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<title>10 November, 2023</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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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>DEFEN-CE: Social Dialogue in Defence of Vulnerable Groups in Post-COVID-19 Labour Markets. Report on Finland and Sweden</strong> -
<div>
This is a comparative country report on Finland and Sweden for the DEFEN-CE project: Social Dialogue in Defence of Vulnerable Groups in Post-COVID-19 Labour Markets. DEFEN-CE is a research project funded by the Directorate-General for Employment, the European Commission (Grant number: VS/2021/0196). The project investigates the experiences of various stakeholders in the design and implementation of Covid-19-related policies relevant to work and employment in EU member states (Finland, Sweden, the Netherlands, Germany, Latvia, Lithuania, Czechia, Slovakia, Italy and Spain) and two candidate countries, Serbia and Turkey. The aim of the project is to identify the role of social dialogue in facilitating policy implementation that addresses the labour market situation of vulnerable groups in the post-Covid-19 labour markets. Based on this aim, the report seeks to answer three main research questions from a comparative perspective, emphasising similarities and differences in Finlands and Swedens pandemic response, industrial relations (with a focus on social dialogue structures and interactions), policy design, and protection of vulnerable groups. 1. What public policy and social dialogue measures targeting the selected vulnerable groups were implemented for employment and social protection during the Covid-19 pandemic in 20202022? 2. To what extent and how did social dialogue play a role in the implementation of the social and employment rights of selected vulnerable groups in the Covid-19 pandemic between 2020 and 2022? 3. What lessons and opportunities does the Covid-19 pandemic yield for strengthening social dialogue in the studied countries? The report combines analysis and findings based on the construction of country-specific Defence Databases (one for Finland and one for Sweden) and qualitative interviews with national stakeholders. The respective database gathers information on more than 30 country- specific Covid-19 policies that have been gathered from international databases (e.g., Eurofound, Eurostat, and OECD/AIAS ICTWSS), national and international policy documents and legislation, reports from trade unions and employers organisations, and academic literature. The policies are systematised with information on who adopted the policy (e.g., executive branch, parliament, central bank), policy form (e.g., legislation and statutory regulations, recommendations, social partner agreements), policy area (e.g., labour market, health and safety, and social security), time period, targeted vulnerable groups (based on employment status, social risks, and health safety), and social partners involvement.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/6t2qp/" target="_blank">DEFEN-CE: Social Dialogue in Defence of Vulnerable Groups in Post-COVID-19 Labour Markets. Report on Finland and Sweden</a>
</div></li>
<li><strong>Emergence and spread of feline infection peritonitis due to a highly pathogenic canine/feline recombinant coronavirus</strong> -
<div>
Cross-species transmission of coronaviruses (CoVs) poses a serious threat to both animal and human health. Whilst the large RNA genome of CoVs shows relatively low mutation rates, recombination within genera is frequently observed and demonstrated. Companion animals are often overlooked in the transmission cycle of viral diseases; however, the close relationship of feline (FCoV) and canine CoV (CCoV) to human hCoV-229E, as well as their susceptibility to SARS-CoV-2 highlight their importance in potential transmission cycles. Whilst recombination between CCoV and FCoV of a large fragment spanning orf1b to M has been previously described, here we report the emergence of a novel, highly pathogenic FCoV-CCoV recombinant responsible for a rapidly spreading outbreak of feline infectious peritonitis (FIP), originating in Cyprus. The recombination, spanning spike, shows 97% sequence identity to the pantropic canine coronavirus CB/05. Infection is spreading fast and infecting cats of all ages. Development of FIP appears rapid and likely non-reliant on biotype switch. High sequence identity of isolates from cats in different districts of the island is strongly supportive of direct transmission. A deletion and several amino acid changes in spike, particularly the receptor binding domain, compared to other FCoV-2s, indicate changes to receptor binding and likely cell tropism.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.08.566182v1" target="_blank">Emergence and spread of feline infection peritonitis due to a highly pathogenic canine/feline recombinant coronavirus</a>
</div></li>
<li><strong>Robust detection of SARS-CoV-2 exposure in population using T-cell repertoire profiling</strong> -
<div>
The COVID-19 pandemic clearly demonstrates the need to monitor the spread of infectious diseases and population immunity. Probing adaptive immunity by sequencing the repertoire of antigen receptors (Rep-Seq) encoding specificity and immunological memory has become a method of choice for immunology studies. Rep-Seq can detect the imprint of past and ongoing infections and study individual responses to SARS-CoV-2 as shown in a number of recent studies. Here we apply a machine learning approach to two large datasets with more than 1200 high-quality repertoires from healthy and COVID-19-convalescent donor repertoires to infer T-cell receptor (TCR) repertoire features that were induced by SARS-CoV-2 exposure. Proper standardization of Rep-Seq batches, access to human leukocyte antigen (HLA) typing and both - and {beta}-chain sequences of TCRs allowed us to generate a high-quality biomarker database and build a robust and highly accurate classifier for COVID-19 exposure applicable to individual TCR repertoires obtained using different protocols, paving a way to Rep-Seq-based immune status assessment in large cohorts of donors.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.08.566227v1" target="_blank">Robust detection of SARS-CoV-2 exposure in population using T-cell repertoire profiling</a>
</div></li>
<li><strong>Navigating Digital Inequality: Examining Factors Affecting Rural Customers Internet Banking Adoption in Post-COVID Bangladesh</strong> -
<div>
As the world continues to navigate the new normal brought about by the COVID-19 pandemic, one issue that has come to the forefront is digital inequality. In Bangladesh, where a significant portion of the population resides in rural areas, the adoption of internet banking has been hindered by various factors. However, understanding these factors is crucial, especially now that digital transactions have become more important. This study aims to understand the factors influencing the adoption of internet banking services among rural customers in Bangladesh. To acquire data, a questionnaire was administered to 443 rural bank customers in the district of Barisal. The Exploratory Factor Analysis (EFA) revealed three primary factors: trust compatibility, service benefit, and access to consumer education. In addition, the research sought to determine if the identified factors, particularly access to consumer education, varied according to the occupation and income level of rural consumers. Using exhaustive Chi-squared Automatic Interaction Detection (CHAID) analysis, the findings revealed that access to consumer education differs significantly by occupation level, with business and service holders being more likely than farmers to have access to consumer education. This research contributes to the literature by providing insights into the adoption of internet banking by rural customers and informing policymakers about the special needs of this demographic.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/h76k8/" target="_blank">Navigating Digital Inequality: Examining Factors Affecting Rural Customers Internet Banking Adoption in Post-COVID Bangladesh</a>
</div></li>
<li><strong>A General Guide for Harmonizing Data</strong> -
<div>
Data harmonization is an important method for generating the requisite datasets to support big data analyses. To date however, articles about data harmonization are field-specific and highly technical, mak- ing it difficult for researchers to derive general principles for how to engage in and contextualize data harmonization efforts. This commentary provides general guidance and criteria for researchers who are considering undertaking such efforts or seek to evaluate the quality of existing ones. We derive these guidelines from the extant literature and our own experience in harmonizing data for the emergent and important new field of COVID-19 public health and safety measures (PHSM).
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/baf2j/" target="_blank">A General Guide for Harmonizing Data</a>
</div></li>
<li><strong>East-West mortality disparities during the COVID-19 pandemic widen the historical longevity divide in Europe.</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
For over half a century, life expectancy in Eastern European (former communist) countries has been appreciably lower than in Western Europe, although this difference has been narrowing since 2000. We investigated the impact of the COVID-19 pandemic on these differences. The pandemic reversed the recent convergence and widened the gap to levels observed more than two decades ago (7.9 years for males and 4.9 for females in 2021). Moreover, the trajectory of excess mortality in the pandemic differed between East and West, with the first major peaks in Eastern Europe occurring on average six months after the first peaks seen in Western countries. Despite this, the East suffered greater losses in life expectancy, especially in 2021. This was due to larger relative mortality increases in the East rather than greater frailty of the Eastern European populations as indexed by higher pre-pandemic mortality levels. East-West differences in life expectancy losses in 2021 were substantially explained by COVID-19 vaccination, which together with trust in government accounted for half the gap. We conclude that the East-West differences in life expectancy losses are associated with structural and psychosocial traits that have their roots in the communist era. This includes differences in the connectivity of populations (which drives the differences in timing), as well as profound contrasts in levels of trust in science, authorities, and their capacity to enforce lockdowns and other regulatory measures (driving the huge differences in excess mortality from autumn 2020 onwards).
