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<title>03 November, 2023</title>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>A preliminary mindsponge-based analysis of Generation Z’s relationship with technologies</strong> -
<div>
In terms of human-machine relationship, Gen Z, those who were born between 1997-2012, is the first generation who becomes productive members of society under so much technological disruption in a short period of time. For example, as a consequence of remote work caused by the COVID-19 pandemic, the global industry of emotional AI is forecasted to almost double from $19.5 in 2020 to $37.1 billion by 2026, at the compound annual growth rate of 11.3% in this period, according to Markets and Markets (Madhumita, 2021). Consequently, as Gen Z is poised to become the largest demographics for entry-level jobs (Pichler, Kohli &amp; Granitz, 2021), they are expected to confront with a so much uncertain time of the various effects of emotion auto-tracking practices on mental and physical health, productivity, security, etc., have only gathered research interests in recent years. In this essay, using the mindsponge framework (Vuong and Napier, 2015), I reflect on the relationship of Gen Z with emotional AI technologies.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/c864d/" target="_blank">A preliminary mindsponge-based analysis of Generation Z’s relationship with technologies</a>
</div></li>
<li><strong>Yếu tố văn hóa và tâm lý của Việt Nam trong ứng phó với COVID-19</strong> -
<div>
This paper points out some notable cultural and psychological factors that contribute to the success of Vietnam’s COVID-19 response.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/6w2sf/" target="_blank">Yếu tố văn hóa và tâm lý của Việt Nam trong ứng phó với COVID-19</a>
</div></li>
<li><strong>Learnings From The Case of Maple Refugees: A Story of Loot Boxes, Probability Disclosures, and Gamer Consumer Activism</strong> -
<div>
The article synthesises what we learned from reviewing the player activism of the “Maple refugee” incident and applies the insights to the European video game industry and commercial context. The Maple Refugee incident was perhaps one of the most disruptive video game incidents that occurred in South Korea in recent years. It saw tens of thousands of Korean players from the game Maple Story (Nexon, 2003) mobilised in unprecedented online and offline protests in Spring 2021. Together with players from other free-to-play (F2P) games, Maple Story players rallied against the industry norms of monetising with loot boxes and the industry self-regulatory approach to probability disclosures to address potential harms. This culminated in the social phenomenon of the proxy activism method of ’truck protests,’ rallies of crowdfunded rented trucks displaying protest messages instead of people mass-gathering in public during the COVID-19 pandemic. Based on the English timeline of the incident collated by Park et al. (2023), we dive deeper into the case with a multidisciplinary group of experts from game studies, law, and human-computer interaction and highlight various issues present in this case: the regulation of loot boxes and probability disclosures, the social pillars of player activism, player trust and theorycrafting, and game production. The paper contributes to the deepening of the industry’s understanding of F2P game business while diversifying the Western-centric discourse of the game research landscape by calling for further cross-cultural and cross-disciplinary inquiries into current video game issues.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/pmk2j/" target="_blank">Learnings From The Case of Maple Refugees: A Story of Loot Boxes, Probability Disclosures, and Gamer Consumer Activism</a>
</div></li>
<li><strong>Comparison of timing of booster vaccination for COVID-19 to prevent severe disease by risk group in the United States</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
While waning protection from vaccination and natural infection against SARS-CoV-2 infection is well-documented, recent analyses have also found waning of protection against severe COVID-19. This highlights a broader need to understand how different frequency of COVID-19 booster vaccines may mitigate the risk of severe COVID-19, while accounting for waning of protection and differential risk by age and immune status. Here we show that more frequent COVID-19 booster vaccination (every 6-12 months) in older age groups and the immunocompromised population would effectively reduce the burden of severe COVID-19, while frequent boosters in the younger population may only provide modest benefit against severe disease. Analyzing United States COVID-19 surveillance and seroprevalence data in a microsimulation model, we estimated that in persons 75+ years, annual and semiannual boosters would reduce annual absolute risk of severe COVID-19 by 199 (uncertainty interval: 188-229) and 368 (344-413) cases per 100,000 persons, respectively, compared to a one-time booster dose. In contrast, for persons 18-49 years, the model estimated that annual and semiannual boosters would reduce annual absolute risk of severe COVID-19 by 14 (11-19) and 26 (21-35) cases per 100,000 persons, respectively, compared to a one-time booster dose. Persons with prior infection had lower benefit of more frequent boosting, while immunocompromised persons had larger benefit. Scenarios with emerging variants with immune evasion increased the benefit of more frequent variant-targeted boosters. This study underscores the benefit of considering key risk factors to inform frequency of COVID-19 booster vaccines in public health guidance, and ensuring at least annual boosters in high-risk populations.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.10.23292473v2" target="_blank">Comparison of timing of booster vaccination for COVID-19 to prevent severe disease by risk group in the United States</a>
</div></li>
<li><strong>Neglected consequences of spatio-temporal heterogeneity and dispersal: Metapopulations, the inflationary effect, and real-world consequences for public health</strong> -
<div>
The metapopulation perspective is an important conceptual framework in ecology, biogeography, and evolutionary ecology. Metapopulations are spatially distributed populations linked by dispersal. Both metapopulation models and their community and ecosystem level analogues, metacommunity and meta-ecosystem models, tend to be more stable regionally than locally and display an enhancement in abundance because of the interplay of spatio-temporal heterogeneity and dispersal (an effect that has been called the "inflationary effect"). We highlight the essential role of spatio-temporal heterogeneity in metapopulation biology, sketch empirical demonstrations of the inflationary effect, and provide a mechanistic interpretation of how the inflationary effect arises and impacts population growth and abundance. The spread of infectious disease is used to illustrate how this effect, emerging from the interplay of spatiotemporal variability and dispersal, can have serious real-world consequences. Namely, failure to recognize the full possible effects of spatio-temporal heterogeneity likely enhanced the spread of COVID-19, and a comparable lack of understanding of emergent population processes at large scales may hamper the control and eradication of other infectious diseases. We finish by noting how the effects of spatio-temporal heterogeneity, including the inflationary effect, have implicitly played roles in many traditional themes in the history of ecology. The inflationary effect is implicit in processes explored in subdisciplines as far ranging as natural enemy-victim dynamics, species coexistence, and conservation biology. Seriously confronting the complexity of spatiotemporal heterogeneity has the potential to push many of these subdisciplines forward.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.30.564450v1" target="_blank">Neglected consequences of spatio-temporal heterogeneity and dispersal: Metapopulations, the inflationary effect, and real-world consequences for public health</a>
</div></li>
<li><strong>Experiencing herd immunity in virtual reality increases COVID-19 vaccination intention: Evidence from a large-scale field intervention study</strong> -
<div>
This study investigates the impact of an immersive virtual reality (VR) simulation of herd immunity on vaccination intentions and its potential underlying mechanisms. In this preregistered field study, N = 654 participants were randomly assigned to one of the three VR conditions: (1) Gamified Herd Immunity; (2) Gamified Herd Immunity + Empathy (with additional narrative elements); (3) Control (gamified with no vaccination-related content). In the Gamified Herd Immunity simulation, participants embodied a vulnerable person and navigated the wedding venue trying to avoid getting infected. A total of n = 455 participants with below maximum intentions to take a novel vaccine and without severe cybersickness symptoms were included in the analyses. The Gamified Herd Immunity + Empathy and the Gamified Herd Immunity conditions increased vaccination intentions by 6.68 and 7.06 points on a 0-100 scale, respectively, compared to 1.91 for the Control condition. The Gamified Herd Immunity + Empathy condition enhanced empathy significantly more than the Gamified Herd Immunity condition but did not result in higher vaccination intentions. The results suggest that immersive VR vaccination communication can effectively increase COVID-19 vaccine intentions; the effect is not solely a consequence of the technological experience itself and does not depend on empathy.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/psyarxiv/68wqn/" target="_blank">Experiencing herd immunity in virtual reality increases COVID-19 vaccination intention: Evidence from a large-scale field intervention study</a>
</div></li>
<li><strong>Discontinuous or Kinked Response? Dynamics of Unemployment Insurance and Public Assistance under the COVID-19 Crisis</strong> -
<div>
This study investigates the responsiveness of Unemployment Insurance (UI) and Public Assistance (PA) programs during the COVID-19 employment shock in Japan. Estimating “excess” UI and PA caseloads under the COVID-19 crisis, we reveal heterogeneous responses to the COVID-19 shock: UI caseloads exhibit an instantaneous and discontinuous increase and subsequent decrease, while PA caseloads show a kinked and incremental increase. These contrasting safety net responses highlight a potential delay in safety net support for workers who are not eligible for UI benefits when a large employment shock occurs.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/vs8tr/" target="_blank">Discontinuous or Kinked Response? Dynamics of Unemployment Insurance and Public Assistance under the COVID-19 Crisis</a>
</div></li>
<li><strong>Exploring the landscape of the genomic wastewater surveillance ecosystem: a roadmap towards standardization</strong> -
<div>
The landscape of genomic wastewater surveillance in the context of infectious disease monitoring is rapidly evolving, and this came into sharp focus during the COVID-19 pandemic. Here we highlight the significance of wastewater surveillance as a passive monitoring system complementary to clinical genomic surveillance activities. Emphasizing the need for coordination, standardization, and the development of a unified catalog of software tools and services, we aim to streamline the implementation of end-to-end genomic wastewater surveillance pipelines. Key considerations such as defining variants, understanding antimicrobial resistance, and assessing viral fitness within the framework of wastewater surveillance are explored, linking to examples of respective tools and existing pipelines. The challenges of wastewater data analysis, the need for specialized tools and bioinformatics workflows, and the significance of integrated pipelines are also discussed in detail. The article presents case studies, including the V-pipe integrated bioinformatics workflow and the integration of tools into the Galaxy platform, underscoring their role in enhancing data analysis efficiency and standardization within the field. Overall, the review highlights the critical importance of continued research efforts to advance understanding and implementation of bioinformatic approaches in wastewater surveillance for the effective monitoring and management of infectious diseases.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/biohackrxiv/rtgk9/" target="_blank">Exploring the landscape of the genomic wastewater surveillance ecosystem: a roadmap towards standardization</a>
