edit: sorry, when i say fake sugars here, i meant to say artificial sweeteners, like sucralose or aspertame. it's early in the morning and im very much an idiot.
drinks, food, whatever has a nutrition label, there's bound to be a weight/measurement to sodium, carbs, sugars (as well as the percentage, but i think adding a % would get confusing) that helps you (even passively) keep track and limit any possible negative side effects or health risks associated with long term over or under indulgence. even alcohol or caffeine is given a similar treatment despite there not being any issues with under indulging.
so why don't nutrition labels do this with fake sugars? it's my opinion that this is a disservice to the population, as there are potential negative side effects from most fake sugars if you have too much, and you should reasonably be able to track or at least have the capacity for informed consent, if you want to say "fuck it, my liver can handle it every once in a while" you should, if you want to limit within reason but indulge a bit, you should. not everyone who wants to limit is desperate to avoid it at all costs.
looking at the ingredients is basically useless as it only shows ingredients in the order of how much of each ingredient is in relative to the other ingredients. this doesnt actually tell us anything unless we're strictly avoiding something at all costs due to health, religious, or philisophical reasons.
granted there are a lot of different kinds of fake sugars, but i think it stands to reason that a label would only focus on the kind that the product uses. the rest can be looked into by the consumer.
im not a health nut, i have no conditions that require i limit (apart from the same way one would sodium sugar, alcohol or caffeine) and i don't avoid it like the plague, i just think it's weird that these are the exception, but no one irl i've spoken agrees with me.

Hi everyone. I was having TedTalks play in the background while doing work stuff and on it was “This is what it's really like to live with ADHD”; Jessica McCabe. As I am hearing her explain her barriers and something she explained caught my attention and I find it relatable and I rewind the episode. I play it in its entirety and I found myself relating and having similar experiences.
Just fyi I was diagnosed with dyslexia and recommended for IEP when I was in Kindergarten. Anyways let’s just say that I remember the special tests with flip cards they evaluated me on and that it was at a qualitative level beyond what I was given access or had reasonable means of discovering.
I once stumbled upon a document that illustrates the Venn diagrams of Dyscalculia, Dyslexia, Autism Spectrum Disorder (ASD), ADHD, and Dyspraxia. And how some of them are more likely to intertwine with each other. So I have an educated guess that my main one is ASD because of it’s connection and interaction with ADHD and Dyslexia. I had made attempts to not study these labels in an effort to not stigmatize. However now I realize it’s better to be knowledgeable to gain an understanding of support area from these labels descriptions.
So I am on a journey of self discovery, learning, understanding and trying to build rapport with individuals who may be more familiar with my circumstances and experiences and have compassion and knowledge of my challenges.
Thank you.🙏

Hi All, Our dog has been on compounded Trilostane (70 mg) for about 3 months to get Cushing's Disease under control. She is a spayed lab mix about 78 pounds. We are not sure of her age as we adopted her from the pound. We think she is between 11-13 years old. She had her second checkup today (05/17) to determine how the meds are working. She has been vomiting more than usual the last month or so and gets diarrhea now and then. In fact, her appt. was on Monday but had to be rescheduled as she was sick and threw up her meds. After her test to check her levels after 2 hours, it came back at 1.4 µg/dL. The test result form we received states < 1.8 µg/dL - Consider adjusting therapy. Emergency medical attention may be needed if iatrogenic signs present. I raised my concerns about this value combined with her throwing up and diarrhea. The vet said she wants to keep her on this level of Trilostane since her liver values have improved so much. (The liver values went to the low side of the high value, so it is working to get her liver issues under control.) They ran an additional blood panel and everything looks great. They sent her home with antibiotics and anti-nausea meds. I'm still wondering if the dose of Trilostane is too high since her value is below the recommended value.
Trilostane FDA Label Recommendations The following are used to guide decisions based on the post-ACTH stimulation cortisol values. Cortisol <1.45 µg/dL: Stop treatment. Restart at a decreased dose.
My biggest concern is I don't want her getting Addison's or worse. She's the best dog and I want her golden years to be as good as I can make them for her. I appreciate any insight or experience into why the vet is ignoring the low value, the vomiting/diarrhea and continuing the current dose of Trilostane. Thank you!