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.08.23298275v1" target="_blank">East-West mortality disparities during the COVID-19 pandemic widen the historical longevity divide in Europe.</a>
</div></li>
<li><strong>Ceding Power in Intra-Household Bargaining in Times of Economic Anxiety: An Experimental Study in Nepal</strong> -
<div>
How do perceptions of ones relative economic status affect beliefs regarding gender roles? We conducted a 2019 survey experiment with approximately 2,000 adults in Nepal. Employing an established survey treatment called a priming experiment to subtly alter half of respondents perceptions of their relative economic well-being, we ?find that increased feelings of relative deprivation make married women significantly less likely to support gender egalitarian perspectives. Women decrease their support for women making decisions over household expenditures, having equal control over household income, sharing household chores, and women working outside the home. A message randomly read to some women and designed to spur increased support for womens empowerment does little to alter beliefs regarding gender roles or to attenuate the effects of the relative deprivation prime. Despite the negative impacts on womens gender attitudes, however, we do not find a similar pattern among married men. The results underscore the deleterious effects that feelings of relative deprivation can have on womens own gender attitudes and provide a cautionary tale given trends toward greater economic inequality further exacerbated by the COVID-19 pandemic.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/vq8ry/" target="_blank">Ceding Power in Intra-Household Bargaining in Times of Economic Anxiety: An Experimental Study in Nepal</a>
</div></li>
<li><strong>Review on Identification of Major Infectious Site and Disease Progression Pathway for Early Detection of Novel Corona Virus Covid-19</strong> -
<div>
The Novel Coronavirus disease, COVID-19, is a new highly contagious infection, transmitted from human to human of pandemic proportion. The number affected is increasing dramatically, without specific therapy nor vaccination available. The major challenges for its epidemiological control include the prolonged incubation period without symptoms and its ability to transmit the disease by both symptomatic and asymptomatic. This review is to bring an awareness to the scientific and medical community a major route of infection during incubation period, suggesting a new diagnostic approach to be adopted. Exploration of this study may unfold a unique approach to the early detection and clinical management well before its progression to severe disease manifestation. We highlight the importance of evaluating pancreatic function, hepatocellular changes and gastrointestinal lining to enable early diagnosis of the disease.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/fu9p8/" target="_blank">Review on Identification of Major Infectious Site and Disease Progression Pathway for Early Detection of Novel Corona Virus Covid-19</a>
</div></li>
<li><strong>How Covid-19 changed the way we visit rivers? Applications of big data for sentiment analysis</strong> -
<div>
Rivers lay the societal foundations to connect people with various activities around them. While the literature has overlooked the river, emotional values, and wellbeing linkage, how the rivers are perceived by visitors and how the use of rivers has changed during the pandemic can assist in evaluation and decision support in land use policies and plans. On the other hand, social media, assisting in articulating visitation patterns and moods proximate to the river, provides unprecedented insight to better macro- manage these areas. In this study, we employed Machine Learning to conduct a content analysis for rivers of Poland to expose User-Generated Content (UGC) through the visitors lens. We aim at understanding an essential cultural hegemony, the patterns of visits, and the moods of visitors. We further compared the results with the Covid-19 daily infections. The findings suggest an increased pressure on rivers during the pandemic, specifically at the time of the lowest sentiments. Our results may help in articulating patterns and moods proximate to the river that provide unprecedented practical insight and illuminate the path for further research proposals.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/rwqa4/" target="_blank">How Covid-19 changed the way we visit rivers? Applications of big data for sentiment analysis</a>
</div></li>
<li><strong>Nanoscale cellular organization of viral RNA and proteins in SARS-CoV-2 replication organelles</strong> -
<div>
The SARS-CoV-2 viral infection transforms host cells and produces special organelles in many ways, and we focus on the replication organelle where the replication of viral genomic RNA (vgRNA) occurs. To date, the precise cellular localization of key RNA molecules and replication intermediates has been elusive in electron microscopy studies. We use super-resolution fluorescence microscopy and specific labeling to reveal the nanoscopic organization of replication organelles that contain vgRNA clusters along with viral double-stranded RNA (dsRNA) clusters and the replication enzyme, encapsulated by membranes derived from the host endoplasmic reticulum (ER). We show that the replication organelles are organized differently at early and late stages of infection. Surprisingly, vgRNA accumulates into distinct globular clusters in the cytoplasmic perinuclear region, which grow and accommodate more vgRNA molecules as infection time increases. The localization of ER labels and nsp3 (a component of the double-membrane vesicle, DMV) at the periphery of the vgRNA clusters suggests that replication organelles are enclosed by DMVs at early infection stages which then merge into vesicle packets as infection progresses. Precise co-imaging of the nanoscale cellular organization of vgRNA, dsRNA, and viral proteins in replication organelles of SARS-CoV-2 may inform therapeutic approaches that target viral replication and associated processes.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.07.566110v1" target="_blank">Nanoscale cellular organization of viral RNA and proteins in SARS-CoV-2 replication organelles</a>
</div></li>
<li><strong>Standardization and Comparison of Emergency Use Authorized COVID-19 Assays and Testing Laboratories</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
SARS-CoV-2, the causal agent of the global COVID-19 pandemic, made its appearance at the end of 2019 and is still circulating in the population. The pandemic led to an urgent need for fast, reliable, and widely available testing. After December 2020, the emergence of new variants of SARS-CoV-2 led to additional challenges since new and existing tests had to detect variants to the same extent as the original Wuhan strain. When an antigen-based test is submitted to the Food and Drug Administration (FDA) for Emergency Use Authorization (EUA) consideration it is benchmarked against PCR comparator assays, which yield cycle threshold (CT) data as an indirect indicator of viral load—the lower the CT, the higher the viral load of the sample and the higher the CT, the lower the viral load. The FDA mandates that 10-20% of clinical samples used to evaluate the antigen test have to be low positive. Low positive, as defined by the FDA, are clinical samples in which the CT of the SARS-CoV-2 target gene is within 3 CT of the mean CT value of the approved comparator test9s Limit of Detection (LOD). While all comparator tests are PCR-based, the results from different PCR assays used are not uniform. Results vary depending on assay platform, target gene, LOD and laboratory methodology. The emergence and dominance of the Omicron variant further challenged this approach as the fraction of low positive clinical samples dramatically increased as compared to earlier SARS-CoV-2 variants. This led to 20-40% of clinical samples having high CT values and therefore assays vying for an EUA were failing to achieve the 80% Percent Positive Agreement (PPA) threshold required. Here we describe the methods and statistical analyses used to establish a predefined cutoff, based on genome copies per ml (GE/ml) to classify samples as low positive (less than the cutoff GE/ml) or high positive (greater than the cutoff GE/mL). CT 30 for the E gene target using Cobas® SARS-CoV-2-FluA/B platform performed at TriCore Reference Laboratories, and this low positive cutoff value was used for two EUA authorizations. Using droplet digital PCR and methods described here, a value 49,447.72 was determined as the GE/ml equivalent for the low positive cutoff. The CT cutoff corresponding to 49447.72 GE/ml was determined across other platforms and laboratories. The methodology and statistical analysis described here can now be used for standardization of all comparators used for FDA submissions with a goal towards establishing uniform criteria for EUA authorization.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.08.23297633v1" target="_blank">Standardization and Comparison of Emergency Use Authorized COVID-19 Assays and Testing Laboratories</a>
</div></li>
<li><strong>Small Fiber Neuropathy after COVID-19: A Key to Long COVID</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objectives: Report a case series of new onset small fiber neuropathy (SFN) after COVID-19 treated with intravenous immunoglobulin (IVIG). SFN is a critical objective finding in long COVID and amenable to treatment. Methods: A retrospective chart review was conducted on patients seen in the NeuroCOVID Clinic at Yale who developed new-onset SFN after a documented COVID-19 illness. We documented demographics, symptoms, treatments, diagnostics, and clinical response to treatment. Results: Sixteen patients were diagnosed with length dependent or independent SFN on skin biopsy (median age 47, 75% female, 75% Caucasian). Among the nine patients tested for autoantibodies, six were positive for either trisulfated heparin disaccharide (TS-HDS) or fibroblast growth factor receptor 3 (FGFR3). Eight patients underwent treatment with IVIG and experience significant clinical improvement in their neuropathic symptoms. 92% of patients reported post-exertional malaise characteristic of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and six patients underwent invasive cardiopulmonary exercise testing (iCPET), which demonstrated neurovascular dysregulation and dysautonomia consistent with ME/CFS. Discussion: Here we present preliminary evidence that SFN is responsive to treatment with IVIG and linked with neurovascular dysregulation and dysautonomia. A larger clinical trial is indicated to further demonstrate the clinical utility of IVIG in treating post-infectious small fiber neuropathy.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.07.23297764v1" target="_blank">Small Fiber Neuropathy after COVID-19: A Key to Long COVID</a>
</div></li>