</div></li>
<li><strong>Gods Lockdown: the effect of the April 2022 Colorado low blizzard on SARS-Cov-2 transmission in the midwest United States</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Lockdowns have been used as a primary non-pharmaceutical intervention to stop transmission of COVID19. There are many issues with interpreting the causal effects of most of these intentional, policy driven interventions. We leverage a natural experiment to avoid many of these issues to better understand the direct effects of lockdown like conditions on COVID19 transmission. Methods: We exploit a blizzard that interrupted activity across several midwestern states in April 2022. This blizzard broke records for snowfall and caused economic disruption. We leverage this to create control and treatment counties that were more or less affected by the snowfall. We demonstrate effects using event studies comparing these treatment and control counties. Results: We find that mobility within treatment counties was severely curtailed as a result of the blizzard relative to control counties. We find cumulative declines in the number of COVID19 cases per country by 400 and cumulative declines in COVID19 deaths by 1 per county over the 30 days after the storm. We find declines in by one per hospitalization due to COVID19. Conclusions: The April 2022 blizzard caused disruption in activity across the midwest United States akin to a lockdown. It reduced the number of COVID19 cases, deaths, and hospitalizations in treatment counties relative to control counties suggesting that similar policies do limit transmissions of SARS-Cov-2.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.01.23297908v1" target="_blank">Gods Lockdown: the effect of the April 2022 Colorado low blizzard on SARS-Cov-2 transmission in the midwest United States</a>
</div></li>
<li><strong>Phylogenetic meta-analysis of chronic SARS-CoV-2 infections in immunocompromised patients shows no evidence of elevated evolutionary rates</strong> -
<div>
Genomic sequences from rapidly evolving pathogens, sampled over time, hold information on disease origin, transmission, and evolution. Together with their sampling times, sequences can be used to estimate the rates of molecular evolution and date evolutionary events through molecular tip-dating. The validity of this approach, however, depends on whether detectable levels of genetic variation have accumulated over the given sampling interval, generating temporal signal. Moreover, different molecular dating methods have demonstrated varying degrees of systematic biases under different biologically realistic scenarios, such as the presence of phylo-temporal clustering. Chronic SARS-CoV-2 infection in immunocompromised patients has been linked to remarkably higher intra-host molecular rates than those of global lineages, facilitating the emergence of novel viral lineages. Yet, most studies reporting accelerated rates lack the evaluation of temporal signal or comparison of multiple methods of inference, both required to reliably estimate molecular rates. In this study, we use 26 previously published longitudinally sampled sequence series obtained from chronically infected immunocompromised patients to re-evaluate the rate of SARS-CoV-2 intrahost evolution. Using a range of methods, we analyse the strength of temporal signal and infer evolutionary rates from tip-calibrated phylogenies. Regardless of heterogeneity in rate estimates between sample series and methods, we find within-host rates to be in good agreement with rates derived from host-to-host transmission chains. Our findings suggest that when certain limitations of the methodology are disregarded, such as the underlying assumption of phylogenetic independence or the method's sensitivity to phylo-temporal grouping, evolutionary rates can be substantially overestimated. We demonstrate that estimating within-host rates is a challenging question necessitating careful interpretation of findings. While our results do not support faster evolution across the complete viral genome during chronic SARS-CoV-2 infection, prolonged viral shedding together with relapsing viral load dynamics may nevertheless promote the emergence of new viral variants in immunocompromised patients.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.01.565087v1" target="_blank">Phylogenetic meta-analysis of chronic SARS-CoV-2 infections in immunocompromised patients shows no evidence of elevated evolutionary rates</a>
</div></li>
<li><strong>SARS-CoV-2 infection leads to sustained testicular injury and functional impairments in K18 hACE2 mice</strong> -
<div>
Compromised male reproductive health is one of the symptoms of long COVID with a decrease in male fertility markers including testosterone levels and sperm count for months in recovering patients. However, the long-term impact of SARS-CoV-2 infection on testicular injury and underlying mechanisms remains unknown. We previously demonstrated a disrupted tissue architecture with no evidence of virus replication in the testis during the acute stage of the disease in K18-hACE2 mice. Here, we systematically delineate the consequences of SARS-CoV-2 infection on the testis injury and function both during the acute stage of the disease and up to 4 weeks after recovery in survivor K18-hACE2 mice. The gross morphological defects included sloughing of healthy spermatids and spermatocytes into the lumen, lack of lumen, and increase in apoptotic cells that sustained for at least 2 weeks after infection. Testis injury correlated with systemic and testicular inflammation, and infiltration of immune cells in the interstitial space and seminiferous tubules. Transcriptomic analysis identified dysregulation of key pathways associated with testicular immune homeostasis, spermatogenesis, and cell death at the symptomatic stage and immediately after recovery. Further, a significant reduction in testosterone levels was associated with transient reduction in sperm count and mouse fertility. Most of the testicular impairments except testosterone levels were resolved within 4 weeks, which is almost one spermatogenesis cycle in mice. These findings provide much-needed mechanistic insights beyond our current understanding of testicular pathogenesis, suggesting that recovering COVID-19 patients should be closely monitored to rescue the pathophysiological effects on male reproductive health.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.31.565042v1" target="_blank">SARS-CoV-2 infection leads to sustained testicular injury and functional impairments in K18 hACE2 mice</a>
</div></li>
<li><strong>Pervasive aggregation and depletion of host and viral proteins in response to cysteine-reactive electrophilic compounds</strong> -
<div>
Protein homeostasis is tightly regulated, with damaged or misfolded proteins quickly eliminated by the proteasome and autophagosome pathways. By co-opting these processes, targeted protein degradation technologies enable pharmacological manipulation of protein abundance. Recently, cysteine-reactive molecules have been added to the degrader toolbox, which offer the benefit of unlocking the therapeutic potential of undruggable protein targets. The proteome-wide impact of these molecules remains to be fully understood and given the general reactivity of many classes of cysteine-reactive electrophiles, on- and off-target effects are likely. Using chemical proteomics, we identified a cysteine-reactive small molecule degrader of the SARS-CoV-2 non-structural protein 14 (nsp14), which effects degradation through direct modification of cysteines in both nsp14 and in host chaperones together with activation of global cell stress response pathways. We find that cysteine-reactive electrophiles increase global protein ubiquitylation, trigger proteasome activation, and result in widespread aggregation and depletion of host proteins, including components of the nuclear pore complex. Formation of stress granules was also found to be a remarkably ubiquitous cellular response to nearly all cysteine-reactive compounds and degraders. Collectively, our study sheds light on complexities of covalent target protein degradation and highlights untapped opportunities in manipulating and characterizing proteostasis processes via deciphering the cysteine-centric regulation of stress response pathways.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.30.564067v1" target="_blank">Pervasive aggregation and depletion of host and viral proteins in response to cysteine-reactive electrophilic compounds</a>
</div></li>
<li><strong>Stability of DNA-Methylation Profiles of Biological Aging in Children and Adolescents</strong> -
<div>
Background and Objectives. Methylation profile scores (MPSs) index biological aging and aging-related disease in adults and are cross-sectionally associated with social determinants of health in childhood. MPSs thus provide an opportunity to trace how aging-related biology responds to environmental changes in early life. Information regarding the stability of MPSs in early life is currently lacking. Method. We use longitudinal data from children and adolescents ages 8-18 (N = 428, M age = 12.15 years) from the Texas Twin Project. Participants contributed two waves of salivary DNA-methylation data (mean lag = 3.94 years), which were used to construct four MPSs reflecting multi-system physiological decline and mortality risk (PhenoAgeAccel and GrimAgeAccel), pace of biological aging (DunedinPACE), and cognitive function (Epigenetic-g). Furthermore, we exploit variation among participants in whether they were exposed to the COVID-19 pandemic during the course of study participation, in order to test how a historical period characterized by environmental disruption might affect children's aging-related MPSs. Results. All MPSs showed moderate longitudinal stability (test-retest rs = 0.42, 0.44, 0.46, 0.51 for PhenoAgeAccel, GrimAgeAccel, and Epigenetic-g, and DunedinPACE, respectively). No differences in the stability of MPSs were apparent between those whose second assessment took place after the onset of the COVID-19 pandemic vs. those for whom both assessments took place prior to the pandemic. Conclusions. Aging-related DNA-methylation patterns are less stable in childhood than has been previously observed in adulthood. Further developmental research on the methylome is necessary to understand which environmental perturbations in childhood impact trajectories of biological aging and when children are most sensitive to those impacts.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.30.564766v1" target="_blank">Stability of DNA-Methylation Profiles of Biological Aging in Children and Adolescents</a>
</div></li>
<li><strong>Incorporation of 5 methylcytidine alleviates innate immune response to self-amplifying RNA vaccine</strong> -
<div>
In order to improve vaccine effectiveness and safety profile of existing synthetic RNA-based vaccines, we have developed a self-amplifying RNA (saRNA)-based vaccine expressing membrane-anchored receptor binding domain (RBD) of SARS-CoV-2 S protein (S-RBD) and have demonstrated that a minimal dose of this saRNA vaccine elicits robust immune responses. Results from a recent clinical trial with 5-methylcytidine (5mC) incorporating saRNA vaccine demonstrated reduced vaccine-induced adverse effects while maintaining robust humoral responses. In this study, we investigate the mechanisms accounting for induction of efficient innate and adaptive immune responses and attenuated adverse effects induced by the 5mC-incorporated saRNA. We show that the 5mC-incorporating saRNA platform leads to prolonged and robust expression of antigen, while induction of type-I interferon (IFN-I), a key driver of reactogenicity, is attenuated in peripheral blood mononuclear cells (PBMCs), but not in macrophages and dendritic cells. Interestingly, we find that the major cellular source of IFN-I production in PBMCs is plasmacytoid dendritic cells (pDCs), which is attenuated upon 5mC incorporation in saRNA. In addition, we demonstrate that monocytes also play an important role in amplifying proinflammatory responses. Furthermore, we show that the detection of saRNA is mediated by a host cytosolic RNA sensor, RIG-I. Importantly, 5mC-incorporating saRNA vaccine candidate produced robust IgG responses against S-RBD upon injection in mice, thus providing strong support for the potential clinical use of 5mC-incorporating saRNA vaccines.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.01.565056v1" target="_blank">Incorporation of 5 methylcytidine alleviates innate immune response to self-amplifying RNA vaccine</a>