So sorry in advance for the long post. I just need to get this out.
TW for talk of suicide and depression
If you’re my partner and you see this - please don’t read this. I promise you are a wonderful support but I know my venting hurts you because you want to fix things and you can’t.
Edit to add some probably important context: I was misdiagnosed with BPD when I was 19 after a traumatic experience. And while every mental health professional I saw after told me it was wrong and was actually PTSD and CPTSD, it was not actually “officially” diagnosed on record until the hospitalization, at the start of my ADHD assessment. But, the psychiatrist that ordered the assessment is the first doctor to ever bring up ADHD or neurodivergence. Just to demonstrate how many people missed these things over the years, how many “second opinions” I’ve had to get. Not in any way dissimilar to my experience seeking diagnosis for my physical health issues.
I feel such immense grief and rage. I don’t even know where to begin, so I guess I’ll start at the start of this “health journey”. When I was 16, I became incredibly ill. I was vomiting all the time, exhausted to the point of sleeping 14 hours a day from the time I got home from school til just before I had to leave for the bus. I don’t remember much from this time period because of the brain fog and genuinely don’t know how I passed my classes. I was gaining a lot of weight, too, and hadn’t had a menstrual cycle in 6 months, and was so so depressed. My mom ignored the health issues because she thought I was just being dramatic (there is much deeper context with the issues there but it comes down to I am now NC as an adult), but when I said I needed to see a doctor for my depression she did. My then-family doctor was wonderful and listened, and to be safe decided to run some blood tests though I hadn’t described to her my physical symptoms aside from the oversleeping I attributed to depression. I was diagnosed with autoimmune thyroid disease, or Hashimoto’s. I started medication and my symptoms improved though some things, like the weight gain, never reversed.
I ended up going into remission for a time and no longer needed the HRT. But when I was around 20/21, I started having health problems again. I started experiencing numbness and tingling in both my hands and wrists, which I thought was from repetitive movement working as a cashier, though the symptoms only appeared about 6 months into that job and in hindsight it probably isn’t normal to develop that quickly that way. But I ignored it because I didn’t think it was serious as it was “just” carpal tunnel, and began wearing wrist splints regularly. I did not ask my doctor, as during this time I was having difficulties hearing at work and the hearing test I requested came back normal and I was dismissed and I didn’t want to reinforce the belief I have unreasonable worries about non-issues - later, I learned this was actually an auditory processing issue, which was never brought up by any medical professional I saw as a possible cause.
In 2020, when I was 24, I began experiencing the same autoimmune symptoms I had when I was first sick at the age of 16. I fell asleep at work which had never happened before and it worried me. I went to the ER on recommendation of Telehealth, where the doctor didn’t believe my symptoms and ordered just an EKG that came back normal. He told me I didn’t fall asleep/pass out while actively working, and simply “took a nap” and it’s normal. Follow-up with my GP after was unsuccessful, until I pushed for thyroid testing. I was found to no longer be in remission and put back on HRT, and once again my symptoms improved but did not resolve.
At the same time, and for the year or so that followed, I experienced extreme digestive health issues. I had visible yellowing of the skin, very dark under eye circles, issues with itchy and red patches of skin, and was passing undigested food and eventually became obviously malnourished as a result. I had what seemed to be a kidney stone that passed before I could get in for the ultrasound so it couldn’t be confirmed. I alternated between constipation and diarrhea, and always felt pain. My GP told me it was “probably just IBS” and had me do an elimination diet (twice) that did not work. He dismissed my concerns telling me I’m fine, until I sent a novel of my symptoms and saying I know he thinks I’m a hypochondriac but I am unwell and need to be looked at. The liver tests I pushed for came back normal. He offered to test me for Celiac but advised against it due to the cost of the blood test, so I didn’t. He did, however, refer me for a colonoscopy but the pandemic made this severely delayed. During the wait, I found some relief of my symptoms by cutting out gluten and dairy from my diet, and the yellowing of my skin and dark circles went away as did, eventually, the skin patches my doctor insisted was “just eczema”. I was off of gluten for a full year when I had my colonoscopy in fall 2022, the results came back normal and that doctor reiterated that it is “probably just IBS”. I learned later that I should have been consuming gluten for at least 3 months prior in order for it to be an effective test for Celiac, and my doctor failed to tell me this.
In early 2022, the joint pain had become frequent enough and painful enough in the knuckles where my hands meet my fingers, and in my wrists with definite carpal tunnel in both wrists as well, that I went to my GP. However, he is busy, and it’s often easier to book an appt with his assistant who is able to assess many conditions. At this time I also believed he would be more likely to listen and take me seriously. I went to the appt, described the nerve and joint pain issues. I had an exam where he confirmed bilateral carpal tunnel and arthritis in my hands. He said no testing was needed. I pushed back, stating that I am only 25 and there is no normal reason for the inflammation, and I have Hashimoto’s which has very high comorbidity with RA and I was concerned due to the fact the inflammation was symmetrical. I was dismissed, told the only test that could be done is an x-ray which was pointless as all it would do is confirm the presence of arthritis which he already confirmed with the exam. He told me to keep wearing wrist splints, keep taking ibuprofen and acetaminophen for the inflammation and pain, told me taking them was risk-free, and told me to come back when the redness and swelling of my joints got worse. I didn’t feel comfortable going to my GP for fear of being marked further as a problem patient, and assumed he would tell me the same information his assistant had based on my experiences with him and the fact his assistant is his staff that sees many of his patients.