<li><strong>The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Abstract Background: Children (&lt;18 years old) were not initially considered significant sources of infection (SOIs) for SARS-CoV-2. Risk mitigation strategies were thus prioritized for adults, and vaccination was inaccessible for children until mid-2021. Emergence of novel variants led to significant increases in COVID-19 cases in both children and adults. Whether these emergence events and increased vulnerability of unvaccinated children had a synergistic effect resulting in increased caseloads in adults requires further exploration. Methods: A retrospective cohort study was conducted among 3,545 workers diagnosed with COVID-19. Case details were compiled during contact investigations. Variants of concern were identified following sequencing of biological samples collected through employer-based testing programs. Logistic regression was performed to compare the odds of having a child SOI based on the dominant variant in the workforce. Results: One-fourth (24.5%) of the cohort reported having a child in-residence; 11.2% identified a child as their SOI. In Alpha-dominant months, the odds of having a child SOI were 0.3, and the child SOI was likely older (5-17 years old). The odds of having a child SOI increased to 1.3 and 2.2 in Delta- and Omicron-dominant months, respectively. The odds of having younger child SOIs (&lt;5 years old) were significantly higher in Omicron-dominant months. Conclusions: Children were highly likely to acquire the virus and posed a significant risk of transmission to their adult caretakers during Delta- and Omicron-dominant months. Without proper mitigation strategies in both the home and the workplace, child-associated transmission can threaten operations in the forms of staff shortages.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.07.23297422v1" target="_blank">The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study</a>
</div></li>
<li><strong>Combining genomic data and infection estimates to characterize the complex dynamics of SARS-CoV-2 Omicron variants in the United States</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
SARS-CoV-2 Omicron surged as a variant of concern (VOC) in late 2021. Subsequently, several distinct Omicron variants have appeared and overtaken each other. We combined variant frequencies from GISAID and infection estimates from a nowcasting model for each US state to estimate variant-specific infections, attack rates, and effective reproduction numbers (Rt). BA.1 rapidly emerged, and we estimate that it infected 47.7% of the US population between late 2021 and early 2022 before it was replaced by BA.2. We estimate that BA.5, despite a slower takeoff than BA.1, also infected 35.7% of the US population, persisting in circulation for nearly 6 months. Other Omicron variants - BA.2, BA.4, or XBB - infected 30.7% of the US population. We found a positive correlation between the state-level BA.1 attack rate and social vulnerability. Our findings reveal the complex interplay between viral evolution, population susceptibility, and social factors since Omicron emerged in the US.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.07.23298178v1" target="_blank">Combining genomic data and infection estimates to characterize the complex dynamics of SARS-CoV-2 Omicron variants in the United States</a>
</div></li>
<li><strong>Overview of the 8th Social Media Mining for Health Applications (#SMM4H) Shared Tasks at the AMIA 2023 Annual Symposium</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The aim of the Social Media Mining for Health Applications (#SMM4H) shared tasks is to take a community-driven approach to address the natural language processing and machine learning challenges inherent to utilizing social media data for health informatics. The eighth iteration of the #SMM4H shared tasks was hosted at the AMIA 2023 Annual Symposium and consisted of five tasks that represented various social media platforms (Twitter and Reddit), languages (English and Spanish), methods (binary classification, multi-class classification, extraction, and normalization), and topics (COVID-19, therapies, social anxiety disorder, and adverse drug events). In total, 29 teams registered, representing 18 countries. In this paper, we present the annotated corpora, a technical summary of the systems, and the performance results. In general, the top-performing systems used deep neural network architectures based on pre-trained transformer models. In particular, the top-performing systems for the classification tasks were based on single models that were pre-trained on social media corpora. To facilitate future work, the datasets, totaling 61,353 posts, will remain available by request, and the CodaLab sites will remain active for a post-evaluation phase.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.06.23298168v1" target="_blank">Overview of the 8th Social Media Mining for Health Applications (#SMM4H) Shared Tasks at the AMIA 2023 Annual Symposium</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>Clinical Evaluation of the Panbio™ COVID-19/Flu A&amp;B Panel to Support Home Use</strong> - <b>Conditions</b>: COVID-19; Influenza A; Influenza Type B <br/><b>Interventions</b>: Diagnostic Test: Panbio™ COVID-19/Flu A&amp;B Panel <br/><b>Sponsors</b>: Abbott Rapid Dx <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>Building Engagement Using Financial Incentives Trial - Colorectal Cancer Screening</strong> - <b>Conditions</b>: Health Behavior; Colorectal Cancer; Influenza; COVID-19; Vaccine Hesitancy; Vaccine-Preventable Diseases; Healthcare Patient Acceptance <br/><b>Interventions</b>: Behavioral: Financial incentive for colorectal cancer screening; Behavioral: Financial incentive for flu shot; Behavioral: Financial incentive for COVID-19 shot <br/><b>Sponsors</b>: Tulane University; National Heart, Lung, and Blood Institute (NHLBI) <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>Effects of Rehabilitation Combined With a Maintenance Program Compared to Rehabilitation Alone in Post-COVID-19</strong> - <b>Conditions</b>: Post-COVID-19 Syndrome <br/><b>Interventions</b>: Procedure: Rehabilitation + maintenance program; Procedure: Rehabilitation only <br/><b>Sponsors</b>: Schön Klinik Berchtesgadener Land; Bavarian State Ministry of Health and Care (Funding); Deutsche Rentenversicherung Bund (German pension insurance) (Design); Betriebskrankenkassen Landesverband Bayern (Bavarian health insurance) (Design) <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>Child and Adolescent Mental Health Literacy for Primary Schools Teachers. A Multicomponent Intervention</strong> - <b>Conditions</b>: Child Mental Health <br/><b>Interventions</b>: Behavioral: Child Mental Health Literacy Program <br/><b>Sponsors</b>: Universidad de Valparaiso <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>Brief Digital Intervention to Increase COVID-19 Vaccination Among Individuals With Anxiety or Depression</strong> - <b>Conditions</b>: Misinformation; Vaccine Hesitancy; Anxiety; Depression; COVID-19 <br/><b>Interventions</b>: Behavioral: Attitudinal inoculation; Behavioral: Cognitive-behavioral therapy-informed intervention; Behavioral: Conventional public health messaging <br/><b>Sponsors</b>: City University of New York, School of Public Health; University of North Carolina, Chapel Hill <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 PhaseⅡ Study to Evaluate the Safety and Immunogenicity of COVID-19 Vaccine</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>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 a Full Face 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>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 Phase 1 Study to Evaluate the Safety and Immunogenicity of COVID-19 Vaccine</strong> - <b>Conditions</b>: SARS-CoV-2 Infection <br/><b>Interventions</b>: Biological: Placebo; Biological: COVID-19 Vaccine (Vero Cell) ,Inactivated; Biological: COVID-19 mRNA Vaccine (ZSVG-02-O) 10 μg; Biological: COVID-19 mRNA Vaccine (ZSVG-02-O) 30 μg; Biological: COVID-19 mRNA Vaccine (ZSVG-02-O) 60 μg <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>: Communicable Diseases; Prevention; Workplace Intervention <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>
</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>An efficient eco-friendly, simple, and green synthesis of some new spiro-N-(4-sulfamoyl-phenyl)-1,3,4-thiadiazole-2-carboxamide derivatives as potential inhibitors of SARS-CoV-2 proteases: drug-likeness, pharmacophore, molecular docking, and DFT exploration</strong> - INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that can cause severe respiratory illness. There is no specific treatment for COVID-19, and the development of new drugs is urgently needed.</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>Lipid and cholesterols modulate the dynamics of SARS-CoV-2 viral ion channel ORF3a and its pathogenic variants</strong> - SARS-CoV-2 accessory protein, ORF3a is a putative ion channel which immensely contributes to viral pathogenicity by modulating host immune responses and virus-host interactions. Relatively high expression of ORF3a in diseased individuals and implication with inflammasome activation, apoptosis and autophagy inhibition, ratifies as an effective target for developing vaccines and therapeutics. Herein, we present the elusive dynamics of ORF3a-dimeric state using all-atoms molecular dynamics (MD)…</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>The anti-SARS-CoV-2 BNT162b2 vaccine suppresses mithramycin-induced erythroid differentiation and expression of embryo-fetal globin genes in human erythroleukemia K562cells</strong> - The COVID-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the ongoing coronavirus disease 2019 (COVID-19) pandemic. The SARS-CoV-2 Spike protein (S-protein) plays an important role in the early phase of SARS-CoV2 infection through efficient interaction with ACE2. The S-protein is produced by RNA-based COVID-19 vaccines, that were fundamental for the reduction of the viral spread within the population and the clinical severity of COVID-19. However, the S-protein has been…</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>Optimizing indoor air quality: CFD simulation and novel air cleaning methods for effective aerosol particle inhibition in public spaces</strong> - In contemporary building ventilation, displacement and mixing ventilation demand high air volumes for rapid virus elimination, resulting in elevated energy consumption. To minimize the spread of viruses and decrease energy consumption for ventilation, this study employed CFD to explore the efficacy of a downward uniform flow field in impeding the transmission of aerosol particles in a high-traffic public facility, like a supermarket. The findings indicate that the downward uniform flow field…</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>Modulation of the replication of positive-sense RNA viruses by the natural plant metabolite xanthohumol and its derivatives</strong> - The