execute if you only want to hit a couple of targets.
  • Sacred Arrow with Hookshot, Fortune's End, Fissure, Homing Missile, or Nightmare (with a mobility spell to move away after casting said Nightmare) allows one to land long-ranged Arrows with ease. Sharpshooter can work similarly.
  • Tombstone with Decrepify or Sprout allows one to protect their Tombstone.
  • Proximity Mine with any disable of sufficient length makes the mines' wind-up time irrelevant.
  • Requiem of Souls with any sufficiently-long disable can insta-kill anyone caught out, provided one has enough Necromastery souls. The stun must be 1.67 seconds or longer, and the caster must also have Necromastery. If the stun also provides mobility (e.g., Burrowstrike, Blast Off, Firesnap Cookie) this makes the execution much easier.
  • Penitence will allow a Death Ward to attack ludicrously fast. It also works well with Winter's Curse and Chaotic Offering.
  • Arena of Blood is excellent with large-AoE spells like Midnight Pulse, Shrapnel, or Tombstone (place the Tombstone outside of the arena).
  • Savage Roar is hilarious with Arena of Blood or Dream Coil, forcing enemies to run away into even worse effects.
  • Song of the Siren with Tombstone allows zombies to begin stacking up while the Tombstone remains safe. Upheaval can serve a less effective but similar purpose.
  • Phantom's Embrace, Proximity Mines, or Supernova with any source of disarm (e.g. Inner Fire, Decrepify, Reactive Taser) stops the enemy from attacking the phantom, mines, or egg, respectively.
  • Any stun that has a moderate cast range works very well with the Ability-Draft-exclusive version of Shadow Raze, which gives 3 charges of the medium-range Raze.

Closing

I am certain there are many, many interesting and powerful builds not mentioned here. Moreover, many obvious synergies (e.g., False Promise with any healing ability) were left out due to their... well... obvious-ness. Finally, many abilities can make for quite potent builds that were not called out here (such as Pulse Nova) due to them usually not involving any explicit combo, instead just making a build strong overall.
All in all, Ability Draft is a realm of infinite possibilities. Tell me what you think! Thank you for your time and feedback!
submitted by TheGreatGimmick to TrueDoTA2 [link] [comments]


2024.04.30 06:50 spitoon-lagoon Polishing an Old Relic (An Impractical Guide for Playing Ancestor's Oracle the Way it's "Supposed" to Be Played)

