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Myths Busted: The Truth About Diamonds
Dec 14, 2017 4:45 AM By Sarah Jordan
RAPAPORT... Myths about the industry, especially among consumers, are some of the hardest to debunk. Here, leading experts correct some common misconceptions.
Myth: Customers are significantly at risk of buying a conflict diamond
Reality: Perhaps the most pervasive myth of all, the issue of conflict diamonds — or "blood diamonds" — has a firm grip on the public consciousness.
"Our industry has made great strides since the widespread awareness that came to light during the brutal civil wars in Sierra Leone and Angola in the 1990s," says Don Palmieri, president of the Gem Certification & Assurance Lab (GCAL). The percentage of the global diamond trade funding or facilitating conflict at that time is up for debate, with estimates ranging from less than 1.5% to as much as 15%. But since the introduction of the Kimberley Process (KP) certification scheme and the World Diamond Council (WDC) System of Warranties, more than 99.8% of the world's diamonds are certified conflict-free, with the support of 81 countries.
As such, the industry is extensively self-regulated, and various countries have additional layers of government regulation in place. The UK's Government Diamond Office, for example, works closely with HM Revenue & Customs, the European Commission and civil groups to combat illicit diamonds.
Voluntary and self-regulation systems are effective in maintaining the diamond pipeline, explains Ronnie VanderLinden, president of the Diamond Manufacturers & Importers Association of America (DMIA). As an example, he points to the Diamond Source Warranty Protocol developed by leading US organizations.
"We have systems in place to ensure those doing business have the confidence to know that their source of supply is conflict-free. There are also those that subscribe to the Responsible Jewellery Council, De Beers' Best Practice Principles, and the Signet Responsible Sourcing Protocol," he adds.
Myth: The diamond industry is a monopoly
Reality: "The perception exists that De Beers still controls the market and controls prices, when this hasn't been the case for decades," says Adonis Pouroulis, chairman of Petra Diamonds. "In fact, Petra still gets asked if we sell our diamonds to De Beers."
This myth is rooted in history, harking back to late 1980s. At that time, De Beers did indeed control over 90% of the supply chain and was almost wholly responsible for marketing diamonds, having developed its famous "A Diamond Is Forever" slogan in the 1940s. This also led to the perception that De Beers "invented" the diamond engagement ring, when in fact the first was recorded as early as 1477.
By the 1990s, the market for new mining companies opened, breaking the hold that De Beers and Alrosa had on the industry and ushering in a new wave of diamond discoveries in Angola and Canada, according to Pouroulis.
David Johnson, senior manager of media and commercial communications at De Beers, adds that his company's share "was around 35% of global supply by value [in 2016], while Alrosa supplied nearly 30% of the world's value by rough diamonds. Other producers, such as Sodiam, Dominion Diamonds, Rio Tinto and Petra Diamonds, all also had sizable shares of supply value in 2016, so the industry clearly has a range of competing suppliers."
Myth: Diamond mining takes from the environment and gives nothing back
Reality: "Diamond mining is generally less harmful to the environment than other types of mining, because less or no chemicals are used, which can otherwise be harmful to the staff's health," says Tobias Kormind, managing director of leading European retailer 77Diamonds.com.
Pouroulis adds that "diamond mining tends to have a much smaller footprint, as our orebodies are vertical, not horizontal [and therefore affect less of the surrounding area]. In Petra's case, we have established protected habitats adjacent to our operations, totalling 10,255 hectares, to ensure preservation of fauna and flora."
For many companies, these preserved land areas are larger than the mining operation itself. The De Beers Group conserves 164,000 hectares of land, five times the area disturbed by its mining activities. De Beers is "also leading a ground-breaking research project that aims to deliver carbon-neutral mining at some of our operations in as few as five years," Johnson comments. "Scientists estimate that the carbon storage potential of kimberlite tailings produced by a diamond mine every year could offset up to 10 times the emissions of a typical mine."
In Australia, Rio Tinto's Argyle mine draws more than 92% of its power needs from the hydroelectric Ord Hydro power station, and the company has reduced its diesel consumption by 21%. Overall, the industry has made huge strides in water recycling and waste reduction, and has introduced comprehensive mine closure plans and tree-replanting programs.
Myth: Diamond mining communities are mistreated and at-risk
Reality: "Unlike almost any other industry, mining builds communities and a sense of belonging, none more so than in diamonds," says Kathy Chappell of Fair Trade Gems, who was recently named ethical-issues adviser to the London Diamond Bourse (LDB). The isolated nature of diamond mines means the workforce lives close by and develops a community spirit, which the diamond industry supports by investing in hospitals, schools, training and bursary programs.
Misunderstandings of the situation start at a basic level, with many still presuming miners are extracting diamonds by hand. "People don't understand that diamond mining is a highly automated process, moving millions of tons of rock per year. Miners operating large earth loaders in open pits or underground would never even see a diamond," says Pouroulis.
Consumers also underestimate how much the diamond mines help strengthen the community. Petra, for instance, spent $8.5 million on training in fiscal 2017 and doubled its social spending to $3.4 million in the same period. On a national and global level, says Palmieri, "remote mine discoveries have brought badly-needed foreign exchange to countries and have allowed legitimate governments to educate and provide modern-day medicines and medical facilities to their people."
For example, 33% of Botswana's GDP comes from diamond mining, and an estimated five million people globally have access to health care thanks to diamond revenues, according to diamondfacts.org.
Myth: The whole industry is secretive and closed to outsiders
Reality: The high-value nature of diamonds has fostered a presumption that the industry is riddled with inaccessible people and organizations, more comfortable with secrecy than transparency. But in fact, says Palmieri, "there are a lot of very hard-working people spread out across the globe who are anywhere from struggling to well-off, to rich and wealthy, depending upon how they have built their businesses and the effects of a six-year decline in prices of polished diamonds."
Public attitudes toward transparency have also had an impact on the industry, according to Johnson.
"Society now expects to see businesses reporting on their social activities, and regulators, financiers and other stakeholders increasingly require transparency in corporate structures and financial reporting so they can be confident that companies are acting properly. As such, we have seen a major change in the diamond sector," he says.
Contributing to the secrecy myth is the belief that diamond companies are hoarding mountains of stones, although this, too, is an inaccuracy, Pouroulis notes.
"Some people still think De Beers is sitting on huge stockpiles of diamonds in vaults in London, whereas in fact there are no significant stockpiles of diamonds nowadays," he explains. "Yes, diamond miners all have diamond inventory, but this is generally as per the normal course of business as we build up inventory before making a sale."
This article was first published in a special supplement produced in collaboration with the Diamond Producers Association.
Tags: diamond myths, Sarah Jordan
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Jay Z cried after his mother came out to him a lesbian??!
In the April 6 episode of "My Next Guest Needs No Introduction with David Letterman" on Netflix, Jay Z says he was happy his mother was free.
The rap mogul says he'd known his mother was gay, but they discussed it for the first time eight months ago.
Jay Z says his mother had to live as someone she wasn't because she didn't want to embarrass her children.
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Anheuser-Busch Looks To Be A Big Part Of The Super Bowl
Recently Anheuser-Busch announced that they will be one of the most visible company during the Super Bowl. As NFL fans watch the big game on Sunday, Feb. 7, the brewer will spotlight Super Bowl veterans Budweiser and Bud Light, along with first-time Super Bowl advertiser Shock Top and returning Super Bowl advertiser Michelob ULTRA.
Anheuser-Busch is scheduled to have three full minutes of advertising in this year's game, including the first spot immediately following kickoff.
"People have come to expect groundbreaking creative from our brands during the Super Bowl, and this year is no exception," said Jorn Socquet, vice president, U.S. marketing at Anheuser-Busch. "A powerful Super Bowl ad can set the tone for a brand's performance throughout the following year and beyond, and we've made significant investments to ensure that this year's spots will connect with fans in new and unexpected ways."