COVID-19 pandemic has highlighted the importance of identifying new potent antiviral agents. Nutrients as well as plant-derived substances are promising candidates because they are usually well tolerated by the human body and readily available in nature, and consequently mostly cheap to produce. A variety of antiviral effects have recently been described for the hop chalcone xanthohumol (XN), and to a lesser extent for its derivatives, making these hop compounds particularly attractive for…</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>Unmasking an Allosteric Binding Site of the Papain-like Protease in SARS-CoV-2: Molecular Dynamics Simulations of Corticosteroids</strong> - To date, mechanistic insights into many clinical drugs against COVID-19 remain unexplored. Dexamethasone, a corticosteroid, is one of them. While treating the entire corticosteroid database, including vitamins D2 and D3, with cutting-edge computational techniques, several intriguing results are unfolded. From the top-notch candidates, dexamethasone is likely to inhibit the viral main protease (Mpro), with vitamin D3 exhibiting multitarget [Mpro, papain-like protease (PLpro), and nucleocapsid…</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>Enhancing Employee Job Satisfaction Responding to COVID-19: The Role of Organizational Adaptive Practices and Psychological Resilience</strong> - CONCLUSION: The study provides a new perspective on increasing JS during the COVID-19 pandemic, thereby expanding the scope of the antecedents of employee JS in crisis situations. It also reveals the mediating role of EE and deepens the research on the mechanism by which OAP and PR affect individuals, providing practical guidance for organizations to improve employee satisfaction in sudden public crisis situations.</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>Dexamethasone impairs the expression of antimicrobial mediators in lipopolysaccharide-activated primary macrophages by inhibiting both expression and function of interferon β</strong> - Glucocorticoids potently inhibit expression of many inflammatory mediators, and have been widely used to treat both acute and chronic inflammatory diseases for more than seventy years. However, they can have several unwanted effects, amongst which immunosuppression is one of the most common. Here we used microarrays and proteomic approaches to characterise the effect of dexamethasone (a synthetic glucocorticoid) on the responses of primary mouse macrophages to a potent pro-inflammatory agonist,…</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>Designing Cell Delivery Peptides and SARS-CoV-2-Targeting Small Interfering RNAs: A Comprehensive Bioinformatics Study with Generative Adversarial Network-Based Peptide Design and <em>In Vitro</em> Assays</strong> - Nucleic acid technologies with designed intracellular delivery systems are some of the most promising therapies of the future. Small interfering (si)RNAs inhibit gene expression and protein synthesis and may complement current vaccines with faster design and production. Although successful delivery remains an issue, delivery peptides may help to fill this gap. Here, we address this issue by applying bioinformatic approaches to design new putative cell delivery peptides and siRNAs for COVID-19…</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>The SLC6A15-SLC6A20 neutral amino acid transporter subfamily: functions, diseases, and their therapeutic relevance</strong> - The neutral amino acid transporter subfamily that consists of six members; consecutively SLC6A15-SLC620, also called orphan transporters, represents membrane, sodium-dependent symporter proteins that belong to the family of solute carrier 6 (SLC6). Primarily, they mediate the transport of neutral amino acids from the extracellular milieu toward cell or storage vesicles utilizing an electric membrane potential as the driving force. Orphan transporters are widely distributed throughout the body,…</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>Drug repurposing for the treatment of COVID-19: Targeting nafamostat to the lungs by a liposomal delivery system</strong> - Despite tremendous global efforts since the beginning of the COVID-19 pandemic, still only a limited number of prophylactic and therapeutic options are available. Although vaccination is the most effective measure in preventing morbidity and mortality, there is a need for safe and effective post-infection treatment medication. In this study, we explored a pipeline of 21 potential candidates, examined in the Calu-3 cell line for their antiviral efficacy, for drug repurposing. Ralimetinib and…</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>Inhibitory effects of SARS-CoV-2 Spike protein and BNT162b2 vaccine on erythropoietin-induced globin gene expression in erythroid precursor cells (ErPCs) from β-thalassemia patients</strong> - During the recent COVID-19 pandemic several β-thalassemia patients have been infected by SARS-CoV-2 and most patients were vaccinated against SARS-CoV-2. Recent studies demonstrate an impact of SARS-CoV-2 infection on the hematopoietic system. The main objective of this study was to verify the effects of exposure of erythroid precursor cells (ErPCs) from β-thalassemia patients to SARS-CoV-2 Spike protein (S-protein) and the BNT162b2 vaccine. Erythropoietin (EPO)-cultured ErPCs have been either…</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>Physiological responses and molecular mechanism of Chlorella sorokiniana to surgical mask exudates in wastewater</strong> - Microalgae-based bioremediation is likely to be challenged by the microplastics (MPs) in wastewater induced by the widely use of surgical masks (SMs) during COVID-19. However, such toxic impact was generally evaluated under high exposure concentrations of MPs, which was not in agreement with the actual wastewater environments. Therefore, this study investigated the microalgal cellular responses to the surgical mask exudates (SMEs) in wastewater and explored the underlying inhibitory mechanism…</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>Molecular dynamic simulation reveals spider antimicrobial peptide Latarcin-1 and human eosinophil cationic protein as peptide inhibitors of SARS-CoV-2 variants</strong> - COVID-19 has rapidly proliferated around 180 countries, and new cases are reported frequently. No peptide medication has been developed that can reliably block SARS-CoV-2 infection. The investigation focuses on the crucial host receptors angiotensin-converting enzyme 2 (ACE2) , which can bind receptor-binding domain (RBD) on the SARS-CoV-2 spike protein (S). To investigate the inhibitory effects of human Eosinophil Cationic Protein (hECP) and Latarcin-1 (L1)on SARS-CoV-2 infection, we 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>Role of Enhancing Aerobic Capacity in Countering COVID-19-induced Liver Injury in Elderlies</strong> - COVID-19 is still a world disaster; however, its vaccination is globally available. Liver and gastrointestinal disturbances occur in patients infected with COVID-19 at varying incidences. Aging decreases the functions of the liver. Thus, the elderly have a weaker response to the COVID-19 virus. The COVID-19 virus affects the liver directly through direct and indirect mechanisms. It directly affects the renin-angiotensin system or indirectly causes sepsis, uncontrolled immune reactions,…</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>Nikki Haley Takes On the Scum at the Third Republican Debate</strong> - Donald Trump has dominated the primary season, but his former U.N. Ambassador is the best debater in the field—and she would probably be the G.O.P.s most effective candidate against Joe Biden. - <a href="https://www.newyorker.com/news/our-columnists/nikki-haley-takes-on-the-scum-at-the-third-republican-debate">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inside the Israeli Crackdown on Speech</strong> - Since the October 7th attack, Palestinians and peace activists in Israel have increasingly been targeted by employers, universities, government authorities, and right-wing mobs. - <a href="https://www.newyorker.com/news/annals-of-human-rights/inside-the-israeli-crackdown-on-speech">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Would a Humanitarian Pause Work in Gaza?</strong> - The vague, technocratic term was apparently chosen to avoid “ceasefire.” - <a href="https://www.newyorker.com/news/daily-comment/how-would-a-humanitarian-pause-work-in-gaza">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Warnings About Trump in 2024 Are Getting Louder</strong> - A judges plea, Hillary Clinton invokes the H-word, and a shock poll in the Times. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/the-warnings-about-trump-in-2024-are-getting-louder">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Lessons of Ohios Abortion-Rights Victory</strong> - Tuesdays election results in that state and elsewhere offer fresh evidence of how the issue is likely to help Democrats in 2024. - <a href="https://www.newyorker.com/news/daily-comment/the-lessons-of-ohios-abortion-rights-victory">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Psychedelics can have enormous benefits, but the risks shouldnt be ignored</strong> -
<figure>
<img alt="A head with two faces looking in different directions, one looking upward in a pleasing psychedelic array of colors, another looking down, in a darker, gloomier direction." src="https://cdn.vox-cdn.com/thumbor/8mpzYx-l7xOH6TMdDl-oDMOjRTQ=/473x0:6037x4173/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72850769/GettyImages_1516862786.0.jpg"/>
<figcaption>
wildpixel/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
As access grows, we need better research and education on bad trips.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cfucwf">
The term “psychedelic” was <a href="https://www.mqup.ca/psychedelic-prophets-products-9780773555068.php">coined</a> by psychiatrist Humphry Osmond: “To fathom Hell or go angelic / Just take a pinch of psychedelic.” But todays public messaging around psychedelics has a dangerous tendency to <a href="https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0293349">gloss over</a> the “fathoming hell” part, which has been euphemized into the language of a “bad” or “challenging” trip.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GxJRr0">
Challenging trips are generally ones that involve encounters with intense anxiety, unwelcome loss of control, surfaced trauma, or physical discomfort. Theyre difficult experiences in the moment, but ultimately, once things settle down, they can be cast in a therapeutic light, and people <a href="https://akjournals.com/view/journals/2054/5/2/article-p114.xml">look back on them as worthwhile</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KsIsPZ">
