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<title>26 October, 2023</title>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>Changes in sleep duration during the long-lasting COVID-19 pandemic: individual and regional disparities</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The adequate quality and quantity of sleep are related to maintaining the immune system and mental well-being; therefore, it is necessary to evaluate sleep duration during COVID-19. This study aimed to investigate the changes in sleep duration during the long-lasting COVID-19 period (2020 and 2021) in South Korea, and to examine the individual and regional disparities. The study population comprised 1,143,460 adults aged ≥19 years who participated in the 2017–2021 Korea Community Health Survey excluding those who did not respond to the daily sleep duration questionnaire. For statistical analysis, we first conducted a multiple regression model for 229 districts to estimate the district-specific changes in sleep duration. We then applied a meta-analysis to pool the 229 estimates and a meta-regression to examine the association between changes in sleep duration and regional characteristics. The sleep duration increased by 9.66 (95% CI: 8.53, 10.80) min in 2020 and 3.66 (95% CI: 2.09, 5.22) min in 2021 compared to the pre-pandemic period (2017–2019). The increase was more prominent in males, younger adults, employed individuals, and those with a high socioeconomic status compared to the general population. Communities with a higher proportion of apartments, lower normalized difference vegetation index in summer, and lower practice rate of moderate exercise were associated with a higher increase in sleep duration during the pandemic. The sleep duration increased during the COVID-19 pandemic, and the increase decreased as the COVID-19 lasted longer. The findings of our study highlight that preventive measures to manage sleep health during a pandemic should be framed in consideration of individual and regional characteristics.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.25.23297531v1" target="_blank">Changes in sleep duration during the long-lasting COVID-19 pandemic: individual and regional disparities</a>
</div></li>
<li><strong>Viral and host factors associated with SARS-CoV-2 disease severity in Georgia, USA</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
While SARS-CoV-2 vaccines have shown strong efficacy, their suboptimal uptake combined with the continued emergence of new viral variants raises concerns about the ongoing and future public health impact of COVID-19. We investigated viral and host factors, including vaccination status, that were associated with SARS-CoV-2 disease severity in a setting with low vaccination rates. We analyzed clinical and demographic data from 1,957 individuals in the state of Georgia, USA, coupled with viral genome sequencing from 1,185 samples. We found no difference in disease severity between individuals infected with Delta and Omicron variants among the participants in this study, after controlling for other factors, and we found no specific mutations associated with disease severity. Compared to those who were unvaccinated, vaccinated individuals experienced less severe SARS-CoV-2 disease, and the effect was similar for both variants. Vaccination within 270 days before infection was associated with decreased odds of moderate and severe outcomes, with the strongest association observed at 91-270 days post-vaccination. Older age and underlying health conditions, especially immunosuppression and renal disease, were associated with increased disease severity. Overall, this study provides insights into the impact of vaccination status, variants/mutations, and clinical factors on disease severity in SARS-CoV-2 infection when vaccination rates are low. Understanding these associations will help refine and reinforce messaging around the crucial importance of vaccination in mitigating the severity of SARS-CoV-2 disease.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.25.23297530v1" target="_blank">Viral and host factors associated with SARS-CoV-2 disease severity in Georgia, USA</a>
</div></li>
<li><strong>Fc-dependent functional activity of ChAdOx1-S and CoronaVac vaccine-induced antibodies to the SARS-CoV-2 spike protein</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and COVID-19 disease severity is influenced by immunity acquired by natural exposure and/or vaccination, whereby most vaccines are formulated on the Ancestral strain. However, population-level immunity is complicated by the emergence of variants of concern (VOCs), such as Omicron that is the dominant variant currently in circulation. Antibody Fc-dependent effector functions are being increasingly recognised as important mediators in immunity, especially against VOCs. However, induction of these functions in populations with diverse infection and/or vaccination histories, remains poorly defined. Here, we evaluated Fc-dependent functional antibodies following vaccination with two widely used vaccines: AstraZeneca (AZ; ChAdOx1-S) and Sinovac (SV). We quantified FcγR-binding and C1q-fixing antibodies against Ancestral and variant spike (S) proteins in Brazilian adults vaccinated with AZ or SV (n=222), some of which were previously exposed to SARS-CoV-2. AZ induced greater FcγR-binding responses to Ancestral S than the SV vaccine. Previously exposed individuals had significantly greater vaccine-induced responses compared to their naïve counterparts, with notably high C1q-fixation levels, irrespective of vaccine type. FcγR-binding was highest among AZ vaccinated individuals with a prior exposure, and these responses were well retained against the Omicron S protein. Overall, these findings contribute to our understanding of vaccine-induced immunity and its effectiveness against evolving variants.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.25.23297503v1" target="_blank">Fc-dependent functional activity of ChAdOx1-S and CoronaVac vaccine-induced antibodies to the SARS-CoV-2 spike protein</a>
</div></li>
<li><strong>Plasma-based antigen persistence in the post-acute phase of SARS-CoV-2 infection</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
BACKGROUND: Although RNA viruses like SARS-CoV-2 are generally thought to be transient, the persistence of viral components beyond the acute phase can be driven by a variety of virologic and immunologic factors. Recent studies have suggested that SARS-CoV-2 antigens may persist following COVID-19 but were limited by a lack of comparison to a large number of true negative control samples. METHODS: Using single molecule array (Simoa) assays for SARS-CoV-2 spike, S1, and nucleocapsid antigen in plasma from 171 pandemic-era individuals in the post-acute phase of SARS-CoV-2 infection and 250 pre-pandemic control samples, we compared prevalence of antigen detection. We used logistic regression models and prevalence ratios (PRs) to assess the relationship between demographic and disease factors and antigen persistence. RESULTS: Compared to the proportion of antigen positivity in the pre-pandemic controls (2%), detection of any SARS-CoV-2 antigen was more frequent across all post-acute COVID-19 time bins (3-6 months: 12.6%, p&lt;0.001; 6-10 months, 10.7%, p=0.0002; 10-14 months, 7.5%, p=0.017). These differences were driven by spike protein for up to 14 months and nucleocapsid in the first 6 months after infection. The co-occurrence of multiple antigens at a single timepoint was uncommon. Hospitalization for acute COVID-19 (versus not hospitalized) and worse self-reported health during acute COVID-19 among those not hospitalized (versus more benign illness) were associated with higher prevalence of post-acute antigen detection (PR 1.86, p=0.03; PR 3.5, p=0.07, respectively) in the pandemic era. CONCLUSIONS: Our findings provide strong evidence that SARS-CoV-2 antigens can persist beyond the period of acute illness. The observation that more than 10% of plasma samples for over a year following initial SARS-CoV-2 infection contain detectable viral antigen, which are potentially immunogenic, has significant implications given the sheer number of people infected with SARS-CoV-2 to date. More work will be needed to determine whether these antigens have a causal role in post-acute sequelae of SARS-CoV-2 infection (PASC).
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.24.23297114v1" target="_blank">Plasma-based antigen persistence in the post-acute phase of SARS-CoV-2 infection</a>
</div></li>
<li><strong>Projections of the incidence of COVID-19 in Japan and the potential impact of a Fall 2023 COVID-19 Vaccine</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: The study objective was to estimate the incidence of COVID-19 infection, hospitalization, and deaths in Japan from September 2023 to August 2024 and potential impact of a Fall 2023 COVID-19 vaccine for adults 18 years and older on these outcomes. Methods: A previously developed Susceptible Exposed Infected Recovered model for the United States (US) was adapted to Japan. The numbers of symptomatic infections, COVID-19 related hospitalizations, and deaths were calculated. Given differences in vaccination coverage, masking practices and social mixing patterns between the US and Japan, all inputs were updated to reflect the Japanese context. Vaccine effectiveness (VE) values are hypothetical, but predicted based on existing VE values of bivalent BA.4/BA.5 boosters against BA.4/BA.5 in Japan, from the VERSUS test-negative case-control study. Sensitivity analyses were performed. Results: The base case model predicts overall that there will be approximately 35.2 million symptomatic COVID-19 infections, 690,000 hospitalizations, and 62,000 deaths in Japan between September 2023 and August 2024. If an updated COVID-19 vaccine is offered to all adults aged 18 years and older in Fall 2023, the model predicts that 7.3 million infections, 275,000 hospitalizations and 26,000 deaths will be prevented. If vaccines are only given to those aged 65 years and older, only 2.9 million infections, 180,000 hospitalizations and 19,000 deaths will be prevented. Sensitivity analysis results suggest that hospitalizations and deaths prevented are most sensitive to initial vaccine effectiveness (VE) against infection and hospitalizations, and the waning rate associated with VE against infection. Symptomatic infections prevented was most sensitive to initial VE against infection and VE waning. Conclusions: Results suggest that a Fall 2023 COVID-19 vaccine would reduce total numbers of COVID-19 related infections, hospitalizations, and deaths.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.24.23297475v1" target="_blank">Projections of the incidence of COVID-19 in Japan and the potential impact of a Fall 2023 COVID-19 Vaccine</a>
</div></li>
<li><strong>Estimating the maximum risk of measles outbreaks due to heterogeneous fall in immunization rates</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Immunization rates for childhoold vaccines, such as MMR, have seen a reduction over the recent years; this fall has only been accentuated after the COVID-19 pandemic. However, there is limited data on where the rates have reduced, and prior work has shown that heterogeneity in the drop in immunization rates has a significant impact on the risk of an outbreak. An important question from a public health perspective is: what is the maximum size of an outbreak in a region, when limited information is available on the fall in immunization rates within the region? This turns out to be a very hard computational problem. We develop a Bayesian optimization based approach for estimating the maximum outbreak size, and use it on a measles model for the state of Virginia. Our results show that the maximum outbreak size is several orders of magnitude higher than estimated in a baseline which assumes homogeneous fall. Even for a 5% reduction in the statewide immunzation rate, the expected outbreak size can be very high. The maximum outbreak size depends crucially on the importation location, i.e., where the disease starts, and importation in an urban region leads to a significantly higher outbreak. The outbreak size remains high even if the drop in immunization is bounded in health service areas in the state.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.24.23297486v1" target="_blank">Estimating the maximum risk of measles outbreaks due to heterogeneous fall in immunization rates</a>
</div></li>