A stalwart of the Super Bowl stage, Bud Light – the Official Beer of the NFL – will continue its more than 30-year Super Bowl advertising tradition, and Budweiser, an iconic in-game advertiser since its first Super Bowl appearance in 1975, will also return. Shock Top will make its Super Bowl advertising debut, and Michelob ULTRA will return with its first Super Bowl spot since 2010. Anheuser-Busch's Super Bowl advertising legacy also includes 14 Ad Meter wins since the award began in 1989 – the most of any advertiser.
Preview The Super Bowl XLIX Ads From Budweiser & Bud Light
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Super Bowl XLVII Pick
Print article This entry was posted by Art Eddy III on January 17, 2016 at 5:24 pm, and is filed under Entertainment. Follow any responses to this post through RSS 2.0. Both comments and pings are currently closed.


The discovery of sodium-glucose co-transporter 2 (SGLT2) inhibitors, with a novel mechanism independent of insulin secretion or sensitization, bring about a new therapeutic approach to the management of type 2 diabetes mellitus. The aim of this meta-analysis was to evaluate the safety and efficacy of SGLT2 inhibitors at different doses in randomized double blind clinical trials.
This meta-analysis was conducted by including randomized double-blind controlled trials of SGLT2 inhibitors in patients with type 2 diabetes irrespective of their antidiabetic drug exposure history but with an inadequate glycemic control. All the effect sizes were computed using the random effects model. Standardized mean differences (SMDs) and odds ratios (OR) were computed for continuous and dichotomous variables, respectively. Additional analyses like sensitivity analysis, subgroup analysis and meta-regression were also performed.
The pooled analyses demonstrated a significant reduction in mean changes in Hemoglobin A1c (HbA1c) (SMD = −0.78%, 95% CI, -0.87 to −0.69), fasting plasma glucose (FPG) (SMD = −0.70 mg/dl, 95% CI, -0.79 to −0.61), body weight (overall SMD = −0.59 kg, 95% CI, -0.65 to −0.52) and blood pressure from baseline with SGLT2 inhibitors based therapy. Consistently a significant number of patients treated with SGLT2 inhibitors achieved HbA1c < 7% (OR = 2.09, 95% CI, 1.77 to 2.46). SGLT2 inhibitors based therapy was associated with adverse events like genital and urinary tract infections.
All studied doses of SGLT2 inhibitors, either as monotherapy or in combination with other antidiabetic agents, consistently improved glycemic control in patients with type 2 diabetes. However, a small percentage of patients suffer from genital and urinary tract infections.
The persistent hyperglycemia in patients with type 2 diabetes mellitus is strongly associated with microvascular and macrovascular complications . Chronic hyperglycemia is postulated to contribute to the continuous loss of pancreatic β-cells and the impairment of insulin secretion . Microvascular complications like diabetic retinopathy, nephropathy, and neuropathy are major causes of new cases of blindness and renal insufficiency . Moreover, in type 2 diabetes macrovascular complications, including coronary heart disease and stroke, are major causes of morbidity and mortality . According to a prospective study, in patients with type 2 diabetes, a 1% increase in HbA1c was associated with 20% to 30% increase in mortality or cardiovascular events .
Intensive glycemic control in patients with type 2 can delay the onset and progression of the early stages of diabetic microvascular complications . In the UKPDS, a reduction in mean HbA1c was associated with reductions in both microvascular and macrovascular complications . But the risk reduction of myocardial infarction, stroke, and heart failure was relatively low . Furthermore a meta-analysis of randomized controlled trials reported that an intensive glycemic control resulted in no significant effect on events of stroke or all-cause mortality . As a result, researchers recommend a multidisciplinary approach to the management of the cardiovascular risk factors in patients with type 2 diabetes .
Currently many antidiabetic agents are available with a variety of chemical groups and site of actions. Most of these agents act by either improving the insulin sensitivity or by enhancing insulin secretion. Nevertheless, as the pancreatic β-cells function continues to decline, failure of therapy to achieve adequate glycemic control is inevitable. The cumulative incidence of monotherapy failure was 15% with rosiglitazone, 21% with metformin, and 34% with glyburide after 5 years of therapy . On the other hand, agents like insulin, sulphonylureas, and thiazolidinediones are associated with significant safety concerns such as weight gain and hypoglycemic events [9, 10].
The discovery of SGLT2 inhibitors, with novel mechanism independent of insulin secretion or sensitization, may possibly expand the armamentarium in the battle against type 2 diabetes mellitus. SGLT2 plays an important role in the kidneys and is responsible for most renal glucose re-absorption in the proximal convoluted tubule . Currently there are a number of SGLT2 inhibitors that are under development or in clinical trials . Prior meta-analyses had established the safety and efficacy of SGLT2 inhibitors as a group [13, 14]. However, recently published randomized clinical trials reported more frequent adverse events with SGLT2 inhibitors and no significant difference in the proportion of patients achieving HbA1c levels <7.0% as compared to placebo treated [15, 16]. Thus, the primary aim of this meta-analysis is to determine the safety and efficacy of SGLT2 inhibitors alone or in combination with other anti-diabetic drugs relative to placebo or placebo with other anti-diabetic drugs by including both previously and recently published randomized double blind clinical trials.
Electronic based literature search was conducted in the databases of MEDLINE, HINARI, EBASE and The Cochrane Library by both authors (AB and AB). The literature search was further strengthened by searching relevant articles from the reference list of retrieved articles. During searching the following search terms were alternatively combined using the Boolean logic (AND, OR and NOT): sodium glucose co-transport (SGLT) inhibitors, dapagliflozin, canagliflozin, ipragliflozin, empagliflozin, sergliflozin etabonate, remogliflozin etabonate, tofogliflozin and type 2 diabetes.
The predetermined study inclusion criteria were: (1) randomized double-blind controlled trials of SGLT2 inhibitors in patients with type 2 diabetes mellitus; (2) studies which recruited patients with type 2 diabetes irrespective of their antidiabetic drug exposure history (naïve or drug experienced) but with an inadequate glycemic control (HbA1c ≥7.0); (3) studies written in English and (4) studies with a minimal duration of therapy for 12 weeks. The study selection of the retrieved literature was conducted in two steps: First, all the retrieved literature titles and abstracts were reviewed and then grouped either under "eligible for full document review" or "ineligible for full document review". Second, all literatures that were grouped under "eligible for full document review" were reviewed in detail and then grouped as "eligible for the meta-analysis" or "ineligible for the meta-analysis".
Data extraction from the selected studies was conducted by both authors independently with the same data extraction template. Standard Excel spreadsheets were used for the data extraction. The following information was abstracted from the included studies: name of the first author, year of publication, sites of the study, the study design, duration of therapy, antidiabetic drugs used by the patients before they were recruited in the studies, antidiabetic drugs used in combination with SGLT2 inhibitors, dose, change in HbA1C(%) from baseline, number of patients with HbA1c < 7.0%, change in FPG, change in body weight, change in blood pressure, number of patients with adverse events, And number of patients who discontinued medication due to adverse events, experienced serious adverse events, experienced hypoglycemia, experienced urinary tract infection, and experienced genital tract infection.
Risk of bias in every of the included studies was assessed by the Cochrane risk of bias assessment tool. The predefined key domains were: random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting and other bias. Based on the included articles, each domain was judged as "low risk of bias" or "unclear risk of bias" or "high risk of bias".
Before the pooled analyses were conducted, some statistical transformations and unit conversions were performed. In case of continuous variables, where the standard deviation (SD) was not reported in the included studies, we computed the SD from standard errors (SE), 95% confidence intervals (CI) or P-values. When the value of FPG was reported in mmol/L, it was converted to mg/dl using an online converter .
All effect sizes in this meta-analysis were computed using the random effects model. SMDs and the 95% CIs were computed for the changes in HbA1C (%), FPG, body weight, and blood pressure from baseline using the inverse variance method (IV). For dichotomous variables (adverse events, discontinuation of medication due to adverse events, serious adverse events, hypoglycemic events, urinary tract infection, and genital tract infection) ORs and 95% CIs were computed with Mantel-Haenszel method (M-H). When the 95% CI does not include zero for the SMDs and one for ORs, it was considered as statistically significant. Sensitivity analysis was performed by removing a study with a specific dose from the analysis at a time to evaluate the stability of the pooled values.