My depression worsened during these years, coming to a head in early 2023 when I attempted. I did not succeed due to a mistake I made, fortunately. I was hospitalized for a time, where I was finally officially diagnosed with PTSD and CPTSD. And for the first time, a doctor asked if I suspected I’m neurodivergent. I was assessed and diagnosed with ADHD, which explained a significant amount of non-health related issues, though it also explained some like my KP and teenage cystic acne as they are common comorbidities. It’s important to note that I have a younger sibling that was diagnosed with ADHD as a child, and I was viewed as the “normal” child and any issues were dismissed as my sibling had higher support needs and was the priority and I was always viewed as simply being overdramatic and wanting attention. I was told the cause of my depression was trauma, including childhood trauma, as well as 26 years of undiagnosed and unmanaged ADHD I had been forced to deal with on my own. I was told I had done the best I could but they were not surprised it reached the point it did, as sadly the mental health system in Ontario is not what it should be and often people do not receive help until they’re long past the point of needing it. And for many, it’s too late. I am fortunate that it wasn’t too late for me, I’m fortunate I survived.
Prior to my stay at the hospital, I had gotten to the point of needing to take ibuprofen daily for the inflammation. When disclosing my medical history and medications, I was asked if I had received a formal diagnosis for my arthritis and what tests had been performed. I told them I had been assessed for and diagnosed with arthritis, but that no tests were performed. It was clear they did not believe me, and I wasn’t provided ibuprofen during my stay. They did not follow-up with my GP regarding the arthritis either, though to be fair I was in the psych ward and non urgent physical ailments were not their concern.
Now we get to 2024. It’s a jump, but I don’t feel anything between is significant. I do not go a day without pain, and havent for 3 months. The pain has now reached every joint in my body, I feel fatigued and foggy, I feel horrible all the time and have had 3 UTIs since February. The last one reached my kidneys rapidly, and coincided with the worst full-body arthritis flare of my life - this was 2 weeks ago. I woke up every 2 hours sobbing in agony because my body and knees in particular were so warm and painful and stiff. For a full day I was unable to get out of bed and ran a low grade fever with chills I assumed were due to the infection but now I’m not so sure. Since then, I have been in constant pain though not as severe as then. My knee and hip pain keep me up at night, and/or wake me up often due to the pain and stiffness. Regardless of my larger joints, my hands and wrists always hurt now. I feel ill in the way I did with my Hashimoto’s. Ibuprofen and acetaminophen aren’t doing anything anymore, and I rely on cannabis for relief which isn’t always suitable. My partner got me a topical ointment that has been incredibly but isn’t affordable enough to be sustainable with how much of it I need in one go, and I need to use it sparingly when I absolutely need it. Despite not feeling that my joints are red and swollen enough to go back (because I see them every day and they look normal because they always look like that), I stuck with my plan to see my GP. I first tried to book in February, but only saw him this week.
I described all the physical symptoms asking about my lower leg/ankle swelling and to have my thyroid levels checked for potential med increase need, and I described my joint issues. He assessed my hands, and told me my knuckles are red and swollen. I’ve realized after in research and really looking at my hands that the top knuckle on one of my fingers has a lump on it, albeit a very small one. He immediately said he is testing me for RA with blood work, and in my research I’ve confirmed the req form is thorough, and also includes urinalysis and an EKG. However he told me for the inflammation marker test to go for it when it’s at its worst, and with my work schedule I can’t, and I’ve waited so long for this I refuse. I’m going for it as soon as I can. I’ve waited so long to be listened to and believed. And as many as half of people with RA test negative on the blood tests so I’ll end up needing imaging tests anyway either way and I want this process to be as fast as possible. Even if it’s not RA, I need them to figure out what’s wrong with me and give me the appropriate treatment. He was alarmed and visibly displeased to hear that I had seen his assistant 2 years ago for an assessment - though I forgot to mention to him that that appointment was also for bilateral carpal tunnel (which I now know is an early sign of RA due to compression of nerves). It wasn’t explicitly stated but it was clear that I should have been tested 2 years ago. And wasn’t.
I’m tired of being in pain. I’m tired of being sick. I’m just plain tired. I feel so failed by the system that’s supposed to care for us. I’m so frustrated with people insisting that doctors are all-knowing and infallible and if they tell you you’re fine, you are. I’ve been fighting for years to be heard and have only been left to feel like I’m losing my mind and imagining these problems and am just overdramatic after all. I feel vindicated that I was right all along, but it’s too little too late. RA is a progressive disease, and the earlier it’s diagnosed and aggressively treated the better. I’ve had at minimum 2 years of progression that cannot be undone. The damage can’t be reversed. I am angry and devastated. The grief is so f*king immense.
I’m 27. I don’t know what my future looks like anymore and that scares me. I’m worried about the damage this disease has done to my internal organs. I worry having kids is no longer an option for me, due to my health. I worry that my physical capabilities will continue to deteriorate. I am so angry that I’ve been written off as an anxious hypochondriac when I knew something was wrong.
Diagnosis of an autoimmune disease or any illness really, apparently doesn’t negate medical misogyny and ageism. Advocating for yourself doesn’t go anywhere when you’ve been labelled crazy and a problem patient. The most it’s gotten me is my doctor “offering” to send my files if I wanted to switch to a different GP, which I can’t with the GP shortage. I have to live with the lifelong consequences of doctors failing me. And it f*king sucks.

i think i was panicking i labelled it price instead of cost/revenue 😭😭😭 i thought i did so well on 25 mark essay but i only realised it now how many mark will i potentially lose for this ???? pls someone tell me

Soooo.....I have NO TIME to shop, let alone look at EVERY SINGLE number on the nutrition label for my newly diagnosed "pudgy" liver. My job and life just doesn't allow it. It stinks! So is there anyone out there that uses pre-made meal delivery services? Specifically one that has a "Mediterranean" diet type options?? (Also looking for a friend who's husband has strict diet restrictions due to Kidney problems.) This getting old stuff, is for the birds! 😝 Thanks everyone!