Then there are just plain bad trips that do not resolve into a harmonious insight, no matter how much therapy, intention, and journaling you throw at them. “Choking, breathless, I was having a grief-tinged cosmic panic attack,” the Harvard theologian Rachael Petersen <a href="https://bulletin.hds.harvard.edu/a-theological-reckoning-with-bad-trips/">wrote of her experience</a> in a psilocybin clinical trial. “A small kernel of doubt: a splinter wedged between me and the world … What if terror is just that — terrible, terrifying, absolute?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ucT0ir">
The positive sides of psychedelics — therapeutic promise, spiritual renewal, and <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1152896/full">radical forms of creativity</a> — attract more interest, and more funding, than research into what might go wrong for a minority of users. And to be clear, even outside of the well-controlled settings of clinical trials, the majority of psychedelic trips do seem to lean positive. One recent study that surveyed 613 lifetime psychedelic users drawn from <a href="https://www.sciencedirect.com/science/article/pii/S0165032723000915?via%3Dihub">a nationally representative sample</a> found that 82.4 percent reported “never” or “rarely” experiencing bad trips. More than 90 percent reported either no subsequent impairment in their ability to function, or difficulties lasting no more than 24 hours.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZSiigA">
But the attention capture of good trips has fed a poor understanding of the <a href="https://bulletin.hds.harvard.edu/a-theological-reckoning-with-bad-trips/">vast array of experiences</a> that fall into the “bad trips” category, leaving those who suffer from them without much institutional support or information, even as states have begun providing regulated access to psychedelics and <a href="https://psychedelicalpha.com/data/psychedelic-laws">decriminalizing</a> them for personal use.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qotsnu">
“We need to learn more about the risks and harms of psychedelics … Were still at the beginning of that process, in my view,” said Jules Evans, director of the <a href="https://challengingpsychedelicexperiences.com/">Challenging Psychedelic Experiences Project</a>. “Its not just about researchers trying to be more rigorous in reporting adverse experiences in trials. Its also about actively researching harms and how to treat them.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UCnwSS">
In the late 1960s, poor public understanding of the actual risks of psychedelics allowed misinformation and <a href="https://ir.library.louisville.edu/cgi/viewcontent.cgi?article=1072&amp;context=tce">sensationalized stories</a> — of LSD users leaping from tall buildings to their death under the impression that they could fly, or irreparably damaged chromosomes — to spread, stoking a moral panic that led to the prohibition that is only just being relaxed, more than 50 years later.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1KVmSJ">
This time around, we run a similar risk. Except now, many of those who are working to spread awareness of the potential harms <a href="https://themicrodose.substack.com/p/what-if-someone-harms-you-while-youre?utm_source=post-email-title&amp;publication_id=371945&amp;post_id=138561616&amp;utm_campaign=email-post-title&amp;isFreemail=true&amp;r=iprz&amp;utm_medium=email">dont want</a> another prohibition, and opposing one shouldnt mean sweeping the risks under the rug so as to rush through legislation. Instead, an honest and transparent account of both the benefits and risks of psychedelics can help build a better, more resilient post-prohibition world.
</p>
<h3 id="9CBqIJ">
If good trips can change long-term behaviors, so can bad ones
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kB8QJj">
Last month, an off-duty pilot <a href="https://www.nytimes.com/2023/10/24/us/alaska-airlines-off-duty-pilot-arraignment.html">aboard a flight</a> to San Francisco tried pulling the planes emergency shut-off handles because he thought he was in a dream and crashing would wake him up. He had struggled with depression for six years and also reported struggling with the recent death of a friend. Forty-eight hours before the flight, he tried psilocybin mushrooms for the first time, had a terrible experience, and hadnt slept since.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qAudTl">
In the subsequent media coverage, <a href="https://www.ecstaticintegration.org/p/the-cost-of-utopia">experts debated</a> what role the drugs — whose subjective effects generally fade after <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156539/">six hours</a> — might have played in the episode two days later. While it might seem strange that psychedelics could play a role in behavior changes that take place well after the molecules have left the body (psilocybin is generally metabolized within <a href="https://www.sciencedirect.com/science/article/abs/pii/B978044453717100158X?via%3Dihub">24 hours</a>), most of the hype around their therapeutic effects depends on it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="12L308">
Current <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2206443">research</a> on psilocybin suggests that a single dose, coupled with psychological support, can reduce symptoms of treatment-resistant depression for at least three weeks or <a href="https://pubmed.ncbi.nlm.nih.gov/27441452/">help people quit smoking</a> for good. If thats the case, why wouldnt it be possible to see negative effects persist along the same timelines? Why couldnt the psilocybin have something to do with an episode occurring 48 hours later?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YIGlks">
“There is hardly any empirical research on how best to treat extended difficulties. Thats one example of a massive research gap that still exists,” Evans said. At least until last month, when <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293349">a new study</a> he co-authored was published, surveying 608 psychedelic users who all reported extended difficulties lasting more than 24 hours after the trip itself subsided. Thirty-two percent reported difficulties persisting longer than a year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pQOoG8">
Participants reported using a number of drugs — mostly LSD and psilocybin — in a broad range of settings, including solo trips, underground ceremonies, clinical trials, therapy sessions, and raves. The most common type of difficulty reported was emotional, including things like anxiety, depression, paranoia, and low mood. Another 42 percent reported “existential difficulties,” consisting of subtypes like “existential struggle,” derealization (when the world comes to feel “less real,” or as if its a dream, akin to what the pilot reported), and difficulties integrating experiences into everyday life. In total, the report divided the blunt category of “extended bad trips” into nine themes and 62 subthemes, creating a more granular account of what exactly people experience.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zruRPg">
Despite the entire sample reporting extended difficulties, about 90 percent agreed that “the insights and healings gained from psychedelics” are worth the risks, “when taken in a supportive setting,”<em> </em>which is left open to interpretation.
</p>
<h3 id="JH9j0z">
What should bad trips mean for regulation and access?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mYyFU8">
“None of us want to see psychedelics become less accessible,” Erica Siegal, a social worker who supports victims of sexual assault who were harmed while on psychedelics, <a href="https://themicrodose.substack.com/p/what-if-someone-harms-you-while-youre">told</a> the Berkeley Center for the Science of Psychedelics newsletter, the Microdose.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9hoyXf">
Thats a big shift from the late 1960s, when stories of distressed airline pilots or psychedelic sexual abuse might have fed directly into prohibition efforts. But if heavy restrictions are not whats wanted, then what to do?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rG3MCJ">
According to <a href="http://www.thecuriousspirit.org/meet-the-team.html">Katrina Michelle</a>, the former director of harm reduction for the Multidisciplinary Association for Psychedelic Studies (MAPS), “The power lies in educating people and empowering them with information to make intelligent choices.” She explains that public access to <a href="https://psychedelics.berkeley.edu/understanding-risk/">information about risk management</a> can help mold the publics idea of what responsible use looks like. Society uses a similar approach to cars and alcohol, where after meeting basic accessibility criteria or obtaining a license, we rely on a mix of public education and individual responsibility.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Av68Lk">
Evans offers another metaphor, likening psychedelics to “dangerous sports, like diving or mountain climbing. It took humans decades to develop safety protocols for these sports, and even now there are accidents.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EvkcOr">
He outlines four pillars for improving psychedelic safety: researching harms, communicating them, supporting those who experience them, and regulating the emerging psychedelic markets to minimize those harms.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="47J1mU">
That last point will be thorny, especially since we dont know what types of markets will be legalized (state-level reforms have focused on decriminalization, research, and restricted access rather than full commercialization). <a href="https://transformdrugs.org/">Transform</a>, a UK-based drug policy foundation, will publish <a href="https://idpc.net/events/2023/11/book-launch-how-to-regulate-psychedelics-a-practical-guide">a report</a> next week that provides guidance on four different approaches: decriminalized private use and non-commercial sharing, nonprofit membership associations (a model pioneered by <a href="https://www.nytimes.com/2014/07/11/world/europe/marijuana-clubs-rise-out-of-decades-old-spanish-laws.html">cannabis social clubs</a> in Spain), licensed production and retail, and commercial guided experiences.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EkGpOx">
“Despite there being plentiful, eloquent critiques of the failure of prohibition, these have not necessarily produced credible visions for an alternative approach which public, professional and policy-maker audiences can buy into,” the report states.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cIrYLf">
As these regulatory visions take shape, addressing the imbalance in research on benefits and risks could be an important part of building good institutions for the next era of legal psychedelic use. It wont be easy, but Evans sees a few hopeful signs. “Thankfully, I see some of the big psychedelic philanthropists now looking to fund more research in this area,” he said. “I also see younger psychedelic researchers keen to learn more to make the field safer.”