</div></li>
<li><strong>SARS-CoV-2 spike protein induces the cytokine release syndrome by stimulating T cells to produce more IL-2</strong> -
<div>
Cytokine release syndrome (CRS) is one of the leading causes of mortality in COVID-19 patients caused by the SARS-CoV-2 coronavirus. However, the mechanism of CRS induced by SARS-CoV-2 is vague. This study shows that dendritic cells loaded with spike protein of SARS-CoV-2 stimulate T cells to release much more IL-2, which subsequently cooperates with spike protein to facilitate peripheral blood mononuclear cells to release IL-1{beta}, IL-6, and IL-8. These effects are achieved via IL-2 stimulation of NK cells to release TNF- and IFN-{gamma}, as well as T cells to release IFN-{gamma}. Mechanistically, IFN-{gamma} and TNF- enhance the transcription of CD40, and the interaction of CD40 and its ligand stabilizes the membrane expression of TLR4 which serves as a receptor of spike protein on the surface of monocytes. As a result, there is a constant interaction between spike protein and TLR4, leading to continuous activation of NF-{kappa}B. Furthermore, TNF- also activates NF-{kappa}B signaling in monocytes, which further cooperates with IFN-{gamma} and spike protein to modulate NF-{kappa}B-dependent transcription of CRS-related inflammatory cytokines. Targeting TNF-/IFN-{gamma} in combination with TLR4 may represent a promising therapeutic approach for alleviating CRS in individuals with COVID-19.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.01.565098v1" target="_blank">SARS-CoV-2 spike protein induces the cytokine release syndrome by stimulating T cells to produce more IL-2</a>
</div></li>
</ul>
<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pilot Randomized Study of RD-X19 Tx Device in Subjects With PCC (Long Covid) in the Outpatient Setting</strong> - <b>Conditions</b>: Post COVID-19 Condition (PCC) <br/><b>Interventions</b>: Device: RDX-19 <br/><b>Sponsors</b>: KNOWBio Inc.; NAMSA <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>CPAP Therapy Through a Helmet or an Oronasal Mask in Patients With Acute Hypoxemic Respiratory Failure: Cross-over Study</strong> - <b>Conditions</b>: Pneumonia, Bacterial; Respiratory Failure; COVID-19 Pneumonia <br/><b>Interventions</b>: Diagnostic Test: Arterial blood gases; Diagnostic Test: Respiratory rate (RR); Diagnostic Test: Pulseoximeter; Diagnostic Test: Assessment of accessory respiratory muscles work; Diagnostic Test: Esophageal pressure measurement; Diagnostic Test: Discomfort Visual Analog Scale (VAS); Diagnostic Test: Noninvasive blood pressure; Diagnostic Test: Heart rate <br/><b>Sponsors</b>: I.M. Sechenov First Moscow State Medical University <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A PhaseⅡ Study to Evaluate the Safety and Immunogenicity of SARS-CoV-2 (COVID-19) Vaccine( ZSVG-02-O)</strong> - <b>Conditions</b>: SARS-CoV-2 Infection <br/><b>Interventions</b>: Biological: COVID-19 mRNA Vaccine (ZSVG-02-O); Biological: COVID-19 mRNA Vaccine (ZSVG-02-O); Biological: COVID-19 Vaccine (Vero Cell) ,Inactivated <br/><b>Sponsors</b>: CNBG-Virogin Biotech (Shanghai) Ltd. <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Investigation of Efficacy and Safety of Electrical Signal Therapy Provided by Dr Biolyse® Device in COVID-19 Disease</strong> - <b>Conditions</b>: COVID-19 Pneumonia; Virus Diseases; COVID-19 <br/><b>Interventions</b>: Device: Signal Therapy provided by Dr.Biolyse device; Other: Liquid Support Treatment <br/><b>Sponsors</b>: AVB Biotechnology <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A PhaseⅠ Study to Evaluate the Safety and Immunogenicity of SARS-CoV-2 (COVID-19) Vaccine( ZSVG-02-O)</strong> - <b>Conditions</b>: SARS-CoV-2 Infection <br/><b>Interventions</b>: Biological: COVID-19 mRNA Vaccine (ZSVG-02-O); Biological: Placebo; Biological: COVID-19 Vaccine (Vero Cell) ,Inactivated <br/><b>Sponsors</b>: CNBG-Virogin Biotech (Shanghai) Ltd.; Shulan (Hangzhou) Hospital <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SAFE Workplace Intervention for People With IDD</strong> - <b>Conditions</b>: Developement of Infectious Airborne Disease Prevention Workplace Curriclulm <br/><b>Interventions</b>: Behavioral: SAFE Employment Training <br/><b>Sponsors</b>: Temple University; National Institute on Disability, Independent Living, and Rehabilitation Research <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effects of an EMDR Intervention on Traumatic and Obsessive Symptoms</strong> - <b>Conditions</b>: Adult ALL; Post-traumatic Stress Disorder; Obsessive-Compulsive Disorder; Disgust; Guilt; Shame <br/><b>Interventions</b>: Behavioral: EMDR <br/><b>Sponsors</b>: University of Pisa <br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Lithium Long COVID Dose-finding Study</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Dietary Supplement: Lithium <br/><b>Sponsors</b>: State University of New York at Buffalo <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pharmacokinetics and Safety of GST-HG171 Tablets in Subjects With Impaired and Normal Renal Function</strong> - <b>Conditions</b>: COVID-19 Pneumonia <br/><b>Interventions</b>: Drug: GST-HG171 Tablets <br/><b>Sponsors</b>: Fujian Akeylink Biotechnology Co., Ltd. <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Preoperative Educational Videos on Maternal Stress Whose Children Received Congenital Heart Disease Surgery: During COVID-19 Panic</strong> - <b>Conditions</b>: COVID-19; Educational Videos; Maternal; Uncertainty; Anxiety; Depression; Congenital Heart Disease; Children <br/><b>Interventions</b>: Other: Preoperative educational videos plus routine education; Other: Preoperative routine education <br/><b>Sponsors</b>: Chung Shan Medical University <br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pharmacokinetics and Safety of GST-HG171 Tablets in Subjects With Impaired and Normal Liver Function</strong> - <b>Conditions</b>: COVID-19 Pneumonia <br/><b>Interventions</b>: Drug: GST-HG171 Tablets <br/><b>Sponsors</b>: Fujian Akeylink Biotechnology Co., Ltd. <br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Concordance Between Exhaled Air Test (eBAM-CoV) and RT-PCR to Detect SARS-CoV-2</strong> - <b>Conditions</b>: SARS-CoV-2 Infection; COVID-19; Coronavirus <br/><b>Interventions</b>: Device: eBAM Cov Testing <br/><b>Sponsors</b>: Centre Hospitalier Universitaire de Nīmes; University of Nimes; brains’ laboratory sas, FRANCE <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study to Safety, Tolerability and Immunogenicity of EG-COVII in Healthy Adult</strong> - <b>Conditions</b>: COVID-19 <br/><b>Interventions</b>: Biological: EG-COVII <br/><b>Sponsors</b>: EyeGene Inc. <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pharmacokinetics and Bioequivalence of Aterixen 100 mg Tablets and Aterixen 100 mg Film-coated Tablets in Healthy Volunteers</strong> - <b>Conditions</b>: Viral Infection COVID-19 <br/><b>Interventions</b>: Drug: Aterixen <br/><b>Sponsors</b>: Valenta Pharm JSC <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Practical RCT of TCM in the Treatment of LCOVID and Analysis of Syndrome Types and Medication Characteristics.</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Drug: Traditional Chinese medicine treatment; Drug: Western medicine treatment <br/><b>Sponsors</b>: Chinese University of Hong Kong <br/><b>Not yet recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Promising role of Vitamin D and plant metabolites against COVID-19: Clinical trials review</strong> - Vitamin D possesses immunomodulatory qualities and is protective against respiratory infections. Additionally, it strengthens adaptive and cellular immunity and boosts the expression of genes involved in oxidation. Experts suggested taking vitamin D supplements to avoid and treat viral infection and also COVID-19, on the other hand, since the beginning of time, the use of plants as medicines have been vital to human wellbeing. The WHO estimates that 80 % of people worldwide use plants or herbs…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Plant-Derived Antioxidants for Management of COVID-19: A Comprehensive Review of Molecular Mechanisms</strong> - We aimed to review the literature to introduce some effective plant-derived antioxidants to prevent and treat COVID-19. Natural products from plants are excellent sources to be used for such discoveries. Among different plant-derived bioactive substances, components including luteolin, quercetin, glycyrrhizin, andrographolide, patchouli alcohol, baicalin, and baicalein were investigated for several viral infections as well as SARS-COV-2. The mechanisms of effects detected for these agents were…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SARS-CoV-2 viral persistence in lung alveolar macrophages is controlled by IFN-γ and NK cells</strong> - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA generally becomes undetectable in upper airways after a few days or weeks postinfection. Here we used a model of viral infection in macaques to address whether SARS-CoV-2 persists in the body and which mechanisms regulate its persistence. Replication-competent virus was detected in bronchioalveolar lavage (BAL) macrophages beyond 6 months postinfection. Viral propagation in BAL macrophages occurred from cell to cell and was…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A novel cell-permeable peptide prevents protein sumoylation and supports the mislocalization and aggregation of TDP-43</strong> - SUMOylation is a post-translational modification (PTM) that exerts a regulatory role in different cellular processes, including protein localization, aggregation, and biological activities. It consists of the dynamic formation of covalent isopeptide bonds between a family member of the Small Ubiquitin Like Modifiers (SUMOs) and the target proteins. Interestingly, it is a cellular mechanism implicated in several neurodegenerative pathologies and potentially it could become a new therapeutic…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Much ado about nothing? Discrepancy between the available data on the antiviral effect of hydroxychloroquine in March 2020 and its inclusion in COVID-19 clinical trials and outpatient prescriptions</strong> - CONCLUSIONS: The number and size of (H)CQ clinical trials for COVID-19 launched in 2020 were not supported by the literature published before April 2020.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Type 1 interferon auto-antibodies are elevated in patients with decompensated liver cirrhosis</strong> - Patients with decompensated liver cirrhosis, in particular those classified as Childs-Pugh class C, are at increased risk of severe COVID-19 upon infection with SARS-CoV-2. The biological mechanisms underlying this are unknown. We aimed to examine the levels of serum intrinsic antiviral proteins as well as alterations in the innate antiviral immune response in patients with decompensated liver cirrhosis. Serum from 53 SARS-CoV-2 unexposed and unvaccinated individuals, with decompensated liver…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Surface enhanced Raman scattering investigation of tecovirimat on silver, gold and platinum loaded silica nanocomposites: Theoretical analysis (DFT) and molecular modeling</strong> - As of today, there have been 612 million confirmed cases of coronavirus disease (COVID-19) around the world, with over 6 million fatalities. Tecovirimat (TPOXX) is an anti-viral drug, and it was the first drug approved for the treatment of anti-pox virus in the US. However, the effectiveness of this drug against COVID-19 has not yet been explored. Since TPOXX is an anti-viral drug, an attempt has been made to determine its ability to act as a COVID inhibitor. Recent medical advances have…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Plasma cell leukemia in a 34-year-old male: rare scenario case report</strong> - CONCLUSION: This report showcases a rare age presentation with unique manifestations of secondary plasma cell leukaemia. Multiple myeloma should be a differential diagnosis for cases with unexplained back pain despite an unclassical age.