The consistency of the included studies was evaluated by the heterogeneity test (I2 statistics); when the value of I2 is greater than or equal to 50%, the included studies were considered as statistically inconsistent. To identify the possible sources of heterogeneity subgroup analysis and meta-regression were conducted. Publication bias was assessed by funnel plots and by funnel plot asymmetry test (Egger's test). All the statistical analyses were performed with OpenMetaAnalyst software and Review Manager (RevMan) Version 5.1 software. We reported the meta-analysis by following the PRISMA checklist.
Using the Google scholar search engine about 6,390 literatures on SGLT2 inhibitors were identified. One hundred and four articles were retrieved. After reviewing the abstracts of all the retrieved articles 26 articles were selected for full document review. Then, following the full document review of the 26 articles, 17 fulfilled the predetermined inclusion criteria. Eleven of studies were on dapagliflozin [15, 18–27], 3 on canagliflozin [16, 28, 29], 2 on ipragliflozin [30, 31], and the remaining one was on empagliflozin  (Figure 1). A total of 4,811 patients with type 2 diabetes received one of the SGLT2 inhibitors alone (2,686) or in combination with other antidiabetic drugs (2,125) and 1,921 received placebo (887) or placebo with other antidiabetic drugs (1,034) (Table 1). The risk of bias assessment in the included individual studies did not demonstrate the presence of bias in randomization, blinding or reporting. Similarly, funnel plot did not also show the existence of publication bias.
n number of patients, N/R not reported, QD once daily, BID twice daily, PBO placebo, CANA canagliflozin, EMPA empagliflozin, IPRA ipragliflozin, DAPA dapagliflozin.
As presented in Figure 2, the pooled analysis of the mean change in HbA1c from baseline established a significant reduction in patients who were treated with SGLT2 inhibitors than placebo treated patients (overall SMD = −0.78; 95%CI, -0.86 to −0.69). All the SGLT2 inhibitors included in the meta-analysis, canagliflozin (subtotal SMD = −0.97; 95%CI, -1.25 to −0.69) dapagliflozin (subtotal SMD = −0.73; 95%CI, -0.82 to −0.64), ipragliflozin subtotal SMD = −0.68; 95%CI, -0.861 to −0.490) and empagliflozin subtotal SMD = −0.78; 95%CI, -0.967 to −0.599), demonstrated the significant reduction in HbA1c. The reduction in HbA1c appears more prominent in canagliflozin treated patients. However, heterogeneity testing revealed the presence of a considerable heterogeneity among the studies on canagliflozin (I2 = 90%) and a moderate heterogeneity among studies on dapagliflozin (I2 = 57%) and ipragliflozin (I2 = 56%).
Standardize mean difference of the change in HbA1c from baseline.
Subgroup analysis based on the doses of SGLT2 inhibitors and the type of regimen (SGLT2 inhibitors monotherapy vs SGLT2 inhibitors in combination with other antidiabetic drugs) and meta-regression using duration of therapy and the doses of SGLT2 inhibitors as a covariates did not show a significant difference in HbA1c change from baseline. On the other hand sensitivity analysis confirmed the stability of the overall SMD when any of the studies with a specific dose removed from the analysis. The overall SMD ranged within −0.75 to −0.79%.
In support of the above analysis, the odds of SGLT2 inhibitors treated patients who achieved HbA1c < 7.0% were more than two folds of placebo treated groups (overall OR = 2.09; 95% CI, 1.77 to 2.46). Similarly, the mean FPG levels (overall SMD = −0.70 mg/mL, 95% CI, -0.79 to −0.61) and mean body weight (overall SMD = −0.59 kg; 95% CI, −0.66 to −0.52) of patients who were treated with SGLT2 inhibitors were significantly decreased from baseline compared to placebo treated patients (Figure 3). Furthermore, treatment with SGLT2 inhibitors was significantly associated with a reduction in both systolic (overall SMD = −0.27 (mmHg; 95% CI, -0.34 to −0.20) and diastolic (overall SMD = −0.24, 95% CI, -0.30 to −0.17) blood pressure from baseline. Most of the individual studies did not show the significant association of SGLT2 inhibitors with an increase in HDL cholesterol level from baseline. However, the overall SMD demonstrated a significant increase in HDL cholesterol level in patients who were treated with SGLT2 inhibitors (overall SMD = 0.21 mg/dl; 95% CI, 0.09 to 0.33). The change in the level of LDL cholesterol from baseline in SGLT2 inhibitors treated groups was not different from placebo treated groups (overall SMD = 0.07 mg/l; 95% CI, -0.01 to 0.14).
Standardize mean difference of the change in body weight from baseline.
Even though the SGLT2 inhibitors with all doses did not show association with adverse events, the overall OR revealed the significant association of SGLT2 inhibitors with adverse events (overall OR = 1.18; 95% CI, 1.08 to 1.29) (Figure 4). The subtotal ORs in the subgroups of canagliflozin (subtotal OR = 1.31; 95% CI, 1.08 to 1.59) and dapagliflozin (subtotal OR = 1.17; 95% CI, 1.05 to 1.31) showed significant association with adverse events. Whereas the subtotal ORs in the subgroups of ipragliflozin was not statistically significant (OR = 0.95; 95% CI, 0.677 to 1.325). Dapagliflozin (subtotal OR = 3.07; 95% CI, 2.32 to 4.05) and canagliflozin (subtotal OR = 3.42; 95% CI, 1.86 to 6.28) were associated with genital tract infections. Dapagliflozin was also associated with urinary tract infection (subtotal OR = 1.32; 95% CI, 1.06 to 1.63). Nevertheless the number of patients who were treated with SGLT2 inhibitors and experienced serious adverse events was not different from placebo treated groups (overall OR = 0.83; 95% CI, 0.65 to 1.05). Similarly the number of patients who experienced hypoglycemic events during the study periods was not different from placebo treated groups (overall OR = 1.16; 95% CI, 0.94 to 1.43). As presented in Figure 5, The odds of discontinuation of medication due to adverse events in the SGLT2 inhibitors treated patients was not significantly different from placebo treated patients (overall OR = 1.05; 95% CI, 0.81 to 1.36).
Mantel-Haenszel odds ratio of patients who experienced any adverse events.
Mantel-Haenszel odds ratio of patients who discontinued the treatment due to adverse events.
In agreement with prior meta-analyses [13, 14] this meta-analysis demonstrated the significant improvement of glycemic control in patients with type 2 diabetes treated with SGLT2 inhibitors. Patients treated with SGLT2 inhibitors either as monotherapy or in combination with other antidiabetic agents significantly decreased HbA1c and FPG from baseline at all doses studied as compared to patients treated with placebo or placebo with other antidiabetic agents. A significantly large number of patients treated with SGLT2 inhibitors achieved HbA1c < 7% at the end of the study period of the included studies. The reduction of HbA1c from baseline with SGLT2 inhibitors may reflect the long term mean glycemic control for the previous 2 to 3 months; while, FPG indicates the glycemic control on the day of the visit [33, 34].
On top of this, the meta-regression and subgroup analysis did not demonstrate a significant change in the efficacy of SGLT2 inhibitors depending on the duration of therapy and the doses SGLT2 inhibitors studied. Accordingly, the glycemic control with SGLT2 inhibitors does not seem to decline when the duration of therapy gets longer. On the other hand, the increase in doses of SGLT2 inhibitors was not accompanied by an increase in the efficacy of SGLT2 inhibitors. A phase 3 long-term extension dapagliflozin study (102 weeks), reported the sustained reductions in HbA1c and FPG level . However, the finding of the meta-regression should not be taken as a confirmation of the long term efficacy and safety of SGLT2 inhibitors at all doses. The included studies in the meta-regression reported the change in HbA1c and FPG level after a duration of therapy not more than 26-weeks (Table 1).