<li><strong>COVID-19 vaccination-induced antibody responses and waning by age and comorbidity status in a large population-based prospective cohort study</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background Information on the magnitude and duration of antibody levels after COVID-19 vaccination in different groups may be useful for prioritizing of additional vaccinations. Methods Serum samples were collected every six months in a prospective cohort study among adults in the Netherlands. Geometric mean concentrations (GMCs) of antibodies against the receptor binding domain of the SARS-CoV-2 spike protein were calculated after the primary series, first, and second booster vaccinations. Effects of age (18-59 vs 60-85 years) and medical risk conditions on GMC 2-6 weeks and 21-25 weeks after each vaccination, and on waning during 3-25 weeks after each vaccination, were estimated by linear regression. Results We included 20,816, 16,820 and 5,879 samples collected after primary, first and second booster vaccination, respectively. GMCs at 2-6 and 21-25 weeks after primary series were lower in participants with older age or medical risk conditions. After the first booster, older age was associated with lower GMC at 2-6 weeks, higher GMC at 21-25 weeks, and slower waning. GMCs or waning after the first and second boosters (only 60-85) were not associated with medical risk conditions. Conclusions Since antibody differences by age and medical risk groups have become small with increasing number of doses, other factors such as disease severity rather than antibody levels are useful for prioritization of additional vaccinations.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.24.23297192v1" target="_blank">COVID-19 vaccination-induced antibody responses and waning by age and comorbidity status in a large population-based prospective cohort study</a>
</div></li>
<li><strong>Inferring community transmission of SARS-CoV-2 in the United Kingdom using the ONS COVID-19 Infection Survey</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Key epidemiological parameters, including the effective reproduction number, R(t), and the instantaneous growth rate, r(t), generated from an ensemble of models, have been informing public health policy throughout the COVID-19 pandemic in the four nations of the United Kingdom of Great Britain and Northern Ireland (UK). However, estimation of these quantities became challenging with the scaling down of surveillance systems as part of the transition from the 9emergency9 to 9endemic9 phase of the pandemic. The Office for National Statistics (ONS) COVID-19 Infection Survey (CIS) provided an opportunity to continue estimating these parameters in the absence of other data streams. We used a penalised spline model fitted to the ONS CIS test positivity estimates to produce a smoothed estimate of the prevalence of SARS-CoV-2 positivity over time. The resulting fitted curve was used to estimate the 9ONS-based9 R(t) and r(t) across the four nations of the UK. Estimates produced under this model are compared to government-published estimates with particular consideration given to the contribution that this single data stream can offer in the estimation of these parameters. Depending on the nation and parameter, we found that up to 77% of the variance in the government-published estimates can be explained by the ONS-based estimates, demonstrating the value of this singular data stream to track the epidemic in each of the four nations. We additionally find that the ONS-based estimates uncover epidemic trends earlier than the corresponding government-published estimates. Our work shows that the ONS CIS can be used to generate the key COVID-19 epidemics across the four UK nations. This is not intended as an alternative to ensemble modelling, rather it is intended as a potential solution to the aforementioned challenge faced by public health officials in the UK in early 2022.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.24.23297454v1" target="_blank">Inferring community transmission of SARS-CoV-2 in the United Kingdom using the ONS COVID-19 Infection Survey</a>
</div></li>
<li><strong>Discovery of CMX990: A Potent SARS-CoV-2 3CL Protease Inhibitor Bearing a Novel Covalent Warhead</strong> -
<div>
There remains a need to develop novel SARS-CoV-2 therapeutic options that improve upon existing therapies by increased robustness of response, fewer safety liabilities, and global-ready accessibility. Functionally critical viral main protease (Mpro, 3CLpro) of SARS-CoV-2 is an attractive target due to its homology within the coronaviral family, and lack thereof towards human proteases. In this disclosure, we outline the advent of a novel SARS-CoV-2 3CLpro inhibitor, CMX990, bearing an unprecedented trifluoromethoxymethyl ketone warhead. Compared with the marketed drug nirmatrelvir (combination with ritonavir = Paxlovid), CMX990 has distinctly differentiated potency (~5x more potent in primary cells) and human in vitro clearance (&gt;4x better microsomal clearance and &gt;10x better hepatocyte clearance), with good in vitro-in vivo correlation. Based on its compelling preclinical profile and projected once or twice a day dosing supporting unboosted oral therapy in humans, CMX990 advanced to a Phase 1 clinical trial as an oral drug candidate for SARS-CoV-2.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.24.563688v1" target="_blank">Discovery of CMX990: A Potent SARS-CoV-2 3CL Protease Inhibitor Bearing a Novel Covalent Warhead</a>
</div></li>
<li><strong>Cross-platform comparison of highly-sensitive immunoassays for inflammatory markers in a COVID-19 cohort</strong> -
<div>
A variety of commercial platforms are available for the simultaneous detection of multiple cytokines and associated proteins, often employing antibody pairs to capture and detect target proteins. In this study, we comprehensively evaluated the performance of three distinct platforms: the fluorescent bead-based Luminex assay, the proximity extension-based Olink assay, and a novel proximity ligation assay platform known as Alamar NULISAseq. These assessments were conducted on serum samples from the NIH IMPACC study, with a focus on three essential performance metrics: detectability, correlation, and differential expression. Our results reveal several key findings. Firstly, the Alamar platform demonstrated the highest overall detectability, followed by Olink and then Luminex. Secondly, the correlation of protein measurements between the Alamar and Olink platforms tended to be stronger than the correlation of either of these platforms with Luminex. Thirdly, we observed that detectability differences across the platforms often translated to differences in differential expression findings, although high detectability did not guarantee the ability to identify meaningful biological differences. Our study provides valuable insights into the comparative performance of these assays, enhancing our understanding of their strengths and limitations when assessing complex biological samples, as exemplified by the sera from this COVID-19 cohort.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.24.563866v1" target="_blank">Cross-platform comparison of highly-sensitive immunoassays for inflammatory markers in a COVID-19 cohort</a>
</div></li>
<li><strong>VIPERA: Viral Intra-Patient Evolution Reporting and Analysis</strong> -
<div>
Viral mutations within patients nurture the adaptive potential of SARS-CoV-2 during chronic infections, which are a potential source of variants of concern. However, there is no integrated framework for the evolutionary analysis of intra-patient SARS-CoV-2 serial samples. Herein we describe VIPERA (Viral Intra-Patient Evolution Reporting and Analysis), a new software that integrates the evaluation of the intra-patient ancestry of SARS-CoV-2 sequences with the analysis of evolutionary trajectories of serial sequences from the same viral infection. It has been validated using positive and negative control datasets and successfully applied to a novel case, contributing to easy and automatic analysis of intra-patient SARS-CoV-2 sequences.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.24.561010v1" target="_blank">VIPERA: Viral Intra-Patient Evolution Reporting and Analysis</a>
</div></li>
<li><strong>Simulation-Driven Design of Stabilized SARS-CoV-2 Spike S2 Immunogens</strong> -
<div>
The full-length prefusion-stabilized SARS-CoV-2 spike (S) is the principal antigen of COVID-19 vaccines. Vaccine efficacy has been impacted by emerging variants of concern that accumulate most of the sequence modifications in the immunodominant S1 subunit. S2, in contrast, is the most evolutionarily conserved region of the spike and can elicit broadly neutralizing and protective antibodies. Yet, the usage of S2 as an alternative vaccine strategy is hampered by its general instability. Here, we use a simulation-driven approach to design highly stable S2-only antigens retaining a closed prefusion conformation. Weighted ensemble simulations provide mechanistic characterization of the S2 trimer opening, informing the design of tryptophan substitutions that impart kinetic and thermodynamic stabilization. Alchemical free energy perturbation calculations and a corroborating set of experiments confirm that V991W and T998W in the central helices of S2 stabilize the trimer in the closed prefusion conformation, producing an antigen with increased protein expression, superior thermostability, and preserved immunogenicity against sarbecoviruses.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.10.24.563841v1" target="_blank">Simulation-Driven Design of Stabilized SARS-CoV-2 Spike S2 Immunogens</a>
</div></li>
<li><strong>An infectious disease model with asymptomatic transmission and waning immunity</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Infectious diseases present persistent challenges to global public health, demanding a comprehensive understanding of their dynamics to develop effective prevention and control strategies. The presence of asymptomatic carriers, individuals capable of transmitting pathogens without displaying symptoms, challenges conventional containment approaches focused on symptomatic cases. Waning immunity, the decline in protective response following natural recovery or vaccination, introduces further complexity to disease dynamics. In this paper, we developed a mathematical model to investigate the interplay between these factors, aiming to inform strategies for the management of infectious diseases. We derived the basic reproduction number for the model and showed that the disease would die out when this number falls below 1. We obtained a formula to estimate the relative contributions of asymptomatic and symptomatic transmission to the basic reproduction number, which remains unchanged when vaccination is included in the model. Through computer simulations with parameter values tailored for COVID-19 and sensitivity analysis, we demonstrated that population susceptibility significantly impacts the timing and magnitude of infection peaks. Populations with lower susceptibility experience delayed and less severe outbreaks. Vaccination was shown to play a crucial role in disease control, with an increased vaccination rate, extended immunity, and heightened vaccine efficacy proving pivotal. However, the effectiveness of these strategies hinges on maintaining a low vaccine escape proportion. Taken together, this study underscores the need for multifaceted, adaptable approaches to infectious disease management, highlighting the central role of vaccination in mitigating disease spread. Further research and validation with disease-specific data will enhance parameter estimates, improve model predictions, and inform evidence-based disease control strategies.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.24.23297464v1" target="_blank">An infectious disease model with asymptomatic transmission and waning immunity</a>
</div></li>
<li><strong>Evaluating aerosol and splatter during orthodontic debonding: implications for the COVID-19 pandemic</strong> -
<div>
Introduction: Dental procedures often produce splatter and aerosol which have potential to spread pathogens such as SARS-CoV-2. Mixed guidance exists on the aerosol generating potential of orthodontic procedures. The aim of this study was to evaluate aerosol and/or splatter contamination during an orthodontic debonding procedure. Material and Methods: Fluorescein dye was introduced into the oral cavity of a mannequin. Orthodontic debonding was carried out in triplicate with filter papers placed in the immediate environment. Composite bonding cement was removed using a slow-speed handpiece with dental suction. A positive control condition included a high-speed air-turbine crown preparation. Samples were analysed using digital image analysis and spectrofluorometric analysis. Results: Contamination across the 8-metre experimental rig was 3% of the positive control on spectrofluorometric analysis and 0% on image analysis. There was contamination of the operator, assistant, and mannequin, representing 8%, 25%, and 28% of the positive control spectrofluorometric measurements, respectively. Discussion: Orthodontic debonding produces splatter within the immediate locality of the patient. Widespread aerosol generation was not observed. Conclusions: Orthodontic debonding procedures are low risk for aerosol generation, but localised splatter is likely. This highlights the importance of personal protective equipment for the operator, assistant, and patient.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/djcus/" target="_blank">Evaluating aerosol and splatter during orthodontic debonding: implications for the COVID-19 pandemic</a>