Polishing an Old Relic (An Impractical Guide for Playing Ancestor's Oracle the Way it's
Long time no see, all. So in the past I did a post about Ancestor's Oracle Shenanigans where the most optimal way to play an Ancestor's Oracle was to Don't. I stand by that statement because you look at that curse and tell me that's worth the tradeoff but that got me thinking: Is there a way to properly play the Ancestor's Mystery Oracle while completely leaning into the curse and all its randomness? Well surprisingly I found a few playstyles that make this sort of workable in an "actually play the game" kind of way. They're not optimal, some of them rely on shenanigans, and there isn't a lot of benefit you can't get anywhere else but you can get something playable out this travesty. I'm not gonna go over all the reasons I think it's bad in detail, that's in my last post, but what I will do is cover the basics and the build philosophy we're going to go by. Without further ado lets dive into this dumpster fire.
\"If you all don't shut up and stop telling me what to do I swear to Pharasma I'm getting an exorcist.\"
The Fundamentals
We need to start by taking a look at what makes the subclass so bad, which will inform us on what we have available to work around it. What The Curse of Ancestral Meddling does is you start out by rolling a type of action between Strikes, Skills, Spells, or player's choice and gain scaling benefits as your curse increases, but it comes with a scaling 15/25/35% chance to waste any action you perform other than what you rolled. That also means that you're not going to roll what you want to 50% of the time and risk losing actions. You also reroll your action at the end of every turn. That's pretty bad, but if we're going to lean into this we want to use our preferred action as often as possible in order to get the benefits and escape consequences. This means three things: that actions that do not fall into any category are incredibly valuable, feats that increase the diversity of actions we can take are good, and that feats and actions that combo into different type of actions are usually bad unless they have action compression that makes up for potentially losing an action.
What I mean by feats and actions that combo into different types of actions is any feat or action that relies on or supports another action out of Strikes, Skills, and Spells. For instance Spellshape feats are great if you can use spells but when you waste your Cast a Spell action that's one more action you just wasted, and any spell that requires you to make a Strike or Skill action such as Blink Charge and Telekinetic Maneuver can fail if your preferred action is to Cast Spells. Feint is an example of a Skill action that's a combo action, since you Feint to make enemies Off Guard to your attacks if you Stride, Feint, and fail the flat check to attack then you just wasted two actions, not one. Some actions are also very bad to use, such as Aid or Ready, because you reroll your preferred action at the end of your turns and might lose the action you prepared. Here's where the exception to that comes in: Activities are not Actions. According to the rules for Activities and Subordinate Actions each Action of an Activity is its own separate thing that does not inherit anything it doesn't say it does. Certain feats will give you access to Activities that do more than one action at once, which are good with this build as long as you can get either of them out and the activity isn't enough to justify the loss of an action. For instance take Sudden Charge, which lets you Stride twice and then make a Strike against an adjacent enemy at the end. If Skills are your preferred action you'd roll a flat check to avoid losing the Strike, but if you did fail you still Stride twice which takes the same number of actions as... just Striding twice so you didn't actually lose anything (and then you could attempt to Grab with no MAP from the Strike you didn't make). Same thing with Scout's Charge, you Stride, Feint, and then Strike. If your preferred actions are Strikes then you roll the flat check to Feint and can fail and lose it, but you still Strike at the end: the same number of actions as Striding and Striking. This can be important for considering your build. Be careful, however, since some feats rely on other actions of the feat happening first (such as Combat Assessment and Underhanded Assault) you can lose the whole Activity if you don't use it with your preferred action.
There's a few universal constants when approaching play as an Ancestors Oracle. One of them is a good rule of thumb that you should reasonably be able to dedicate two actions per turn to your preferred action for that turn, which can be entirely actions that aren't attributed to anything affected by your curse. It's a good idea to have a way to make natural attacks or wield your weapon or some other way to make Strikes that are worth the effort and to have a shield or buckler in the other hand for Raise a Shield. You also want to positively contribute to the fight in a meaningful way which is most important to remember when rolling Skill actions or Strikes in a bad situation. If you spend your entire turn Striding, Raising a Shield, Hiding and similar you're not contributing so carrying helpful items, investing in Battle Medicine, specializing in Athletics to Grab, or using ranged weapons to Strike from anywhere is a good thing to do and when all else fails it can be worth proccing your curse if you wouldn't accomplish anything on your turn anyway (which you can even mitigate with Hero Points). Taking items that do things on activation that don't fall into any of the categories affected by your curse is a good choice. Another universal constant is that being a spellcaster we'll almost always want to roll spellcasting as that provides the best benefit.
The Build
There are two approaches to maintaining your curse: keeping it high and never going down or resetting it back to neutral for rerolls. In the first instance you can immediately go up to your highest curse level by using Ancestral Touch targeting yourself out of combat, eating the damage, and having yourself or an ally Treat Wounds you back to full HP. In the second scenario we'll want the Death Domain for Death's Call and the Advanced Revelation feat for Ancestral Defense. The Death Domain gives us a way to upgrade our curse off-turn in case we roll Spellcasting for next turn and want to keep our flat check low right now if we're gambling around it. Ancestral Defense, on top of being a good spell, gives us a reroll off-turn for another attempt at getting spellcasting. If you're desperate an ally with a free action to spend can attempt to Demoralize you and manually trigger the reroll from Ancestral Defense. There are very, very few actual Oracle feats we want other than Advanced Revelation at 6, but you might take Divine Access, Oracular Warning, Quickened Casting (combo feat but it's only once per day; use it when you have Spellcasting and go to town), Mysterious Repertoire, and Scapegoat Parallel Self.