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Exploring Pharmacy Student Experiences with Student Debt and Perspectives on Future Burnout and Loan Relief</strong> - CONCLUSION: Pharmacy students burdened with debt described a variety of different experiences and attitudes toward that debt and provided their perspectives on how student debt influences short-term education and career decisions. While students accept the trade-off of debt for their education as an inevitable burden, reported coping mechanisms and strategies shared suggest some solutions may be available to ameliorate this burden.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Potential PDE4B inhibitors as promising candidates against SARS-CoV-2 infection</strong> - Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an RNA virus belonging to the coronavirus family responsible for coronavirus disease 2019 (COVID-19). It primarily affects the pulmonary system, which is the target of chronic obstructive pulmonary disease (COPD), for which many new compounds have been developed. In this study, phosphodiesterase 4 (PDE4) inhibitors are being investigated. The inhibition of PDE4 enzyme produces anti-inflammatory and bronchodilator effects in the lung…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Proteomic analyses of smear-positive/negative tuberculosis patients uncover differential antigen-presenting cell activation and lipid metabolism</strong> - CONCLUSION: Our study provides valuable insights into the differential molecular mechanisms underlying SNPT and SPPT, reveals the critical role of antigen-presenting cell activation in SNPT for effectively clearing the majority of Mtb in bodies, and shows the possibility of APC activation as a novel TB treatment strategy.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong><em>Antrodia cinnamomea</em> May Interfere with the Interaction Between ACE2 and SARS-CoV-2 Spike Protein in vitro and Reduces Lung Inflammation in a Hamster Model of COVID-19</strong> - CONCLUSION: AC shows potential as a nutraceutical for reducing the risk of SARS-CoV-2 infection by disrupting the interaction between ACE2 and the SARS-CoV-2 spike protein, and for preventing COVID-19-associated lung inflammation.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Computational Screening Using a Combination of Ligand-Based Machine Learning and Molecular Docking Methods for the Repurposing of Antivirals Targeting the SARS-CoV-2 Main Protease</strong> - CONCLUSION: Results demonstrated the efficiency of LBVS combined with MD. This combined strategy provided positive evidence showing that the top screened drugs, including CCX-140, which had the lowest MD score, can be reasonably advanced to the in vitro phase. This combined method may accelerate the discovery of therapies for novel or orphan diseases from existing drugs.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Defining neutralization and allostery by antibodies against COVID-19 variants</strong> - The changing landscape of SARS-CoV-2 Spike protein is linked to the emergence of variants, immune-escape and reduced efficacy of the existing repertoire of anti-viral antibodies. The functional activity of neutralizing antibodies is linked to their quaternary changes occurring as a result of antibody-Spike trimer interactions. Here, we reveal the conformational dynamics and allosteric perturbations linked to binding of novel human antibodies and the viral Spike protein. We identified epitope…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Impact of influenza immunity on the mortality among older adults hospitalized with COVID-19: a retrospective cohort study</strong> - It has been suggested that the outcomes of coronavirus disease 2019 (COVID-19) are better in individuals having recently received an influenza vaccine than in non-vaccinated individuals. We hypothesized that this association depends on the humoral responses against influenza viruses. We aim to assess the relationship between the humoral immunity against influenza and the 3-month all-cause mortality among hospitalized older patients with COVID-19. We performed an exploratory retrospective study…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Israel Is Splitting the Democrats</strong> - The Democratic coalition once seemed united in its staunch, unquestioning support for the country. Today, that consensus seems to be cracking. - <a href="https://www.newyorker.com/news/the-political-scene/how-israel-is-splitting-the-democrats">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Gaza-ification of the West Bank</strong> - As the war in Gaza escalates, so, too, has the forcible displacement of Palestinians in the West Bank. Is Israel’s approach to the two regions linked? - <a href="https://www.newyorker.com/news/q-and-a/the-gaza-ification-of-the-west-bank">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tim Scott’s Racial Absolution</strong> - The senator from South Carolina presents an early electoral victory—he became president of his high school, years after a “race riot”—as a tidy tale of prejudice overcome. Is that the full story? - <a href="https://www.newyorker.com/news/the-political-scene/tim-scotts-racial-absolution">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Not All of America’s National-Security Threats Are Overseas</strong> - Congress’s foreign-aid follies with Israel and Ukraine, and the fear of Trump in 2024. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/not-all-of-americas-national-security-threats-are-overseas">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Smoking Gun for Biden’s Big Climate Decision?</strong> - A new analysis suggests that L.N.G. exports may well be worse for the environment than burning coal. - <a href="https://www.newyorker.com/news/daily-comment/a-smoking-gun-for-bidens-big-climate-decision">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Patients don’t know how to navigate the US health system — and it’s costing them</strong> -
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<img alt="A woman in surgical mask and hair covering looks upward at a blackboard filled with white chalk question marks. " src="https://cdn.vox-cdn.com/thumbor/wDwJj0d1CDxr5KOeH2Nl7GdNnQo=/154x0:3951x2848/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72824523/GettyImages_185234355.0.jpg"/>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A crisis of confusion is making health care more expensive for many Americans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hpNtKq">
Of all the culprits that make it harder for Americans to afford and access <a href="https://www.vox.com/health-care">health care</a>, the sheer confusion many patients experience when trying to select an insurance plan or when faced with an expensive medical bill may be the most overlooked.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iVK09J">
That’s according to a <a href="https://www.fightcancer.org/sites/default/files/medical_debt_final_survey_results_report_10-30-23.pdf">recent survey from research firm Perry Undem</a>, which reveals the deep confusion Americans feel when receiving <a href="https://www.vox.com/health-care">health care</a> — confusion that could put them on the hook for higher costs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YQ1Tms">
US health care costs are dire enough as-is, and it’s easy to look at the data on <a href="https://www.healthsystemtracker.org/indicator/spending/prices-of-common-services/">US prices for common procedures</a> compared to the prices in other countries, or to compare the <a href="https://www.healthsystemtracker.org/indicator/access-affordability/out-of-pocket-spending/">out-of-pocket costs Americans typically must pay</a> for medical services under their insurance plan compared to their peers elsewhere and see the issue. It’s the prices, stupid, as some of the country’s leading health care economists <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.22.3.89">once described the problem</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pnGtvX">
And the prices are indeed a big part of the US health system’s shortcomings: Research <a href="https://www.vox.com/policy-and-politics/22276166/us-health-insurance-out-of-pocket-costs-research">has shown</a> that people will skip necessary care if they have even a small cost to pay, and recent surveys <a href="https://news.gallup.com/poll/468053/record-high-put-off-medical-care-due-cost-2022.aspx">find</a> one in three Americans say they have postponed medical treatment in the last year due to the cost.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Nki0dv">
The Perry Undem survey, which polled nearly 2,700 Americans on behalf of the American Cancer Society’s Cancer Action Network, the Leukemia and Lymphoma Society, and RIP Medical Debt, also detected widespread struggles to afford health care. About 7 in 10 people say they have received a medical bill that they could not afford, it found, and more than 60 percent of Americans said they had made some kind of sacrifice — delaying care, skipping appointments, changing the food they buy at the grocery store, etc. — in order to afford health care in the past two years.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8EHyn4">
But new data, from Perry Undem and from the health policy think tank KFF, further indicates that Americans have a lot of misconceptions about how their health care and insurance benefits are supposed to work, and could find themselves exposed to higher costs as a result. About 40 percent of people said they were always or frequently unsure how much their medical services would cost after they received care, according to the Perry Undem survey; another 30 percent said they were uncertain about the costs at least some of the time. Nearly two-thirds of US patients said they were at least sometimes unsure how much their insurance plan would cover after being treated.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PivJP8">
More than half of Americans said they were either always, frequently, or sometimes uncertain about whether they had been seen by an in-network provider when receiving medical care. If they were treated by an out-of-network doctor, most insurance plans will charge the patient more money out-of-pocket for those services.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="APJGQt">
Those front-end issues — seeing a doctor or receiving a service not covered by your insurance plan — can create big medical bills in the first place. But patients also often don’t know what to do when they receive an invoice they can’t afford.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MrAO0C">
Only 3 in 10 Americans said they had fought or appealed a medical bill they had received. The survey reveals wide disparities in who has actively worked to reduce their health care bills: Older Americans, people with a college education, and white Americans were roughly twice as likely to say they had contested a medical bill than young adults, people without a college education, or <a href="https://www.vox.com/race">Black Americans</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ED8ENR">
Why are so few Americans fighting back against exorbitant medical costs, even though 70 percent of those who did said they were successful in reducing their balance and experts like investigative journalist Marshall Allen have pleaded with patients to <a href="https://www.penguinrandomhouse.com/books/635536/never-pay-the-first-bill-by-marshall-allen/">“never pay the first bill”</a>?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vgV5xN">
