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# CEO of the Buck Institute for Research on Aging
edsonjnovaes · 10 months
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Bryan Johnson que busca imortalidade diz que é improvável que humanos sobrevivam sem IA 1.2
Bryan Johnson, um bilionário da tecnologia de 46 anos que tenta reverter o processo de envelhecimento, acredita que é improvável que a humanidade sobreviva sem a ajuda da inteligência artificial (IA), segundo a Fox News. Época Negócios – 14/10/2023 Algumas de suas rotinas incluem um horário rígido para dormir às 20h30, tomar mais de cem comprimidos diariamente, coletar amostras de fezes e ter um…
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wolfliving · 6 years
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Really, really old people in big cities afraid of the sky
https://www.researchamerica.org/blog/healthy-aging-month-how-we-can-all-live-better-longer
HEALTHY AGING MONTH: HOW WE CAN ALL LIVE BETTER LONGER
Eric Verdin, MDSeptember 19, 2018
September is Healthy Aging Month, and here at the Buck Institute for Research on Aging(link is external), we are on a mission to end the threat of age-related disease for this and future generations. We believe it is possible for people to enjoy healthy lives at age 95 as much as they do at 25, and to achieve that, we’re seeking a more comprehensive understanding of the biology of aging itself.
Over the last century, average human lifespan has been increasing at a rate of approximately 2 years per decade, primarily due to advancements in antibiotics and other medical treatments, as well as improved public health efforts. The U.S. Census Bureau estimates(link is external) that by 2035, people over the age of 65 will outnumber people under 18 for the first time in U.S. history. This means that there is an increasing population of older adults who suffer in the later years of life from chronic diseases including diabetes, neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease, and cancer. While basic scientific research has provided a lot of insight into the causes and potential treatments of individual diseases, the root cause of these and many other chronic diseases is the biological process of aging.
The goal of the Buck Institute and several other aging research groups across the country is to study and understand more about the underlying mechanisms of aging so that we may find new therapeutic targets to help us delay or even eradicate age-related diseases. The results so far are very compelling. By focusing on the biological mechanisms of aging such as cellular senescence (normal cells stop dividing), chronic inflammation, and changes in metabolism, scientists have been able to extend the disease-free lifespan of laboratory model organisms including flies, worms, and mice. The challenge now is to translate these discoveries into the clinic and determine the best preventative practices to maintain health throughout our lifetime.
Funding for this field of research is absolutely imperative for a healthy, aging population. While research aimed at understanding and treating individual chronic diseases is still highly valuable, a recent study(link is external) estimated that the economic value of delaying aging by an average 2.2 years of healthy life could be more than $7 trillion over the next 50 years. To put this into context, the total research budget for the NIH last year was about $37 billion, and of this just over $2 billion was allocated to the National Institute of Aging to fund aging research. The potential return-on-investment of federal and private research dollars emphasizes our need to accelerate basic aging research. But most important is the impact that discoveries from aging research will have on the lives of millions of older adults in this country and worldwide, and the possibility of a long and healthy future to come.
Dr. Eric Verdin is President and CEO, Buck Institute for Research on Aging
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madlinaart · 5 years
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50 Genius Ways to Be More Productive in 2020, According to Experts
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As a new year begins, you have likely set out some ambitious resolutions for yourself, or at least some modest changes you'd like to see in the year ahead. But whatever your plans—weight loss, career change, or maybe taking up a new hobby—getting it done might be less about what it is you're aiming to do, and more about how you go about doing it. To that end, here are 50 smart ways to get things done and be more productive in the new year.
1Stop multitasking.
When you have a lot on your to-do-list, your instinct might be to handle it all at the same time. But a key to ensuring your work gets done effectively is to avoid the temptation to do everything (or more than one thing) at once.