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<li><strong>The Influence Of Covid-19 On Patient Mobilization And Injury Attributes In The ICU: A Retrospective Analysis Of A Level II Trauma Center</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The objectives of this study were to determine the effect of COVID-19 on physical therapy (PT) mobilization of traumatically-injured patients and to determine if mobilization affected patient course in the ICU. This retrospective study included patients who were admitted to the ICU of a level II trauma center. The patients were divided into two groups, i.e., those admitted before (n=378) and after (n=499) April 1, 2020 when Georgia9s COVID-19 Shelter-in-place order was mandated. The two groups were contrasted on nominal and ratio variables using Chi-square and Student9s t-tests. A secondary analysis focused specifically on the after COVID patients examined the extent to which mobilization (n=328) or lack of mobilization (n=171) influenced ICU outcomes (e.g., mortality, readmission). The two groups were contrasted on nominal and ratio variables using Chi-square and Student9s -tests. The after COVID patients had higher injury severity as a greater proportion was classified as severely injured (i.e., &gt;15 on Injury Severity Score) compared to the before COVID patients. After COVID patients also had greater cumulative number of comorbidities and experienced greater complications in the ICU. Despite this, there was no difference between patients in receiving a PT consultation or day-to-mobilization. Within the after COVID cohort, those that were mobilized were older, a higher proportion were female, they had greater Glasgow Coma Scale scores, had longer total hospital days, and a lesser mortality rate. Despite shifting patient injury attributes post-COVID-19, a communicable disease, mobilization care remained consistent and effective.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.10.25.23297544v1" target="_blank">The Influence Of Covid-19 On Patient Mobilization And Injury Attributes In The ICU: A Retrospective Analysis Of A Level II Trauma Center</a>
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</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>Evaluation of Concordance Between Exhaled Air Test (eBAM-CoV) and RT-PCR to Detect SARS-CoV-2</strong> - <b>Conditions</b>: SARS-CoV-2 Infection; COVID-19; Coronavirus <br/><b>Interventions</b>: Device: eBAM Cov Testing <br/><b>Sponsors</b>: Centre Hospitalier Universitaire de Nīmes; University of Nimes; brains’ laboratory sas, FRANCE <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study to Safety, Tolerability and Immunogenicity of EG-COVII in Healthy Adult</strong> - <b>Conditions</b>: COVID-19 <br/><b>Interventions</b>: Biological: EG-COVII <br/><b>Sponsors</b>: EyeGene Inc. <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pharmacokinetics and Bioequivalence of Aterixen 100 mg Tablets and Aterixen 100 mg Film-coated Tablets in Healthy Volunteers</strong> - <b>Conditions</b>: Viral Infection COVID-19 <br/><b>Interventions</b>: Drug: Aterixen <br/><b>Sponsors</b>: Valenta Pharm JSC <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Long COVID Brain Fog: Cognitive Rehabilitation Trial</strong> - <b>Conditions</b>: Long COVID; Brain Fog; Cognitive Impairment; Cognitive Dysfunction; Post-Acute COVID-19 Syndrome <br/><b>Interventions</b>: Behavioral: Speed of Processing Training; Behavioral: In-lab Instrumental Activities of Daily Living Training; Behavioral: In-lab Brain Health Training; Behavioral: Transfer Package; Behavioral: Follow Up Phone Calls; Behavioral: Vocational Rehabilitation; Behavioral: Peer Mentoring <br/><b>Sponsors</b>: University of Alabama at Birmingham; National Institute on Disability, Independent Living, and Rehabilitation Research <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>Paradoxical Response to Chest Wall Loading in Mechanically Ventilated Patients</strong> - <b>Conditions</b>: ARDS; COVID-19; Mechanical Ventilation Pressure High; Ventilator-Induced Lung Injury <br/><b>Interventions</b>: Diagnostic Test: Manual loading of the chest wall <br/><b>Sponsors</b>: HealthPartners Institute <br/><b>Withdrawn</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Practical RCT of TCM in the Treatment of LCOVID and Analysis of Syndrome Types and Medication Characteristics.</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Drug: Traditional Chinese medicine treatment; Drug: Western medicine treatment <br/><b>Sponsors</b>: Chinese University of Hong Kong <br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Narrative Intervention for Long COVID-19 (NICO)</strong> - <b>Conditions</b>: Long COVID; Long Covid19 <br/><b>Interventions</b>: Behavioral: Narrative Intervention for Long COVID-19 (NICO) <br/><b>Sponsors</b>: University of Colorado, Denver <br/><b>Active, not 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>Immunogenicity of Concomitant Administration of COVID-19 Vaccines With Influenza Vaccines</strong> - <b>Conditions</b>: COVID-19; Influenza; Vaccine Reaction; Contaminant Injected <br/><b>Interventions</b>: Biological: Omicron-containing COVID-19 vaccine; Biological: influenza vaccine <br/><b>Sponsors</b>: Catholic Kwandong University; Korea University Guro 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>Inspiratory Muscle Strength Training in Post-Covid Syndrome</strong> - <b>Conditions</b>: Cardiovascular Abnormalities; Post-COVID-19 Syndrome; Physical Exercise <br/><b>Interventions</b>: Other: Inspiratory muscle strength training <br/><b>Sponsors</b>: D’Or Institute for Research and Education <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>Home-Based Respiratory Muscle Strength Training Program for Individuals With Post-COVID-19 Persistent Dyspnea</strong> - <b>Conditions</b>: Post-COVID-19 Syndrome; Dyspnea <br/><b>Interventions</b>: Device: Respiratory Muscle Strength Trainers <br/><b>Sponsors</b>: University of South Florida <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>Inspiratory Muscle Training in People With Long COVID-19- A Pilot Investigation.</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Device: PrO2 <br/><b>Sponsors</b>: University of Bath; Swansea University <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>Cognitive Rehabilitation Therapy for COVID-19</strong> - <b>Conditions</b>: Post-Acute COVID-19 Syndrome <br/><b>Interventions</b>: Behavioral: Compensatory Cognitive Training for COVID-19; Behavioral: Holistic Cognitive Education <br/><b>Sponsors</b>: VA Office of Research and Development <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>Rural Tailored Communication to Promote SARS-CoV-2 Antibody Testing in Saliva</strong> - <b>Conditions</b>: SARS-CoV2 Infection <br/><b>Interventions</b>: Behavioral: General SARS-CoV-2 Communication; Behavioral: Rural-Targeted SARS-CoV-2 Communication <br/><b>Sponsors</b>: Michigan State University; National Cancer Institute (NCI); Johns Hopkins 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>COVID Rehabilitation</strong> - <b>Conditions</b>: Rehabilitation; Post-Acute COVID-19 Syndrome; Post-Infectious Disorders <br/><b>Interventions</b>: Behavioral: One day course; Behavioral: Individual follow-ups <br/><b>Sponsors</b>: University Hospital of North Norway; University of Bergen; Oslo University Hospital; Norwegian University of Science and Technology <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>Food Effects of GST-HG171 Tablets Combined With Ritonavir in Healthy Chinese Participants</strong> - <b>Conditions</b>: COVID-19 Respiratory Infection <br/><b>Interventions</b>: Drug: GST-HG171/ritonavir; Drug: ritonavir <br/><b>Sponsors</b>: Fujian Akeylink Biotechnology Co., Ltd. <br/><b>Active, not recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effects of Two Soluble ACE2-Fc Variants on Blood Pressure and Albuminuria in Hypertensive Mice: Research Letter</strong> - CONCLUSIONS: Soluble ACE2-Fc variant K reduces blood pressure and tends to lower albuminuria in hypertensive mice. Furthermore, soluble ACE2-Fc variant K has prolonged tissue retention, associated with increased tissue ACE2 activity. The results support further studies directed at the therapeutic potential of soluble ACE2-Fc variant K for cardiovascular and kidney protection.</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>Identification of CCZ1 as an essential lysosomal trafficking regulator in Marburg and Ebola virus infections</strong> - Marburg and Ebola filoviruses are two of the deadliest infectious agents and several outbreaks have occurred in the last decades. Although several receptors and co-receptors have been reported for Ebola virus, key host factors remain to be elucidated. In this study, using a haploid cell screening platform, we identify the guanine nucleotide exchange factor CCZ1 as a key host factor in the early stage of filovirus replication. The critical role of CCZ1 for filovirus infections is validated in 3D…</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>TMPRSS2 is a functional receptor for human coronavirus HKU1</strong> - Four endemic seasonal human coronaviruses causing common colds, HKU1, 229E, NL63 and OC43 circulate worldwide¹. After binding to cellular receptors, coronavirus spike proteins are primed for fusion by transmembrane-serine protease 2 (TMPRSS2) or endosomal cathepsins^(2-9). NL63 uses angiotensin-converting enzyme 2 (ACE2) as a receptor^(10), whereas 229E uses human aminopeptidase-N^(11). HKU1 and OC43 spikes bind cells through 9-O40 acelytated sialic acid but their protein receptors remain…</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>Epidemiological profile of COVID-19 in patients with prostate cancer undergoing androgen deprivation therapy at a Brazilian Cancer Center</strong> - CONCLUSION: Androgen deprivation therapy was not associated with protective factors or potential treatments in patients with prostate cancer and COVID-19. Although the number of patients analyzed was limited, and there may have been a selection bias, this is a unique study that cannot be expanded or replicated in similar (unvaccinated) populations.</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>Inhibition of the lectin pathway of complement activation reduces Acute Respiratory Distress Syndrome severity in a mouse model of SARS-CoV-2 infection</strong> - Most COVID-19 patients requiring ICU care develop an acute respiratory distress syndrome (ARDS), characterised by severe hypoxemia, decreased lung compliance, and high vascular permeability. Activation of the complement system is a hallmark of moderate and severe COVID-19, with abundant deposition of complement proteins reported in inflamed tissue and on the endothelium during COVID-19. Using a transgenic mouse model of SARS-CoV-2 infection we assessed the therapeutic utility of an inhibitory…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Computational screening of neuropilin 1 unveils novel potential anti-SARS-CoV-2 therapeutics</strong> - Neuropilin 1 (NRP-1) inhibition has shown promise in reducing the infectivity of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and preventing the virus entry into nerve tissues, thereby mitigating neurological symptoms in COVID-19 patients. In this study, we employed virtual screening, including molecular docking, Molecular Dynamics (MD) simulation, and Molecular Mechanics-Poisson Boltzmann Surface Area (MM-PBSA) calculations, to identify potential NRP-1 inhibitors. From a…</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 effect of zofenopril on the cardiovascular system of spontaneously hypertensive rats treated with the ACE2 inhibitor MLN-4760</strong> - CONCLUSIONS: Zofenopril treatment reduced MLN-induced adiposity and improved cardiac function regardless of ACE2 inhibition. Although the concomitant MLN and zofenopril treatment increased thoracic aorta vasorelaxation capacity, zofenopril increased the participation of H(2)S and NO in the maintenance of endothelial function independently from ACE2 inhibition. Our results confirmed that the beneficial effects of zofenopril were not affected by ACE2 inhibition, moreover, we assume that ACE2…</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>Assessing the gene expression of the adenosine 5’-monophosphate-activated protein kinase (AMPK) and its relation with the IL-6 and IL-10 plasma levels in COVID-19 patients</strong> - CONCLUSION: Increasing AMPK gene expression is likely a necessary effort of the immune system to inhibit inflammation in critical COVID-19. However, this effort seems to be inadequate, probably due to factors that induce inflammation, like erythrocyte sedimentation rate (ESR) and IL-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>SARS-CoV-2 neurotropism-induced anxiety and depression-like behaviors require Microglia activation</strong> - The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with a wide range of “long COVID” neurological symptoms. However, the mechanisms governing SARS-CoV-2 neurotropism and its effects on long-term behavioral changes remain poorly understood. Using a highly virulent mouse-adapted SARS-CoV-2 strain, denoted as SARS2-N501Y (MA30) , we demonstrated that intranasal inoculation of SARS2-N501Y (MA30) results in…</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>Development of an Integrated Sample Amplification Control for Salivary Point-of-Care Pathogen Testing</strong> - BACKGROUND: The COVID-19 pandemic has led to a rise in point-of-care (POC) and home-based tests, but concerns over usability, accuracy, and effectiveness have arisen. The incorporation of internal amplification controls (IACs), essential control for translational POC diagnostics, could mitigate false-negative and false-positive results due to sample matrix interference or inhibition. Although emerging POC nucleic acid amplification tests (NAATs) for detecting SARS-CoV-2 show impressive…</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>Intestinal injury and vasculitis biomarkers in cats with feline enteric coronavirus and effusive feline infectious peritonitis</strong> - OBJECTIVE: To investigate intestinal injury, repair and vasculitis biomarkers that may illuminate the progression and/or pathogenesis of feline infectious peritonitis (FIP) or feline enteric coronavirus (FECV) infection.