As you can tell from some of the above paragraphs we're also going to be going for Archetypes. Having Free Archetype isn't necessary for any of the builds I'll suggest (though it helps a bunch), but you will have to take them. We'll have enough room since most of our Oracle feats are feats that combo with spellcasting or other actions and aren't great for us to take. From these archetypes we're looking for a few things: actions that aren't affected by our curse that we can use and good actions that give us variety and make rolling any preferred action worthwhile. Out of these we have two amazing crutches: The Kineticist and the Psychic. It's well been established the Elemental Blasts that Kineticists make are neither Strikes nor Spells but a secret third thing and taking Kineticist at Level 2 ensures that we will never, ever have any of our turns wasted since we will always be able to use them. Being at such low level Elemental Blasts also aren't anywhere farther behind than making weapon attacks so it's a viable in many situations and it has a bit of scaling with Gate Attenuators. Kineticist also gains Impulses that can be used curseless. Psychic, similarly, gains Psi Burst that we can pick up at Level 4. Psi Burst is also not a Strike or a Spell and can be used once a turn to fill the turn out. Psi Burst says it forces a Basic Reflex save but does not say against what DC, though the Psychic only becomes trained in Spell DCs. Since the Remaster dropped this is great because there's only one Spell DC now, Psychic can use your Charisma stat, and it'll always scale with you to be relevant. Psychic also has the benefit of granting extra spellcasting and giving you something else to do with your Focus Points if you're always in max curse. No matter what late game build you make to take every archetype you need to be useful no matter what you roll, these two archetypes will always be relevant.
When looking for an archetype that isn't the Kineticist or Psychic you'll want something that preferably grants you both Skill actions and actions that include Strikes to round out whatever you roll each turn and capitalize on what you get. Other good Archetype picks include:
  • Wrestler - Picks up several combat actions that give extra benefits on hit like Snagging Strike, Combat Grab, and Running Tackle. Goes well with Skill actions too by giving free Titan Wrestler and maintaining several offensive options with Skill actions like Submission Hold, Whirling Throw, and Spinebreaker.
  • Scout - Scout's Charge works well as an option when rolling Strikes and it gains synergy with Skills with Fleeting Shadow. The Dedication for Scout's Warning combos incredibly nicely with the Status bonus rolling Skills for the day grants you.
  • ArcheRanger - Interchangeable, but gives options for holding onto a bow and making use of the different types of shot feats that they gain access to. Archer gains more access to better feats for filling in Strike actions but Ranger comes with earlier access to Hunter's Aim which will put you on-par with martial attack bonus at the cost of Hunting Prey and offers a wider variety of feats that can compliment Skill actions like Snare Specialist.
  • Martial Artist - Grants access to good attacks for Strikes and some unique options for actions with Skills. Gorilla Pound has action compression in a Skill action and a Strike but Powder Punch Stance gives Thunder Clap and Black Powder Flash, neither of which are affected by your curse. Also leaves your hands free for combat maneuvers, using items, holding a Stave, or wielding a shield.
  • Alchemist - A good archetype all around, but especially useful for you since using items isn't blocked by your curse. Maybe not the best to pick since you'll need better filler actions but a solid late game choice.
  • Marshal - If you've got a way to get training martial weapons, Marshal's actions are usually skill-based or don't proc the curse as they command allies instead.
  • Unexpected SharpshootePistol Phenom/Gunslinger - Interchangeable but all of these archetypes grant both Skill actions and special Strikes to take advantage of.
  • Thaumaturge - Glimpse Vulnerability is curseless and quite a few options for Implements like the Chalice, Bell, Amulet, and Wand can use their special Initiate benefit without restriction.
Ancestries
While it might not seem like a big deal, Ancestors Oracles has the benefit of gaining two extra Ancestry feats: one at Level 1 and the other at 11. This is huge for some ancestries that want two different starter feats or have more than one feat chain and is especially good for Versatile Heritages who want to follow a feat chain from their heritage and base ancestry at the same time. Rule of thumb for Ancestry feats is passives are good, actions that don't trigger your curse are good, and so is any action that gives an option for doing something with Skills or Strikes. Here are some examples of what you can do with them:
  • A Human with the Versatile Heritage can get Armor Proficiency up to Heavy and Weapon Proficiency by taking General Training three times, making it possible to go into melee. They also have Multitalented which lets you pick back up on your crutch Archetype while retraining what you took from Level 2, giving you a power boost by Level 10.
  • Ancient Elves have their free Dedication at Level 1 which can be used for Kineticist so you can start the game at Level 1 and never have an off-turn with your curse since Elemental Blasts will always be an option for you. Worth it if you want the three Focus Points by starting with Psychic and pretending you don't have a curse until Level 4 or if you're sticking with Kineticist the entire way through. They also have access to bows as an ancestral weapon feat that gets them good ranged attacks for builds that take advantage of Striking turns with a ranged weapon so they don't have to move or go out of their way.
  • Goblins have a ton of unarmed attacks and Skill and Strike options with Ankle Bite, Goblin Song, Kneecaper, Tail Spin, Cling, and Freeze It!. With more than a few options for it they can be good up close and personal for making use of their worthwhile skills.
  • Catfolk can combine Catfolk Dance with Trip attempts when Skills are their preferred action and have a claw attack while still being able to go down the Cat's Luck feat line.
  • Kobolds have Kobold/Dragon's Breath which isn't affected by the curse and can also pick up options for Snarecrafting feats to fill out Skill actions.
Skills and General Feats