Treatment with SGLT2 inhibitors was associated with a significant reduction in body weight, systolic and diastolic blood pressure. Therapy with SGLT2 inhibitors was associated with a rise in HDL cholesterol level without a significant change in LDL cholesterol level. Provided that most of the antidiabetic agents are associated with weight gain [9, 10] and the vast majority of patients with type 2 diabetes are overweight or obese , the introduction of SGLT2 inhibitors with an insulin independent mechanism could have a pivotal role in the management of type 2 diabetes. The drop in blood pressure and the rise in HDL cholesterol level with SGLT2 inhibitor therapy could even make SGLT2 inhibitors more promising. This is because; in patients with type 2 diabetes the major cause of morbidity and mortality is attributed to cardiovascular diseases [4, 37]. But SGLT2 inhibitors long term effects on cardiovascular outcomes is uncertain. Moreover, in this study, the meta-analyses of change in blood pressure and cholesterol levels were not controlled to change in body weight. Since body weight reduction was strongly associated with a drop in blood pressure and a change in cholesterol levels [38, 39], the changes in blood pressure and cholesterol levels in SGLT2 inhibitors treated groups could be mediated by the weight changes.
This meta-analysis has shown a statistically significant association of SGLT2 inhibitors based therapy with adverse events. The number of patients experiencing genital or urinary tract infections was significantly higher in SGLT2 inhibitors treated groups than placebo treated groups. Both genital and urinary tract infections were more common among females than males . However, the proportions of patients with severe adverse events, hypoglycemic events and discontinuation of medication because of adverse events in SGLT2 inhibitors treated groups were not different from placebo treated groups. Similarly, previous meta-analyses reported an increased risk of urinary and genital tract infections with dapagliflozin without a significant increase in hypoglycemic events [13, 14]. Moreover, a study of women with type 2 diabetes has established the significant association of canagliflozin therapy with vulvovaginal candidiasis .
As limitations, firstly heterogeneity testing has revealed the presence of significant inconsistency among the included studies. But, the uncertainty of the results from this meta-analysis did not appear increased. This is because; sensitivity analysis by removing any of the study with a specific dose from the analysis confirmed the stability of the overall values. The possible explanation for the significant heterogeneity could be: the variation in the patients' antidiabetic agents experience, the variation in the SGLT2 inhibitors regimens, and the difference in baseline demographic and clinical characteristics of the patients recruited.
Secondly, a pooled data from phase 2b and 3 clinical trials has shown an increased incidence of cancer and hepatotoxicity with dapagliflozin . This meta-analysis did not have any evidence to rule out or to share these concerns. That is, further analyses were not conducted to determine the association of SGLT2 inhibitors with rare adverse events like cancer development and hepatotoxicity. Meta-analysis of rare adverse events, using studies that were not primarily designed to test adverse events, can yield misleading information . Thirdly, since all the included studies were sponsored by pharmaceutical companies, the findings of studies could be biased by business interests. Lastly, the number of studies on canagliflozin, ipragliflozin and empagliflozin that were included in this meta-analysis is very small. Thus, the pooled values of this meta-analysis may not reveal the clinical effect.
In conclusion, in patients with type 2 diabetes, all studied doses of SGLT2 inhibitors either as monotherapy or in combination with other antidiabetic agents improved glycemic control consistently. Furthermore SGLT2 inhibitors were associated with a significant reduction in body weight and blood pressure. However, a small percentage of patients suffer from genital and urinary tract infections. Yet, SGLT2 inhibitors appear to be safe as the number of hypoglycemic events and the number of patients who discontinued therapy were similar between SGLT2 inhibitor treated groups from placebo treated patients. Finally, further investigations with long term duration of therapy are needed to establish the safety and efficacy of SGLT2 inhibitors.
The authors would like to acknowledge WHO and major publishers for setting up HINARI (Health InterNetwork Access to Research Initiative). To conduct this meta- analysis the authors have not got any financial or technical support.
ABe: conceived and designed the study, conducted the analysis, wrote the manuscript and participated in the literature search, study selection and data abstraction. ABa: reviewed and edited the manuscript and participated in the literature search, study selection and data abstraction. Both authors read and approved the final manuscript.


Twenty-five years ago today, in the landlocked African country of Rwanda, over a million people — primarily Tutsi, including women and children — were slaughtered in just 100 days. In the "land of a thousand hills" the blood ran like rivers, as bodies piled up or were tossed into unmarked mass graves. In many cases, there was no one left to bury them. For Fr. Ubald, more than five years passed before he learned the fate of his mother and other extended family members — when the man who had given the order for their execution stepped forward to beg his forgiveness, then took him to the place they had been buried.
His family home was destroyed, obliterated by crops that his former neighbors had sown in an effort to eradicate the memory. "They could not look at us, could not speak to us," remembers Fr. Ubald. "They had too much shame." And yet, in time, they found peace. They discovered, as Fr. Ubald so often tells people, that Forgiveness Makes You Free.
What is most remarkable about Fr. Ubald is not only the fact that survived, or that he was able to forgive and show mercy to those who had committed such unspeakable crimes. What is most remarkable is the spiritual legacy that he has built since then — a beautiful retreat center called the Center for the Secret of Peace.
Since 2009, Fr. Ubald has expanded his ministry to the United States at the invitation of his friend Immaculée Imibagiza, author of the NYT bestseller Left to Tell. He travels all over the world, inviting people to open their hearts to Jesus, to let go of old burdens, and to receive the healing Jesus wants to give them. If you would like to experience this for yourself, you can find his speaking schedule here. Or you can get a copy of his new book here.


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Minneapolis Protesters Storm…
Minneapolis Protesters Storm Police Precinct, Vandalizing Building and Squad Cars in Response to George Floyd's Murder
Chaos erupted in Minneapolis Tuesday night over the senseless police-involved murder of George Floyd.
Protesters flooded the streets at the intersection where the 46-year-old laid on the concrete and repeatedly cried, "I can't breathe," while an officer forcibly pinned his knee into the man's neck for approximately seven minutes. Floyd died a short time later at Hennepin County Medical Center.
At about 6 PM, the protest turned into a march towards the 3rd Precinct, where it is believed the four officers connected to the fatal incident—who've since been fired — worked. A group of protestors began vandalizing the building, shattering windows, and spray painting squad cars.
"It's real ugly. The police have to understand that this is the climate they have created, this is the climate they created," a protester said to CBS Affiliate WCCO 4
Officers showed up in riot gear, firing tear gas and flash grenades at protesters as they hurled rocks, water bottles and anything they could get their hands on towards the cops.
So far, the number of arrests and/ or injuries sustained as a result of the rioting remains unclear.
Do you think rioting will help or hurt the already tragic situation?
Tags: George Floyd murder Police brutality protest


Tips for Comforting Yourself in the Midst of Anxiety. Take a slow, deep breath and tell yourself, "It's okay to be scared." The deeper and more regulated your breath is, the less anxious you are.... 26/09/2018 · If you like to use prayer beads for mindfulness, try to commit a short strand to memory and carry it with you, so you can use it to calm yourself if your anxiety flares. If you can't carry the physical strand, count on your hands!
Mindfulness means being fully present in the moment without judgement and with compassion. It involves focusing on what is happening right now, your moment-to-moment experience – both internal and external. It can be a great way to distract yourself from smoking thoughts.... Mindfulness is proving to be an effective mental health tool – better than medications in many studies – for reducing depression and anxiety that's free and that you can use anytime anywhere.
Over the past forty years a wide variety of clinical issues and syndromes, including chronic pain, anxiety, OCD, depression, self-harming behavior, and addictions, have been proven to respond positively to mindfulness-based interventions.... Teaching kids how to use mindfulness to cope with this relentless barrage of worries can be incredibly helpful. Mindfulness can help with anxiety and OCD in many ways. Mindfulness can help with anxiety and OCD in many ways.
Use an app like Headspace or Calm as a guide. Amanda Stemen is a licensed therapist who runs a practice centered around mindfulness in Los Angeles. She says the easiest way to get started with meditation is to practice what she calls the one breath.