Once again, confusion is to blame: 23 percent of respondents said they didn’t know they could fight a bill, 19 percent said they didn’t know the steps to take, 17 percent said that the process was overwhelming, and another 12 percent said they were too busy to contest a bill. Many Americans are also ignorant of the financial assistance that may be available to them: Nearly half of the people surveyed were not aware of the programs run by hospitals or physician practices that are meant to help patients pay their share of their bills. Only one in four said they had actually asked for or been offered such assistance.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4Z5yZb">
The findings of the Perry Undem survey — that patients are often overwhelmed by the complexity of the health care system and unaware of their options to reduce their own costs — are consistent with other recent studies. KFF’s Larry Levitt and Drew Altman recently <a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2811354">wrote in JAMA Forum</a> that complexity in US health care is “the enemy of access and affordability,” citing results from <a href="https://www.kff.org/mental-health/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/">a KFF survey taken over the summer</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ERySxe">
About 6 in 10 Americans said they had experienced a problem using their health insurance in the past year, according to KFF. People reported being unable to receive care, experiencing a decline in their health, and/or paying more than they expected for treatment as a result of those insurance problems. In findings similar to those of Perry Undem, the KFF survey found 60 percent of Americans didn’t know they can appeal a medical bill and three-quarters didn’t know which government agency to contact for help with insurance issues.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ckoId0">
“Complexity is [an] underappreciated problem that hinders access and affordability and is … difficult to quantify,” Levitt and Altman wrote in their commentary. “The reality is that many people are hopelessly confused by how their insurance works,”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NCvSBw">
The confusion starts during <a href="https://www.vox.com/23914351/health-insurance-plans-open-enrollment-guide-obamacare-medicare-dental">open enrollment</a>, as Levitt and Altman noted, when people enrolling in Medicare Advantage have more than 40 plans available to them, on average, and people who sign up for coverage on the <a href="https://www.vox.com/obamacare">Affordable Care Act</a>’s marketplaces may have more than 100 to choose from. HR industry surveys <a href="https://www.alegeus.com/insights/2019-open-enrollment-exit-poll-infographic/">have</a> also <a href="https://www.benefitspro.com/2022/12/06/employees-often-dread-open-enrollment-misunderstand-benefit-options-survey-finds/?slreturn=20231002111409">found</a> that people who enroll in health insurance through their job often feel uncertain about the selections they are making.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CriQF4">
And it continues as people actually receive medical treatment and then receive a bill, as evidenced by these findings. People don’t know if their providers are in-network or that they can contest a bill, and they may end up paying more than they should as a result.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YgHKCb">
<a href="https://www.vox.com/congress">Congress</a> and the states have attempted to take steps in recent years to reduce the confusion among patients. Insurers are supposed to provide accessible and up-to-date provider directories. The <a href="https://www.cms.gov/nosurprises">No Surprises Act</a> sought to remove patients from any disputes over out-of-network emergency bills, leaving the insurer and hospital to sort out the costs. But enforcement remains inconsistent, Levitt and Altman noted.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d7E9uY">
These surveys suggest that Americans remain perplexed by the process of seeking out medical services and paying for treatment — and their health is suffering as a result.
</p></li>
<li><strong>What happened to Airbnb?</strong> -
<figure>
<img alt="A wooden toy house with a thumbs-down symbol on it." src="https://cdn.vox-cdn.com/thumbor/ZHbIgf7eqYU7Wk4hlrSE8DHwb-g=/667x0:7334x5000/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72824148/GettyImages_958332858.0.jpg"/>
<figcaption>
In the past few years, Airbnb prices — and guest complaints — have sharply risen. | Getty Images/iStockphoto
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Financially, the sharing economy darling is thriving, but guests, hosts, and cities have had enough.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RfL7Ad">
Airbnb knows people are unhappy. Its CEO, Brian Chesky, has acknowledged the “<a href="https://youtu.be/5szUkjOudmA?si=Cv0UGpOvl5lnumpU&amp;t=560">tens of thousands</a>” of complaints across social media about the platform’s growing costliness. It knows that hosts’ expenses — like <a href="https://www.cnn.com/2023/06/19/business/homeowners-insurance-more-expensive-climate/index.html">home insurance</a>, property taxes, and the cost of labor for cleaning and maintenance — have climbed amid a period of high inflation. The internet is strewn with complaints of pictures that don’t match the actual property, extreme demands and rules from hosts, <a href="https://www.theatlantic.com/technology/archive/2019/03/what-happens-when-you-find-cameras-your-airbnb/585007/">hidden cameras</a>, reservations getting unceremoniously canceled, and more. And several cities are aiming to regulate short-term rentals, even setting down a <a href="https://www.nytimes.com/2023/09/05/nyregion/airbnb-regulations-nyc-housing.html">de facto ban</a> on them, as New York, one of the biggest Airbnb markets in the US, did in September.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XLdZLK">
Yet Airbnb, which launched in 2008, is also making more money than ever. Bookings <a href="https://www.cnn.com/2023/05/09/tech/airbnb-earnings/index.html">reached an all-time high earlier this year</a>, and the company raked in almost <a href="https://news.airbnb.com/airbnb-q4-2022-and-full-year-financial-results">$2 billion in profits in 2022</a>, marking its first full profitable year. Airbnb’s stock price is also up dramatically from where <a href="https://www.wsj.com/market-data/quotes/ABNB/research-ratings">it was at the end of last year</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L63N1B">
All this success is part of the company’s problem. What started as a scrappy idea offering an affordable alternative to hotels has now made Airbnb a target for lawmakers and a magnet for critics. Airbnb may not be collapsing, as some doomsayers are predicting, but it is facing a reckoning — an existential questioning of what it offers and where it will go from here.
</p>
<div id="gQigIq">
</div>
<h3 id="dpdgze">
The great pandemic Airbnb boom transformed the business
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="daHKKm">
How Airbnb arrived here is complicated. Covid-19 was a giant blow to the travel sector, including Airbnb, as lockdowns reduced the supply of short-term rentals by a significant 25 percent, according to Jamie Lane, chief economist at AirDNA, a short-term rental data analytics firm.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="enfnYt">
Simultaneously, people also started wanting more space outside of dense cities. Interest rates were very low, so in general, <a href="https://www.vox.com/22264268/covid-19-housing-insecurity-housing-prices-mortgage-rates-pandemic-zoning-supply-demand">people bought houses</a> during this period — some to live in, others to rent out.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JDp6lk">
Meanwhile, the idea that one could get rich by becoming an Airbnb host — the gold rush-like dream that helped spur the company’s success through the 2010s — found renewed popularity on social media platforms like TikTok, Reddit, and YouTube. New hosts were encouraged<strong> </strong>by just how quickly demand bounced back: By 2021, domestic travel was revving up again, but concentrated on rural destinations where social distancing was easier. Supply couldn’t catch up fast enough, and Airbnb prices leaped. Amateur investors eager to meet the Airbnb demand bought up properties to turn into short-term rentals, piling in “when the rates were really low,” says Lance Lambert, a housing expert and editor of real estate analytics site ResiClub.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sdEW2H">
Between mid-2021 and mid-2022, the number of new Airbnb hosts in the US jumped by <a href="https://news.airbnb.com/while-inflation-in-the-us-rises-new-hosts-grow-in-q2-2022/">over 50 percent</a>, and the growth was biggest in small towns, says Lane. Expansion, however, hasn’t been an entirely positive change: In some cases, Airbnb has rapidly changed the character of these neighborhoods from residential areas to tourist towns. Because there are so many more listings now, <a href="https://www.marketwatch.com/story/airbnb-hosts-say-bookings-fell-off-a-cliff-amid-influx-of-new-vacation-rentals-and-rising-prices-11666373242">Airbnb hosts</a> say they <a href="https://www.wsj.com/articles/the-housing-slowdown-is-wreaking-havoc-on-the-short-term-rental-market-11670518837">are</a> <a href="https://time.com/6223185/airbnbs-empty-short-term-rentals/">watching their bookings</a> plummet. The flood of new hosts has meant fewer can earn good money. “Now, the markets are completely oversaturated,” says Melody Wright, founder of mortgage strategy and technology company Huringa.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Q1AqD1">
Meanwhile, excess supply hasn’t led to lower prices, and anecdotes about bad Airbnb experiences keep pouring in. Some of the most vocal grievances center on cleaning fees. In the US, <a href="https://www.airdna.co/blog/airbnb-cleaning-fees-what-hosts-need-to-know">only 15 percent of Airbnb listings</a> don’t have cleaning fees, and a <a href="https://www.nerdwallet.com/article/travel/airbnb-has-a-plan-to-fix-cleaning-fees">NerdWallet analysis</a> found that cleaning fees now make up about a quarter of the total price guests pay. Airbnb’s <a href="https://www.airbnb.com/help/article/1857">service fee</a> is generally under 14 percent on top of the nightly rate, and it also takes 3 percent from most hosts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8pNB2U">
All this is encouraging a hospitality-industry doom loop: If hosts see their bookings drop, they might try to raise rates to make up for it (or at least resist lowering them), which drives guests back to hotels or the cheapest Airbnbs that tend to be run by bigger professional hosts who can afford to cut prices in ways small hosts can’t. If hosts try to lower rates to draw in more bookings, they might still be unable to turn a profit. “For both the guest and the host, it’s just not a good value proposition anymore,” says Wright. The only one winning, it seems, is Airbnb.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YkG74h">
Airbnb did not respond to Vox’s request for comment. But Chesky has been vocal about listening and attempting to fix guests’ top gripes. In its <a href="https://news.airbnb.com/airbnb-2023-fall-update/">2023 fall update</a>, Airbnb rolled out a site layout letting customers <a href="https://news.airbnb.com/airbnb-is-introducing-total-price-display-and-updating-guest-checkout/">see the total price</a>, including cleaning fees, when browsing listings. This feature follows the release of a new <a href="https://www.airbnb.com/resources/hosting-homes/a/new-pricing-tool-compares-similar-listings-nearby-583">pricing tool for hosts</a> that would display rates other hosts are charging nearby — a way to encourage hosts to lower their prices. “We need to get our house in order,” Chesky told <a href="https://www.bloomberg.com/news/articles/2023-10-02/airbnb-is-broken-its-ceo-says-here-are-his-plans-to-fix-it">Bloomberg</a> in a recent interview. Ultimately, Airbnb doesn’t seem to be able to — or perhaps<strong> </strong>won’t — rein in the high rates and fees customers are grumbling about, and <a href="https://community.withairbnb.com/t5/Support-with-your-bookings/No-support-for-hosts/m-p/1455927">hosts continue</a> <a href="https://community.withairbnb.com/t5/Hosting/Airbnb-doesn-t-support-hosts/m-p/1155154">to bemoan</a> <a href="https://www.curbed.com/2023/09/airbnb-host-meltdown-new-york-september-regulations.html">that they aren’t given the support</a> they need to thrive.