Hello!
Just wanted to post some highlights and stats from the recent conference regarding GLP-1 meds etc. This is general information - most supported by current clinical trials. I cannot verify any of the information as I am not the author. I went to a conference and found a lot of interesting stats so I jotted them down: These include Q & A pages for Dr's to give out to potential patients of zepbound etc. answering potential questions.
Note: Some of these are based on different versions of the meds because it wasn't a conference focused soley on Zepbound. But it gives overall information.
· Usually cause muscle loss with all current meds.
· Eli Lilly and Novo are both trying to figure out oral versions of the medications.
· There is currently a class action lawsuit by roughly 60 ppl regarding GI complications as a result of the medications. (Philadelphia)
Continued weight loss post 12 months – (Ozempic)
18% Weight Regain
26% Some regain
20% Maintained loss
17% Additional Loss
12% Doubled Loss
Zepbound D/C Weight regain study:
473 women, 197 men. Mean age 48 years. Over 70 medical centers in 4 countries
335 received Zepbound, 335 Placebo - Primary outcome is that the mean percent change in weight from weeks 36 to 88.
At week 36 weight reduction was 20.9%
Findings:
At 88 weeks Zepbound loss – 89.5% of participants with Zebound at 88 weeks maintained at least 80% of the weight loss compared with 16.6% placebo.
(This does not include continued weight loss over time after D/C, only at a 88 week marker)
FDA Warnings and Precautions – Zepbound:
· Severe Gastrointestinal Disease
· Acute Kidney Injury
· Acute Gallbladder Disease
· Acute Pancreatitis
· Hypersensitivity Reactions
· Hypoglycemia
· Diabetic Retinopathy Complications in Patients with Type 2 Diabetes
· Suicidal Behavior and ideation
o Serious adverse effects were reported by 5.3-7% of patients taking Zepbound. As opposed to 2.8% in Wegovy group.
General Q&A Answers:
Are Ozempic, Wegovy, Mounjaro, and Saxenda (furthermore “GLP‐1/GIP RA”) controlled substances?

๏ No ๏
Can GLP‐1/GIP RA be obtained without prescription?

๏ No ๏ Is there a generic version of GLP‐1/GIP RA?

๏ No, and not expected until 2031 at the earliest ๏

Is Berberin the same as Ozempic or other GLP‐1/GIP RA?

๏ No, the mechanism of action and biochemical properties are different

๏ Are there patient assistance programs for GLP‐1/GIP RA?

๏ Yes ๏ https://www.novocare.com/psp/PAP.html for Ozempic, Rybelsus and Victoza ๏ https://www.mounjaro.com/savings-resources for Mounjaro ๏

Can I drink alcohol while on Mounjaro (and other GLP‐1/GIP RA)? ๏

You should avoid combining Mounjaro (tirzepatide) and alcohol if you can. Alcohol can potentially worsen Mounjaro’s digestive side effects, such as nausea and vomiting. In rare cases it may aggravate or cause hypoglycemia. ๏

Can GLP‐1/GIP RA reduce my desire to drink and other addictive behaviors? ๏

Research is ongoing. Preliminary results suggest that there may be a desirable effect.

๏ Are compounding pharmacies breaking the law by selling compunded GLP‐1 medications?

๏ No, as there is a current shortage of these drugs. The FDA allows to compound equivalent medications in cases of storage.(* Not legal advice, see a professional if legal opinion is needed).

๏ How long will Ozempic take to work? (similar but specific information is available for other GLP‐1/GIP RA) ๏

When you first start Ozempic, you’ll inject a low dose for the first 4 weeks to help your body get used to the medication. This dose isn’t meant to have a significant effect on your blood glucose (sugar) levels. But some people may start to see some improvements during this time. ๏ It takes about 4 to 5 weeks to reach a steady level of Ozempic in your system. Full effects may not be seen until at least 8 weeks of treatment. If after 2-3 months your A1C isn’t at the target, your provider may increase the dose

What can I expect after I stop taking GLP‐1/GIP RA ? ๏

Most people will regain some or all weight they lost. However, cardiovascular benefits are more durable. ๏

Should I stop Ozempic and other long‐acting GLP‐1/GIP RA before surgery? ๏

Specifically for Ozempic the recommendation is to stop at least 1 week prior to a planned surgery.

๏ How long should I wait after the last dose if I am trying to conceive?

๏ If you want to become pregnant, you may need to stop taking Ozempic at least 2 months before trying to conceive so it is fully excreted. ๏

Can I flush Ozempic or other long‐acting GLP‐1/GIP RA from my body?

๏ No. And if side-effects are affecting you, you cannot remove these medications by “detox”, laxatives or hydration. ๏

Do GLP‐1/GIP RA cause termination of pregnancy or birth defects? ๏

These drugs have NOT been studied extensively during pregnancy in humans, so the potential risks aren’t fully known. But animal studies have shown a higher risk of pregnancy loss and birth defects with some of the GLP-1 drugs. ๏

Do GLP‐1/GIP RA cause depression and/or psychosis? ๏

While prescrbing information for some of these drugs mentions such side effects, they are rare and causal connection has not been established. Warnings about suicidal ideation are included in prescribing information for Saxenda and Wegovy. ๏


Can GLP‐1/GIP RA interfere with oral contrceptives? ๏

Prescribing information for Mounjaro warns that it may reduce the efficacy of oral hormonal contraceptives. Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with MOUNJARO. No such warning is provided for Ozempic/Wegovy and Saxenda ๏

Where can I find prescribing information for weight loss GLP‐1/GIP RA? ๏ https://www.accessdata.fda.gov/drugsatfda\_docs/label/2023/215256s007lbl.pdf = Wegovy ๏ https://www.accessdata.fda.gov/drugsatfda\_docs/label/2014/206321orig1s000lbl.pdf = Saxenda ๏ https://www.accessdata.fda.gov/drugsatfda\_docs/label/2022/215866s000lbl.pdf = Mounjaro
Comparison of Clinical Trials:
Zepbound 15mg at 72 weeks
Body weight change overall - -20.9
Ø 5% weight loss – 90.5
Ø 10% weight loss – 83.5
Ø 15% weight loss – 70.6
Ø 20% weight loss – 56.7
Semaglutide 2.4mg at 104 weeks
Body weight change overall – 15.2
5% weight loss – 77.22
10% weight loss – 61.8
15% weight loss – 52.1
Zepbound
Can cause delayed absorption of orally administered medications.
Acetaminophen – Take at least 1 hour before injection
Contraception – take at least 1 hours before injection - findings are possibly indicating a contradiction between Ozempic and contraception - possibly causing 'Ozempic babies' - still under investigation. Unsure if there are clinical studies yet.
Weight Loss Slows Brain Aging = 1% body weight loss was equal to gaining back 8.9 months’ attenuation of brain age.
Attenuation of brain age was significantly associated with improved liver biomarkers, decreased liver fat, and a visceral and deep subcutaneous adipose tissues after 18 months of intervention.