Having useful skills to use on your turn when you roll for Skills as your preferred action and, more importantly, having them be valuable by themselves is important. Athletics is great for this since you have combat maneuvers you can conduct with it Medicine is also a good pick for Battle Medicine which is a useful turn of Skills. For Crafting specifically if you have the formula you can make items in a day, so if you roll Skills during a day of downtime you can enjoy up to an extra +2 Status bonus. Every day you continue to work on the project you don't roll a check at all. You may also take Crafting if you specialized in shields to fill out your actions for the turn by leveraging Improvised and Quick Repair. Battle Prayer isn't great but it's a way to still do damage if you rolled Skills and keep up with Religion, as is Occultism for Disturbing Knowledge and have an alternate Demoralize on deck. Intimidation goes without saying as you'll probably being using this the most for Demoralize. Any downtime skill feat can also be a good investment as you get a noticeable bump to those half the time.
Items
Because you're going to have a lot of filler turns there's more than a few items that either work around your curse or fill in turns. Little known fact, rolling Skills as your preferred action makes you the best at skill actions, so it's always good to keep up with item bonuses for your primary skills. When you do roll Skills for the day you can do better than everyone else in the areas you specialize in.
  • If you're going for a melee build an Extending Rune for your weapon gives great value if you can't otherwise reach anything. At two actions to activate it's normally not worth it, but since it's your best option without wasting turns it can be a good one if you want to stay where you're at.
  • Healer's Gloves can heal when activated, which requires no skill check and isn't Casting a Spell. Good for having an option to heal when you roll Strikes.
  • The various Bravery Baldrics give benefits equal to a spell, but are only Command actions to activate.
  • An Ash Gown is generally useful, but has an action-less Stride attached that can deal damage to creatures.
  • Spellhearts of any kind are great additions to your arsenal. They give you more options for blasting when you have Spellcasting as your preferred action and can bleed over into the next turn if you roll Strikes for your preference.
  • A Horrid Figurine can be used more than once and is a great action-filler for the turn.
And last but not least, the pièce de résistance, I've made a bunch of....
Example Builds
These aren't built out all the way, just the important stuff. Room to fill in the blanks and less work for me dear god this post is long enough as it is.
Strength Melee Build
This build starts out with Kineticist for our crutch early game and retrains it out for Wrestler at 9th level, where we go back into Kineticist. Kineticist is used early for when we roll something we don't want since every action Kineticist wants to do doesn't interfere with the curse. It showcases how you can use Human to get heavy armor too, I went Dromaar for Tusks to get a d6 unarmed attack but you could just as easily build for Monk instead of Kineticist at 9th and be a Skilled Human for more training in skills and better things to do during your Striking turns. Focuses Athletics for Grabs and Trips, by the time we hit 11th level we have a useful attack in Snagging Strike, several ways to capitalize off Skill actions and even do damage with Mask of Pain, Submission Hold, and Whirling Throw.
Dex Ranged Build
Showed off potential for the build to just straight up pick Kineticist at Level 1 and not have to care about the early parts of the game where you roll something you don't want, but this one displays what I have after retraining out of Kineticist. It starts with Elven Weapon Familiarity early too to make use of Strikes when we actually want to do that but we end up retraining it for Gunslinger at 10th where we can get the Slinger's Reload. This build is meant to use two Slide Pistols and the Reaction abilities that Gunslinger has if available, Fake Out is dicey if it's a Skill action or not since that depends what you'd call Aid and if Fake Out is Aid but you can choose between it and Deflecting Shot turn by turn. Paired Shots fill out our Strike preferred action turn and the Slinger's Reload can also help fill out our Skill action turns with Gundpowder Guantlet and you have Smoke Curtain to use if you don't have enough actions to Reload twice and do a Paired Shot. Using the Slinger's Reload when it's not your preferred action just loses you the Demoralize or Create a Diversion so you can still Interact to change barrels on your Slide Pistols on your own turn. If you have to actually "put in bullets" Reload the Capacity of a Slide Pistol gives you turns where you can Demoralize and do that after putting a gun away.
Psychic Build
Went Kobold with Psychic to show that between Kobold Breath and Psi Burst you can fill out most any turn where you roll something other than Spellcasting, but you can also take Kineticist early until you can get Archer. Archer fills out our Strike action turns and we go for Multishot Stance to get a metric ton of arrows off, which works great with our damage bonus from the curse but Archer's Aim is can be a smarter way to go to fill out those turns since you hit above your weight with the circumstance bonus. For Skill action turns we have good ol' Demoralize and Bon Mot but between Kobold Breath and Psi Burst you can basically completely ignore Skill action turns if you want. Once you pick up Brain Drain you almost don't have to do anything but Psychic stuff and Spellcasting anymore. For the Conscious Mind I picked up Silent Whisper and Message to make use of the Focus Points we won't be able to use, since it's just one action and gives a nearly always valuable benefit.
So there we have it. These aren't the greatest builds and this is far from the greatest subclass (it's actually the worst subclass in the game fight me) but it has its upsides. The biggest upsides are those initial Ancestry feats for ancestries that get a ton of great options at lower levels and multiple feat chains, such as the Goblin that can be a Tailed Goblin, take Chosen One for Snow Goblin, and then get both Freeze It! and Tail Spin to be an Athletics monster on its skill turns which it can get on-time to have it all at the same level. No other class can do that. And speaking of Skills, the Ancestors Oracle technically does any skill it wants best out of everyone with the proper support if they have the Skill actions preference and that meaty Status bonus to their checks. Lastly they have a huge boost to spellcasting with their damage bonus and can be incredible blasters, the issue is it's all pretty much luck and what these builds and designs are meant to do is make it so no matter what you roll you're still going to have something useful to do and value to contribute by leveraging the curse instead of suffering and wasting turns when you roll anything but spellcasting. Remember, The Best We Can Do is Something(tm)!
\".......I don't want to be that guy, but remember when you Cast a Spell when I was advising you that a melee Strike was the best course of action? What was that all about? Pretty rude if you ask me.\"
submitted by spitoon-lagoon to PF2eCharacterBuilds [link] [comments]