I am honored to share a guest blog by Sharon Martin, LCSW this week. She is a therapist, author and prolific blogger! She shares strategies on using mindfulness to calm the over-stressed, overt-anxious, overwhelmed mind.
Teaching kids how to use mindfulness to cope with this relentless barrage of worries can be incredibly helpful. Mindfulness can help with anxiety and OCD in many ways. Mindfulness can help with anxiety and OCD in many ways.


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I think Toronto is heading for some steamy weather and perhaps a dry spell or two. At any rate, I hope to hop on my bike and toodle around the neighbourhood. Here are some research pictures I took for my June calendar.
oh my goodness. My friend Mark sent me the following pictures that he took while travelling. These totally beat my selection any day.
The first (who steers?), the second is plastic, the third (bottom left i think) is a really popular bike in Copenhagan, and the fourth was taken in Amsterdam.


ATTENTION: If you've been contacted by fake check scammers, your personal information may have been breached. ScamGuard highly recommends that consumers whose information has been breached obtain identity theft protection service immediately. There are several companies that offer identity theft protection in the US. One of the most inexpensive options we were able to find is the protection offered by LifeLock. You can start your protection here.
Sends fake checks and then want you to Western Union some of the money.
She sent money by Paypal and said some checks was being mailed. Then wanted me to send her most of the money from Paypal to her and then when the checks cleared to send her more money. The checks never cleared my account but the Paypal was deposited. I never sent her any of this money this time and she has been very upset. Now will not even respond to me.


gadgets; Apple quietly announces new iPad upgrades. Apple has released new products ahead of an event next week, including giving some long awaited love to an old favourite. iPad Air 2 and iPad mini 3 Conclusions: One Major Innovation and One Major Disappointment… The primary goal of this Display Technology Shoot-Out article series has always been to point out which manufactures and display Apple's (AAPL) has, for years, been my favorite tablet on the market. Its 7.9-inch display and lightweight design make it perfect for tossing in my bag to play games, watch movies, and Apple reveals 10.5-inch iPad Air Apple today revealed two new tablets: a 10.5-inch Air starting at $499, and the fifth-generation , starting at $399. The two models are being offered as midrange alternatives to last Tags: apple, reveals, inch, ipad, If you are not sure what you have don't worry. We show you how to find out which model of you have, as well as some of the features. I've always been fond of Apple's ; I bought the first one as a Mother's Day gift, and the 4 was one of the first big reviews I ever wrote for Engadget. Explore the world of . Featuring Pro in two sizes, Air, and . Visit the Apple site to learn, buy and get support.


Editor's note: Dear reader, considering the correction in the stock market, I think it's a good idea for me to share with you a relevant piece from our friends at Equitymaster. This one is authored by one of their best analysts, Richa Agarwal, who covers small caps stocks. I believe, you will find it helpful.
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Equitymaster requests your view! Post a comment on "Are You Trying to Time Your Stock Investments? Read This...". Click here!


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Biden Calls Benjamin Netanyahu "Friend", Vows To Press "2 State Solution"
Joe Biden said that the US will continue to support the two-state solution and to oppose policies that endanger its viability or contradict our mutual interests and values.
US President Joe Biden said Thursday he would work with Israeli Prime Minister Benjamin Netanyahu, calling the returning right-wing leader his "friend" but vowing to oppose policies that endanger a two-state solution with the Palestinians.
"I look forward to working with Prime Minister Netanyahu, who has been my friend for decades, to jointly address the many challenges and opportunities facing Israel and the Middle East region, including threats from Iran," Biden said in a statement.
"As we have throughout my administration, the United States will continue to support the two state solution and to oppose policies that endanger its viability or contradict our mutual interests and values."
Netanyahu -- who had a tense relationship with the last US president of Biden's Democratic Party, Barack Obama -- was sworn in Thursday, leading the most right-wing government in Israel's history.
The government, Netanyahu's sixth, includes extreme-right figures such as Itamar Ben-Gvir, who once hung a portrait in his home of a gunman who massacred Palestinian worshippers and now will serve as national security minister.
As Netanyahu formed a coalition, Secretary of State Antony Blinken said the Biden administration would judge the cabinet by "the policies they pursue, not the personalities that happen to form a government."
US officials say they hope to encourage moderation on Netanyahu's part by quickly convening a meeting between foreign ministers of Israel and Arab countries that recognize the Jewish state.
Three Arab nations -- the United Arab Emirates, Bahrain and Morocco -- normalized ties with Israel in 2020 under Netanyahu, who considered the so-called Abraham Accords a crowning achievement, as did then-president Donald Trump.
Biden said the United States "is working to promote a region that's increasingly integrated, prosperous and secure, with benefits for all of its people."
In a subtle jab at past suggestions by Netanyahu that the Abraham Accords showed it was time to move on from diplomacy centered on the Palestinian issue, Biden called for work on a "more hopeful vision of a region at peace, including between Israelis and Palestinians."
#Donald Trump #Joe Biden


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My Life, Starting Up: Spruce - A Restaurant Review. Totally Off Topic.
Thank you very much for your kind review. Flattery will get you everywhere! If you need any help preparing your pork feast let me know I will be happy to help. I will look forward to seeing you soon for burgers at lunch.
Brining is awesome - Chris and I discovered it several months ago. We haven't tried pork yet, but we brine chicken all the time. It gives it a great flavor and keep the juices in so the chicken just comes out really fresh.


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Senate Majority Rebukes Trump Administration And Saudi Arabia Over Yemen War
Author: Marion Schneider ; Last update: 30 November , 2018 02:03:39
The U.S. has imposed sanctions on 17 Saudis who were involved in Khashoggi's murder, but a bipartisan group of senators - including Lindsey Graham (R-S.C.) - favor harsher sanctions against the Saudi royal family, specifically the crown prince.
Trump has said it may never be known who was responsible for the killing, and in public comments - and a long and unusual statement last week - he reinforced the United States' long-standing alliance with the Saudis.
It's necessary to demand accountability for Khashoggi's murder "while recognizing the reality of Saudi Arabia as a necessary strategic partner", he said.
Pompeo told reporters that the resolution could thwart USA efforts to negotiate a ceasefire between the opposing sides in the conflict.
Freeland said the sanctions "target individuals who are, in the opinion of the government of Canada, responsible for or complicit in the extrajudicial killing of journalist Jamal Khashoggi on October 2, 2018".
Senators voted 63-37 on the measure, which allows debate on the bill that would terminate usa support.
The US Senate voted 63-37 Wednesday to advance a resolution calling for an end to US support for the Saudi-led war in Yemen.
The BBC's Barbara Plett Usher in Washington says opposition to the war in Yemen has gained momentum because of outrage at the administration's response to the killing and many in Congress want a tougher stance from the White House.
USA intelligence agencies have concluded that the Saudi crown prince must have at least known about a plot to kill Khashoggi. "But I may now be willing to get on the [legislative] vehicle, knowing it can be amended, to figure out some way for us to send the appropriate message to Saudi Arabia that appropriately displays American values and American national interest".
"The question for me is whether or not the Central Intelligence Agency supports the conclusion, with a high degree of confidence, that the crown prince was complicit in the murder of Mr Khashoggi", Graham told reporters.
MLB Requesting Refund of $5K Donated to Mississippi Senator Cindy Hyde-Smith
The Republican candidate also and pushed for a revisionist review of the Civil War in 2007 when she was the state's senator. Hyde-Smith ultimately apologized but not before Espy responded during a debate calling the comments, "what's in her heart".
"The Argentine judiciary has sent a clear message that even powerful officials like Mohammed bin Salman are not above the law and will be scrutinized if implicated in grave global crimes", HRW Executive Director Kenneth Roth said in a statement.
CIA Director Gina Haspel, who traveled to Turkey as part of the investigation, was absent from the meeting.
The Saudi government's story about what happened has changed repeatedly, from questioning whether Khashoggi actually disappeared to admitting that he was killed by Saudi agents in what a prosecutor has called a bungled rogue operation to bring him back to Saudi Arabia.