DAY: MAY 14, 2024

• 5-14-2024CAN EATING OR DRINKING CAFFEINE BEFORE BED IMPACT YOUR HEALTH? Having a lot of food in your stomach before bed can redirect blood flow to your gut to digest the food, meaning there is less blood flow going to your brain. You need that blood flow to your brain to make sure you go into the different sleep stages. If you have caffeine in your system or are sensitive to it, the time to fall asleep can double. Caffeine has a half-life of up to 4.5 hours, so a safe bet is to avoid caffeine after noon.
• 5-14-2024RESEARCHERS DETECT HIDDEN INGREDIENTS AND QUESTIONABLE CLAIMS IN SUPPLEMENTS some supplement companies may mislead customers with unproven health claims and undeclared ingredients. The researchers focused on supplements that have been associated with the purported treatment or prevention of COVID-19 and other respiratory illnesses. During the pandemic, the use of dietary supplements skyrocketed throughout the world. “There was a big spike in purchase and use of these types
• 5-14-2024TEXT MESSAGES WITH FINANCIAL INCENTIVES CAN HELP MEN WHO ARE LIVING WITH OBESITY LOSE WEIGHT, UK STUDY FINDS text messages with financial incentives can help men who are living with obesity lose weight and could be a valuable alternative to traditional weight management programs. Men who were offered cash for hitting weight loss targets lost more weight than those not given a financial incentive,
• 5-14-2024EXERCISE BENEFITS THE BRAIN, BUT IMPROVING ITS BLOOD VESSELS MAY TAKE LONGER People with less consistent brain blood flow patterns may be at greater risk of dementia and cerebrovascular disease. To explore whether regular aerobic exercise can help, researchers at Iowa State University have conducted a pilot study, the results of which were recently published in the Journal of Applied Physiology. “The big take-away is that exercise is good for the arteries and brain, but its effects are complex and takes time to accumulate benefits
• 5-14-2024SOCIAL ONLINE TRAINING CAN HELP AGAINST LONELINESS AND DEPRESSION a ten-week, partner-based mental online training program boosted resilience, empathy and compassion, and deepened social connections. At the same time, these short daily, app-based practices done with another person, so-called Dyads, decreased loneliness, depression, anxiety and a negative outlook
• 5-14-2024TECH ALONE CAN’T REPLACE HUMAN COACHES IN OBESITY TREATMENT, STUDY FINDS technology alone can’t replace the human touch to produce meaningful weight loss in obesity treatment. The study, titled “An Adaptive Behavioral Intervention for Weight Loss Management: A Noninferiority Randomized Clinical Trial,” . “Giving people technology alone for the initial phase of obesity treatment produces unacceptably worse weight loss than giving them treatment that combines technology with a human coach
• 5-14-2024ULTRASOUND CAN HELP PATIENTS WITH A TYPE OF RHEUMATIC DISEASE LEAD LONGER AND HEALTHIER LIVES ultrasound can help patients with a type of rheumatic disease to live longer and healthier lives. These patients have so far had an increased risk of cardiovascular disease, which contributes to premature death. Patients with a type of rheumatic disease called radiographic axial spondyloarthritis, a disease that causes changes in the bones in the pelvis and spine, have poorer health quality of life than control subjects.
• 5-14-2024SCIENTISTS FIND REPEATED, SMALL HITS TO HEAD IN FOOTBALL PLAYERS CAN DAMAGE BLOOD VESSELS IN THE BRAIN The work involved specialized helmets that were used to monitor head impacts in 60 university football players. Credit: Dalhousie University Repeated blows to the heads of football players can damage the small blood vessels of the brain, according to research by Dalhousie University scientists from the Brain Repair Center who believe this damage may contribute to brain dysfunction in some athletes years after play has ended. The neuroscientists found that the brain’s blood vessels can get damaged by a succession of small hits
• 5-14-2024‘MICROPREEMIE’ BABY WHO WEIGHED JUST OVER 1 POUND AT BIRTH GOES HOME FROM ILLINOIS HOSPITAL Nyla was born at just 22 weeks weighing 1 pound and 1 ounce, making her what’s known as a “micropreemie.” She left Silver Cross Hospital on Monday weighing a healthy 10 pounds, and was taken home by her first-time parents
• 5-14-2024RESEARCHERS INVESTIGATE IF PHARMACOLOGICAL TREATMENT OF ADHD REDUCES CRIMINALITY pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD) reduced violence- and public-order related crimes. However, it did not reduce other types of crimes, among patients with ADHD in early to late adolescence considered to be in the gray zone (or on the margin) for such treatment.
• 5-14-2024A NEW DRUG SHOWS POTENTIAL BENEFITS IN THE RECOVERY OF PATIENTS AFTER A HEART ATTACK beneficial effects of the novel drug Sacubitril/Valsartan in the management of myocardial infarction (MI). The research offers new insights into the drug’s ability to reduce inflammation, cardiac fibrosis, and prevent dangerous heart arrhythmias post-MI. Cardiovascular diseases, especially MI,
• 5-14-2024STUDY EXPLORES ROLE OF EPIGENETICS, ENVIRONMENT IN DIFFERING ALZHEIMER’S RISK BETWEEN BLACK AND WHITE COMMUNITIES environmentally caused alterations to specific areas of the genome—known as imprint control regions—during early development may contribute to the risk of developing Alzheimer’s disease, and that Black people may be more affected than white people. The work adds to our understanding of the ways in which environmental factors can contribute to genetic alterations and disease susceptibility.
• 5-14-2024NEW AI TOOL IMPROVES RISK ASSESSMENT FOR HEART FAILURE CARE researchers have developed a powerful new risk assessment tool for predicting outcomes in heart failure patients. The researchers have made the tool publicly available for free to clinicians. The new tool improves on existing risk assessment tools for heart failure by harnessing the power of machine learning (ML) and artificial intelligence (AI) to determine patient-specific risks of developing unfavorable outcomes with heart failure.
• 5-14-2024FAR FROM TOXIC, LACTATE RIVALS GLUCOSE AS BODY’S MAJOR FUEL AFTER A CARBOHYDRATE MEAL A volunteer is monitored after being given a large dose of glucose to determine how well people switch from fat to carbohydrate metabolism as they age. In the tests at UC Berkeley, subjects had their blood monitored for labeled lactate and glucose, underwent periodic blood sampling, and had their breath monitored for oxygen and carbon dioxide.
• 5-14-2024STUDY EXPLORES WHAT MOTIVATES PRESCHOOLERS TO PREPARE FOR THE FUTURE Adults find it particularly easy to prepare for the future when they imagine how they will feel. Researchers at Ruhr University Bochum, Germany, have investigated whether this is also the case with preschoolers. The researchers conducted the study at the intersection of philosophy and psychology. They described their findings in the journal Emotion. Rehearsing for a school play, getting a present for a friend’s birthday and packing a book for a long car journey:
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I'm walking through a bustling underground train station. I push and shove my way through all the other commuters onto the platform. As I look around, there seems to be endless rows of platforms in both directions, stretching well into a dense fog. Further ahead, neat lines of railway tracks extend out from the fog and through the platforms. I instinctually look up at the info screen
Next train in ### minutes
I furrow my brow, squint to try and focus on the numbers but they're heavily pixelated and illegible. I look around at the other commuters, who stream onto the platform completely unaware of the anomaly. Most people are on their phone, or wearing headphones while some are talking to each other. No one seems to notice the malfunction with the screen.
That's when the absurdity of the situation clicks for me. Endless platforms, a wall of fog, unreadable numbers and people that don't care. It's all a dream. I bring my hand up to my face and pinch my nose, trying to breathe through it. An old reality check I remembered from back when I was trying to learn to lucid dream.
My heart rate jumped when I realised, that I couldn't breathe through my nose. Before I could even process this, another problem presented itself. I didn't know why I was here. I didn't know where I was going and I definitely did not know how I even got here. It seems as if reality ceased to exist right before I walked onto this platform. Just like it typically feels in a dream, you spawn in out of nowhere and don't really know what happened prior - except this wasn't a dream.
I knew I was sure of it because deep inside my bones I felt this anxious urgent message. I need to catch this train. It was a primal feeling.
At this point, my head is spinning and I need to sit down somewhere. I choose a silver bench with a middle aged woman sitting on it. She shuffles further to the left as I sit down next to her clutching my head and racking my brain to try and figure out what it is happening. This is what amnesia feels like, I thought to my self as I gnawed at scraps of messy muddled memories. Each image that came into my mind was just a fragment - A school, a library, sickeningly white walls. It hit me that I didn't even know my name. I was starting to hyperventilate but then my body kicked into autopilot. I started to take deep breaths, focusing on my diaphragm and calming myself down. It felt like I was trained to do this. I started to focus on the current situation.
Where was my ticket? Instinctually, I knew I had to have gotten one on my entry to the train station. I reached into my pockets and pulled out a scrap of paper. Scrawled in very familiar cursive:
*In case of memory loss, read the journal in your backpack*
Strange message but I didn't have any choice then to at least give the instructions a try. I removed my backpack and rummaged through it for the journal. I wouldn't really call it a backpack - more a tattered and frayed bundle of cloth that was reminiscent of a backpack. I finally found a series of small thick journals, bundled in cloth with their leather covers on the verge of disintegration. The pages still seemed in good condition though. Each cover was sequentially labelled which I'm guessing corresponded to the chronological order of the writings within.