</p>
<h3 id="nZNI47">
Why are cities cracking down on Airbnb?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sFOaaL">
Airbnb began as a more flexible, more social experience than hotels, but that sense of peer-to-peer exchange has all but disappeared. Airbnb hosts today are often professionals who intend for hosting to be their main job and source of income, and new hosts often list entire homes rather than home-sharing their primary residence. Many form LLCs, hire employees, or engage the services of professional property management companies to manage their listings. The majority of Airbnbs are run by <a href="https://skift.com/2022/12/02/airbnb-talking-points-about-individual-hosts-run-into-a-reality-check/">hosts with multiple listings</a>. That’s contributing to the persistent shadow now looming over Airbnb: the perception that it’s a social ill worsening the housing crisis.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jsivxa">
Last May, <a href="https://www.curbed.com/2022/05/new-york-more-airbnb-listings-apartments-rentals.html">Curbed reported</a> that the number of Airbnb listings outstripped the number of available apartments for rent in all of Manhattan, Brooklyn, and northwest Queens. That lopsidedness is happening in many other cities, too. Asheville, North Carolina, has 2,881 properties — not private rooms — listed on the service as of September, according to <a href="http://insideairbnb.com/asheville/?neighbourhood=&amp;filterEntireHomes=false&amp;filterHighlyAvailable=false&amp;filterRecentReviews=false&amp;filterMultiListings=false">Inside Airbnb</a>, a site collecting data on Airbnb units to show the company’s impact on residential communities. At the time of writing, there are a little over 250 long-term rentals listed on <a href="https://www.zillow.com/asheville-nc/rentals/">Zillow</a>. Austin had <a href="http://insideairbnb.com/austin/">12,205 full-property Airbnbs</a> and about <a href="https://www.zillow.com/austin-tx/rentals/">3,700 long-term rentals</a>. Skyrocketing rents in the past two years have been a major issue in <a href="https://www.citizen-times.com/story/news/local/2022/01/31/asheville-nc-rents-rise-most-expensive-city-live-north-carolina-apartment-list/9256946002/">both</a> of these <a href="https://www.axios.com/local/austin/2022/10/03/austin-worst-cities-for-renters">cities</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cpLzqo">
The national housing shortage has led to more scrutiny of Airbnb as short-term rentals constrain housing supply that would otherwise be available for residents. Studies have shown that <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3006832">Airbnbs raise</a> <a href="https://comptroller.nyc.gov/wp-content/uploads/documents/AirBnB_050318.pdf">home values and rents</a>, and the impact tends to be bigger in very densely populated areas where the housing shortage is worst. A 2018 report from the <a href="https://comptroller.nyc.gov/wp-content/uploads/documents/AirBnB_050318.pdf">NYC Comptroller’s office</a> estimated that 9 percent of the city’s rent increases between 2009 to 2016 could be blamed on Airbnb.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OP3LjY">
It’s not just cities. The Airbnbs that have moved into rural America at full force are also becoming an intense concern for residents facing ever-higher rents and home prices there.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ChFSJm">
“Take somewhere like Missoula, Montana,” says Wright. The small city of about 77,000 people had 60 homeless encampments as of August 2022, while the state has seen a <a href="https://www.wsj.com/business/hospitality/a-montana-town-faces-a-homelessness-problem-similar-to-san-francisco-and-l-a-eba26824">62 percent increase</a> in homelessness since 2019. “Missoula never had a homeless situation, not like this,” Wright says. The median listing for a home is now over <a href="https://www.realtor.com/realestateandhomes-search/Missoula_MT/overview">$600,000</a> there. AirDNA currently shows over 600 active short-term rentals in Missoula, the vast majority of which are entire homes, while Zillow shows <a href="https://www.zillow.com/missoula-mt/rentals/">just over 200</a> long-term rentals. Other small towns are facing similar rapid changes. Sedona, Arizona — a town with under 10,000 residents — is running rampant with short-term rentals as its reputation as a tourist destination grows. As of 2021, as a <a href="https://www.wired.com/story/airbnb-rentals-sedona-arizona/">report from Wired</a> last year highlighted, 15 percent of Sedona’s housing supply was listed as short-term rentals. Right now, AirDNA shows about 2,800 active listings for entire homes; Zillow shows about <a href="https://www.zillow.com/sedona-az/rentals/?searchQueryState">50 long-term rentals</a>. The median price of a single-family home there is now <a href="https://www.realtor.com/realestateandhomes-search/Sedona_AZ/overview">over $1 million</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qV8fU9">
“And so you have no affordable inventory for anyone anymore,” says Wright.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x8BAn2">
Anti-Airbnb neighborhood groups have been popping up in communities for over a decade now, and though they’re spread all across the country, their grievances are similar: They don’t want higher rents and property prices, and they don’t want to be surrounded by <a href="https://www.texasmonthly.com/news-politics/inside-bro-tastic-party-airbnb-gentrifying-east-austin/">noisy Airbnbs</a> occupied by a revolving door of strangers. Plus, there are some unexpected knock-on effects when there’s a housing shortage exacerbated by short-term rentals: Amid a national teacher shortage, for example, schools struggle to find teachers because <a href="https://fortune.com/2023/09/08/housing-market-teacher-shortage-affordability-crisis-redfin-low-salaries/">many can’t find affordable housing</a> in the area.
</p>
<h3 id="D35uca">
Can Airbnb fix its problems?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Op7ARj">
The relative slowness of Airbnb regulation, happening in piecemeal fashion across the country, is why so many regions now find themselves overrun with short-term rentals. The era of an unfettered short-term rental market, however, is over.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7wxQKb">
New York, San Francisco, Los Angeles, and Honolulu are among the major cities that have passed short-term rental restrictions of varying strictness. In New York, hosts must now register their short-term rentals listed on sites like Airbnb, firming up enforcement of its existing short-term rental laws, including a 2016 bill that <a href="https://www.bloomberg.com/news/articles/2018-03-05/what-airbnb-did-to-new-york-city-s-housing-market">limited a host to listing just a single address on Airbnb</a> and banned stays of fewer than 30 days. These measures essentially eliminate professional hosts from taking long-term rentals from locals. San Francisco and Portland, Oregon, have similar “one host, one home” policies. A <a href="https://business.purdue.edu/news/features/2023/short-term-rentals.php">study conducted by Ralph Siebert and Zaiyan Wei</a>, professors of economics and management, respectively, at Purdue University, found that the policy reduced rents and home values in these cities by an average of 3 percent. “With the restriction, people stopped buying properties from the local markets, or they put more properties back to the long-term rental market,” Wei told Vox. He expects the new NYC law to have a sizable impact on rents and home values.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jVines">
Other cities and towns require hosts to register their short-term rentals and pay a fee, but they don’t put a residency requirement or limit how long the property can be rented out as an Airbnb. In some cases, <a href="https://www.ajc.com/news/atlanta-news/atlantas-delayed-crackdown-on-unregulated-vacation-rentals-continues/5BR76SAFSVH3BBMWIM6RS2KLQE/">enforcement of new regulations</a> is delayed as Airbnb and hosts fight back. To block short-term rental restrictions in San Francisco, the company spent <a href="https://www.businessinsider.com/airbnb-spends-8-million-against-prop-f-2015-9">over $8 million</a>; it sued the city of New York in an attempt to stop the latest restrictions from going into effect and allegedly <a href="https://www.ft.com/content/1afb3173-444a-47fa-99ec-554779dde236">rallied hosts to lobby the city</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AcmefC">
As for what’s needed to win back customer goodwill, that’s simple: “Economics will win here,” says Lambert. Hosts that keep their nightly rates too high won’t get the number of bookings they need to be profitable, and could simply exit the short-term rental market.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LZwOnC">
Yet Airbnb keeps pushing for more hosts to join. It was a core goal of a <a href="https://www.sec.gov/Archives/edgar/data/1559720/000119312523202832/d446942dex991.htm">shareholder letter</a> released earlier this year, with the company stating that it wanted to turn hosting “mainstream.” “Look at their earnings reports — their only strategy is increasing listings on the platform,” says Wright. It has been working, but it’s also exacerbating some hosts’ struggle to stay in business. More listings while demand slows might mean lower nightly rates, but even if Airbnb prices do come down, there’s no indication Airbnbs will ever return to being the cheaper, cozier alternative to hotels.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0U6ufH">
“The economics for Airbnb and for hosts are very different,” says Lambert. For the company, it’s probably a good thing to have as many hosts as possible. For hosts, the opposite is true.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JGMuL6">
It’s a predictable arc seen among some of the biggest tech companies of the past decade, such as Uber or Netflix. At first, affordability and convenience won over customers, but many have similarly soured on these services when the companies raised prices.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ygw0jF">
“When Airbnb rolled out, everybody thought it was going to kill hotels,” says Lambert. “And it really just became hotels.”