Emerging from the briefing, Pompeo said the vote would be "poorly timed" as diplomatic efforts to end the conflict are underway.
Senators are expressing disappointment that officials from the intelligence community were not present at a closed-door briefing over the US response to the killing of Saudi journalist Jamal Khashoggi. "The longer we enable the conflict to continue, the more innocent men, women and children will die", said Sen.
"I was asked to be here, and here I am", he said.
Nihad Awad, the national executive director and founder of the Council on American-Islamic Relations, said he was a close friend of Khashoggi.
Bin Salman will be among the world leaders gathering for the G20 and few want to be seen shaking hands with the Saudi crown prince.
After speaking with the White House on Wednesday, Sen.
A Saudi-led coalition is fighting Houthi rebels in Yemen. "They said they are going to brief me, and I said appreciate it".
Happy ending for huge steer saved from slaughter Melania Trump defends controversial White House holiday decorations
Death toll from Uganda cruise boat accident jumps to 29
The boat's passengers, in a party mood halfway through their journey, likely panicked when the vessel started to sink, he said. Some of the boat cruise passengers were singers Iryn Namubiru and The Mith of the group Klear Kut.
Union rep hopeful ahead of GM's shutdown of Oshawa plant
It said earlier this month that it plans to move workers at its Pontiac propulsion facility to its Tech Center in Warren. Calling it a sad day for Durham, Premier Doug Ford said he will do "everything possible" to support the GM workers.
Minutes After Wishing Everyone Happy Thanksgiving, Trump Criticizes Chief Justice John Roberts
It seemed a fight that Trump would relish but one Roberts has taken pains to avoid. It's highly unusual for a president to single out judges for personal criticism.
USA confirms Trump-Putin G20 meeting, Morrison hopeful for his turn
GM makes the Buick Envision in China , but so far this year has shipped fewer than 25,000 of the SUVs to the United States . Additionally, Trump said that he expects to boost tariffs on $200 billion of Chinese products to 25 percent in January.
Paul Manafort Met With Julian Assange Months Before WikiLeaks Published DNC Emails
The next month they hacked into the Democratic Congressional Campaign Committee and the Democratic National Committee. His visit was not logged with guards as is typical for such face-to-face meetings.
Gender-reveal party explosion starts massive wildfire
An off-duty Border Patrol agent, Dennis Dickey , filled a target with a colored powder, to reveal the gender of his unborn baby. Blue smoke can briefly be seen billowing up before flames spread onto the surrounding shrubby grass.
Melania Trump promotes campaign with White House Christmas decorations
But social media has savaged one element in particular - the dozens of blood-red Christmas trees which line a White House hallway. In the East Room are four 14-foot trees displaying 72 handmade paper ornaments representing the six different regions of America.
Winter Storm Bruce Heads East After Dumping Snow Throughout Midwest
Flights were mostly on time Monday at Kansas City International Airport, one day after the storm caused widespread delays. The bulk of the snow is expected to fall Sunday evening, which could also potentially affect the Monday morning commute.
Coric, Cilic put Croatia on brink of Davis Cup title
Cilic lived up to his status of team leader this weekend, winning his two matches without dropping a set. Playing two sets is not the Davis Cup .
Wallabies not in disarray, insists Michael Cheika
Even former Wallabies coach Bob Dwyer, a close ally of Cheika's, said it was time for him to draw a line in the sand. But Cheika was only told at the start of this week, having fielded both men against Italy in Padua last Saturday.
Melania Trump defends controversial White House holiday decorations
Outside the White House, another Christmas tree was causing less controversy. "You're all very welcome to visit the White House". Trump was speaking at a Liberty University "town hall" about the opioid addiction epidemic.
Three US service members killed in Afghanistan blast
The deaths of Jasso and the three service members bring the number of US troops killed in Afghanistan this year to 13. Tuesday's blast also follows a visit to Ghazni last week by the top US commander in the country, Gen.
CONMEBOL postpones Copa Libertadores final
We've only just been able to breathe well because we were affected by the gas. Boca Juniors are refusing to play the final of the Copa Libertadores .
Photos show migrant children fleeing tear gas attacks at USA border
After running to relative safety a few hundred feet away, hundreds of the caravan members held a sit-in. General Services Administration.
Man fatally shoots woman at Ocala Walmart
The Ocala Fire Department said on Facebook that emergency responders returned to the shooting scene to treat three people. The Ocala Star-Banner reports that the woman and the shooter had been dating for nine months, but had recently broken up.
Government climate change report says US GDP under threat
Happy ending for huge steer saved from slaughter
Prince Harry And Meghan Markle Are Moving To Frogmore Cottage
Manchester United's Victor Lindelof misses training ahead of Young Boys clash
Big Ten championship has huge implications for Ohio State
Van Bommel: We will go for the win against Barcelona
Shoppers hit the stores early for Black Friday bargains
Mourinho tells players: 'Stay home' if you can't handle Old Trafford pressure
Here Are The Best Cyber Monday Deals On Electronics
Ukraine imposes martial law amid 'growing aggression with Russia'
First Images Sent Back From InSight Mars Lander Moments After Touchdown
GM closing several plants and cutting 15% of its salaried workers


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In-depth | Video
COVID-19: Is it over?
Let's get back to basics.
A virus has transformed our lives across the globe.
In Kosovo, we've been living almost exclusively inside since the first COVID-19 cases were confirmed by Prime Minister Albin Kurti on March 13. With much of the usual economic and social activities paralized due to lockdown measures undertaken to help stop the spread of the virus among the population, can we now say now that the pandemic is almost over?
In this video, we look at how the new coronavirus has taken form in Kosovo, the effects of the lockdown measures on the spread of the virus, and the capacity of the health care system to deal with a potential second wave of infections — a real risk now that the government has announced its de-escalation phases, in an attempt to return to some kind of normality.
But while societies everywhere are eager to get back to business, can we really do so?
Click play and learn more.
This video was produced as part of the project ''Innovation for resilient media and citizen engagement'' with the financial support of the European Union Office in Kosovo and implemented by Kosovo 2.0 in partnership with GAP Institute. Its contents are the sole responsibility of Kosovo 2.0 and GAP Institute and do not necessarily reflect the views of the European Union;
ABOUT THE AUTHOR Kosovo 2.0 is a pioneering independent media organization that engages society in insightful discussion. Through our print and online magazines, debates and advocacy initiatives, we are dedicated to deepening the understanding of current affairs in Kosovo, the region and beyond.


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Lord of the rings franchise brought a new title to the collection, an open world action-adventure game, that follows Talion, Gondor captain, that survived the sacrifice that was meant to bring the Elf Lord Celebrimbor as a wraith. Losing his wife and his son, Talion is merged with Celebrimor, escaping death. Players will have to gain EXP in order to upgrade abilities through completing various missions and defeating Uruk warlords. Some missions might require special conditions for the greater reward. Shadow of Mordor implemented the Nemesis System. It tracks the progress of every special Uruk warrior. Each special Uruk has a set of strengths and weaknesses, and players can assassinate higher ranked officers in order to promote easy to defeat Uruk to defeat them at a higher rank, weakening the Sauron's army. This planning allows players to adapt, and use mechanics of stealth kills, ranged combat, wraith skills and head-on melee more effective.