The lady next to me was weirdly getting agitated. She kept stealing glances, her body shaking and eyes burning with a fierce rage. I slowly got up from the bench and began to step backwards. My backpack bumped into a pillar. The dull thud it made seemed to cause a drastic change to everyone around me though. They all snapped their heads, locking eyes on me and staring through my very soul. I felt exposed.
The rumble of an arriving train stole away their attention and within a split second everyone was ignoring me again, going back to their usual activities. It seriously felt like I had just imagined it and it was becoming more and more clear that I was having some sort of mental breakdown. Nevertheless, as the train slowed to a stop on the platform, I walked into it and found a seat. The train seemed to be old and new at the same time. Typical blue seats with abstract dirty patterns complete with a modern sleek interior of gentle curves clashing with a boxy dull metallic exterior and doors that looked like they belonged on a rusty submarine.
I opened the first of the journals and began to read. I soon realised that the handwriting was mine and within the next few moments I was attacked by a barrage of memories that had remained repressed and buried in the back of my mind.
*
My name is Jacob and I have been stuck here in this place called *The Limbo* for an eternity. When I say 'eternity', I don't mean it lightly. Back when I used to keep track I counted over 500 years through my wristwatch that never seemed to run out of battery. Now I know counting is meaningless. There have been periods like this where my mind falls into a deep trance and I lose my whole identity as I mindlessly wander in this place much like the entities that inhabit it. Occasional periods of lucidity breach this trance and then I find myself lost and confused. It's why I keep the journals with me. I think its some sort of psychological survival mechanism that human brains develop when faced with the infinite vastness of The Limbo.
Speaking of The Limbo, I've come to learn a few things about its nature through my stay here. Some of its been through people that I've come across (Yes others are also stuck here) and some has been through my own experiences. Perhaps the most important is the question of where I get my food and water. The answer is weird. I have never felt hungry or thirsty. The sensation of having cool water slide down my throat remains a memory so distant that it feels like the snippet of a childhood dream.
I guess the next natural topic about this place would be time. Through various experiences of mine (that you'll get to read about) and discussions with others, the leading theory of mine is that The Limbo exists outside of time itself. While I myself have fallen here sometime during 2001, I've met many others from various years like the 80s, 90s and even one recent fellow from 2043.
Most people in The Limbo eventually fall into a trance, withering away until they become one of the entities or become mere tools for them. It's probably naive but I keep going through this place with only two hopes. The first is to somehow get out of here at the right time point and see my son, who I never got to see. The second is to come out of this place and die so that I no longer have to live out the empty agony of eternity (I'll explain how you can't age or die in The Limbo later). Perhaps my hopes will dwindle as the centuries pile and I will become just like those who I look upon in pity now.
I am writing this consolidated diary of my experiences for several reasons. I'd like someone to know of my unending journey in this place. To be aware of the capacity of the human spirit to keep going in the worst of situations. I have never had a long term friend in The Limbo, but know that I consider you the reader a dear friend even if I never get to meet you because you will know my story. I'm also sharing this in hopes that there is more awareness of The Limbo. Perhaps the military and scientists can actually figure out what it is. Perhaps all of us can be brought home. Or maybe this can serve as a survival guide to those who may be unfortunate enough to fall through.
There are small holes in The Limbo. Most of them are barely large enough for a pinkie finger to fit in let alone a person, but sometimes I've come across one large enough for this journal to go through. I'm not sure what time or place these holes lead to, so the safe passage of this book into a person capable of reading it has about the same chances as me ever leaving this place.
The train I'm on supposedly leads to the edge of The Limbo, where the holes are large enough for humans to fit through. It's really more of a legend amongst the poor souls that are trapped here and I've followed trails and clues for a long time to even find this train.
There are only two ways this goes. Both outcomes would lead to you reading this book in your hands. I'll either find my way out of this hell or give up hope and slip this journal through a Hole. You will find my fate at the end.
I should stop rambling now though. It would be best to start at the very beginning.
*
I was rushing out of work in pure ecstasy. My wife had gone into labor while I was at work and been rushed to hospital. I needed to get there fast. People were glancing over at me over their cubicles in confusion as I packed up my work bag and rushed out to the elevators. I couldn't stop thinking about seeing my first son as the elevator made its way down. The elevator doors finally opened and I rushed out.
The ground entrance of the building I worked at, particularly near the lobby, is an intersection of various hallways. I was already walking to close to the wall when someone came rushing around the corner and bumped me right into the wall. I was only able to hear half their apology when I fell *through* the wall like it was just a holographic projection. In hindsight, I find it oddly funny how easy it is for a life to get ruined. Just when you think you've got it all, when everything is going smoothly, a small incident like that is enough to take it all away.
I found myself in a room that resembled a classroom. It looked as if someone who had never stepped inside a classroom was asked to imagine the space. Desks were arranged in messy uneven rows with the chairs facing various directions. The board at the front of the room was a seamless patchy mixture of both chalk and modern whiteboard and mounted way too low on the wall, nearly hugging the floor. A large teachers desk sat in the front of the room. The walls were filled with posters of absolute gibberish along with diagrams and pictures that seemed like they showed something tangible but no matter how close you looked you could never identify anything in the picture.
The initial confusion was replaced by an immense panic. My heart was drumming against my chest as I searched the room for a doorway to exit it. My mind was trying to rationalise the situation. I was trying to convince myself that this was just some old part of the building and I had fallen into a hallway instead of the wall.
I ran through the doorway at the far end of the room and found myself in a large hallway that seemed to extend forever in both directions. The walls were a muted grey and the floors were that typical dirty linoleum. Soon I would find out that the regularly spaced doorways on either side of the hall led to other nonsensical classrooms.
I ran down the hallway screaming for help in pure panic, which was a terrible mistake in hindsight. I stopped running down the hallway when I suddenly heard the distinct scratch of chalk against board. In this large empty space, the sound echoed and boomed. Since I was still refusing to buy in to the reality of the situation, my hopes were momentarily increased by the supposed presence of another person here.
I slowly walked over to the doorway that the sounds were coming from. My stomach filled with an uneasy dread. This deep primal instinct within me urged me to hold back. I peeked carefully in the classroom and saw a woman with their back turned to me drawing something on the chalkboard.
It took me a few moments to notice that it was a very realistic portrait of my face.
She was drawing lines across my throat, her long dark hair swaying as she drew in the details. The drawing was completed with a terrible slash across the throat, blood gurgling out. I was frozen in place, transfixed on the hauntingly beautiful realism of the picture.
She began to turn around slowly while humming a high pitched tune. To this day I can't describe the face I saw. It is still etched into my mind. A face full of so much hatred, so much anger that I don't think its possible for a human to make that face. It expressed an emotion beyond human understanding. No artist in the world could ever render the expression on the paper. No words could describe the pure fear that coursed through my veins as she stared at me and began to approach.
I turned around to run, only to realise that a bunch of school children had gathered around me. They were headless, the bleeding stumps dripping thick blood onto the floor in a rhythmic patter. Somehow they were laughing.
I shoved through the group and ran down the hallway. I wasn't sure where I was going. My whole world had shattered and now I was completely aimless in some nonsense dimension with horrors beyond imagination that wanted me dead.
*
The extract above is from this journal I found at the foot of a large tree on a hiking trail. It's a miracle that I spotted its faded leather cover given that it was almost buried under rotting leaves. I really don't know what to make of what I'm reading, so I'll be slowly transcribing bits of it in separate posts over the next few days.
I know this subreddit is good for this sort of stuff. I'd love if someone else could share anything they know about The Limbo. This whole journal feels like some sort of prank, but the words and memories within feel way too real.
I can't help but feel a connection to this story. My mum doesn't speak much of my Dad, who I know left before I was born. No one ever found out where he went.
I was born in 2001
X