2024.04.28 15:06 hutchib For the NCMHCE you need to be using the DSM-5-TR not the DSM-5

For the NCMHCE you need to be using the DSM-5-TR not the DSM-5 submitted by hutchib to NCMHCE22 [link] [comments]


2024.04.28 11:04 M00n_Slippers Loki 'Mischief Maker' Rework

Everyone knows Loki needs a rework, as while his Invisibility is amazing utility that is single handedly propping up his usage numbers, his other abilities are fairly impotent and not especially useful in the current state of the game. DE is aware of this, but I respect that Pablo has stated he doesn't want to do one until he has a good idea that is worth it and people will like. So here it is, an idea I think people will like. Will anyone read or like this? Who knows, but here is my contribution either way.
The theme for Loki is 'Mischief', and I imagine his abilities would come with snickering laughter sound effects, to reinforce that he is a trickster. To differentiate him from Ash who is more of a Ninja or Assassin, he does not have any effects related to Stealth finishers or stealth kills. His kit is themed around confusion, damage vulnerability, and movement.
Passive: Abilities cast while invisible have reduced energy cost and + 50% Power Strength (Does not effect Helminth abilities)
Ability 1: Tricky Trail -- Loki receives a sprint boost and leaves a trail of glowing footsteps on the ground (trail length effected by range). Enemies that step on the trail receive 5 random status procs and are inflicted with confusion. (New Helminth)
Ability 2: Invisibility (Basically unchanged): Loki becomes invisible (affected by Duration).
Ability 3: Switcheroo (formerly Switch Teleport). Loki can switch locations with an enemy target or a duplicate.
When cast on Enemy: The enemy receives damage vulnerability and becomes confused, while Loki receives increased Ammo Efficiency, Reload speed and Firerate for his weapons.
When Cast on Imposter: Imposter immediately detonates at the Switched Location with increased range, and Loki receives the same buffs as if it were an enemy.
Ability 4: Imposter (formerly Decoy): Tap cast creates an illusory duplicate of Loki which attracts enemy aggression. Damage to the imposter is stored, then amplified and released at the end of the Duration as additional damage in a large AOE Blast which also inflicts Damage Vulnerability and confusion on enemies. Hold cast detonates the Imposter immediately.
Augment changes:
(Savior Decoy and Deceptive Decoy) Benevolent Imposter: Damage to Loki up to 80% is redirected to the Imposter, contributing to the Blast damage on detonation. If Loki takes Fatal damage during this time, he does not go down but Imposter is immediately Detonated and Loki is healed by an amount based on the damage dealt to enemies with the blast.
Imposter Syndrome (Formerly Damage Decoy): The effect of Imposter can be cast on an enemy, turning all enemies against them. The enemy is immune to damage until detonation at which point it will receive the detonation damage along with other enemies and also be inflicted with Damage Vulnerability. Additionally, the effected enemy leaves behind a Tricky Trail for the Duration of the ability.
Hushed invisibility: (Same)
Tag Team Switcheroo (Formerly Safeguard Switch): Casting Switcheroo on an Ally, you trade places and the Ammo Efficiency, reload and firerate bonus is granted to all Allies.
Vacuum Trick: (Formerly Radial Disarm I guess) crossing your trail, creating a closed circle with the Tricky Trail, triggers a vacuum effect at the point of intersection, pulling in enemies.
Opinions and comments welcome.
submitted by M00n_Slippers to Warframe [link] [comments]