</p></li>
<li><strong>Joe Manchin retires, making Democrats brutal 2024 Senate map even more brutal</strong> -
<figure>
<img alt="Senator Joe Manchin seen from the shoulders up, wearing a tan suit jacket and light blue shirt. He has close-cropped, grey hair. " src="https://cdn.vox-cdn.com/thumbor/mC_CblZpSNjdXPyzOqXCOnqM0-Q=/613x0:7952x5504/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71681516/GettyImages_1244110710.7.jpg"/>
<figcaption>
Senator Joe Manchin, a Democrat from West Virginia, speaks during a community listening session at Piketon High School in Piketon, Ohio, on October 20, 2022. | Gaelen Morse/Bloomberg via Getty
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Republicans have lots of good pickup opportunities. Democrats, not so much.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OKgc0X">
Sen. Joe Manchin (D-WV) will not run for reelection — a decision that likely means Democrats will lose a Senate seat in the narrowly divided chamber in 2024.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="suK5cG">
The stubborn centrist represented one of the most Republican states in the country — one that Trump won by nearly a 39 percentage point margin in 2020. Yet Manchin was able to defy West Virginias partisan leanings via <a href="https://www.vox.com/22339531/manchin-filibuster-bipartisanship-senate-west-virginia">his long history in state politics,</a> including as a former governor, dating back to the years when Democrats won the state regularly.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="s2ewpg">
Since then, the West Virginia Democratic Party has been decimated, as the states voters have increasingly voted with their national partisan loyalties. It is hard to believe any other potential Democratic nominee would be able to match Manchins political strength there.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J8SpGw">
Democrats currently have a 51-49 majority in the Senate, so losing Manchins seat would put them back to 50-50 — still enough for control if President Joe Biden and Vice President Kamala Harris win reelection.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b9UztA">
The problem is that Democrats 2024 Senate challenges go far beyond West Virginia. They face such a starkly unfavorable map that, if things even go somewhat poorly for the party, they could fall into a deep Senate hole for years to come.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="z4sOZn">
Besides Manchin, two other Democratic senators represent states Donald Trump won in 2020, and theyre also up for reelection in 2024. Sens. Jon Tester (D-MT) and Sherrod Brown (D-OH) are both running again, but<strong> </strong>these are all very red states, and winning them in a presidential year will be quite difficult for Democrats.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lAPotU">
But the vulnerabilities go deeper. The only remotely close states (per presidential results) where Republicans are defending seats are Florida and Texas — two states where Democrats have had few victories in recent years. Meanwhile, Democrats are also defending seats in five states Joe Biden very narrowly won in 2020. These seats are currently held by Kyrsten Sinema (I-AZ), Tammy Baldwin (D-WI), Bob Casey Jr. (D-PA), Jacky Rosen (D-NV), and Debbie Stabenow (D-MI).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GgLbGM">
Democrats might think they have nothing to worry about regarding this group of seats, because, look, the party defied the naysayers in the tough year of 2022, winning at least one statewide contest in all these states — so clearly these states lean in their favor.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j5692E">
But its always a mistake to overread the results of the last election, and to underestimate how much things could change before the next one. Particularly if Trump is not the nominee again, the party coalitions could be scrambled in unpredictable ways. And even Trump came quite close to winning these states in 2020.
</p>
<h3 id="1lWU8v">
The Class of 2024
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1LgPgg">
Senators serve six-year terms, so only one-third of the body is up for election each cycle. And the particular grouping of Senate seats (referred to as a “<a href="https://www.senate.gov/senators/Class_I.htm">class</a>”) up for election in 2024 has enjoyed a particularly charmed run for Democrats. You have to go all the way back to the 1994 GOP wave for a strong Republican performance. Since then, theyve been on the ballot in the following years:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3BGdDa">
2000: A closely fought presidential year in which Al Gore won the popular vote but George W. Bush won the Electoral College, and Democrats picked up four Senate seats on net
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QEBZsa">
2006: A Democratic wave year, in which the party retook both the House and the Senate, picking up six seats in the latter chamber
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vcmw0Q">
2012: A strong Democratic year for Barack Obamas reelection, in which the party unexpectedly expanded its Senate majority by two seats
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CYCxjd">
2018: Another Democratic wave year — but the party had won so many seats in deep red states in previous cycles that they had several incumbents in strongly Republican territory, so they ended up with a net loss of two seats
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fWxUMm">
So this Senate class is risky for Democrats in part because theyve had such good luck with it in the past. Nearly half of Democrats Senate majority — 23 sitting senators — come from this grouping of seats, so theyll all be on the ballot in 2024. Meanwhile, only 10 Republicans will be up, though special elections could increase this number. Thats already a numerical disadvantage. But the disadvantage extends to which specific seats are up.
</p>
<h3 id="wiIyvH">
Which specific seats are up
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QOJOC9">
To understand the extent of the Democrats challenge, its important to realize that the Senate has changed. In the past, it was common for a states voters to back Senate and presidential candidates from different parties. For instance, after the bitterly fought 2000 election, 30 of 100 sitting senators represented states that their partys presidential nominee did not win in the most recent election. Thats a lot of ticket-splitting.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8pkI1s">
Since then, that number has gradually dwindled, as red-state Democrats and blue-state Republicans have retired or gone down to defeat. When Trump took office, there were 14 such senators remaining. Now, there are just six. The Senate has sorted by partisanship.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tjAlN3">
Of course, states that have a roughly equal partisan balance can still go either way. But its gotten much tougher to defy partisan gravity in deeply Republican or Democratic states — especially in a presidential year. In 2016, zero states elected presidential and Senate candidates from different parties. In 2020, just one state did, as Republican Sen. Susan Collins won in Maine, a Biden state.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nuugks">
Now, in 2024, the seats of all three Democratic senators representing states Trump won in 2020 — Manchin in West Virginia, Tester in Montana, and Brown in Ohio — are up.
</p>
<figure class="e-image">
<img alt="A chart showing Democrats have 23 Senate seats up for election in 2024. Three are in states Trump won by large margins in 2020, and five more are in closely fought swing states." src="https://cdn.vox-cdn.com/thumbor/OocNf4c-Q5bJfParHm7fERWMZR8=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24220842/Screen_Shot_2022_11_22_at_4.04.02_PM.png"/> <cite>Andrew Prokop/Vox</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Gs97OZ">
Manchins seat is likely lost due to his retirement. But the best hope for Tester and Brown is for Republicans to have a <a href="https://www.politico.com/news/2023/07/17/larose-gops-ohio-senate-primary-00106459">messy</a> and <a href="https://www.politico.com/news/2023/08/08/conservative-roadblock-to-ousting-tester-00110258">divisive primary</a>, after which a controversial nominee emerges. Even then, though, it would be tough to defy the presidential lean of their states, which have both backed Trump pretty solidly in the past two cycles.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qtbr9F">
So thats three seats where, per underlying partisanship alone, Democrats will have a hard go of it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TA0miq">
Then there are five swing states which, if recent history is any guide, are likely to have closely matched Senate and presidential outcomes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CWVivc">
In Arizona, Kyrsten Sinema quit the Democratic Party, and <a href="https://www.nbcnews.com/politics/2024-election/krysten-sinema-pitches-donors-arizona-senate-race-path-victory-rcna117002">its currently unclear whether shell run for reelection</a>; if she does, a three-way race would ensue. In Nevada, Jacky Rosen just saw her colleague Catherine Cortez Masto narrowly survive <a href="https://www.vox.com/policy-and-politics/23425137/midterm-elections-2022-nevada-senate-cortez-masto-adam-laxalt">a very close contest</a> in 2022.<strong> </strong>Then there are the three seats in the Rust Belt swing states — those held by Tammy Baldwin (D-WI) and Bob Casey Jr. (D-PA), who are running again, and Debbie Stabenow (D-MI), who is retiring.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VMedRn">
Democrats dont start off as underdogs in any of these states, and they could well win them all. But again, much will likely depend on the presidential contest. If that contest trends toward the GOP, several of these Senate seats could follow.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="khcZ4D">
Moving on to the GOP-held seats up for election — barring some sort of GOP candidate catastrophe in a deep red state, Democrats have only two plausible targets: Florida and Texas.