I have attached some images and some measurements on the floor plan, all measurements are in cm's. I'm seeking some help on where to place a tv and how big it should be? In the diagram I've labelled zones A and B, where should I place it?

Following up on on my latest post TLDR: had failed a hysterectomy in February and second surgery was successful.
34 y/o, high BMI, stage IV endo, suspected adeno, (not confirmed in biopsy)dense adhesions and scarring. Had my LAVH, robotic assisted on May 7th. I found a super compassionate doctor who reassured me and gave me hope after I lost it when my first surgery had to be aborted. Surgery went better than expected, with no complications. It took about 6 hours and took forever for me to wake up. I went home the day of the procedure, only took oxy twice and been managing pain with over the counter meds and gabapentin before bed. Hot water bottles and heating pads. Bloating is annoying, I am lonely and bored but I am happy to be done with it. I felt immediate relief, pain peaked on day 2 - gas pain is no joke. I wanted to thank this community for the advice and support provided, it has been crucial for my journey and I am grateful 💗
My hysterectomy was the culmination of more than 13 years of seeking relief from my discomforts that only worsened over time.
It started with anemia on the verge of blood transfusion that had no explanation other than hypermenorrhea. Each menstrual cycle became more tortuous with the passage of time, heavy bleeding, clots, leg cramps, lumbar pain and chronic fatigue.
I will have seen more than a dozen gynecologists and various doctors.
Blood studies, ultrasounds, resonances, endometrial biopsies, colonoscopy, contraceptives, hormonal IUD that ruined my mental health, I tried absolutely everything. I even went to the middle of the Amazon rainforest to seek relief in the medicine used by the Shipibo people.
I came out of many consultations crying, medical gaslighting and gordophobia were 98% of my experience.
They sent me to the psychiatrist because my pain seemed to have no other explanation than to be psychological.
Since I knew about endometriosis I KNEW that surely it was what happened to me, but finding a doctor who would take me seriously and believe me cost so much. It cost time, money, energy, tears, mental health, putting the body.
First they confirmed fibroids, then suspicion of adenomyosis (waiting confirmation of the biopsy), in February I was operated on for 3 hours without being able to remove my uterus due to the intensity of the adhesions and the advanced endometriosis (phase 4 that was confirmed in said failed surgery)
I had my second operation with a specialist and an interdisciplinary team of gynecologists, urologists and general surgeons.
They took out my uterus, cervix and fallopian tubes. The uterus was attached to the abdominal wall, bladder, intestines and basically everything around it. They drained cysts in the ovaries that I keep. I was cleaned of endometriosis of the sacrous ligaments and mainly of the bladder that was very compromised. They took adhesions from me and I'm sure I forget more.
I feel like I was born again and although this disease is chronic and has no cure, I already hope to see improvements and have a better quality of life, make up for lost time ❤️‍🩹 I can’t wait to see if I can ride a bike again.
Now slowly recovering and feeling very emotional and tired, otherwise happy and excited for my new healing era.
Will include surgery notes, biopsy report and pictures for the curious ones, Hope everyone is having a lovely pre surgery or recovery journey, it’s not easy, but we got this 💪 we are stronger and more resilient than we give ourselves credit for, we fight relentlessly and we show up for each other, our bodies are amazing and can do incredibly things. Sending lots of love your way, internet strangers ✨ 💗
Surgery notes:
Surgery
Findings: Laparoscopy: Smooth diaphragmatic peritoneal surfaces and liver without gross lesion. No injury under site of injury at umbilicus and no umbilical adhesions. Intraabdominal adhesions in the right lower quadrant at the site of prior appendectomy, with bowel and omentum adherent to the right abdominal sidewall. Once this omentum and bowel was taken down, there was a divot with a small amount of fat seen in the RUQ. Dr. Kim evaluated this did not require intervention. Similarly, no clear indirect R inguinal hernia seen without bowel and omentum involved, so Dr. Kim similarly did not recommend intervention. Omentum, bladder adherent to the lower uterine segment anteriorly. Extensive pelvic adhesions and evidence of endometriosis. Thickening of the bladder peritoneum and tacked up to lower uterine segment. Fallopian tubes and ovaries adhered to pelvic side wall, with left hematosalpinx noted in the setting of tortuous left tube. R ovary with small ~1cm functional-appearing cyst. L ovary with hemorrhagic ~2-3cm cyst. Rectum free, no posterior adhesions but extensive serosal endometriosis between the uterosacral ligament and on R posterior serosa overlying R uterosacral. Due to the ICG and use of firefly technology, the course of the ureters were well visualized. Procedure Details: After discussion of risks, benefits and alternatives to the procedure, written consent was obtained. The patient was brought to the operating room. The patient was positioned in the dorsal lithotomy position in yellowfin stirrups with arms padded and tucked at her sides. An exam under anesthesia was performed with findings as noted above. Urology completed a cystoscopy (no endometriosis) and placed ureteral stents with ureteral indocyanine green dye placement. See their operative note for further details. The cervix was dilated with tonsil forceps. Paracervical block was placed. The Rumi uterine manipulator with medium Koh ring was secured to the cervix. A Foley catheter was placed to drain the bladder intraoperatively. A 0.8 cm incision was made at the umbilicus, kocher used to elevate the fascia, and a Veress needle was inserted. Intraperitoneal placement was confirmed. The abdomen was insufflated until an adequate dome was achieved. A 8 mm robotic port was placed and the robotic scope was inserted. Under direct visualization, 3 additional ports were placed, two 8 mm robotic ports to the right of the umbilicus and one 8 mm robotic port to the left of the umbilicus. The patient was placed on steep Trendelenburg and the bowels were swept into the upper abdomen. The Da Vinci robot was then docked in position. The filmy adhesions in the RUQ were taken down with combination of cautery and sharp technique. The omentum was taken down off of the uterine fundus with bipolar and monopolar cautery. The left fallopian tube was followed out to the fimbria. The salpingectomy was then performed, starting at the distal fimbriated end of the tube and sequentially coagulating and transecting the mesosalpinx adjacent to the fallopian tube and well away from the ovary. The fallopian tube was left attached at the cornua. The procedure was repeated on the contralateral side. Good hemostasis was noted. The bladder was noted to be densely scarred to the LUS/cervical junction. The junction was incised with monopolar cautery and the bladder was meticulous dissected off of the underlying uterus/cervix to the level of the KOH ring as marked cephlad traction was placed on the Rumi device. Due to the anterior compartment scarring, round ligaments were not clearly identified. The thickened tissue in this area was grasped, cauterized with bipolar and divided with monopolar. Both ureters were seen using firefly technology. The left utero-ovarian ligament was ligated with bipolar cautery and divided with monopolar. The same procedure was performed on the right side. Marked cephlad traction was applied to the KOH ring. The uterine vessels on either side were skeletonized and ligated with bipolar cautery. The remainder of the cardinal and parametrial attachments were ligated with bipolar and divided with monopolar. The vagina was opened over the Colpo device circumferentially. The fibrotic uterosacral ligaments with overlying endometriosis was incised below the implants and fibrosis, taking care to avoid the ureters. The endometriotic implants over the right uterosacral ligaments were excised. The uterus and fallopian tubes were then removed through the vagina. Given the extensive adhesions and fibrosis, this portion of the surgery took an additional 60 minutes longer than expected. After that, the vaginal occluder was placed into the vagina to maintain the pneumoperitoneum. Dr. Kim then came to assess the inguinal hernia. He deemed no intervention was necessary for the R inguinal hernia or the RUQ divot. The functional ovarian cyst in the R ovary was drained. The 2 cm hemorrhagic ovarian cyst in the L ovary was felt to represent hemorrhagic corpus luteum. Two <1cm nodules on the R uterosacral were excised using cautery, taking care to avoid the right ureter. The vaginal cuff was closed using 0 V-lock in a running fashion in 2 layers . The area was irrigated, and hemostasis was evident. All instruments were then removed under direct visualization. The skin was closed with 4-0 Biosyn . Sterile dressings and Tegaderm were applied to all port sites. The ureteral stents were removed and inspected by urology and noted to be intact. A foley catheter was placed for routine voiding trial in PACU. Sponge and needle counts were correct times x2. The patient tolerated the procedure well and went to the recovery room in stable condition. There were no complications to the case.
Pathology:
Final Diagnosis A) Uterus, cervix, bilateral fallopian tubes, hysterectomy and salpingectomy: - Myometrium with leiomyoma. - Serosal/subserosal endometriosis. - Early secretory endometrium, negative for neoplasm. - Bilateral fallopian tubes and cervix negative for neoplasm. B) Peritoneum, right utero-sacral, biopsy: - Fibrotic squamous epithelium-lined tissue with scattered lymphocytic inflammation. - Negative for neoplasm and no definite endometriosis. Clinical Information Pre-op diagnosis: Adenomyosis [N80.03] Dysmenorrhea [N94.6] Menorrhagia with regular cycle [N92.0] Pelvic peritoneal adhesions, female [N73.6]
Gross Description A. Uterus, with or without tubes and ovaries, other than neoplastic/prolapse. Received fresh labeled; 1)Uterus,cervix,bilateral tubes" is a uterus with attached bilateral fallopian tubes.. The uterus alone is 105 g, 9.5 cm cervix to fundus by 6.0 cm cornu to cornu by 5.0 cm anterior to posterior. The cervix is 3.3 cm long by 3.0 cm diameter with a 0.6 cm diameter os. The ectocervix has punctate areas of hemorrhage. The serosa has scant fibrous adhesions anteriorly and extensive cautery and disruption posteriorly. The endometrium is ragged, hemorrhagic, 0.1-0.4 cm thick. The myometrium is up to 2.6 cm thick and is mildly trabeculated with cysts up to 0.1 cm greatest dimension filled with hemorrhagic material, suggestive of adenomyosis. There is a 0.2 cm diameter intramural well-circumscribed nodule with a whorled cut surface. No areas of softening are identified. The right fallopian tube is slightly serpentine, congested, 5.3 cm long by 0.5-0.6 cm diameter and has attached hemorrhagic fimbria. The left tube is 5.0 cm long by 0.5-0.6 cm diameter, purple-tan with attached hemorrhagic fimbria. Representative sections are submitted: A1-anterior cervix A2-posterior cervix A3-anterior endomyometrium A4-A5-posterior endomyometrium with possible adenomyosis (A4 with leiomyoma) A6-right fallopian tube and entire fimbria A7-left fallopian tube tube, entire fimbria. (MUA) B. Soft tissue, OTHER. Received in formalin labeled, ; 2)right utero-sacral biopsy" are 2 tan red rubbery tissue fragments, 0.7 and 1.0 cm, that are entirely submitted in B1. (AA) Case Report Value Surgical Pathology Report Case: SU24-15696 Authorizing Provider: Chiang, Seine, MD Collected: 05/07/2024 03:42 PM Ordering Location: UWMC Main Operating Room Received: 05/07/2024 05:21 PM Pathologist: Garcia, Rochelle Lorraine, MD Specimens: A) - Uterus, with or without tubes and ovaries, other than neoplastic/prolapse, 1)Uterus,cervix,bilateral tubes B) - Soft tissue, OTHER, 2)right utero-sacral biopsy
Surgery pics