2024.04.28 10:35 somehfguy Frequently Asked Questions (Work in Progress)

Please consult this FAQ before posting a duplicate question.
Authors: Everyone
This is being written by a lot of people. This is a collective, community effort. If problems with some of the answers, please offer a constructive alternative or suggestion and/or re-write the paragraph
Do I have hard flaccid?
Hard Flaccid Syndrome (HFS) presents itself with a set of overlapping symptoms which may include physical and textural alterations in genital appearance, sexual dysfunction and dysesthesia. At this point in time, hard flaccid syndrome is almost entirely self-diagnosed.
Some of the hallmark symptoms of Hard Flaccid Syndrome are:
  1. A shrunken, shrivelled penis in the flaccid state: The penis may appear shrunken, shrivelled and retracted in the flaccid state. Upon palpation, the flaccid penis will often appear to be hardened and rubbery. Other commonly reported visual and textural changes include altered appearance of veins on the penis body (engorged veins, spider veins), constantly retracted testicles, a penis tilt or curve in flaccid and erect states, dimples at the base of the penis, as well as wrinkly, discolored, leathery and dry skin.
2. Hourglassing: Many sufferers report the appearance of a penis that is pinched in the middle of the shaft. The penis shape will resemble the shape a hourglass. The pinched area will sometimes seem hardened and discolored. Hourglassing is noticeable in both flaccid and erect states.
  1. Worsening of symptoms before, during and after bowel movements and urination.
  2. Sexual dysfunction: Hard flaccid may lead to difficulties with achieving or maintaining an erection. Spontaneous and nocturnal/morning erections are sometimes entirely absent. Erections are alternatively described as "hollow feeling", "disconnected", "uneven- filling" and "posture-dependent". Libido is sometimes negatively affected.
  3. Pelvic floor dysfunction: Symptoms of hard flaccid will ofter occur alongside PFD symptoms including but not limited to urinary issues (urinary hesitancy, weak stream, post-void dribble, urethral burning), sphincter dysfunction (dysynergia, involuntary kegelling), muscle fasciculations, spasms, pain or tenderness (levaror ani syndrome, CPPS).
  4. Sensory changes: These include paresthesias, dysesthesias and numbness. Commonly reported symptoms include but are not limited to numbness (= reduced sensation or lack of sensation), lack of erogenous sensation, cold and hot sensations, pulling/crawling/pins-and-needles/tingling sensations in and around genitals.
What causes hard flaccid?
The current established causes are still unknown. However, there have been many theories and hypotheses. There is no established singular cause and many individual conditions have been hypothesised to independently give rise to hard flaccid symptomatology. Such conditions include: trauma to the genitals, pelvic myoneuropathy and pelvic floor dysfunction (PFD), chronic prostatitis/ chronic pelvic pain syndrome (CPPS), pudental neuralgia and pudental nerve entrapment (PNE) syndromes, hip issues (hip impingement and hip dysplasia), spine issues (bulging disks, annular tears, perineural cysts), PSSD, various neuropathies (small fiber neuropathy), HPA axis dysfunction.
Goldstein et al. (2023) proposed five regions that contribute to hard flaccid. Please see Appendix A for more information on this. genitals.
I have hard flaccid. Now what?
Consider following one of the treatment algorithms: Algorithm 1 Algorithm 2
Is hard flaccid a result of pelvic floor dysfunction (PFD) or chronic pelvic pain syndrome (CPPS)?
For many cases, hard flaccid syndrome is concomitant with PFD and CPPS symptomatology.
Is hard flaccid a result of pudendal neuralgia?
For many cases, it could be a contributor or a cause. Until more research is conducted on HFS, we won’t have an exact answer to this question.
What is the difference between hard flaccid and long flaccid?
Is hard flaccid and peyronie's disease the same condition?
While they have some overlapping symptoms, hard flaccid and peyronie’s condition are completely different and should not be considered as such. Peyronie’s is caused by the build-up of scar tissue (fibrosis) in the shaft of the penis. However, in the overwhelming majority of cases involving hard flaccid there is no fibrosis. The disease is characterized by the development of fibrous scar tissue or plaques in the penis. These plaques can cause the penis to bend or curve during erections, leading to pain, discomfort, and in some cases, erectile dysfunction. The exact cause of Peyronie's disease is not well understood, but it is believed to involve a combination of genetic, trauma-related, and inflammatory factors. While the condition often develops gradually and can affect men of any age, it has been reported as being more prevalent in middle-aged men.
Symptoms of Peyronie's disease may include:
  1. Penile curvature: The penis may develop a noticeable curve or bend during erections.
  2. Pain: Some men may experience pain or discomfort during erections, especially if there is tension on the affected area.
  3. Erectile dysfunction: Peyronie's disease can lead to difficulties achieving or maintaining an erection.
How is Peyronie's diagnosed:
  1. Physical examination: The urologist will palpate for plague inside the penis body in flaccid and erect state.
  2. Ultrasound: The urologist will look for plaques using ultrasound in flaccid and erect state.
In some cases, Peyronie's disease may resolve on its own without treatment. However, if symptoms are persistent or severe, medical intervention may be necessary. Treatment options may include:
  1. Medications: Certain medications, such as collagenase clostridium histolyticum (Xiaflex), may be injected directly into the plaque to help break it down.
  2. Penile traction devices: These devices are designed to apply gentle and consistent stretching to the penis, with the goal of reducing curvature over time.
  3. Surgery: In more severe cases, surgical procedures may be considered to correct the curvature and remove the plaque. However, surgery is typically reserved for cases where other treatments have not been successful or when the symptoms are particularly severe.
Reference:Reference: Sandean DP, Lotfollahzadeh S. Peyronie Disease. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560628/
Do I have nerve damage/irreversible nerve damage?
There is no way to diagnose nerve damage from symptoms alone. A set of specialised tests (EMNG, MRN etc) are needed to assess the function of nerves.
Is surgery recommended for hard flaccid?
If the symptoms are chronic and debilitating, surgery is often recommended to such patients with a reduced quality of life.
The current surgeries that have been attempted by patients include:
References:
Maggi, M., Pirola, G. M., Absil, F., De Plaen, E., Mosca, A., Salciccia, S., Sciarra, A., & Bollens, R. (2020). Erectile function recovery after laparoscopic decompression of pudendal artery and nerve: a documented case report. Central European journal of urology, 73(4), 569–571. https://doi.org/10.5173/ceju.2020.0088.R1
https://auanews.net/issues/articles/2023/may-2023/hard-flaccid-syndrome-proposed-to-be-secondary-to-pathological-activation-of-a-pelvic/pudendal-hypogastric-reflex
/doctor_appointment_generic_questions/
I am having surgery, how should I prepare for surgery?
https://www.reddit.com/HardFlaccidStudy/comments/14o6gq4/generic_surgery_preparation_list/
Will sexual intercourse make my hard flaccid worse?
As a general rule, sexual activity should be avoided during the initial period following the injury that resulted in hard flaccid symptoms. Following the end of the acute period of injury it should be fine to engage in sexual intercourse (if possible). Moreover, anecdotal evidence suggests that sexual intercourse is preferable to masturbation as it is less likely to cause a flare up of symptoms. However, avoid all sexual activity when you’re experiencing pain in the penis.
What should I ask my doctor in an appointment?
https://www.reddit.com/HardFlaccidStudy/comments/14ng32e
I went to a doctor and they told me that my hard flaccid symptoms are all in my head. Is it true?
The mental aspect is not a CAUSE of hard flaccid and is it NOT in your head. Depression and a negative mood may exacerbate them for some people, but not cause. If the symptoms of hard flaccid persist for an extended period of time it is unlikely that they are a result of mental health issues.
Is there a link between diet and hard flaccid symptoms?
At present, there is no research suggesting any direct correlation between diet and hard flaccid symptoms. While maintaining a proper diet can be beneficial as part of a holistic treatment approach for any sexual dysfunction condition and maintaining good health to prevent comorbidities, it is VERY unlikely that a proper diet alone is enough to recover from hard flaccid. However, there have been reports of alcohol consumption resulting in flare ups of the hard flaccid symptoms. Additionally, there is anecdotal evidence suggesting that excessive consumption of caffeine can also result in a flare up of hard flaccid symptoms.
Can a penile implant help resolve hard flaccid symptoms?
There is limited research on penile implant surgery. Regarding a penile implant as a treatment for hard flaccid also has no research. Therefore, it is difficult to ascertain whether the surgery will yield any improvements to the hard flaccid symptoms. However, it may be a valid treatment for individuals with hard flaccid who mainly suffer from erectile dysfunction. It must be noted that a decision to undergo a penile implant surgery should not be taken lightly and should be a measure of last after exhausting all other treatment options (e.g. exercise, medication, etc.) as it is irreversible and precludes the patient who undergoes it from ever being able to achieve an erection without a penile implant. Moreover, penile implants have to be replaced every 10-15 years and there is no guarantee that they will be able to alleviate symptoms not related to erectile dysfunction like pain or genital numbness.
What is the Dynamic Contraction Technique (DCT) and is it helpful in treating hard flaccid?
Dynamic Contraction Technique (DCT) is a primarily paid online-based exercise program that advertises itself as offering an exercise regimen that can help recover from hard flaccid. However, the feedback regarding the effectiveness of the program has been rather mixed (if not relatively negative) and a significant number of participants of the program did not experience any notable improvement in their hard flaccid symptoms.
Is there a link between stress and hard flaccid symptoms?
Anecdotal evidence suggests that periods of intense stress can contribute to the worsening of the hard flaccid symptoms. However, the exact extent to which stress can be linked to hard flaccid is unclear. Moreover, management of stress, depression, and anxiety alone is usually not sufficient for recovery from hard flaccid in most cases.
Are kegels recommended for treating hard flaccid?
Kegels are always debated in every sexual dysfunction forum and it's a your mileage may vary” treatment for hard flaccid symptoms. With all sexual dysfunction conditions, many suggest that kegels are particularly bad for the pelvic floor. The general consensus, particularly among those who believe that hard flaccid is caused by overly tense (hypertonic) pelvic floor, is that kegels can result in the worsening of the hard flaccid symptoms due to making the already tense muscles even more tense. On the other hand, there has been a notable increase in the amount of anecdotal evidence that kegels, when done in moderation, can be beneficial as part of a holistic treatment of hard flaccid, particularly for those who believe that their hard flaccid symptoms is a result of weak pelvic floor muscles. However, it is strongly advised not to do kegels exercises without consulting with a pelvic floor physical therapist as they can evaluate whether your pelvic floor muscles are tight (hypertonic) or weak (hypotonic). Do them at your own risk.
Does hard flaccid have any affect on fertility?
There is no research suggesting a correlation between hard flaccid symptoms and fertility. Therefore, it is unlikely that hard flaccid can result in infertility. The only effect that hard flaccid can result in infertility is an indirect one as the common symptoms of hard flaccid include erectile dysfunction and genital numbness, which can make conception through sexual intercourse challenging. However, it should not affect alternative conception methods such as in-vitro fertilization
Any helpful videos?
Has anyone been cured from Hard Flaccid?
Given the nature of the internet and online self-report format of these forums, we cannot confirm the validity of people claiming to be cured. We define "cure" as people who have basically returned to baseline prior to receiving hard flaccid symptoms. The only confirmed case-report includes Btcalvit’s case by Nico et al. (2022). There is no scientifically agreed upon treatment method for hard flaccid yet. However, there have been several reports of people experiencing a major improvement and even complete resolution of hard flaccid symptoms from a variety of treatment methods.
Nico, E., Rubin, R., & Trosch, L. (2022). Successful Treatment of Hard Flaccid Syndrome: A case report. The Journal of Sexual Medicine, 19(4), S103.
Reddit Reports of People Self-Reporting to Be Cured or Almost Cured - Read at your own risk
Where is Ben’s routine?
https://www.reddit.com/Hard_Flaccid/comments/s18opt/experimental_hf_routine/
Where are the discords?
What are the existing hard flaccid websites?
submitted by somehfguy to hardflaccidresearch [link] [comments]