</p>
<figure class="e-image">
<img alt="A chart showing that Republicans are only defending 10 Senate seats in 2024, and theyre all in states Trump won in 2020." src="https://cdn.vox-cdn.com/thumbor/1XfQYH4aKqWa3jgvODXKDSd1GLo=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24220565/Screen_Shot_2022_11_22_at_2.37.28_PM.png"/> <cite>Andrew Prokop/Vox</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nEctYM">
In Florida, Sen. Rick Scott (R) is running for a second term. Back in 2018, Scott only won by an incredibly narrow 0.12 percent margin. But the Sunshine State has been trending away from Democrats since then, as seen in Gov. Ron DeSantis and Sen. Marco Rubios landslide reelection victories last year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5VXGC1">
Texas, where Sen. Ted Cruz (R) is up, has been moving the other way demographically —Trump only won it by <a href="https://www.nytimes.com/interactive/2020/11/03/us/elections/results-texas-president.html">5.6 percentage points</a> in 2020, and Cruz won reelection by <a href="https://www.nytimes.com/elections/results/texas-senate">2.6 percentage points</a> in 2018). Still, Democrats havent won a statewide race there <a href="https://www.kxan.com/news/texas-politics/why-cant-texas-democrats-win-state-stays-solidly-red/">since 1994</a>. Rep. Colin Allred, the <a href="https://thehill.com/homenews/campaign/4250481-texas-democrat-allred-raises-4-7-million-in-third-quarter-to-challenge-cruz/">frontrunner</a> for the Democratic nomination to face Cruz, hopes to change that.
</p>
<h3 id="5ANhAs">
The takeaway
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mN1StY">
Democrats are fortunate that they picked up a Senate seat in the 2022 cycle, expanding their majority to 51-49 rather than 50-50. That gives them a cushion to survive the likely loss of Manchins seat. But they have no other room for error.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WwDAtC">
The problem is that even if Democrats have a great year nationally in 2024, the underlying partisanship of the map means theyd likely lose three seats. The 2022 Senate map was, <a href="https://www.vox.com/2021/10/18/22724808/democrats-senate-disadvantage-shor-klein">as I wrote during that cycle</a>, “relatively balanced,” but the 2024 map just isnt. (And again, thats mainly because Democrats have been so successful in these races previously, so they simply have more to lose.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uiX65m">
And if 2024 is not a good year for Democrats nationally? Well, then they could lose some or all of those five swing state seats, putting them at a serious deficit in the Senate that it could take many years to climb out of.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4FH77e">
<em><strong>Update, November 9, 2023, 4:00 pm ET</strong></em><em>: This article was originally published in November 2022. It has been updated to include developments in Senate races since then.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZltNdm">
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gwEDYg">
</p></li>
<li><strong>The Marvels post-credits scene brings back [spoiler]</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/C62xuJQNR42ePLNp0xt_O_c8vHE=/960x0:8640x5760/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72849154/GRO_13045_R.0.jpg"/>
<figcaption>
Brie Larson as Captain Marvel, one of <em>The Marvels</em> and not to be confused with Ms. Marvel. | Marvel/Laura Radford
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The latest from the MCU teases a comic book superhero team.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZnPSw2">
<em><strong>This post includes spoilers for</strong></em><strong> The Marvels.</strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zaorBV">
<em>The Marvels</em> had everything: the return of Captain <a href="https://www.vox.com/marvel">Marvel</a> a.k.a. Carol Danvers (Brie Larson), the big-screen debut of Ms. Marvel a.k.a. Kamala Khan (Iman Vellani), and the ascension of Monica Rambeau (Teyonah Parris) to full-fledged superhero. It had that illustrious trio teaming up, becoming The Marvels, and saving the day from Dar-Benn (Zawe Ashton), a beautiful Kree alien with a giant hammer and a maniacal thirst to drain worlds of their natural resources. It had a bunch of aliens that look like cats, with a song from Andrew Lloyd Webbers feline musical to boot.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8rQTHM">
Given all that, youd think that Marvel might hold off on introducing more stuff. But this is Marvel, a studio that <a href="https://www.vox.com/22893634/marvel-post-credits-scene-history">cant help</a> but attach a teaser or some kind of Easter egg to its films. And for longtime superhero fans, this movie has a huge one.
</p>
<figure class="e-image">
<img alt="Image reads “spoilers below,” with a triangular sign bearing an exclamation point." src="https://cdn.vox-cdn.com/thumbor/uPQF4l3Wvpgo7pB7TTD6_3CasSQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/8565937/spoilers_below.png"/>
<figcaption>
Spoilers for The Marvels below…
</figcaption>
</figure>
<h3 id="9fHCEc">
The Marvels credits scene teases the introduction of the X-Men, again
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XsJpOj">
In the movies finale, Captain Marvel, Ms. Marvel, and Monica Rambeau have to fix Dar-Benns mess.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="e88dXj">
Before perishing, Dar-Benn uses a massive amount of power to tear through space and time, creating, as Monica describes, a wormhole into another universe. Yes, its back to the multiverse for the MCU, but thankfully its very simple here: No one needs to know Kang or quantum realms or any of the complicated stuff found in this years <a href="https://www.vox.com/culture/23612887/ant-man-quantumania-marvel-flop-era"><em>Quantumania</em></a>. Monica has to use her light powers to patch up the hole so that each universe remains intact.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QgTjto">
Monica is able to seal them shut, but in doing so, she crosses over to the parallel universe. Captain Marvel tries to save her, but shes too late. The movie ends with Monica separated from Carol and Kamala.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CcM2bY">
In the credits scene, Monica wakes up in what appears to be some kind of medical unit. She looks over and sees a woman who appears to be her dead mom, Maria Rambeau (Lashana Lynch). The woman doesnt recognize Monica and pulls away. Monica slowly starts to put together that even though this woman looks like her mom (after all, its the same actress), she isnt the Maria that Monica knows. She might not even be Maria at all.
</p>
<figure class="e-image">
<img alt="Monica Rambeau in a spacesuit." src="https://cdn.vox-cdn.com/thumbor/7nGwhUmNc3qJLKL3cxCxzyVElwc=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25068868/SSW1180_comp_trx_v0016.1105.jpg"/> <cite>Courtesy of Marvel Studios</cite>
<figcaption>
In the comic books, Monica Rambeau once held the codename “Captain Marvel,” which makes <em>The Marvels </em>even more confusing.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EljIQL">
While both women are trying to piece together whats happening, someone unseen enters the room and starts briefing them. The male voice explains that Monica was found floating in space by someone called Binary, and Binary took Monica in for medical care. Monica, the voice says, seems to be from a different universe. The camera pans up and reveals that the person speaking is Beast a.k.a. Hank McCoy a.k.a one of the X-Men. Kelsey Grammer, who played Beast in Foxs <em>X-Men</em> <a href="https://www.vox.com/movies">movies</a>, reprises his role.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FKEdBi">
Beast tells Monica that Charles (as in Charles Xavier, head of the X-Men) wants to speak to all of them and that the woman she thinks is her mom is Binary, the hero who saved her. The scene cuts as Monica puts it all together that shes trapped in a parallel timeline and has to figure out how to get back home — probably with the help of Beast, Binary, Charles, and possibly the X-Men. The<a href="https://www.imdb.com/title/tt0290334/"> <em>X2</em> theme</a> from the 2003 movie plays as the scene ends.
</p>
<h3 id="hSXkp2">
What <em>The Marvels</em> post-credits scene means
</h3>
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The scene is significant for a number of reasons, but the biggest one is that it teases the possibility of the X-Men finding their way into the MCU sooner than later. Since Marvel re-acquired the film rights to X-Men (as part of the <a href="https://www.vox.com/culture/2019/3/27/18280941/marvel-fox-disney-merger-x-men">Fox acquisition</a>), fans have been waiting to see when and how the company would bring mutants into the MCU. Before Marvel turned the Avengers into a multibillion-dollar movie franchise, the X-Men, along with Spider-Man, were the companys most recognizable and profitable heroes.
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If the X-Men exist in a parallel universe and Monica Rambeau is there too, it stands to reason that there could be a storyline in which one or two of our merry mutants tag along with her when she gets back to the main timeline.
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But thats not all.
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<img alt="Monica Rambeau making a battle snarl and extending a glowing hand to the camera." src="https://cdn.vox-cdn.com/thumbor/_j6xlYPJB31UCMc5q7S4S0Ny7ME=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25068870/ALF1100_comp_WTA_v0061.1040_R.jpg"/> <cite>Courtesy of Marvel Studios</cite>
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Monica Rambeau might need the X-Mens help to get back to her home timeline!