Hi guys, I downloaded an anatomy textbook that was ONLY labelled diagrams on one page and the page directly after that was the diagram without the labels & instead were blank lines so that you could fill them in yourself. My iCloud didn’t save it and I don’t remember the name. I only got past the first few diagrams which were the vertebrae specifically the vertebral column. I don’t remember the name if anyone can please assist! This is the only way I can visually learn! Thank you.

Why is Dr. Mark Spitzer still on our BoD? Hmmm.
https://www.patentlyapple.com/2024/05/googles-smartglasses-patent-acquired-from-canadian-company-north-was-published-last-week.html
Integrated Laser Package with Light Intensity Package
Google's acquired patent describes systems and methods for providing laser projectors having laser-based optical engines as well as light intensity and/or laser output power measuring (e.g. monitoring) capabilities. According to the various embodiments described herein, an optical engine of a laser projector includes at least one laser source (e.g., a laser diode or a plurality of laser diodes) that may be enclosed in a (e.g. partially or completely hermetically sealed) enclosure. The enclosure may include an optical window (sometimes referred to herein as an “exit window”) that may be integrated with one of its side walls or top surface or that forms one of its side walls or top surface.
Laser light beams output by the laser source(s) may pass through the exit window to exit the enclosure during active operation of the laser projector. The optical engine may support a relatively small substrate area for power monitoring, reducing the overall size of the optical engine. The laser projector or the optical engine can therefore be flexibly employed in a variety of display designs, including wearable heads-up displays or other head-mounted displays.
In some embodiments, after passing through the exit window, the light beams are passed through respective collimating lenses to a dichroic filtebeam combiner, at which light beams of different wavelengths are combined. The combined light beams may then be directed to one or more scanning elements that project the light beams across a display surface of an object, such as the holographic lens of a pair of smart glasses or another type of wearable heads-up display.
While various embodiments described are provided in the context of a wearable heads-up display, it should be understood that the laser projector and optical engine of the present patent application can instead be included in other systems, such as projection engines, lidar systems, sensing systems, ranging systems, external cavity laser diodes (e.g., as an integrated intensity stabilization servo), and/or the like.
It is generally desirable to monitor the laser output power of the laser sources of the optical engine of the laser projector, which allows for improved control over the quality of the projected image or video and enables a controller or processor of the device that includes the laser projector to dynamically limit the maximum output power of the optical engine based on real-time or near-real-time measurements of the laser output power.
For example, laser output power monitoring tends to be particularly important for the design of laser projectors used in wearable heads-up displays due to the generally limited availability of power and space (e.g., volume) in such wearable devices. Conventional methods for designing a laser projector with laser output power monitoring capabilities require a relatively large footprint on the laser projector substrate, which may be a printed circuit board (PCB) to be dedicated to the placement of a photodetector such as a photodiode, to the placement of optical components such as a pickoff mirror, and to maintaining a clear optical path to the photodetector.
In some instances, this footprint may be as large as that of the optical engine itself. Accordingly, it would be advantageous to reduce the substrate area taken up by the photodetector(s) and/or optical component(s) (sometimes referred to collectively herein as “laser output power monitoring component(s)”) that implement laser output power monitoring for an optical engine of a laser projector.
The systems, devices, and techniques described in the patent application may provide a reduction in the substrate area required for laser power output monitoring components, e.g. by utilizing an exit window of an enclosure of an optical engine having e.g. a diffraction grating that may be disposed in or on a primary output surface of the exit window and that may redirect (e.g., via diffraction) a portion of the incident light from the laser light beam(s) output by the laser source(s) toward one or more photodetectors, which may be photodiodes, and which may be disposed across from one or more surfaces of the exit window.
According to various embodiments, the exit window includes a diffraction grating that can be disposed or formed on or in the exit window, and that redirects the incident light from the laser sources toward the one or more photodetectors. In some embodiments, one or more photodetectors may be disposed on a top surface of the substrate so as to receive light that is redirected by the diffraction grating and that is output through a one or both side walls of the exit window. A “side wall” or “side surface” of the exit window may be defined as a surface of the exit window that extends between the primary input surface of the exit window and the primary output surface of the exit window that defines a plane that intersects (e.g., that is perpendicular to) the surface of the substrate upon which the optical engine is disposed.
In some embodiments, one or more photodetectors may be disposed below the exit window and completely or partially embedded in the substrate, such that the one or more photodetectors receive light that is redirected by the diffraction grating and that is output through a bottom surface of the exit window. In some embodiments, the exit window is disposed on a first side of the substrate and one or more photodetectors, which may be photodiodes, may be disposed below the exit window on a second side of the substrate that is opposite the first side, such that the one or more photodetectors receive light that is redirected by the diffraction grating and that is output through a bottom surface of the exit window, which passes through one or more apertures that extend through the entire thickness of the substrate to reach the one or more photodetectors. In some embodiments, one or more photodetectors may be disposed above the exit window on the surface of a second substrate that opposes the surface of the first substrate on which the window is disposed, such that the one or more photodetectors receive light that is redirected by the diffraction grating and that passes through a top surface of the window.
Google's patent FIG. 1 below is an illustrative diagram showing a side view of a wearable heads-up display (WHUD) #100 that employs a laser projector #110, which may be a scanning laser projector. For example, the WHUD 100 may be a pair of smartglasses or a virtual reality (VR) headset. The laser projector comprises an optical engine #111 that includes a red laser diode (labeled “R” in FIG. 1), a green laser diode (labeled “G” in FIG. 1), and a blue laser diode (labeled “B” in FIG. 1), and a scan mirror #112 that is controllably rotatable about two axes of freedom
Generally, it is desirable to monitor laser output power in the laser projector in order to better control the image or video projected onto the Holographic Optical Element (HOE) #130 (i.e., display surface) and to limit the maximum output power of the WHUD. Monitoring laser output power in a laser projector such as the laser projector is typically performed using a discrete pickoff component to redirect a portion of the laser light #120 to an on-chip photodetector. However, such laser output power monitoring approaches require a relatively large footprint on the laser projector substrate. In order to reduce the footprint of laser output power monitoring components, an exit window of an enclosure that includes some or all of the components of the optical engine may be configured to redirect a portion of the laser light through the top, bottom, or side walls of the exit window toward one or more photodetectors placed across from and in the optical path of the top, bottom, or side walls of the exit window.
2Google-smartglasses-fig.1
Google's patent FIG. 2 below is an isometric view of a wearable heads-up display with a laser projector that includes an optical engine.
3Google-smartglasses-figs-2&4
Google's patent FIG. 4 above is a block diagram of a top-down view of a laser projector having an optical engine that includes an exit window having a holographic diffraction grating.
For more details, review patent application US20240154379 published on May 9, 2024.
Inventors
Dan Adema: Opto Mechanical Engineer (formerly from 'North,' Kitchener, Ontario) Timothy Bodiya: AR Hardware Research (formerly from 'North')

New sticker?

If examiner gives you 2 solids and asks to separate they cannot be separated instantly, mostly one of them will be soluble for eg he gives you sand and NaCl and asks u to separate them, we know that sand is insoluble in water and NaCl is soluble so we will add water to both solids the NaCl will dissolve then we will take a filter funnel on a conical flask , place a filter paper on it and pour the solution, the insoluble sand will be collected on the filter paper as residue and the salt solution will flow through as filtrate. Now here he can ask two things 1. NaCl in crystal form 2.Nacl in powder form. 1) heat the NaCl solution to crystallization pint and allow the remaining liquid to slowly cool or evaporate, after some time crystals will be formed and we can just filter them and dry them by tapping with filter paper or in an oven. 2) Just heat the salt solution till constant mass nothing else.
now for the sand that we got although we have separated it, it may contain some soluble impurities of NaCl, which we do not want so we wash the sand with "DISTILLED" water and then dry it by using filter paper.
Also for the crystals that we got for the NaCl, please do not wash them with any water as NaCl is soluble in water so they will dissolve again. everything i wrote is for understanding the process in exam please summarize this.
Liquid+Solid If solid is insoluble just filter it and wash with distilled water to remove any soluble impurities and dry it
if solid is soluble we will do simple distillation. please do not sit there write the whole setup just draw the distillation diagram and label it (a picture speaks a thousand words) showing the heat source the round bottom flask the condenser with water in and water out and thermometer labelled, the solid will remain in the flask and the water or liquid will be evaporated and and then condenser and collect in the beaker at the other end.
PLEASE IF IT IS A ORGANIC LIQUID THAT WE ARE SEPARATING DO NOT USE A BUNSEN BURNER TO HEAT THE FLASK AS THEY ARE HIGHLY FLAMMABLE. use an electric heater or a thermostatically controlled water bath. also please make sure that whatever the liquid being separated, its boiling point should be below 100 degrees or we cannot use water to separate it as the water we are using in the condenser to condense the liquid will evaporate itself.
Liqud+Liquid if both are immiscible meaning they form layers and do not mix. use a separating funnel and pour one the more dense one off as it will settle at the bottom. if asked why are we able to separate them in this way, the answer to that is because both liquids have different density.
if both are miscible, then just write we will use fractionating column please do not sit there mentioning the details just draw a rough diagram including the round bottom flask, fractionating column, thermometer, Liebig condenser with water in and out marked, beads in the fractionating column to allow only particles with more energy to pass through and particles with less energy meaning lower temp to fall back in to the flask and a beaker in the end to collect the separated liquid.
if GAS + GAS then first step is to liquify them, which is done by lowering their temp, and then we will again be facing a liquid + liquid (miscible) so we will then do fractional distillation to separate them.
if both gases have different MOLECULAR MASS then we easy way to separate them is by diffusion. Gas with lower Mr will diffuse faster hence can be separated
hope everyone understands :)

Looking for basic example AWS example diagrams for practising such as label the diagram, for example EC2, Private subnet, auto scaling group, load balancer to help with understanding/ passing tests etc. Any recommendations?

I just ran my wiring harness to my board but the labeling does not match of the voron wiring diagram for Spider Board
I’m left with GD - Ground 24v - 24v line H0 - hotend heater 0
I have nothing hooked up to my extruder heater post yet which I assume these in some configuration go to.
Also for the XY end stop PCB the wiring on the connectors are in a different pin then the voron wiring guide and it doesn’t say which is x and which is y just 4 colors