</p></li>
<li><strong>The Israel bill is a reminder that Trump-aligned Republicans run the House now</strong> -
<figure>
<img alt="Johnson, clean-shaven in black framed glasses and a dark suit, shoots a finger gun at someone off-camera. He’s flanked by grey and white-haired senators, all in dark blue suits: Sen. Ron Johnson (R-WI), Sen. Ted Budd (R-NC), and Sen. Rick Scott (R-FL)." src="https://cdn.vox-cdn.com/thumbor/IY-bHcUxCFP7oZCCyka-3F7fZPM=/442x0:5113x3503/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72823261/GettyImages_1757699148.0.jpg"/>
<figcaption>
House Speaker Mike Johnson and members of the Senate GOP caucus walk through the Capitol on November 1, 2023. | Bill Clark/CQ-Roll Call, Inc./Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
MAGA Republicans took down the last GOP speaker. Now they’ve passed an aid package tailored to their goals.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5rjcdo">
Although Rep. Mike Johnson was a relative unknown when he took the House speakership, one of the few things that’s quickly become apparent is how closely aligned he is with the MAGA wing of the party. He’s made that obvious in his first major legislative action: an aid package for <a href="https://www.vox.com/israel">Israel</a> that advances far-right priorities, including antipathy for the IRS and aversion to Ukraine funding.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1Z4fH9">
<a href="https://www.nytimes.com/2023/10/27/opinion/mike-johnson-speaker-house-maga.html#:~:text=And%20while%20he%20was%20not,is%20a%20dollar%20too%20much.">As various reports have documented</a>, Johnson was one of the House members who previously voted to overturn the <a href="https://www.vox.com/2020-presidential-election">2020 election</a> results, and has long espoused hardline positions opposing <a href="https://www.vox.com/lgbtq">LGBTQ</a> rights and <a href="https://www.vox.com/abortion">abortion</a> rights. He’s also, as the Israel bill demonstrates, willing to continue advancing the goals of the party’s right flank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ftDzCl">
Johnson’s Israel aid package contains $14.3 billion in support for Israel amid its ongoing war with <a href="https://www.vox.com/politics/2023/10/10/23911661/hamas-israel-war-gaza-palestine-explainer">Hamas</a>. But it does not contain new money for the <a href="https://www.vox.com/russia-invasion-ukraine">war in Ukraine</a>, border security funding, and <a href="https://www.nytimes.com/2023/10/20/us/politics/biden-aid-israel-ukraine-taiwan-border.html">security aid for Taiwan</a>. <a href="https://www.vox.com/joe-biden">President Joe Biden</a>, Democratic Senate leaders, and Senate Minority Leader Mitch McConnell wanted to fund all those priorities in a single legislative package, and they’ve opposed decoupling them. (Johnson has stated that <a href="https://www.politico.com/live-updates/2023/11/01/congress/what-johnson-wants-ukraine-israel-funding-00124806">he’s not against more money for Ukraine</a>, but that he’d rather tackle that question in a separate package unrelated to Israel.)
</p>
<div class="c-float-right">
<div id="qrEboY">
<div>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="syKh18">
The bill passed the <a href="https://www.politico.com/live-updates/2023/11/02/congress/israel-bill-passes-00125127">House on Thursday night</a>. Democrats overwhelmingly opposed the bill, though 12 staunch allies of Israel voted for it. Republicans nearly unanimously supported it. But the measure is dead on arrival in the Senate, amid opposition from leaders of both parties, and from the White House.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Uw24gm">
As well as decoupling aid to Ukraine and Taiwan from support for Israel, the House bill would also cut funding allocated to the IRS through the <a href="https://www.vox.com/2022/8/8/23296951/inflation-reduction-act-biden-democrats-climate-change">Inflation Reduction Act</a>. Additionally, Johnson’s bill does not contain humanitarian aid for <a href="https://www.vox.com/2018/11/20/18080046/gaza-palestine-israel">Gaza</a>, which Biden has also requested.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GQiqSQ">
Several of these provisions echo longstanding conservative demands.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rhtOLi">
For months, the GOP has steadily begun to turn against additional aid to Ukraine as <a href="https://apnews.com/article/ukraine-funding-trump-biden-republicans-1271243a1d052f68765d9f39fe115592">former President Donald Trump</a> has called for conditioning further funding on federal agencies providing information about the Biden family’s business practices and <a href="https://www.cnn.com/2023/05/12/politics/trump-ukraine-russia-warning/index.html">reiterated his “America First” isolationist approach</a> to foreign policy. Once, only a smaller group of Republicans, led by the likes of <a href="https://thehill.com/policy/defense/4096744-majority-of-republicans-vote-down-greene-gaetz-ukraine-bills/">Reps. Matt Gaetz and Marjorie Taylor Greene</a>, were willing to speak out on the record against more Ukraine funding. Recent House votes on the subject, however, suggest opposition to Ukraine aid is only growing among members of the party.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kqRAe0">
In July, 70 Republicans voted for <a href="https://thehill.com/policy/defense/4096744-majority-of-republicans-vote-down-greene-gaetz-ukraine-bills/">an amendment to the annual defense bill</a> that would prohibit more US military funding to Ukraine. In September, that number went up, with 93 House Republicans <a href="https://www.nbcnews.com/politics/congress/house-republican-opposition-ukraine-aid-grows-threatening-funds-war-ra-rcna117406#:~:text=An%20amendment%20to%20the%20defense,measure%20by%20Gaetz%20in%20July.">voting in favor of a similar amendment</a> to the Pentagon appropriations bill.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w1Y8es">
Anti-Ukraine sentiment is spreading in the Senate as well. McConnell has made a public relations push in recent weeks to try to convince his caucus of the need for more Ukraine aid. His rhetoric doesn’t appear to be having much effect, with <a href="https://punchbowl.news/archive/11123-punchbowl-news-am-2/">Sen. Rand Paul</a> (R-KY) calling McConnell’s plans “out of touch,” and McConnell deputy <a href="https://www.politico.com/news/2023/10/30/mcconnell-goes-all-out-as-ukraine-fight-fractures-gop-00123966">Sen. John Thune (R-SD) noting</a> that despite McConnell’s best efforts, “We have a number of our members who are not for Ukraine funding.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0fWTNt">
Much like his desire to uncouple Israeli aid from other foreign policy initiatives, Johnson’s plan for paying for the Israel package has its roots on the far right. The legislation seeks to go after Biden’s Inflation Reduction Act, a measure Republicans have often railed against for its investments in green energy tax credits, <a href="https://www.vox.com/health-care">health care</a>, and the IRS. Specifically, the bill would reappropriate funding originally meant to go to the IRS — an agency that’s been the subject of the GOP’s anti-government sentiment and past allegations of bias.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZqAi7S">
The GOP has tried repeatedly to roll back the Inflation Reduction Act’s $80 billion in funding to the IRS, which they misleadingly claim is going to be used to <a href="https://www.nytimes.com/2022/08/19/us/politics/more-money-for-irs-spurs-conspiracy-theories-of-shadow-army.html">hire tax agents to harangue everyday Americans</a> — <a href="https://www.politifact.com/factchecks/2022/aug/12/matt-gaetz/no-biden-not-arming-irs-guns-and-ammunition/">including at gunpoint</a>, some on the far right have incorrectly stated. In reality, the funding is intended to boost the agency’s ability to track down wealthy individuals who’ve failed to pay their taxes, to improve its IT capabilities, and to replace a retiring workforce. About <a href="https://www.nytimes.com/2022/08/19/us/politics/more-money-for-irs-spurs-conspiracy-theories-of-shadow-army.html">1 percent of those new jobs</a> are expected to have a law enforcement component, and may require employees to carry firearms, though few ordinary Americans are likely to come across an armed IRS official.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fvVslV">
Defunding the IRS has nevertheless become a goal of many on the right, and the new Israel bill would directly contribute to that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Kvy7FI">
Johnson has claimed that repurposing the IRS funds is a fiscally responsible “offset” and a way to address America’s most pressing immediate needs, like providing Israel military assistance without having to spend too much. However, the Congressional Budget Office actually estimates that the measure could add $26 billion to the deficit because it would <a href="https://thehill.com/homenews/house/4287168-house-gop-israel-irs-bill-add-deficit-cbo/">reduce the revenue</a> the IRS is able to bring in over the next decade. The IRS, meanwhile, says <a href="https://www.washingtonpost.com/business/2023/11/01/israel-aid-irs-gop/">the Israel bill would actually cost the government $90 billion</a> in that same timeframe.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5kFUPj">
The Israel package is just one bill. But it does highlight how Johnson could lead as speaker and which priorities he may spotlight in this role. He’s also made other comments — including claiming that it’s “<a href="https://www.dailymail.co.uk/news/article-12687291/Speaker-Mike-Johnson-Biden-impeachment.html">very likely</a>” Biden has committed impeachable offenses, which Republicans don’t have evidence of. Collectively, these statements and <a href="https://www.vox.com/policy">policies</a> point to how he’ll lead.