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This is now the second time an X-Man has appeared in an MCU movie. In 2022s<a href="https://www.vox.com/23064297/doctor-strange-multiverse-of-madness-x-men-mcu"> <em>Doctor Strange in the Multiverse of Madness</em>,</a> Charles Xavier a.k.a. Professor X (Patrick Stewart), appears in, yes, a parallel universe. But Wanda Maximoff (Elizabeth Olsen) kills him in a fit of rage. Professor Xs death in that previously seen universe would indicate that Monica is actually in a different world from the one we saw in <em>Multiverse of Madness. </em>That means there are at least two parallel universes in the MCU in which X-Men exist and have interacted with the main MCU timeline. And if there are X-Men in these alternate realities, it could suggest there might be some variation of the X-Men and mutants already present in the main MCU timeline.
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The other shocking thing that happens in the credits scene is the reference to Binary. <a href="https://www.vox.com/2014/11/5/7138099/captain-marvel-background-history-movie">In the comics</a>, Binary is Captain Marvel/Carol Danverss most powerful form. Carol becomes a cosmic entity and this allows her to travel at the speed of light and command the power of the stars. While this <a href="https://www.vox.com/comic-books">comic book</a> incarnation possesses Carols human consciousness, their Binary is referred to as a higher or more powerful autonomous being. Shes an ally to the X-Men (mainly because the X-Men are in space a lot and because the X-Men are friends with Carol) but prefers to travel and adventure solo in the cosmos, zooming from galaxy to galaxy. The X-Men usually stick close to Earth.
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Given that Binary is associated with Carol Danvers, it could be that the woman Monica thinks is her mom (and again, played by the same actress) is actually that universes variant of Carol. Or, perhaps in that universe, Maria Rambeau becomes Binary herself, which would explain why she doesnt know Monica.
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Whats clear is that the introduction of Binary and twisty reprisals of all these X-Men characters are going to spur fan theories and speculation — and thats something Marvel needs given the lackluster state of the MCU. Its an exciting crossover with a lot of potential. The rub is that well only find out exactly how the X-Men will factor into the MCU when Monica and the trio reunite — whenever that may be.
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<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Easy to give opinion on TV; captaincy didnt affect my batting: Babar takes on critics</strong> - Former skippers including Moin Khan and Shoaib Malik have openly criticised Babars captaincy on air and felt that the burden of leadership has affected his batting.</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>Bangladesh coach calls for timed-out rule change as Shakib row rumbles on</strong> - Bangladesh defeated Sri Lanka by three wickets in a World Cup group-stage game in Delhi on November 6.</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>Watch | How is a cricket ball made?</strong> - A video showing the various stages in the making of a cricket ball, at a sports equipment factory in Meerut, Uttar Pradesh</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>AFG vs SA | Afghanistan opt to bat against South Africa</strong> - Afghanistan, who are chasing an improbable semifinal spot, are unchanged. The Proteas have brought in Andile Phehlukwayo and Gerald Coetzee in place of Tabraiz Shamsi and Marco Jansen</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>Sri Lanka team returns home, chief selector blames external conspiracy for poor World Cup show</strong> - Sri Lanka recorded their worst World Cup performance since 1992, winning only two of their nine games</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Century-old Gandhi Park inaugurated after extensive renovation in Guntur</strong> - Located in the heart of the city, the park now offers recreational facilities for people of all age groups; the GMC spent around ₹6.50 crore on its facelift, say officials</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>Here are the big stories from Karnataka today</strong> - Welcome to the Karnataka Today newsletter, your guide from The Hindu on the major news stories to follow today. Curated and written by Nalme Nachiyar.</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>Vela movie review: This Shane Nigam-starrer fails to make use of its intriguing premise</strong> - Vela, starring Shane Nigam and Sunny Wayne, and directed by debutant Syam Sasi, gets repetitive after a point and limps towards a laboured climax</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>Constable ends life at workstation in Rayachoti</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>Bhojpur weighs choices of MLAs to carry on its rich political legacy</strong> - Voters in the constituency, once represented by the late BJP stalwart Sunderlal Patwa, list the condition of roads, cash assistance for women, and the safeguarding of culture as key issues this time</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Jewish fears as German support for Israel is challenged on streets</strong> - As fighting continues between Israel and Hamas, social discord is emerging 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>Spains Sánchez secures power deal with Catalan separatists prompting anger</strong> - Pedro Sánchezs agreement is attacked by conservatives in Spain as opening a back-door to tyranny.</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>Ukrainian teen may be forced into the Russian army</strong> - Bogdan Yermokhin, originally from Mariupol, is ordered to report to a draft centre when he turns 18.</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>Iceland volcano: Blue Lagoon closes over eruption fears</strong> - More than 20,000 minor earthquakes have been detected by Icelandic authorities since late October.</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>Transgender people can be baptised and be godparents, Vatican says</strong> - The Roman Catholic Church says priests can baptise trans people so long as it does not cause “scandal”.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Daily Telescope: Peeling back the layers of the Garlic Nebula</strong> - “Without narrowband filters, its almost impossible to photograph.” - <a href="https://arstechnica.com/?p=1982361">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Is the NFL making progress in tackling its concussion crisis?</strong> - Concussion counts are not as objective as they may seem. - <a href="https://arstechnica.com/?p=1982723">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rocket Report: Tough times Astra and Virgin; SpaceX upgrading launch pad</strong> - The worlds busiest launch pad will soon be capable of supporting astronaut flights. - <a href="https://arstechnica.com/?p=1982804">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Owner of Tumblr confirms sites shift from “surging” to “small and focused”</strong> - CEO confirms Tumblr has lost “well north of $100M” since acquisition. - <a href="https://arstechnica.com/?p=1982553">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Combined Hulu and Disney+ app launches in March; beta debuts in December</strong> - Consolidated libraries could bring fatigued streamers slight relief. - <a href="https://arstechnica.com/?p=1982754">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
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<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Make the horse laugh</strong> - <!-- SC_OFF --></p>
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Theres a sign outside a local bar that says, Anybody who can make our horse laugh can drink for free all night. A guy walks into the bar and says to the bartender, Id like to try and make the horse laugh. He walks into the stables and a few moments later, the horse is laughing hysterically. The guy drinks for free all night. A few weeks later, he returns. The sign now says, Anybody who can make our horse cry drinks for free all night. The guy tells the bartender he wants to try again, goes into the stables, and when he comes out, the horse is crying buckets. The bartender says, Okay buddy, before you say anything, you have to tell me how you made my horse laugh, and then came back weeks later and made him cry. The guy sips on his free drink and says, well when I made him laugh, I told him that I have a bigger package than him. The man continues, and when I came back and made him cry, I showed him.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Western-String-8768"> /u/Western-String-8768 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17rswl6/make_the_horse_laugh/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17rswl6/make_the_horse_laugh/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>This Halloween I went as a former gifted student.</strong> - <!-- SC_OFF --></p>
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I just wore normal clothes, and when people asked me what I was supposed to be, I sighed and said “I was supposed to be a lot of things.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/delofan"> /u/delofan </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17rv4ye/this_halloween_i_went_as_a_former_gifted_student/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17rv4ye/this_halloween_i_went_as_a_former_gifted_student/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Three nuns die and arrive in heaven</strong> - <!-- SC_OFF --></p>
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Three nuns arrive in heaven. Peter is standing at the gates, and he welcomes them into heaven, but tells them before they can enter they must answer a question.
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Peter comes to the first nun and asks “what was the name of the first man on earth ?”
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“Oh thats an easy one!” the nun says. “Adam!” And the gates swung open.
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Peter then goes to the second nun and asks “what was the name of the first woman on earth?”
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“Oh thats an easy one!” The nun says. “Eve!” And the gates swung open.
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Peter then goes to the head nun, who being more senior is expected to be more knowledgeable. “What was the first thing Eve said to Adam?”
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“Oh thats a hard one” the nun says. And the gates swung open.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/FitzyFarseer"> /u/FitzyFarseer </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17rkf2x/three_nuns_die_and_arrive_in_heaven/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17rkf2x/three_nuns_die_and_arrive_in_heaven/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>After a grueling 12 hour shift I felt my mood lift as I walked in on my girlfriend wearing nothing but her skimpiest undies and a smile.</strong> - <!-- SC_OFF --></p>
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My smile soon faded as she yelled at me, saying Id “stretch the material” and that I should “buy my own”.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/EarthMarsUranus"> /u/EarthMarsUranus </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17rqs5r/after_a_grueling_12_hour_shift_i_felt_my_mood/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17rqs5r/after_a_grueling_12_hour_shift_i_felt_my_mood/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A dwarf once offered me money for a blowjob.</strong> - <!-- SC_OFF --></p>
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Id never stoop so low.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Stephenf1234"> /u/Stephenf1234 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17rnbat/a_dwarf_once_offered_me_money_for_a_blowjob/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17rnbat/a_dwarf_once_offered_me_money_for_a_blowjob/">[comments]</a></span></p></li>
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