PC, PlayStation 3, Xbox 360, PlayStation 4, Xbox One
Action, Adventure, RPG
Monolith Productions,
Warner Bros. Interactive, Feral Interactive
Full controller support, Action RPG, Steam Achievements, Assassin, Steam Cloud, Atmospheric, Based On A Novel, Контроллер (полностью), Dark Fantasy, Fantasy, Gore, Hack and Slash, Lore-Rich, Magic, Коллекционные карточки, Open World, Parkour, RPG, Sandbox, Singleplayer, Stealth, Story Rich, Third Person, single-player, steam, category, steam-trading-cards
http://www.shadowofmordor.com
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So after I got my Bug problems fixed (Check Datein) I am Writing my Review again. I don't think I have to say too much about this slightly older Title, but I still want to do my impressions. The Game is a great Title whose Story Plays between the Books of "The Hobbit" and "Lord of the Rings." The Story is kept quite simple, so I'm not going to say Anything about it to avoid Spoilers. The Game World Mordor is very lovingly designed, and with the HD Textures DLC, The Game can still be seen today, Mordor is not very large, and Consists of only two Areas that you can quickly walk/Sneak through. I haven't even used the fast journey in all The time. Since I preferred it has to fight my way through. The Combat System is kept quite simple, and it is relatively difficult to die As long as you can counter, and deal with Shield opponents. Likewise, it will then be a little too easy, because you no longer have to fight the Opponents big, but simply to kill them en masse instead of them. And then let them kill, and when they have done their Service, you just Destroy them. So even the most braving greyly becomes an absolute Laughing Stock. Furthermore, I like the whole Uruk Chiefs And the opportunities you are offered to deal with them and the lower Ranks. However, they get a little too easy in the first Part of the Game because you ascend very quickly here as in other Games and have a walk from the Midgame. Example Games: Kingdoms of Amalur or Lords of the Fallen. Now I have finished Hunting Kampanie, and for this Short but very well done Story you get a little more from the Dwarf Torvin and get to know his View of the Things. And here I have to say that this Kampanie has made me sweat a little more because the Focus here is on the Creatures. Especially the Last Chief and Fighting Champion really demanded me this Boss had more fire than any other Boss so far. And from this Kampanie I am really hard hyped, now I just lack the Kampanie with Celebrimbor and then I would be so far through. And the big Schreenshot Editor, discovered Late by me, is absolutely Awesome, you already know it from Mad Max, but here it's a bit more Extensive. And so you can Perfect the Screenshots that are Perfect for you. Nevertheless, I have a Shortcoming, and it is about the Memory System. Either you Store at the Towers, or through Story-based Quests. The Game probably doesn't save any other way. So Whoever Collects everything, and does the small Side Tasks, and finishes the Game without taking advantage of any of the above opportunities, is allowed to do it all again next Start ... big Minus point for that. Verdict: First Of all, sry for so much Review. But you should have just played this Game, it strengthened and weakened. But if you can Hide these times for this slightly older Title, then you definitely have your bright joy at the Uruk Gemezel. You don't need to know the Books to understand the Story either, the Story tells everything quite well at its Core, even if There are gaps. So Reading books is not a Duty, but is recommended. And if you can't do anything with Middle-earth, you won't find fun here. Clear Buy recommendation, you could actually miss a very good Game here.
[StwA] Asbestbrezel
After 20 hours I am so tired of Assassin's Creed: Shadow of Arkham that I am uninstalling it. I have no intention to return to the game and regret the time I spent with it.
Gameplay-wise, Shadow of Mordor is an exhibition of achievements of game development of the past few years. Roughly speaking, it's 49% Assassin's Creed, 49% Batman Arkham series and 2% of its own.
The Assassin's Creed part is effortless parkour, climbing towers and "synchronizing" for fast-travel and stealth with a few ways to distract and eliminate foes. Although I must admit that stealth here is more inventive than in AC, it's not just whistle, wait, one-button kill, rinse and repeat. At least later in the game you'll be given more tools to assassinate: such as poisoning the beverage and controlling uruks.
If you fail at stealth, here comes the Batman Arkham part. The combat is a shameless copy-paste and works like this: counter every time you see a prompt, attack every time no one is attacking you, perform a special attack every 5 blows, rinse and repeat.
Nevertheless, I must give credit that the combat is actually fun and made me stay with the game for so long. It feels good to chain combos, the killing animations are satisfying and varied and there are quite a few special moves that you are going to like to perform. But when it's the only thing that makes you stay, it starts feeling repetitive after a while too. I can ruin this for you before you play, just watch the 404 hits combo below and you'll know just about everything the combat has to offer.
The 2% come in the Nemesis system, the gimmick that journalists went on and on about and that actually made me play the game. It generates random uruks for each playthrough, bestows unique strengths on them and cripples them with unique weaknesses. These uruks have been fighting for power and will always be, and you act as a disrupting force which shakes up their hierarchy as you please. The problem was that I didn't want to.
I read dozens of nemesis stories on the web before playing Middle-earth: Shadow of Mordor, and all claimed what a unique experience it was to gain a mortal enemy that kept coming back from the dead to face you once again or to bind with an uruk and stay in this love-hate relationship for hours. Perhaps I was too good at the game, was I? I never had an uruk to live long enough for me to get to know him. They all were just expendables, and I cut through the cannon fodder of Mordor with ease. To be honest, I died more from the deadly fauna of Mordor than uruks. At the same time, bumping up the difficulty seemed strange as I understood that more hit-points would not be likely to breathe in more personality into random-generated uruks.
What's left from Shadow of Mordor if you remove the "make your own story" gimmick? Not much, I must say. The characters were uninspired, the storyline was hard to follow and slow to progress, and the twists were simply not there. The story is pieces of Tolkien fan service scattered around the dull bloody cursed land. The first major character you meet is, of course, Gollum with the exact voice, moves, and looks of that from the film. I completed more than half of the storyline and Shadow of Mordor was a parody of Tolkien which distorted every stylistic or narrative trope of the source material. It's not necessarily a bad thing and I, in fact, have never been a fan of the Lord of the Rings universe, but it was a weird mix of fan service and negation of Tolkien at the same time.
Middle-earth: Shadow of Mordor is a very stressful game. It has no ups, the music is always tormented strings and dark ambient effects. It makes you paranoid, you scout for safe places when you start playing but soon you realize that the only places where you can rest are forge towers (fast-travel points) and the pause screen.
Does it make you FEEL like you are in Mordor? Yes, and this is a good thing. Does it make a game enjoyable? No.
This was, perhaps, the main reason I am dropping the game with no intention to play it. I don't mind repetitive and plagiarized gameplay, after all, there are only so many things you can do in action-adventure games targeted at a wide audience. I can tolerate the dull story and even no story at all in an action-adventure game. But I can't play something that is so hostile, unwelcoming and unrewarding. You can't conquer this world, you can only make a dent in the army of Sauron, which will soon be replenished by new random-generated uruks.
Serge UlankinDec 14, 2018
Playing this game in 2018, when it seems every game is open world, is not that exciting. It has all the necessary ingredients for this kind of game, collectibles, various mini-missions, towers to uncover new map parts, but we saw this already in countless other games. What differentiates this game from the crowd is its nemesis system. But the catch is that I didn't like it that much, it's an interesting idea, but not executed too well. The most infuriating thing that it forces to use this system in order to progress the story, one time you have to kill 5 different war chiefs and other time you have to brand them. This is when you can see various design fails of the nemesis system and I almost deleted the game due to these parts.
KaimynasNov 22, 2018
This game is a bunch of bad decisions. The Arkham Asylum type fighting system makes the gameplay look like a dynamic QTA thing without any choice. It's ridiculous that the enemies always (like, ALWAYS) attack you one by one while the rest of them are watching your fight. The game is too easy and even if you lose a fight (you must literally drop the controller to lose here), you won't die - you just get up and run, and, well, you're safe. Even the graphics are not that good now when we have so much better things on the market, so don't waste your time here.
KeravanjokiTue Apr 24 2018 17:20:53 GMT+0000 (Coordinated Universal Time)
Can't stop playing this, even think about calling in sick. Shadow of Mordor definitely deserves the money. I haven't got such fun for a while, you can't imagine how good the story and combat are, so go try it better. Even if you get beaten up by a regular Uruk, you'll be able to revenge soon and that's an awesome feeling!
«Just one more turn»
MeZevTue Apr 24 2018 17:15:47 GMT+0000 (Coordinated Universal Time)
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Никогда до этого процесс шинкования толп орков не был настолько затягивающим.