</p>
<h3 id="jPNMPh">
The legislation is dead on arrival in the Senate
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VNHdcQ">
The fact that the Israel aid bill has no chance of making it through the Senate, where both Democrats and some Republicans — including Senate Minority Leader Mitch McConnell — would oppose it, further suggests it’s meant more as a messaging vehicle than a serious piece of legislation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="w0SnNA">
Senate Democrats and a number of more centrist Republicans have said they’re interested in seeing an aid package including both funding for Israel and Ukraine, as well as humanitarian aid for Gaza. Biden’s original request contained $61 billion in funding for Ukraine aid, $9 billion in humanitarian aid for Israel, Gaza, and Ukraine, and $7.4 billion in security aid for Taiwan and other countries in the Indo-Pacific region, in addition to $14.3 billion in military aid for Israel.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2HRMdU">
“Speaker Johnson and House Republicans released a totally unserious and woefully inadequate package that omitted aid to Ukraine, omitted humanitarian assistance to Gaza, no funding for the Indo-Pacific, and made funding for Israel conditional on hard-right, never-going-to-pass proposals,” Senate Majority Leader Chuck Schumer said in a floor speech this week.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hekBy0">
Democratic lawmakers have also opposed plans to use existing IRS funding for Israel aid and argued that it’s an attempt to defund the agency’s efforts to go after wealthy tax cheats. Because the IRS has been underfunded for years, it hasn’t had the resources to fully enforce tax law against those with the means to evade it. Were the IRS able to pursue such actions effectively, it could result in substantial new revenue for the federal government. In September, the IRS announced that it’s launching an effort targeting <a href="https://www.cbsnews.com/news/irs-audit-wealthy-taxpayers-1600-millionaires/">1,600 millionaires</a> — and procuring back taxes from them — using some of the new funds it’s received from the IRA.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gAeWHG">
“House Republicans are setting a dangerous precedent by suggesting that protecting national security or responding to natural disasters is contingent upon cuts to other programs,” House Appropriations Chair Rosa DeLauro (D-CT) said in a statement.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="57XmUM">
Johnson’s Republican bill puts the House and Senate on a collision course in the coming weeks, and foreshadows what future fights between the two chambers could look like over other must-pass bills. It’s not yet clear whether Johnson will look to take a more moderate stance as time goes on, especially on issues like keeping the government open. But if he continues to embrace conservative priorities and related positions, <a href="https://www.vox.com/congress">Congress</a> will likely struggle to pass those bills as well.
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Women’s Asian Champions Trophy semifinal: Indian women hockey team hopes to continue winning momentum</strong> - India beat Korea 5-0 on November 2 to set up a rematch in the last four but coach Janneke Schopman is wary.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ICC World Cup | To be brutally honest, Pakistan haven’t played to potential, says Mickey Arthur</strong> - Arthur said not being able to strike a balance between the three faculties of the game — batting, bowling and fielding — has been the bane of Pakistan.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Soccer’s prestigious Ballon d’Or awards to be co-organised by European governing body UEFA</strong> - From 2024, the Ballon d’Or awards and ceremony will be co-organized by UEFA and Groupe Amaury, which publishes France Football and L’Equipe.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Security around Pakistan cricket team has been stifling for players in World Cup: Mickey Arthur</strong> - Arthur said the players’ inability to socialise during such a long tournament has made a tough impact on them during the quadrennial showpiece.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>ICC World Cup | Teams should have been allowed more than 15 players in squad considering duration of tournament, says Cummins</strong> - Maxwell suffered a freak injury during a game of golf while Marsh has returned home for personal reasons, and no definite timeline is marked for their return to action.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Secunderabad Cantonment Board receives ₹5 crore grant-in-aid</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dhinakaran condemns DMK government for its “casual attitude” towards violence against Scheduled Castes</strong> - He urged the government to take steps to ensure that there was no incident of violence against the Scheduled Castes and sensitise people to the ill effects of the drugs.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>‘Garudan’ movie review: An effective thriller that needed more layered writing</strong> - ‘Garudan’, starring Suresh Gopi and Biju Menon, is helped by a strong story but its overall treatment from director Arun Varma leaves us wanting</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Two injured in street fight in Belagavi</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>RSS route marches case: SC asks why Tamil Nadu appealed directly in top court</strong> - A single judge bench of the Madras HC said the State’s refusal to permit RSS route marches was contrary to the “principle of secularism”; SC asks why appeal was not made to a division bench of the HC</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Storm Ciarán: Floods ravage Tuscany leaving five dead</strong> - Five people are confirmed dead and several more are missing as winds and rain buffet parts of Italy.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Germany: Illegal migration rise prompts border crackdown</strong> - Soaring numbers of illegal migrants is sharpening a growing debate about migration in Germany.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>German vice-chancellor Habeck hits out against rising antisemitism</strong> - German Vice-Chancellor Robert Habeck criticises Islamists, the far right and political left.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Migrants to Europe dying in gun battles and car crashes</strong> - In the Western Balkans, smuggler gangs are engaging in deadly shootouts as migrant numbers keep rising.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Swiss village of Aarwangen in ding-dong over challenge to cowbells</strong> - New residents in a Bernese Alpine village object to the traditional sound of rural Switzerland.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Teen boys use AI to make fake nudes of classmates, sparking police probe</strong> - Parents told the high school “believed” the deepfake nudes were deleted. - <a href="https://arstechnica.com/?p=1980775">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Apple slides from 2013 skewer Android as “a massive tracking device”</strong> - But Apple also wanted to know what results users clicked on Google from iPhones. - <a href="https://arstechnica.com/?p=1980725">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tenn. vaccine chief, fired after promoting COVID shots, gets $150K settlement</strong> - Dr. Michelle Fiscus was fired after sending a memo on vaccination rights of minors. - <a href="https://arstechnica.com/?p=1980747">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>12 V battery problem forces Toyota to recall 1.8 million SUVs</strong> - Owners should hear about a fix by late December. - <a href="https://arstechnica.com/?p=1980733">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Google is moving Shopping List and other notes into one app to worry about, Keep</strong> - It’s technically a reversal of a bizarre, annoying move they made in 2017. - <a href="https://arstechnica.com/?p=1980624">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A modest country joke [OC]</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I once visited a small town. It was a country town. I asked the locals “What is there to do around here?” One of the old timers said “Well, we have a brothel.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So I went to the brothel and asked “how much does it cost?” They answered “Well, these are simple country girls, it costs a chicken for oral, a goat for sex, and a cow for anal.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I left and came back carrying a platypus and said “OK, listen…”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Smack8001"> /u/Smack8001 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17mkde9/a_modest_country_joke_oc/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17mkde9/a_modest_country_joke_oc/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>There’s a homeless guy in my city that I’ve gotten to know over the last couple months, great guy. Sometimes he asks for money and yesterday he did…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
…I said tell you what all I got is a 10, but if you go down to that gas station and buy me a snickers bar and bring it back to me you can keep the change.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He says alright bet. So he goes to the gas station and I’m standing at the bus stop waiting for him to come back and eventually he comes 15 minutes later or so and to my surprise he gives me TWO snickers bars.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So I tell him hey man you only needed to get me one, you would’ve had more change that way. He says oh no it’s cool man, I just stole them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So he gets ten dollars and I get stolen property….and I ate them both. Delicious.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Nolan-"> /u/Nolan- </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17mrpmc/theres_a_homeless_guy_in_my_city_that_ive_gotten/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17mrpmc/theres_a_homeless_guy_in_my_city_that_ive_gotten/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A woman entered the pharmacy, approached the pharmacist, made direct eye contact, and began to speak.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I would like to buy some cyanide.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The pharmacist asked, “Why in the world do you need cyanide?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The lady: “I need it to poison my husband.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The pharmacist’s eyes got big and he exclaimed: “Lord have mercy! I can’t give you cyanide to kill your husband! That’s against the law! I’ll lose my license! They’ll throw both of us in jail! All kinds of bad things will happen. Absolutely not! You CANNOT have any cyanide!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The lady reached into her purse and pulled out a picture of her husband in bed with the pharmacist’s wife.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The pharmacist looked at the picture and replied: “Oh Well now That’s different. You didn’t tell me you had a prescription.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/ciiena"> /u/ciiena </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17me9qw/a_woman_entered_the_pharmacy_approached_the/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17me9qw/a_woman_entered_the_pharmacy_approached_the/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A farmer and his wife were laying in bed one evening…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The man tells his wife, “I read an article that says humans are the only species where the females can have an orgasm.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Prove it” She replied flirtatious.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Well… alright, here goes…”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He walked out and returned a few hours later.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“The sheep didn’t, the horse didn’t, but I couldn’t really tell with the chickens, they were just clucking alot.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Flip_Six_Three_Hole"> /u/Flip_Six_Three_Hole </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17m6c5k/a_farmer_and_his_wife_were_laying_in_bed_one/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17m6c5k/a_farmer_and_his_wife_were_laying_in_bed_one/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The farmer sells his horse for $2000 to a buyer at the market.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The farmer initially promises to deliver the horse to the man in a week, but halfway through that week, the horse dies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The farmer offers to return the money, but the man decides to proceed with the purchase. In the following week, the farmer encounters the man and inquires about the fate of the deceased horse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The man reveals that he organized a lucky draw, charging $50 per entry for a chance to win a horse, and 100 people participated, generating $5000.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
When asked if anyone was upset about the horse, the man explains that only the winner was disappointed, but he refunded that individual’s $50.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/ciiena"> /u/ciiena </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17msrqo/the_farmer_sells_his_horse_for_2000_to_a_buyer_at/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17msrqo/the_farmer_sells_his_horse_for_2000_to_a_buyer_at/">[comments]</a></span></p></li>
</ul>
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