</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>ORF3c is expressed in SARS-CoV-2-infected cells and inhibits innate sensing by targeting MAVS</strong> - Most SARS-CoV-2 proteins are translated from subgenomic RNAs (sgRNAs). While the majority of these sgRNAs are monocistronic, some viral mRNAs encode more than one protein. One example is the ORF3a sgRNA that also encodes ORF3c, an enigmatic 41-amino-acid peptide. Here, we show that ORF3c is expressed in SARS-CoV-2-infected cells and suppresses RIG-I- and MDA5-mediated IFN-β induction. ORF3c interacts with the signaling adaptor MAVS, induces its C-terminal cleavage, and inhibits the interaction…</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>Chemical Characteristics and Biological Activity Screening of Pistacia lentiscus Mastic Gum and Leaves from Turkiye</strong> - CONCLUSION: The mastic gum and leaves obtained from P. lentiscus may have great potential in terms of their chemical content, antiviral and cytotoxic activities. In ovo antiviral activity studies on the P. lentiscus were evaluated for the first time. Attributable to these properties, it is a sustainable, renewable natural resource that can be used as an additive and flavor in the food and pharmaceutical industries. This article is protected by copyright. All rights reserved.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of Potential Peptide-Based Inhibitors against SARS-CoV-2 and Variants of Concern</strong> - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has greatly affected all aspect of life. Although several vaccines and pharmaceuticals have been developed against SARS-CoV-2, the emergence of mutated variants has raised several concerns. The angiotensin-converting enzyme (ACE2) receptor cell entry mechanism of this virus has not changed despite the vast mutation in emerging variants. Inhibiting the spike protein by which the virus identifies the host ACE2 receptor is a…</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>Some novel bioactivities of <em>Virgibacillus halodenitrificans</em> carotenoids, isolated from Wadi El-Natrun lakes</strong> - Carotenoids come in second among the most frequent natural pigments and are utilized in medications, nutraceuticals, cosmetics, food pigments, and feed supplements. Based on recent complementary work, Virgibacillus was announced for the first time as a member of Wadi El-Natrun salt and soda lakes microbiota, identified as Virgibacillus halodenitrificans, and named V. halodenitrificans DASH; hence, this work aimed to investigate several in vitro medicinal bioactivities of V. halodenitrificans…</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>In Arizona, No Labels Is Attracting Potential Candidates It Doesn’t Want</strong> - The state has recognized the group as a legitimate political party. Why is No Labels so angry? - <a href="https://www.newyorker.com/news/daily-comment/in-arizona-no-labels-is-attracting-potential-candidates-it-doesnt-want">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Is This the End of the Netanyahu Era?</strong> - A biographer of Israel’s longest-serving Prime Minister on how the country’s government has responded to the crisis in Gaza—and what comes next politically. - <a href="https://www.newyorker.com/news/q-and-a/is-this-the-end-of-the-netanyahu-era">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Yes, We Can Tackle International Tax Evasion, if We Really Try</strong> - A new report finds that the amount of offshore wealth shielded from tax authorities has fallen dramatically since the Obama Administration, which pioneered efforts to make countries share banking information. - <a href="https://www.newyorker.com/news/our-columnists/yes-we-can-tackle-international-tax-evasion-if-we-really-try">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Uprooting of Life in Gaza and the West Bank</strong> - Israel’s Prime Minister has vowed to destroy Hamas and turn its territory into a “deserted island,” but Palestinians are determined not to be displaced. - <a href="https://www.newyorker.com/news/daily-comment/the-uprooting-of-life-in-gaza-and-the-west-bank">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Mike Johnson Went from Relative Obscurity to Speaker of the House</strong> - The Louisiana Republican is best known for leading an effort to vote against certifying the results of the 2020 election—not because of fraud but on arcane legal grounds. - <a href="https://www.newyorker.com/news/daily-comment/how-mike-johnson-went-from-relative-obscurity-to-speaker-of-the-house">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>America’s unique, enduring gun problem, explained</strong> -
<figure>
<img alt="Blue police lights streak through the dark of a Lewiston road; illuminated signs of local businesses shine above the road." src="https://cdn.vox-cdn.com/thumbor/s5XQ9-mXThHgEsCby91IqnmjuEE=/0x0:4992x3744/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/70913181/AP23299062250402.94.jpg"/>
<figcaption>
Police search for the shooter in the Lewiston, Maine, killings. | Robert F. Bukaty/AP
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The factors that lead to tragedies like the Lewiston shooting are deeply ingrained in US politics, culture, and law.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aZtQSt">
At least 16 people — and according to <a href="https://www.nbcnews.com/news/us-news/live-blog/active-shooter-incident-reported-lewiston-maine-live-updates-rcna122249/rcrd23184?canonicalCard=true">some officials, as many as 22</a> — have been killed and several dozen injured in a mass shooting in Lewiston, Maine, the northern state’s second-largest city.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RCXiaD">
The shooter wasn’t immediately apprehended and appears to have opened fire at two locations on Wednesday evening: a bowling alley and bar on Wednesday. State and local law enforcement have asked residents of Lewiston and the surrounding area to <a href="https://x.com/MEStatePolice/status/1717332516569243796?s=20">shelter in place</a> as officials work to find the shooter. Schools and many businesses in the area have been shuttered.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZbGFAk">
The shooter, whose <a href="https://www.wmur.com/article/lewiston-maine-shootings-robert-card-suspect/45651233">picture has been shared</a> as part of the search effort, is believed to be a 40 year old white man who worked as firearms teacher and an US Army reservist.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7ovQAV">
The Lewiston shooting was of several hundred mass shootings this year; and it follows a number of other mass shootings this week, including in <a href="https://www.durangoherald.com/articles/one-killed-three-injured-in-shooting-at-santa-rita-park-in-durango/">Colorado</a>, <a href="https://abc7chicago.com/chicago-shooting-englewood-today-justine-street/13961764/">Chicago</a>, and <a href="https://www.cenlanow.com/crime/alexandria-pd-search-for-kelly-street-shooting-suspect-ldarius-taylor/">Louisiana</a>. This kind of violence is unique to the US and should not be normalized.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kV8Il1">
No other high-income country has suffered such a high death toll from<a href="https://www.vox.com/22382180/supreme-court-uvalde-guns-violence-second-amendment-heller-scalia"> gun violence</a>. Every day, <a href="https://everytownresearch.org/report/gun-violence-in-america/">120</a> Americans die at the end of a gun, including suicides and homicides, an average of 43,375 per year. According to the latest available analysis of data from 2015 to 2019,<strong> </strong>the US gun homicide rate was <a href="https://everytownresearch.org/report/gun-violence-in-america/">26 times</a> that of other high-income countries; its gun suicide rate was nearly <a href="https://everytownresearch.org/report/gun-violence-in-america/">12 times higher</a>. Mass shootings, defined as attacks in which at least four people are injured or killed excluding the shooter, have been on the rise since 2015, peaking at <a href="https://everytownresearch.org/mass-shootings-in-america/">686 incidents in 2021</a>. There have been<strong> </strong><a href="https://www.gunviolencearchive.org/reports/mass-shooting">564 mass shootings</a> in the US in 2023 as of late October, and at the current pace, the US is set to <a href="https://www.cnn.com/2023/07/24/politics/us-400-mass-shootings/index.html">eclipse the 2021 record</a> this year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rE1fGR">
Despite that sheer carnage, however, the political debate over how to ensure that guns don’t fall into the hands of people who may hurt themselves and others has long proved intractable. Last year,<strong> </strong>Congress reached a <a href="https://www.vox.com/policy-and-politics/2022/6/23/23180893/senate-gun-control-bipartisan-bill-2022-pass">deal on limited gun reforms</a> for the first time in nearly 30 years<strong> </strong>in the wake of a shooting at an elementary school in Uvalde, Texas — the deadliest school shooting since 2012.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3IgO6E">
But those narrow reforms clearly haven’t stopped America’s gun violence epidemic. The US’s expansive view of civilian gun ownership has been so ingrained in politics, in culture, and in the law since the nation’s founding that there’s no telling how many more people will die before federal lawmakers take further action. In that absence, many red states have loosened their gun laws over the last few years, rather than making it harder to obtain a gun.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UQmeyK">
“America is unique in that guns have always been present, there is wide civilian ownership, and the government hasn’t claimed more of a monopoly on them,” said David Yamane, a professor at Wake Forest University who studies American gun culture.
</p>
<h3 id="r8kFVU">
The US has a lot of guns, and more guns mean more gun deaths
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2Ga6He">
It’s hard to estimate the number of privately owned guns in America since there is no countrywide database where people register whether they own guns, there is a<a href="https://www.everytown.org/issues/gun-trafficking/"> thriving black market</a> for them in the absence of strong federal gun trafficking laws, and people can manufacture their own guns with DIY kits or 3D printers. The gun lobby has also <a href="https://www.motherjones.com/politics/2013/02/atf-gun-laws-nra/">vehemently opposed</a> federal legislation to track gun sales and establish a national handgun registry.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IZkQHX">
One estimate from the Small Arms Survey, a Swiss-based research project, found that there were approximately<a href="https://www.bbc.com/news/world-us-canada-41488081"> 390 million guns</a> in circulation in the US in 2018, or about 120.5 firearms per 100 residents. That number has likely climbed in the years since, given that<a href="https://www.norc.org/NewsEventsPublications/PressReleases/Pages/one-in-five-american-households-purchased-a-gun-during-the-pandemic.aspx"> one in five households</a> purchased a gun during the pandemic, though the 2018 estimate remains the most recent available. There has also been a significant increase in the number of <a href="https://www.thetrace.org/2023/03/guns-america-data-atf-total/">guns manufactured and imported</a> in the years since. But even without accounting for that increase, US gun ownership is still well above any other country: Yemen, which has the world’s second-highest level of gun ownership, has only 52.8 guns per 100 residents; in Iceland, it’s 31.7.
</p>
<figure class="e-image">
<img alt="At Least 5 Dead And 18 Injured In Colorado Springs Gay Nightclub Shooting" src="https://cdn.vox-cdn.com/thumbor/537Vh4HU65iknCFBhNJXafDkgJQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24876824/1443590414.jpg"/> <cite>Scott Olson/Getty Images</cite>
<figcaption>
A makeshift memorial set up for the victims of the Club Q nightclub shooting in Colorado Springs that happened on November 19, 2022.