«Can't stop playing»
Konstantin LukinskikhTue Jul 02 2019 06:27:17 GMT+0000 (Coordinated Universal Time)
Изначальный «клон» Assassin´s Creed по полной натянул своего предшественника с помощью встроенной системы Nemesis, которая самостоятельно генерирует уникальную историю разборок с ублюдочными капитанами и вождями урук-хаев. Эти паршивцы здорово разбавляют игровой процесс своим появлением, репликами, силами и слабостями. Причём в игре отлично поставлены битвы на мечах — рубить этих говнюков в капусту одно удовольствие. За игру (на вдумчивое прохождение у меня ушло 40 часов) Вы устроите геноцид этой многочисленной расы в рамках двух немаленьких локаций.
Из минусов: однообразный геймплей второй половины игры, незатягивающий сюжет с подачей через гребанные кат-сцены; плоские, невыразительные персонажы, которым не хочется сочувствовать (даже главный герой).
Только за новаторство и систему Nemesis - 8/10. Надеюсь что-то похожее в дальнейшем возьмут на вооружение все разработчики игр.
«Blew my mind»
МаксOct 16, 2017
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Pisces are sensitive but not fragile. Stronger than they seem, they are careful with the feelings of others. They can sense another person's mood and modify their own behavior to suit the other person. In relationships, Pisces are sweet and caring, but need space. Don't try to capture one, the harder you squeeze, the more they slip through your hands.
Who is ever going to clean the house? When a Pisces pairs with a Pisces, they may never even notice the dirt. These two will be too busy having fun. Besides, the dirt will still be there when they're done. Eventually, when the other isn't around, one of them will clean it, and they won't expect a thank you, or even expect the other to notice their effort. They did it because they wanted to, and it's that simple. Pisces cannot be controlled. They do things on their own terms, which is the magic of two Pisces together in a relationship. Neither will try to control the other. There will be no bickering or nagging. Of course, this can get out of hand. With no one there to give a reason for limiting the good times, there is a strong possibility that these two may occasionally go too far with the partying. But Pisces somehow turn themselves around and can achieve amazing things using their rules and timetables. This isn't a frequent combination and romance isn't likely, but they will certainly have a great time together, whatever the circumstances may be.
Here we can have a roller coaster of a relationship. These signs are very different and are often very attracted to one another. Initially, Pisces is swept away by Aries' aggressiveness, and Aries is charmed by Pisces' soft and inviting ways. However, as time wears on, Pisces' gentle nature is often trounced by Aries' aggression. Pisces is happy to let Aries take the lead in the beginning when it is all very exciting, but after a while, Pisces may feel crushed and overpowered. The Aries may feel that Pisces needs to be stronger and deal with it, which may cause Pisces to silently slip away. This is a relationship with a lot of attraction, if these signs can deal with the negatives successfully, it can be a very romantic relationship.
This can be a frustrating relationship, but it doesn't have to be. Taurus and Pisces both enjoy the nuances of human relationships and have kind natures. An appreciation of art, food, music and physical pleasure is common to both, and they both know how to truly relax. It's how far they go with these pleasures and the reasons they enjoy them that separates the two. Pisces enjoys them as an escape from the real world and has no limits on how much they enjoy. Taurus enjoys the pleasures of the world as a reward for hard work and will carefully set their own limits on their enjoyment. They do not overdo anything. Therefore, Taurus wants to set limits for Pisces, who they see as weak and overindulgent. Pisces refuses these limits and sees Taurus as stiff and boring. The key is for these two to resist criticizing each other for these differences, then they can truly enjoy each other.
Pisces and Gemini share a love of freedom. Both prefer to have flexibility in their lives by not getting tied down to nine-to-five jobs or committing to restrictive relationships of any type. This similarity works to their advantage in relationships together. But they also enjoy their differences. Gemini is forever intrigued by Pisces' nebulous and fluid nature. Gemini's world is filled with facts, figures and details. Pisces avoids these things like the plague. Pisces prefers to float from one esoterically pleasurable experience to the next, the whole time avoiding being tied down with facts and details which Pisces considers trivial and exhausting. However, Pisces does respect and admire Gemini's ability to focus on these things. This dynamic of differing natures between Gemini and Pisces can breed attraction. The difficulty in this combination lies with Pisces' need for depth of feeling which Gemini is not likely to provide in high enough doses, while Gemini is likely to become frustrated with Pisces scattered, unorganized and sometimes unreliable ways.
Virgo does not always feel that Pisces makes good decisions because Pisces takes things too far and doesn't set appropriate limits. On the other hand, Pisces feels that Virgo has too many rules and is so careful about doing things correctly that they don't live fully enough. For Pisces, life is messy and that's alright. It can frustrate Pisces to watch Virgo take so much time dealing with issues that Pisces would rather overlook completely. Pisces would rather feel their way through life and grasp the big picture than get every detail right but miss the big picture. Because they approach life from opposing angles, these two can combine their efforts and make a great team. In the end, they both want to deal with life's issues effectively so they can move on and have some freedom. They are both free spirits even if their visions of how to get the freedom differ. In love, Pisces may want a bit more emotion and passion than Virgo has to offer, and Virgo may eventually lose patience with Pisces' scattered nature. This relationship can go either way in love and friendship. It's up to the individuals.
Pisces and Scorpio would seem to be the perfect sexual match, but they don't frequently pair together. Too much similarity may keep these from joining sexually as often as you may think. It is a great combination for friendship though, as they can empathize with each other about any of the day's emotional tribulations. They understand each other better than most, and can read each other's feelings amazingly well. They do differ, however, when it comes to control in relationships which doesn't really come into play in friendships they way it does in love. Pisces is not jealous or possessive. Pisces has no need to control their mate. They simply ask that their mate doesn't attempt to control them. Scorpio doesn't want their mate to control them either, but they do need to have at least some control over their mate. This is the rub for these two. Pisces may find Scorpio to be jealous, intrusive, and controlling. Whereas Scorpio may find Pisces to be evasive and untrustworthy. This can be the one wrinkle to iron out for this otherwise easy relationship to work.
The fun never stops when you combine a Sagittarius and a Pisces. Really, it can actually be a problem because both of them can take fun too far. These are both signs who hate boundaries and limits, and they know how to enjoy themselves as well as each other. No matter where Sagittarius' wandering thoughts of adventure or fantasy take them, Pisces will gladly follow. Neither will pass judgment on the other for going too far with an idea or a topic of conversation. Neither will be shocked if the other is honest about their feelings, or goes way out of the norm with their behavior or ideas. They can really stir up some trouble together, just for fun of course! For signs which are astrologically incompatible, these two get along fabulously. They do have a few rubs though. Sagittarius may at times be annoyed by Pisces' indecisive and muddled ways, and Pisces may sometimes feel that Sagittarius can be selfish. But it's a good combination and romance is likely between them.
Hardworking, serious Capricorn seems like an odd match with Pisces who rarely notices that there is even work to be done. At first glance, you would think this combination would be a disaster, but it isn't. Don't forget that behind Capricorn's serious side is a rebellious, fun-loving person who wants nothing more than to break free from their responsibilities. With Pisces, they can find a short escape from the worries of the real world and enjoy a swim in Pisces' world of limitless, carefree fun. Of course, Capricorn will end up setting limits and Pisces will not like it. However, for an amount of time that seems reasonable to Capricorn, Capricorn will indulge themselves in Pisces' sensual fun. They will enjoy it until that voice inside their head starts nagging them to stop. Pisces will happily allow Capricorn to return to work. Pisces won't complain. The only problem will be if Capricorn tells Pisces to return to work. That's a problem. Pisces will get the work done, somehow, when no one is looking. Somehow Pisces do manage to get their work done without signs like Capricorn reminding them to do it. These two don't often join together romantically, but they can get along well as friends.


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Arianna is a junior at Sacred Heart Academy where she loves to take computer science classes and is the President and Co-Founder of the SHA Hack Club. When she's not coding at school, she is an intern at a mentorship and goal-setting mobile application startup called Moxie Girl, an Educational Justice Activist, and a competitive swimmer on the Lakeside National Team and the Sacred Heart State Team. She is a 2021 NCWIT AiC National Award Winner and Kentucky Affiliate Winner, and she loves exploring all things design thinking, hackathons, UX/UI design, and technology.
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