2024.04.26 18:06 disney_info_for_all Barbie epcot!

Barbie epcot!
I was on a trip in volo illinois and found this!! I hope yall enjoy!
submitted by disney_info_for_all to disneyhistory [link] [comments]


2024.04.26 16:24 thisisjerick Ranged Commanders: Are they worth it?

Ranged Commanders: Are they worth it?
I've been consistently experimenting and working on ranged commanders as a side project ever since Margaret and Babur's release. I would like to share my thoughts for those who are curious whether it is worth investing in ranged commanders or not. I'm not sure if anyone's made a comprehensive review of engg yet, but if there's any, please do let me know. Before getting into the details, just a disclaimer that ranged is still not meta and if you're a low-spender like me, invest in your meta commanders first and treat ranged as a side-project! This is for some people who wish to try a different playstyle than the typical march and fight :D
General Mechanics: Free hit = free kill. When properly used, you only exclusively take damage from counter-attacks, thus a Delane's Amulet is necessary. The most satisfying thing about ranged commanders is that they will never stop attacking during huge murder ball fights. Once they're set-up, they will automatically attack enemies within range as long as you have war frenzy. Once it has locked onto a target, it will not stop attacking the target unless it moves out of range, in which it will select a new target without resetting its rage bar, or you manually command it to attack something else. This results in non-stop skill cycles. I haven't really tested the targeting priority, but I would assume it simply attacks the nearest target. Since the small buff to engineering, setting up takes around 6 seconds and dismantling, around 8 or 9. While it requires minimal micro, note that you should constantly pay attention to enemies trying to flank you. You are a very juicy target and enemies are probably marking you since you are a very annoying nuissance to the field. But even so, you are not a priority target, your damage isn't very heavy and only a noob would punch through a murder ball just to get to you. But if they catch you, you're a guaranteed sad face because even if dismantled, you are extremely slow. So you have to anticipate enemy movement and the ebb and flow of murder balls. That being said, you don't want to get caught dismantling in the face of an enemy murder ball, but you don't want your siege sitting around doing nothing as well.
Commander Pairing Reviews: I have a full Epic Engineering set which are mostly talented except for the leg slot. Delane's Amulet is a necessary accessory and for now, i use the march speed flag.
I personally recommend not running double multiple ranged marches because first, they don't hit hard enough, so you're sacrificing some firepower for your murderball, second, you want to have a decent march should you need to protect your siege. But if you insist on such a project, I wouldn't recommend any other pairing than Margaret-Babur and Cordoba-GM. Margaret-Cordoba seems to be quite viable since Margaret amplifies RNormal damage, but the rest of her kit doesn't synergize with smite. While Margaret-GM is basically running a Sargon-Freddy.
Margaret and Babur Rating: 2/5 Mostly negative trades Not recommended for low spenders
Setup during testing: Margaret (5311), Babur (5111) Viable investment should be Margaret 5511, Babur 5555
I believe that being the first ranged pairing released, Margaret and Babur were largely experimental. Lilith wanted siege to have more significance in the field but doesn't want it to be too op to shift the meta.
I consistently used Margaret-Babur for 3 KVKs but eventually gave up and stopped using them last KvK. The biggest problem with this march is obviously being double single-target, and they don't even hit hard. They can't get any significant trades unless they can fire subsequent skills, but even so, they suffer from counter-attack damage against well-built meta commanders, much worse if you haven't noticed you've been firing on the Pakal-Harald for the last two minutes. I typically use Margaret primary because I'm a big fan of the support tree. But because of bad Rnormal attack trades, I tried Babur primary. The skill cycles are much much slower but the normal attack trades are slightly better. Overall, there wasn't much of a difference.
Moreover, there's too much RNG in the M-B pair. It lacks sustain in the field until you get Margaret expertised. Combined with the lack of decent siege stats, you are quickly just dying to counter-attack damage.
I think that the M-B pair starts to power spike once you get Babur expertised and Margaret 5511, but I really don't think it's worth the investment. It reached the point I'm just glad that I got even trades even when free-hitting from afar.
Gonzalo de Cordoba-Gajah Mada Rating: 4.5/5 Mostly positive trades in ball fights, dueling is so-so Recommended only if you enjoy ranged mechanics Setup during testing: Gonzalo primary (5511), Gajah Mada (5211) Viable investment: Gonzalo (5511), Gajah Mada (5111) Most cost-efficient investment: Gonzalo (5515), Gajah Mada (5555)
It seems to me that the release of GC-GM is an attempt to solve the inherent problems of the M-B pairing: exclusively single-target, extremely slow, no sustain until expertised, skill damage not going well with ranged gimmick, and being a juicy sitting-duck. And I should say they did a good job. GC-GM is absolutely fun to play. Smite damage makes total sense when playing ranged, GM has an instant proc healing at level 1 skill. It has an AoE while retaining the consistent proc damage to encourage longer sustained shots. GC has counterattack reduction on his 4th skill which further helps with your sustain and gives much better trades. The stats are not broken, but decent considering they are siege, and both of them have march speed on the 2nd skill, making them nearly as fast as my ZL-HermannP. GC-GM also has safety anti-swarm features (disarm, some resistance, extra counterattack) should you get flanked by a triple cav march. You will still suffer some bad trades, but you will survive like any decent march long enough for your main marches to defend you and punish the enemy for overextending.
Overall Conclusions: Should everyone use Gonzalo-Gajah? No, I don't think so. Ranged commanders still require some extra micromanagement unlike your typical 5 march setup, which can be difficult if you're not playing on PC. It also takes away from the mass of your murderball, thus effectively thinning the frontline that protects you.
Is it useful in the field? Yes, especially for area control. It also acts as a deterrent against marches trying to push against your ball. You're practically untouchable In very niche situations such as river terrains and Orleans. You can hide your tower behind tall allied cities so you're not a very obvious target. lol.
Do you need to rush gold siege equipment? I haven't fully committed to full siege gameplay for me to invest that much equipment materials on siege. After all, there's only one viable siege march in the game. Full epic talented siege gear + a delane's amulet should be enough. For armaments, just go with the typical All damage > Health > Defense > Attack. The screenshots of the reports are me using these sets with a 5511 GC and 5211 GM. I'm sure that with better gear and higher skill levels, you'll get better reports. I personally plan to build GC to 5515 and GM expertised.
Is it better than other meta marches? Definitely not. But it's certainly fun to play :D
submitted by thisisjerick to RiseofKingdoms [link] [comments]


2024.04.25 05:29 Ya_average_Doomer Numbers on BPD

I was just curious, so I searched the web for some numbers on BPD. I thought these might interest you too, so I decided to share them here. However all of these should be taken with a grain of salt since they come from different studies and articles and one of them is from a self help organization, that does not even name their sources. Feel free comment your own, if you found some related statistics.
Prevalence: In the US, 1.6% of the total population were found to have been diagnosed with BPD. It is asumed that the real number is higher. 75% of these were female (found pretty much the same share for other countries). However, this share is probably biased, since females are much more likely to seek out treatment. Among clinical patients in the US 20% were found to have BPD.
Suicidality and self-harm: According to data from a Germany 2023, the suicide rate among people with BPD is 5-10% (quite high), with its peak within the age cohort of 20-30 years. They also found that 60% had at least 1 suicide attempt in their life (70% according to US data). 69-80% injured themselves on purpose at least once.
Trauma and abuse: 40-70% according to the same German source have been mistreated and/or abused during childhood. 60-80% claim to have been subjected to sexual abuse.
Employment: 50% of BPD affected people manage to find employment. Among those, 20% manage to keep their job and stay finacially independent for longer than 12 months, which equals a total of 10%, who stay employed.
Prognosis: Nearly 50% of patients who recieved treatment did no longer fit the diagnostic criteria of BPD after 2 years. After 10 years it was 88%.
Sources: Juurik et al, 2019: https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0220233
Salters-Pedneault, 2020: https://www.verywellmind.com/borderline-personality-disorder-statistics-425481
Sansone & Sansone, 2012: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472897/
Borderline Selbsthilfe, 2023 (the German one without sources): https://borderline-selbsthilfe.org/de/zahlen.html
submitted by Ya_average_Doomer to BorderlinePDisorder [link] [comments]


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