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IbOmoq">
American guns are concentrated in a tiny minority of households: just 3 percent own about half the nation’s guns, according to a 2016 Harvard and Northeastern University<a href="https://news.northeastern.edu/2016/09/study-70m-more-firearms-added-to-us-gun-stock-over-past-20-years/"> study</a>. They’re called “<a href="https://www.theguardian.com/us-news/2016/sep/19/us-gun-ownership-survey">super owners</a>” who have an average of 17 guns each. Gallup, using a different methodology, found that<a href="https://news.gallup.com/poll/1645/guns.aspx"><strong> </strong>45 percent of Americans</a> lived in a household with guns in 2022.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xoicqw">
Researchers have found a clear link between gun ownership in the US and gun violence, and some argue that it’s causal. One 2013 Boston University-led study,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828709/"> for instance</a>, found that for each percentage point increase in gun ownership at the household level, the state firearm homicide rate increased by 0.9 percent. And states with weaker gun laws have higher rates of gun-related homicides and suicides, according to a<a href="https://everytownresearch.org/rankings/"> study</a> by the gun control advocacy group Everytown for Gun Safety.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EQ1cLQ">
The link between gun deaths and gun ownership is much stronger than the link that<strong> </strong>gun rights advocates often seek to draw<strong> </strong>between violence and mental health issues. If it were possible to cure all schizophrenia, bipolar, and depressive disorders, violent crime in the US would<a href="https://www.propublica.org/article/myth-vs-fact-violence-and-mental-health"> fall by only 4 percent</a>, according to a<a href="https://books.google.com/books?id=v4oSb2Na4nQC&amp;lpg=PP1&amp;pg=PA101#v=onepage&amp;q=swanson&amp;f=false"> study</a> from Duke University professor Jeffrey Swanson, who examines policies to reduce gun violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mUBWoP">
There’s still a pervasive idea, pushed by gun manufacturers and gun rights organizations like the<a href="https://www.vox.com/2022/5/25/23140519/uvalde-school-shooting-nra-texas-good-guy-gun"> National Rifle Association</a>, that further arming America is the answer to preventing gun violence —<a href="https://www.vox.com/2022/5/25/23140519/uvalde-school-shooting-nra-texas-good-guy-gun"> the “good guy with a gun” theory</a>. But there have been relatively few instances in which police or armed bystanders have been able to successfully stop an active attack.<strong> </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="URSBLi">
According to a database maintained by Advanced Law Enforcement Rapid Response Training Center at Texas State University, there were 520 active attacks — <a href="https://www.activeattackdata.org/index.html">defined</a> as when one or more people are “actively killing or attempting to kill multiple unrelated people in a public space,” including but not limited to shootings — between 2000 and 2022. In many of those cases, police were <a href="https://www.activeattackdata.org/allattacks.html">unable to stop</a> the attacker, either because the attack had already ended by the time they arrived or because the attacker surrendered or committed suicide. Only in 160 cases were police able to successfully intervene by shooting or otherwise subduing the attacker.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/tHt1aZehxpu8Y8N4xiJRGp1VMRM=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24882439/Ndqdu_police_stopped_fewer_than_a_third_of_active_attacks_between_2000_and_2022__1_.png"/>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8WRO9O">
Another 2021 <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776515">study</a> from Hamline University and Metropolitan State University found that the rate of deaths in 133 mass school shootings between 1980 and 2019 was 2.83 times greater in cases where there was an armed guard present. The researchers argue the results suggest the presence of an armed guard increased shooters’ aggression and that because many school shooters have been found to be suicidal, “an armed officer may be an incentive rather than a deterrent.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jWgibp">
“The idea that the solution to mass shootings is that we need more guns in the hands of more people in more places so that we’ll be able to protect ourselves — there’s no evidence that that’s true,” Swanson said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a070oM">
The prevalence of the self-defense narrative is part of what sets apart the gun rights movement in the US from similar movements in places like Canada and Australia, according to Robert Spitzer, a professor at SUNY Cortland who studies the politics of gun control.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="05FRv4">
Self-defense has become by far the<a href="https://www.pewresearch.org/fact-tank/2021/09/13/key-facts-about-americans-and-guns/"> most prominent reason</a> for gun ownership in the US today, eclipsing hunting, recreation, or owning guns because they’re antiques, heirlooms, or work-related. That’s also reflected in<a href="https://www.nytimes.com/2022/05/17/us/politics/gun-manufacturing-atf.html"> ballooning handgun sales</a>, since the primary purpose of those guns isn’t recreational, but self-defense.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LqVIqI">
American gun culture “brings together the hunting-sporting tradition with the militia-frontier tradition, but in modern times the hunting element has been eclipsed by a heavily politicized notion that gun carrying is an expression of freedom, individuality, hostility to government, and personal self-protection,” Spitzer said.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/lWo0KpSDuPpD5l_xQ_b9EYOexL0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23589886/GettyImages_1240907270.jpg"/> <cite>Chandan Khanna/AFP via Getty Images</cite>
<figcaption>
People gather at Sacred Heart Catholic Church to pray for the victims of the mass shooting at Robb Elementary School in Uvalde, Texas, on May 25, 2022.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mxItMo">
That<a href="https://www.vox.com/2016/6/20/11975850/ar-15-owner-orlando"> culture of gun ownership in the US</a> has made it all the more difficult to explore serious policy solutions to gun violence after mass shootings. In high-income countries lacking that culture, mass shootings have historically galvanized public support behind gun control measures that would seem extreme by US standards.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aoqzYW">
Canada<a href="https://www.washingtonpost.com/world/2021/03/23/mass-shootings-response-other-countries-gun-laws/"> banned military-style assault weapons</a> two weeks after a 2020 mass shooting in Nova Scotia. In 2019, less than a month after the Christchurch massacre, New Zealand lawmakers passed a gun buyback scheme, as well as restrictions on AR-15s and other semiautomatic weapons, and they later established a firearms registry. The 1996 Port Arthur massacre in Australia spurred the government to<a href="https://www.vox.com/2015/8/27/9212725/australia-buyback"> buy back 650,000 firearms</a> within a year, and murders and suicides plummeted as a result.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rw1Khl">
By contrast, nearly a decade went by after the 2012 school shooting at Sandy Hook Elementary School in Newtown, Connecticut, before Congress passed a new gun control law. The<a href="https://www.vox.com/policy-and-politics/2022/6/23/23180893/senate-gun-control-bipartisan-bill-2022-pass"> Bipartisan Safer Communities Act</a>, the law passed in June 2022, was relatively limited:<strong> </strong>It incentivized states to pass red flag laws, enhanced background checks for gun buyers under 21, and closed the “boyfriend loophole,” which allowed some people with domestic violence convictions to purchase guns. But it did not ban any types of weapons, and certain studies suggest that even truly universal background checks may have <a href="https://www.vox.com/policy-and-politics/2019/2/27/18224727/house-universal-background-checks-gun-violence-congress">limited effects on gun violence</a>.<strong> </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qthrPL">
At the same time, many states have sought to expand gun ownership in recent years. At least 27 states have now passed laws allowing residents to carry a <a href="https://www.handgunlaw.us/documents/Permitless_Carry_States.pdf">handgun without a permit</a> and allow school staff and teachers to <a href="https://www.rand.org/research/gun-policy/analysis/laws-allowing-armed-staff-in-K12-schools.html">carry guns on campus</a>.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/RwL-LaKmE7ol0gTwc1FdeZjuEEM=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24882641/nwQcq_27_states_have_passed_laws_allowing_people_to_carry_a_handgun_without_a_permit.png"/>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rNgOhz">
“Other countries look at this problem and say, ‘People walking around in the community with handguns is just way too dangerous, so we’re going to broadly limit legal access to that and make exceptions on the margins for people who might have a good reason to have a gun,’” Swanson said. “Here we do just the opposite: We say that, because of the way that the Supreme Court interpreted the Second Amendment, everybody has the right to a gun for personal protection, and then we tried to make exceptions for really dangerous people, but we can’t figure out who they are.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="irgpOC">
<a href="https://iop.harvard.edu/get-involved/harvard-political-review/vast-majority-americans-support-universal-background-checks">While the majority of Americans</a> support more gun control restrictions, <a href="https://www.pewresearch.org/fact-tank/2021/09/13/key-facts-about-americans-and-guns/">including universal background checks</a>, a vocal Republican minority unequivocally opposes such laws — and is willing to put pressure on GOP lawmakers to do the same. Alongside the NRA, and a well-funded gun lobby, this contingent of voters sees gun control as a deciding issue, and one that could warrant a primary challenge for a lawmaker who votes for it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8wKCli">
The gun lobby has the advantage of enthusiasm. “​​Despite being outnumbered, Americans who oppose gun control are more likely to contact public officials about it and to base their votes on it,” Barnard College’s Matthew Lacombe <a href="https://barnard.edu/news/break-down-gun-politics-america">explained in 2020</a>. “As a result, many politicians believe that supporting gun regulation is more likely to lose them votes than to gain them votes.”
</p>
<figure class="e-image">
<img alt="Two older Asian women stand comforting each other." src="https://cdn.vox-cdn.com/thumbor/nOzeDGIDRyUQcunIBFKGLACA4ZY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24876847/1246706108.jpg"/> <cite>Sarah Reingewirtz/MediaNews Group/Los Angeles Daily News via Getty Images</cite>
<figcaption>
Mourners honor the victims of the January 27, 2023, Monterey Park, California, mass shooting.
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</figure>
<h3 id="x5gwWU">
The Supreme Court has made it impossible to cure America’s gun violence epidemic
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PwxNBc">
In 2008, the Supreme Court effectively wrote NRA CEO Wayne LaPierre’s “good guy with a gun” theory into the Constitution. The Court’s 5-4 decision in<a href="https://www.law.cornell.edu/supct/html/07-290.ZO.html"> <em>District of Columbia v. Heller</em></a> (2008) was the first Supreme Court decision in American history to hold that the Second Amendment protects an individual right to possess a firearm. But it also went much further than that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aWby7X">
<em>Heller</em> held that one of the primary purposes of the Second Amendment is to protect the right of individuals — good guys with a gun, in LaPierre’s framework — to use firearms to stop bad guys with guns. As Justice Antonin Scalia wrote in <em>Heller</em>, an “inherent right of self-defense has been central to the Second Amendment right.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mctR9F">
As a matter of textual interpretation, this holding makes no sense. The Second Amendment provides that “<a href="https://constitutioncenter.org/interactive-constitution/amendment/amendment-ii">a well regulated Militia, being necessary to the security of a free State</a>, the right of the people to keep and bear Arms, shall not be infringed.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uuTZgL">
We don’t need to guess why the Second Amendment protects a right to firearms because it is right there in the Constitution. The Second Amendment’s purpose is to preserve “a well-regulated Militia,” not to allow individuals to use their weapons for personal self-defense.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="b4k6DP">
For many years, the Supreme Court took the first 13 words of the Second Amendment seriously. As the Court said in<a href="https://www.law.cornell.edu/supremecourt/text/307/174"> <em>United States v. Miller</em></a><em> </em>(1939), the “obvious purpose” of the Second Amendment was to “render possible the effectiveness” of militias. And thus the amendment must be “interpreted and applied with that end in view.” <em>Heller</em> abandoned that approach.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sGVwGs">
<em>Heller</em> also reached another important policy conclusion. Handguns, according to Scalia, are “overwhelmingly chosen” by gun owners who wish to carry a firearm for self-defense. For this reason, he wrote, handguns enjoy a kind of super-legal status. Lawmakers are not allowed to ban what Scalia described as “the most preferred firearm in the nation to ‘keep’ and use for protection of one’s home and family.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SR5QS5">
This declaration regarding handguns matters because this easily concealed weapon is responsible for far more deaths than any other weapon in the United States — and it isn’t close. In 2021, for example, a <a href="https://cde.ucr.cjis.gov/LATEST/webapp/#/pages/explorer/crime/shr">total of 14,616 people were murdered in the US</a>, according to the FBI. Of these murder victims, at least 5,992 — just over 40 percent — were killed by handguns.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/zuxWanJjGt4IpihFJwuTpvTv6cA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/23589874/GettyImages_1240908247.jpg"/> <cite>Allison Dinner/AFP via Getty Images</cite>
<figcaption>
A woman holds a photo of Nevaeh Bravo, who was killed in the mass shooting at Robb Elementary School, during a vigil for the victims in Uvalde, Texas, on May 25, 2022.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LcMVNg">
Last year, the Supreme Court made it even harder for federal and state lawmakers to combat gun violence. In its decision in<a href="https://www.supremecourt.gov/opinions/21pdf/20-843_7j80.pdf"> <em>New York State Rifle &amp; Pistol Association v. Bruen</em></a><em>, </em>it massively expands the scope of the Second Amendment, abandons more than a decade of case law governing which gun laws are permitted by the Constitution, and replaces this case law with a new legal framework that, as Justice Stephen Breyer writes in dissent, “imposes a task on the lower courts that judges cannot easily accomplish.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wCmPAt">
<em>Bruen </em>has since allowed handguns — which are responsible for the <a href="https://www.vox.com/22382180/supreme-court-uvalde-guns-violence-second-amendment-heller-scalia">overwhelming majority of gun murders</a> in the United States — to proliferate on many American streets. That’s because <em>Bruen</em> strikes the types of laws that limit who can legally carry handguns in public, holding that “the Second and Fourteenth Amendments protect an individual’s right to carry a handgun for self-defense outside the home.” Amid a flurry of activity in the courts over the last year, <a href="https://www.politico.com/news/magazine/2023/07/28/bruen-supreme-court-rahimi-00108285">more than a dozen state and federal gun control laws </a>have been invalidated in whole or in part as a result.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Zbm2Hq">
Under this new legal regime, the future of firearm regulation looks grim for anyone who believes that the government should help protect us from gun violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iCVN66">
<em><strong>Update, October 26, 7:50 am ET: </strong></em><em>This story was originally published on May 26, 2022, and has been updated multiple times, most recently with details from the October 25 shooting in Lewiston, Maine.</em>
</p>
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</p></li>
<li><strong>Five Nights at Freddy’s, the cult horror game turned movie, explained</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/JUf9Kk3JlLaWsxtfSRa8an6Rj1s=/137x0:1844x1280/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72795228/5769_D030_00226_R.0.png"/>
<figcaption>
A trio of large animatronic animals from <em>Five Nights at Freddy’s</em> | Universal/Blumhouse
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
How a collection of jump scares and killer animatronics shaped a decade of gaming culture.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HaA6F0">
You might not think a story about a bunch of terrifying animatronic pizza joint robots who routinely kill children<strong> </strong>would make for a hot-ticket movie, but <em>Five Nights at Freddy’s</em> is finally getting a hotly anticipated theatrical release on October 27.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rtI01E">
The movie, a product of Universal and Blumhouse, <a href="https://www.youtube.com/watch?v=0VH9WCFV6XQ">seems to be</a> a faithful, fanservice-heavy adaptation of the<a href="https://www.polygon.com/game/five-nights-at-freddys/37798"> hit video game franchise</a>, which became an immediate hit when it was released in 2014. Over time, its popularity grew, a relatively rare indie game penetrating mainstream culture. The game is known for its abundance of classic nostalgic horror elements: scary empty buildings with a maze of corridors, creepy children’s toys that seem fun during the daytime but turn malevolent at night, and jump scares — lots and lots of jump scares. The titular Freddy is a giant animatronic teddy bear that wants, along with all of his fun animal friends, to murder you, and he could be waiting around any corner.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DyE2zl">
If all that sounds like a fairly straightforward pastiche of classic horror movies, you’re not wrong. That’s also why it’s surprising that it took this long to adapt Five Nights at Freddy’s for cinema — it already has all of the components of a horror movie built into its setting and structure.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PUsa0e">
Yet<em> </em>Freddy’s<em> </em>(colloquially styled FNAF, pronounced “finaff”) is more than just a fun horror game. The franchise had a huge impact on gaming fandom and YouTube culture, and epitomized the now-ubiquitous popularity of games that keep their audiences guessing, not just about what’s going to happen, but about what it all means. The game’s ability to worldbuild while taking you through a standard horror scenario only grew over the years, through a staggering eight main games including one in virtual reality, five spinoff games, dozens of books and graphic novels, and now the movie.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TXp0B0">
All of this means that now, nearly 10 years out from FNAF’s debut, its so-called “lore” is incredibly deep. The story about a bunch of giant scary robot animals is also, according to many of its fans, a giant, bottomless, murderous puzzle box.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yHO3IH">
Let’s go exploring!
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<h3 id="p1WGxB">
FNAF is about a scary pizzeria stuffed with animatronic animals that are trying to kill you
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XwSz1B">
This entire saga is the brainchild of Scott Cawthon, a veteran Christian game developer <a href="https://www.geeksundergrace.com/gaming/developer-spotlight-scott-cawthon/">who said in a 2014 interview</a> that he got the idea for FNAF after one of his previous games garnered negative reviews: “[P]eople said the main character looked like a scary animatronic.” At some point, much like the villain of FNAF, Cawthon “snapped” and decided to show the world just how scary he could be. The fascinating element of this backstory, however, is that in the interview where he reveals his Christian faith, he talks of speaking to and being guided by God to direct his life, much as fans of his games are guided by the signs and clues he includes in the design to interpret the story they’re in. (Cawthorn received significant backlash in 2021 after fans discovered he had donated to several conservative causes including political campaigns for Donald Trump and former Congress member Tulsi Gabbard, as well as anti-abortion groups. After the controversy, he <a href="https://www.christianpost.com/news/christian-video-game-creator-retires-after-backlash-to-donations.html">announced his retirement</a> from game development.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gBQebX">
According to a tongue-in-cheek Reddit post from Cawthorn, the film won’t delve too heavily into the fan-constructed universe that spun out over all of the games; instead, it will draw on what he dubbed “the Mike script,” which, judging from his description and from the trailers, seems to be a loose but faithful adaptation of the first game. “The Mike script” is so named because of its central character, Mike Schmidt, played by Josh Hutcherson in the movie. The basic conceit of FNAF — survive five nights with murderous animatronic dolls in this creepy building as they steadily level up their murderous methods — should translate well to the big screen, especially since the film seems to level up the stakes in at least one big way: by giving Mike a daughter, Abby (a variant on a game character introduced later in the series), and bringing her into the nightmarish funhouse.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TWCcpw">
In the game, you play as Mike Schmidt, a lowly new night guard tasked with caretaking the beloved Freddy Fazbear’s Pizza in your town. Everyone loves Freddy’s, with its fun giant robotic dolls and arcade-style galleria. At night, however, the animals begin what the game describes as “free-roaming”— meaning they can move freely throughout the building. The problem arises from the way the animals view humans in their orbit during this free-roaming period: as animatronic robots who’ve lost their suits. If they see a human, your handler informs you at the beginning of the game, they’ll try to stuff the human inside one of the animatronic robot suits. This is apparently not optimal for survival.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Smujdf">
The titular five nights refers to the time you have to spend in the building after everyone else has gone home. If you can last the whole week without getting found and murdered by the robots, you win the game.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hjMm1o">
Surviving is easier said than done. The main animatronic crew of FNAF consists of an aggressive purple rabbit named Bonnie, a giant yellow chicken named Chica, a broken-down robot pirate fox named Foxy who wears an eyepatch and a hook for a hand and has his own <a href="https://sexypedia.fandom.com/wiki/Foxy">devoted subfandom</a>, and Freddy, a slow-moving but ominous brown teddy bear. Together, they roam the halls of the pizzeria, and if they find you, they’ll kill you.
</p>
<figure class="e-image">
<img alt="Three cartoon-animal-shaped robots with glowing eyes." src="https://cdn.vox-cdn.com/thumbor/zBlcLm1fYSbeqAnuWoMk_aVQPTE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25031327/5769_FP_00846A_copy.png"/> <cite>Universal / Blumhouse</cite>
<figcaption>
Bonnie. Freddy, and Chica would like a word.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="slAKot">
Okay, but you’re a security guard, surely you can just stay in the guard room with all the doors locked, right? Not so fast. The guard room uses power to monitor the locations of the animals, light the hallways, and keep the security doors locked. As the night progresses, you use more power. If you run out of power, you can no longer keep the doors locked — and Freddy will surely find you. What’s more, as each night passes, your role gets more and more dangerous. The fifth and final night finds you facing unimaginable horrors in classic scary movie fashion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="l8Y1i0">
When you explore the building using the hidden cameras, you begin to gather clues about the characters that deepen your understanding of what’s happening at Freddy’s and why the animals are after you. You eventually discover what seems to be a whole deranged backstory as the games introduce you to dozens and dozens of new vicious animatronic dolls, all with murder in mind. You also learn details that help constitute a rich meta-narrative about the game. This exploration, combined with the ideas the fandom has brought to the table, make FNAF a famously interactive experience, even though — and perhaps even because — the first game was just a single player in a room by themselves.
</p>
<h3 id="EsPKOO">
FNAF helped unlock multiple core elements of internet culture and gaming fandom
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wQVU0e">
The thing that made FNAF stand out from a crowded field of horror games when it launched was its minimalism. Its stripped-down nature and the spare but immersive effect of being in a dark building at night effectively allowed it to recreate the mounting dread and anticipation of a horror movie and keep that suspense going for the entire game — or at least as long as it took for you to die. And if you think watching jump scares in a movie can be scary, try experiencing them alone in your room with headphones, in the dark, when you are the character being acted upon.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jjBhOM">
This immersive experience is directly linked to FNAF’s role in YouTuber culture. When the game launched, the platform was just beginning to embrace Let’s Play videos, a format in which gamers share their screens and comment on the game as they play it, so that audiences can follow along and enjoy their reactions. This format has since become ubiquitous on Twitch and across YouTube, but at the time, it was still taking off. FNAF reaction videos took Let’s Plays to a whole new level of visibility. Multiple YouTubers like PewDiePie and Markiplier, who would soon become household names in the gaming world for their Let’s Play vlogs, got their first boosts of popularity directly because of their <em>Freddy’s</em> reaction videos, which went massively viral, reaching millions of casual gamers and horror fans who otherwise probably wouldn’t be tuning into YouTube for this kind of content. Markiplier’s <a href="https://www.youtube.com/watch?v=iOztnsBPrAA">first video</a> declaring FNAF “the scariest game in years” has over 100 million views. The main appeal of these videos came from watching the players experience the game for the first time and react wildly to each jump scare.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bDjVD4">
The jump scares may have been the gateway, but if the game were just a walk through a scary building, there’d be little value in replaying it, and little reason to obsess over it the way its fans do. Enter the cryptographic narrative. As academics Ana Paklons and An-Sofie Tratsaert wrote in their 2021 <a href="https://www.jstor.org/stable/pdf/j.ctv1nnwhjt.14.pdf?refreqid=fastly-default%3A7a6ccc32bedf072ce195bc4faa83e4db&amp;ab_segments=&amp;origin=&amp;initiator=&amp;acceptTC=1">case study</a> of the game, a cryptographic narrative is akin to a detective novel, one that “allows the player to become the detective.” A game full of secrets and hidden clues creates “a puzzle-like relation [between] the text and the reader.” In FNAF, “the player does not need the story to enjoy playing the game; its main function is to create a sense of immersion.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6VuI5S">
The kernels of information fans decipher as they play FNAF significantly deepen their understanding of the universe and what’s happening in it. You can enjoy the game as a straightforward frightfest where things are trying to kill you. However, if you want to understand the <em>why</em> of it all, the games are strewn with nonlinear clues that help you piece together a whole picture of the FNAF storyline — or at least the storyline as people presume it to be, since the game itself is a closed box that provides plenty of questions but very few actual answers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pWhl9X">
Fans are also guided by other fans. Matthew Patrick, creator of the YouTube channel <a href="https://www.youtube.com/user/MatthewPatrick13">The Game Theorists</a>, began posting analysis videos of FNAF in 2014 and quickly became a major clearinghouse<strong> </strong>for FNAF fan theories — the ultimate decoder and keeper of the lore, if you will. His <a href="https://www.youtube.com/playlist?list=PLOl4b517qn8jl4Lw8H8cDrDkGwf1FtC7I">FNAF playlist alone</a> has over 60 videos with nearly 800 million views. In his <a href="https://www.youtube.com/watch?v=th_LYe97ZVc">most popular</a> FNAF video, which serves as an introduction to the first game and several of the many mysteries it serves up, Patrick describes the game as “a delightfully incomplete and mysterious story with just enough threads to keep you guessing.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E2xcAz">
What you might not realize if you don’t do much gaming is that, these days, this metatextual style of game design is now everywhere — from other popular survival games like Hello Neighbor to intricate RPGs like <a href="https://www.polygon.com/reviews/2019/11/5/20948146/disco-elysium-review-pc">Disco Elysium</a>. In such games, the element of competition and winning is no longer the primary objective for many players; rather, settling into the universe, exploring the game world and secrets hidden throughout the games, and immersing yourself in the mystery are as important as the narrative goals that are set for you. This shift carries over to fans, too: As with many other parts of fandom, gamers are no longer content with playing games. Now they have to solve them, or at least have fun trying — which means fan theories and community problem-solving and sleuthing have become major parts of the gamer experience.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HFIXhp">
That all comes full circle now that the FNAF film is upon us: Fans have already spun <a href="https://www.reddit.com/r/GameTheorists/comments/13leoo7/my_theories_things_i_noticed_in_the_new_fnaf/">elaborate theories</a> about the film’s <a href="https://screenrant.com/five-nights-at-freddys-movie-lore-problem-fix/">additions to</a> or <a href="https://phasrmedia.com/blumhouse-fnaf-story-explained/">deviations from</a> the lore, its new mysteries, and its <a href="https://www.youtube.com/watch?v=nxf171kyHKU">structure</a>, just based on the trailers they’ve seen and gossip they’ve heard. The film’s director, Emma Tammi, has <a href="https://youtu.be/7nURGN3mi-s?t=324">discussed</a> the importance of accurately representing the lore as well as balancing it with new elements. Plus, she’s hinted she’d be down to direct the<a href="https://www.fangoria.com/original/is-blumhouse-planning-a-five-nights-at-freddys-trilogy/"> rumored film trilogy</a> that might result if this film is a success, which could mean even more rabbit holes for fans to fall into.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CnkYKh">
What does all this mean for the movie? It might just mean that FNAF fans will find themselves with a whole new set of mysteries on their hands. In any event, if you leave the cinema more mystified than when you came in, you’ll know you’re probably on to something.
</p></li>
<li><strong>3 winners and 3 losers from the House speaker circus</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/nXPCJrBp_AkvnLTgbS0OD5qw8PY=/132x0:3000x2151/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72793411/GettyImages_1756447150.0.jpg"/>
<figcaption>
House Minority Leader Hakeem Jeffries (D-NY) hands the gavel to newly elected Speaker of the House Mike Johnson (R-LA) after the House of Representatives held an election in the US Capitol on October 25, 2023, in Washington, DC. | Chip Somodevilla/Getty
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Right-wing hardliners ultimately triumphed by making Rep. Mike Johnson speaker.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Fkvph2">
The winner of the game of House Speaker musical chairs is … Rep. Mike Johnson (R-LA), who won the job Wednesday with unanimous GOP support.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gwVfXm">
After a 22-day struggle among Republicans to agree on Kevin McCarthy’s replacement, the right-wingers and the mainstream members in the conference decided to settle on Johnson, despite — or perhaps because of — his limited experience in leadership and lack of a national profile.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6ekTv4">
As in all good face-saving compromises, there’s some ambiguity over which side has caved — but overall, the right-wingers appear to have emerged triumphant.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CjFz4X">
We know little about how Johnson would tackle the seemingly intractable governing problems that took down McCarthy, such as how he’d keep the government funded and avoid a shutdown. (He has <a href="https://twitter.com/RepHageman/status/1716898450460283064/photo/1">distributed a plan</a><strong> </strong>that would allow for a short-term funding bill to avert a government shutdown, but the best-laid plans …)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2AvEYF">
Overall, though, Johnson is a movement conservative close to the Christian right. He’s also a stalwart Trump ally who <a href="https://twitter.com/costareports/status/1717170722198438007">actively worked to help</a> the former president try to overturn <a href="https://www.vox.com/joe-biden">Joe Biden</a>’s victories in key 2020 swing states — making Trump, who helped torch the chances of Johnson’s leading rival Tom Emmer on Tuesday, another winner.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OiXtfJ">
The losers include the existing slate of House GOP leaders, all of whom took embarrassing public L’s over the past few weeks. And while a bloc of mainstream Republicans got some satisfaction in taking down Jim Jordan, they decided to stop there rather than flexing their muscles further — meaning that the party leadership has ultimately gotten further away from them.
</p>
<h3 id="dTbQMA">
Winner (for now): Mike Johnson
</h3>
<figure class="e-image">
<img alt="Johnson touches his glasses as he and McHenry engage in conversation." src="https://cdn.vox-cdn.com/thumbor/yx5V14mEVG92EFx1tM1KJIxA14E=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25032572/GettyImages_1756336344.jpg"/> <cite>Win McNamee/Getty Images</cite>
<figcaption>
Johnson (left) talks to Speaker Pro Tempore Rep. Patrick McHenry (R-NC) as the House of Representatives holds an election for a new Speaker of the House at the Capitol on October 25, 2023, in Washington, DC.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1ksJZW">
When this saga started 22 days ago, no one would have predicted that it would end with Speaker of the House Mike Johnson. And yet it has.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Av4YCj">
Johnson was first elected to the House in 2016, which would make him the least experienced speaker <a href="https://twitter.com/ChadPergram/status/1717182604787499110">since the 1880s</a>. Yet for close House watchers, Johnson didn’t totally come out of nowhere. Since 2021, he’s been the fifth-ranking member of the House GOP leadership’s team, serving as vice chair of the conference. Before that, Johnson chaired the Republican Study Committee — an organizing body of House conservatives who are mostly not far-right enough to be in the Freedom Caucus.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OEjWOg">
But now he’s suddenly speaker, in large part because all the other contenders who were more prominent than him — McCarthy, Steve Scalise (R-LA), Jim Jordan (R-OH), and Tom Emmer (R-MN) — had made too many enemies. Since it currently takes a mere five Republican defections to sink a GOP speaker nominee on the House floor, having few haters in the party is actually more important than having passionate supporters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="G7PHrN">
Hence Speaker Johnson. But is the speakership a poisoned chalice, destined to result in the demise of anyone who drinks from it? The core problem that has bedeviled GOP speakers since John Boehner is that there is a faction of hardliners on the right who seem fundamentally unsuited to the reality of governance and especially to the compromises necessary when Democrats control the White House and Senate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hKPeAc">
Speaker Johnson has no secret plan to force President Biden and 60 senators to bend the knee and accept massive cuts to government spending. He may be <a href="https://twitter.com/RepHageman/status/1716898450460283064/photo/1">talking a big game </a>about passing 12 separate appropriations bills with Republican votes, but McCarthy made that same promise in January and found it impossible to fulfill. And inevitably, a spending deal has to be cut with Democrats, or the government shuts down and Republicans get blamed, imperiling their chances of holding the chamber in 2024.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y2k4SH">
Johnson’s best hope is that he can convince the hardliners to chill out for a bit and give him more leeway to cut those deals than they gave McCarthy. But the longer he remains in the speaker job, the more he’ll inevitably disappoint some Republicans. And it is worth noting that he has never done this job before. Can he do it?
</p>
<h3 id="7yIF3t">
Winner: GOP hardliners
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xIDOy6">
Rep. Matt Gaetz (R-FL), who started this whole ball rolling by moving to oust McCarthy, <a href="https://twitter.com/atrupar/status/1717198721178357949">summed up his takeaway</a> on Steve Bannon’s podcast Wednesday: “If you don’t think that moving from Kevin McCarthy to MAGA Mike Johnson shows the ascendance of this movement and where the power in the Republican Party truly lies, then you’re not paying attention.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Fcj6QL">
Indeed, Republican hardliners didn’t get the Speaker Jim Jordan that they dreamed of. But they firmly established the principle that the hard right is entitled to veto any speaker nominee the conference produces — and they torched the careers of all of the top three “establishment” party leaders. Not a bad month’s work.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="o0EQDy">
Johnson’s surprising ascendance is also a win for the Christian right. While Boehner, Ryan, and McCarthy all supported conservative <a href="https://www.vox.com/policy">policies</a> and viewed the religious right as an essential part of the GOP coalition, Johnson is <em>of</em> that movement: Before entering elected office, he <a href="https://www.lgbtqnation.com/2023/10/new-house-speaker-nominee-mike-johnson-is-an-anti-lgbtq-extremist-who-once-worked-for-a-hate-group/">was a top lawyer</a> for a Christian legal advocacy group and has long opposed <a href="https://www.vox.com/abortion">abortion</a> rights and <a href="https://www.vox.com/lgbtq">LGBTQ</a> rights. (In contrast, Emmer was sunk in part because he <a href="https://www.nytimes.com/2022/12/08/us/politics/republicans-who-voted-same-sex-marriage.html#:~:text=sex%2Dmarriage.html-,The%2039%20House%20Republicans%20Who%20Voted%20for%20the%20Same%2DSex,it%20passed%20over%20the%20summer.">had voted</a> in favor of <a href="https://www.vox.com/marriage-equality">marriage equality</a> — one holdout House Republican told him Tuesday that <a href="https://news.yahoo.com/room-gasped-during-bible-thumping-235532270.html">he needed to</a> “get right with Jesus.”)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RNy5Bb">
The practical impact of Johnson’s conservatism will be limited so long as Democrats control the Senate and the White House. A more conservative speaker does not necessarily translate to more conservative laws. But the right-wing hardliners have proven that while they may not yet fully control the party, they’re now the most powerful force inside it.
</p>
<h3 id="WtRw3S">
Losers: The House Republican leadership slate
</h3>
<figure class="e-image">
<img alt="McCarthy speaking at a podium with a sign that says “defend our nation.”" src="https://cdn.vox-cdn.com/thumbor/xUEqBZVYerqTuNgBy4q3jZsYBbo=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25032579/GettyImages_1543267435.jpg"/> <cite>Anna Moneymaker/Getty Images</cite>
<figcaption>
Then-Speaker Kevin McCarthy (R-CA) speaks to reporters during a news conference after the passage of the National Defense Authorization Act (NDAA) at the Capitol on July 14, 2023, in Washington, DC.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wFHMgn">
McCarthy, Scalise, and Emmer were the first-, second-, and third-ranking members of the leadership team the House GOP elected less than a year ago. But in the past few weeks, they’ve all been publicly humiliated as their speakership dreams were dashed by right-wing hardliners — even though each was clearly preferred by a majority of the GOP conference.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CiuFcq">
McCarthy was tossed out of his job by just eight defecting Republicans (who joined with all Democrats to oust him as speaker). Then Scalise, after winning an internal GOP conference vote, <a href="https://www.vox.com/politics/2023/10/12/23914703/house-speaker-race-steve-scalise-republicans-jim-jordan">lasted barely more than a day</a> as speaker nominee before quitting. And this week, Emmer exceeded even that — he was the speaker nominee for just four hours before dropping out.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OCozrH">
Now, the top three ranking Republicans all have egg on their face, with their political futures uncertain. The party is moving on to new leaders and may no longer have room for them.
</p>
<h3 id="LLhqf8">
Winner: Donald Trump
</h3>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/4G82mrDlmwt3B5auhAXS7Dxsb_k=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25032583/GettyImages_1754498829.jpg"/> <cite>Mike Sega/Getty Images</cite>
<figcaption>
Former President Donald Trump.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KTCTHW">
Trump was mostly a minor player in the House speaker race — the GOP hardliners don’t need his encouragement to make trouble for party leaders. But while he didn’t end up with Speaker Jordan (his initial endorsement), he may have ended up with the next best thing.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fAFxWP">
“Johnson was deeply involved in efforts to keep Trump in power starting immediately after 2020 election,” the Washington Post’s Robert Costa <a href="https://twitter.com/costareports/status/1717170722198438007">tweeted</a>. “Johnson — then all but unknown — worked with allied Trump groups and conservative leaders in a coordinated way to make sure that whole orbit was working together to help Trump.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hsHgoX">
Early on, Johnson <a href="https://nymag.com/intelligencer/2023/10/house-speaker-republican-mike-johnson-january-6-mastermind-trump-election-2020.html">publicly</a> made false claims that voting machines were “rigged.” In December, he used his constitutional law expertise to put together a legalistic justification for throwing out Biden’s wins in key swing states — he <a href="https://www.supremecourt.gov/DocketPDF/22/22O155/163550/20201211132250339_Texas%20v.%20Pennsylvania%20Amicus%20Brief%20of%20126%20Representatives%20--%20corrected.pdf">claimed</a> that state voting policy changes implemented during the pandemic were illegal unless they went through state legislatures, and got more than 100 House Republicans to sign on to the argument. He stuck by that argument <a href="https://mikejohnson.house.gov/news/documentsingle.aspx?DocumentID=715">up to January 6 itself</a>, and even when <a href="https://www.vox.com/congress">Congress</a> reconvened after the attacks, he <a href="https://www.vox.com/2021/1/6/22218058/republicans-objections-election-results">voted to</a> throw out Biden’s wins.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="f7LdF8">
Trump also played a role in the denouement of the crisis. Emmer had initially defeated Johnson for the speaker nomination midday Tuesday, but he’s long had a tense relationship with Trump. And while Emmer was struggling to win over hardliner holdouts, Trump publicly blasted Emmer as a “<a href="https://www.foxnews.com/politics/trump-blasts-emmer-globalist-rino-warns-republicans-would-be-tragic-mistake-elect-him-speaker">Globalist RINO</a>,” in what may have been the nail in the coffin for his bid. Now, he has a true loyalist in the speaker’s chair rather than someone backing him through gritted teeth.
</p>
<h3 id="SHZhD2">
Loser: Anyone dreaming about bipartisanship
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kvTA7x">
As Republicans struggled for so long to achieve near-unanimity to elect a speaker, many observers asked an obvious question: Why couldn’t some Republicans cut a deal with some Democrats to pick a speaker, and govern the House from the center?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uRiUft">
Various ideas to this effect were batted around — the one that gained the most steam was for an “empowerment” of temporary speaker Patrick McHenry for a set period of time. But it proved to be toxic among Republicans. It drew fury from conservative media, and GOP leaders distanced themselves from any idea of a “coalition government.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2pjb1l">
A Washington Post editorial <a href="https://www.washingtonpost.com/opinions/2023/10/24/tom-emmer-republicans-house-speaker-democrats/">blamed Democrats</a> for failing to throw a reasonable Republican their votes. But that argument missed the point — the relatively more “reasonable” Republican options, Scalise and Emmer, never actually went to the House floor, instead quitting beforehand. For Emmer in particular, there had been chatter that some Democrats might throw him their votes or vote present. But he evidently didn’t <em>want</em> to be elected as a speaker with Democratic votes, since that would forever mark him as a party traitor. Partisanship and polarization remain ascendant.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="79ZmK2">
This is also why the mainstream bloc of Republican holdouts ultimately lost their staring contest with the hardliners. The ultimate leverage the mainstreamers could have deployed would have been a threat to deal with Democrats. But they all have Republican primaries they want to win, Republican donors they want to woo, and Republican social worlds they inhabit. A deal with Democrats would likely have meant the end of their own political careers, and evidently no one wanted to take that risk.
</p>
<h3 id="OU8kuv">
Loser: The stability of the US electoral system
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QOVCY9">
After Johnson won the GOP conference’s speaker nomination Tuesday night, one reporter <a href="https://twitter.com/Acyn/status/1717013355775545630">asked him about</a> having led Trump’s challenges to the 2020 election results. The assembled GOP leadership team booed, with one member yelling “shut up!” Johnson demurred: “Next question.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ruTj56">
In January 2021, when Trump was trying to stay in power, the House of Representatives was under Democratic control, so the actions of House Republicans didn’t matter all too much. Most of them could vote to throw out Biden’s wins in key states, but they didn’t have a majority, so they couldn’t actually <em>do</em> that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iRLcnt">
January 2025 could be different. The House that meets to certify the presidential election results that month will be newly elected, but Johnson could well still be speaker. If so — and if there’s a similar dispute where Trump is denying a Biden victory — it’s far from clear what Johnson will do.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BJpJMc">
Generally, from November 2020 through January 2021, the Republican Party behaved terribly irresponsibly, but just enough Republicans in positions of power did the right thing — <a href="https://www.vox.com/22230929/trump-coup-why-failed-capitol-storming">certifying the results</a> at some political cost. Since then, critics of Trump’s attempt to seize power have largely been purged from the party, and election denial has been increasingly normalized. For instance, Rep. Ken Buck (R-CO), an idiosyncratic conservative, <a href="https://www.axios.com/2023/10/11/republican-speaker-vote-ken-buck-2020-election">said he initially</a> wouldn’t support a speaker candidate who denied the election results — but he backed Johnson anyway.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lYAj0N">
Would a GOP-controlled House certify a Democratic victory in the <a href="https://www.vox.com/2024-elections">2024 presidential election</a>? With Johnson in charge, that may have grown less likely — and that has ominous implications for the state of American democracy.
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Golden Glow shines</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>ENG vs SL | Mathews, Kumara shine as Sri Lanka bowls England out for 156</strong> - After making a rapid start with a flurry of boundaries to reach 44/0 in six overs, England suffered a batting collapse as they were shot out for a second consecutive total under 200</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>Devils Magic, Julio, Three Little Words, General Patton and Aquamatic please</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>You have to fight fire with fire: Angelo Mathews on Sri Lanka’s England clash</strong> - The 36-year-old is in as an injury replacement for speedster Matheesha Pathirana</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>England faces Sri Lanka in a must-win game for both</strong> - Buttler’s men come into the contest after the big loss against South Africa while the Islanders tasted success versus Netherlands in their last outing</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Endosulfan: Finance department sanctions ₹4.82 crore for rehabilitation-related activities</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>Alappuzha youth collective buys ambulance using funds raised through ‘challenges’</strong> - Thuravoor-based Team Prahladaa sold cakes and vegetables, and conducted ‘challenges’ to raise ₹8 lakh for a mini ambulance. They plan to continue efforts to generate funds to buy an ICU ambulance for the public in the Cherthala taluk.</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>Chennai hospital to help Chad govt. develop healthcare facilities</strong> - Madras Medical Mission will also train Chad healthcare personnel</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>Man dies after being stung by bees</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>‘Art wall’ unveiled at Vellar</strong> - The Art wall features celestial themes including the Milky Way, the solar system and the moon</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Israel Gaza: EU leaders set to discuss humanitarian pauses</strong> - Thursday’s summit is overshadowed by Hamas’s war with Israel and a failure to project a united front.</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>Rédoine Faïd: France’s jailbreak king gets more jail time for helicopter escape</strong> - Rédoine Faïd is given another 14 years in jail for a spectacular escape involving a helicopter.</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>Ukraine war: Russians likely targeted Khmelnytsky nuclear plant - Zelensky</strong> - The International Atomic Energy Agency said the plant’s operations were unaffected.</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>Ukraine war: Russia goes back to prisons to feed its war machine</strong> - Russia’s defence ministry has taken over from Wagner in recruiting inmates to fight in Ukraine.</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>Russia says it rehearsed ‘massive’ nuclear strike</strong> - The drills come as Moscow pulls out of a treaty banning physical nuclear weapons tests.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Leonardo da Vinci used toxic pigments when he painted the Mona Lisa</strong> - Plumbonacrite has previously been found in later works by Rembrandt. - <a href="https://arstechnica.com/?p=1978513">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pro-Russia hackers target inboxes with 0-day in webmail app used by millions</strong> - Previously unknown XSS in Roundcube let Winter Vivern steal government emails. - <a href="https://arstechnica.com/?p=1978806">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Teeny jumping spider found in woman’s ear after days of torturous racket</strong> - The spider was nesting on her eardrum—and there’s video. - <a href="https://arstechnica.com/?p=1978787">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Apple raises prices of Apple TV+ and other services</strong> - The Apple One bundle is getting pricier, too. - <a href="https://arstechnica.com/?p=1978725">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>University of Chicago researchers seek to “poison” AI art generators with Nightshade</strong> - Altered images could destroy AI model training efforts that scrape art without consent. - <a href="https://arstechnica.com/?p=1978501">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The CEO of a company was in need of a secretary</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He spread ads all over town. A few days later, there was a knock on his door. It was a dog. He had a newspaper in his mouth. He opened it to the classifieds page and pointed to the ad that the CEO had placed. The CEO was impressed. But he thought it was a joke, so he decided to test the dog:
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Look, I need a secretary who understands the basics of computers”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The dog went to one of the secretary’s desks, climbed on the chair, turned on the computer and the printer in total tranquility.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The CEO was amazed, but decided to go further:
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“That’s good, but I need a secretary who understands spreadsheets”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The dog quickly opened Excel, scanned rows and columns of data and then used pivot tables to create dashboards of charts. The astonished CEO desperately followed:
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Well, that’s really fantastic, but my secretary must be bilingual!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The dog replied:" Meow"
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Des-You-color"> /u/Des-You-color </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17gnqdi/the_ceo_of_a_company_was_in_need_of_a_secretary/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17gnqdi/the_ceo_of_a_company_was_in_need_of_a_secretary/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A husband and wife go to Jamaica for vacation…</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
After seeing the typical tourist attractions, they wander off the beaten path into a darker part of town.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
After walking a few blocks, they see an adult store and after some persuasion, the wife convinces her husband to enter.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
They look around for a few minutes, and then they come upon a display case with a pair of sandals inside, and a sign hanging above them that reads, “Voodoo Sex Shoes.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I wonder how these are suppose to work?” the man asks. Suddenly, the shops only employee walks up, and hearing the question, he responds, “These are special voodoo shoes, mon. Put them on, and get ready: it will make you horny for women like nothing else, and you will be a fucking machine, mon!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The wife hears this and starts urging her husband to get them. “C’mon babe, please? You’ve been needing a little help lately.” The husband blushes and says, “well, I guess it couldn’t hurt to try them on.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Pulling the shoes out of the case, he slips them on his feet. Instantly, he stiffens. His eyes pop out, his muscles tense, and his dick stands straight up. He glances at his wife for a long minute, then suddenly grabs the shop employee, bends him over, and starts fucking him in the ass like a wildman.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The employee starts screaming, “Take them off! Take them off! You’ve got them on the wrong feet, mon!”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/No_Security_1276"> /u/No_Security_1276 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ge9a6/a_husband_and_wife_go_to_jamaica_for_vacation/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ge9a6/a_husband_and_wife_go_to_jamaica_for_vacation/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Farmer’s Daughter</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A traveling salesman was driving from one large city through several small towns to another large city when his car broke down…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It was getting rather dark, so he decided to walk to the closest lit farmhouse and knock on the door… A farmer with a shotgun in his hand, opened the door and greeted the man…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The salesman told him about his car on the side of the road… And asked if he could spend the night on the sofa and that he would be out quickly in the morning…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The farmer said the sofa belonged to his two dogs and the only bed in the house was where his daughter slept, that the farmer slept next to the dogs…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The farmer said that he would place an egg between the two and if it got broken he would know they were messing around…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The daughter started getting a little frisky after the father had left and the egg ended up getting broken… The salesman just happened to be on his way to the next town for a glue conference, so they glued the egg back together and changed out the sheets on the bed…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
In the morning the farmer returned to the daughter’s bedroom and picked up the egg, only to find out it had no weight…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So he grabbed his shotgun and his daughter screamed, “..daddy, daddy, what are you going to do with your gun..?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The farmers said, “I’m going to go shoot that fucking rooster, he’s using condoms again…”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/emzirek"> /u/emzirek </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17glxrh/farmers_daughter/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17glxrh/farmers_daughter/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What’s the best thing about transphobia?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It finally got people interested in women’s sports.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/hudsonvall"> /u/hudsonvall </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ge9n9/whats_the_best_thing_about_transphobia/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ge9n9/whats_the_best_thing_about_transphobia/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A charity worker goes to visit a very successful businessman in his town to find out why he has never donated to any charity in the community.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Sir, you have been so very successful in this town, and this community has given you much. Why have you never given back to the community?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The businessman says, “Listen, son, did you know that my wife’s mother has been suffering for years in the hospital, and requires constant care and medical expenses.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The charity worker says, “Umm… no, I was not aware of that.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“And my brother, has 7 kids, two with severe disabilities, and he just got in an accident at work due to unsafe conditions, and they’ve fired him and they’re screwing him on compensation.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Charity worker “I’m sorry to hear about this….”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“AND MY OWN SON, and his new wife and newborn baby, their house was destroyed by tree that fell down in the storm last year, and insurance hasn’t given them a penny!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Charity worker: “I’m very sorry to have taken up your valuable time…”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Businessman: “IF I HAVEN’T GIVEN ANY OF THEM ANY MONEY, WHAT MAKES YOU THINK I’M GOING TO GIVE IT TO YOU?”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/mralex"> /u/mralex </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17gn0ov/a_charity_worker_goes_to_visit_a_very_successful/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17gn0ov/a_charity_worker_goes_to_visit_a_very_successful/">[comments]</a></span></p></li>
</ul>
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