"We're hurting our productivity levels by doubling up to get more done," says growth and productivity expert Jandra Sutton, host of The Wildest Podcast. "Instead, focus on one thing at a time and only that thing. Every distraction, every time we try to pick something else up, we end up doing something called context switching—which only slows us down. Then it takes us time to get back 'into' doing the thing, and we have to repeat that process every time we check our phones, emails, etc. That lost time adds up quickly."
2Delegate more.
Think about the people you'd consider truly high-achieving—whether they're CEOs, rock stars, or Olympic athletes. Do you think they do everything themselves? Of course not. To take your productivity to the next level, you have to get comfortable delegating tasks.
"Forget the hustle culture. You do not need to be busy for the sake of it," says Rhys Williams, managing director of Sigma Recruitment. "Focus on the tasks that are most important to you, and find ways to get others to do the rest for you. This also helps with your mental health."
3If it takes two minutes or less, do it.
David Allen, an author of Getting Things Done, has something he calls a "two-minute rule" that can make a major impact on anyone's effort to get a handle on their workload. The rule is simple: If it takes less than two minutes, do it right now. When you remember you need to send that email or call to make a reservation, don't add it to your to-do list or tell yourself you'll do it later—just get it out of the way now and get on with your day with one less thing to deal with.
4Exercise.
When it comes to New Year's resolutions, most lists include this right near the top—but what does it have to do with productivity? Quite a bit, actually.
As Robert C. Pozen explains for the Brookings Institution, an exercise routine can give you more energy throughout the day thanks to the stimulation of mitochondria in your cells.
"That gives you more energy to exert yourself physically, but it also means more energy for your brain, boosting your mental output," he writes. "A modest exercise habit can help keep you sharper into old age, give you more energy to take on the day, and improve your mood. So stop making excuses, find a group of like-minded peers, and start exercising today."
5Meditate.
When you're taking breaks throughout the day, it's beneficial to overall productivity to turn at least one of those breaks into a brief meditation. This is a time to attempt to fully relax and clear your mind of all distractions.
"Find little moments throughout the day to meditate," says Deborah Sweeney, CEO of MyCorporation. "This time will help center and ground you to be in the moment and express gratitude for the little things that might be forgotten throughout the day."
A 2018 study published in Psychological Science points to how meditation can provide a person with greater focus throughout their day. If you're new to meditation, Psychology Today offers these helpful tips for beginners to help get you started.
6Get enough sleep and get up early.
The classic Ben Franklin exhortation, "Early to bed and early to rise, makes a man healthy, wealthy, and wise," has been proven by science to be sage advice. For example, a 2014 study published in the journal Cognitive Therapy and Research found that those who go to bed later are more likely to suffer negative and repetitive thoughts.
Christopher Randler, a biology professor at the University of Education in Heidelberg, Germany, writes, "When it comes to business success, morning people hold the important cards. My earlier research showed that they tend to get better grades in school, which get them into better colleges, which then leads to better job opportunities. Morning people also anticipate problems and try to minimize them." The researcher has found that those who wake up early tend to be more persistent, cooperative, agreeable, and conscientious.
7Add something green to your workspace décor.
"Research shows that … looking at something green—trees out of the window, office plants, or even the green screen—can make us feel a bit better and increase our productivity," says Darko Jacimovic, co-founder of WhatToBecome. "What's more, attention restoration theory suggests that nature has therapeutic benefits on people and enables us to recharge and refresh, regain focus, and increase overall productivity."
So pick up a few plants and add some flora to your workspace.
8Find an accountability partner.
You are more likely to complete many tasks, whether that's an exercise routine or a writing assignment, by telling someone else you are going to try to do it.
"You are more likely to achieve your goals if you have an accountability partner or partners," says Nina Dafe, a networking advisor for women entrepreneurs. "This is because of the many benefits that accountability holds. As such, accountability and mastermind groups are great ways to keep focused and motivated—especially if you find it difficult to stay on track independently."
9And establish a system to make each other accountable.
Even more impactful than an accountability partner is one who you have to pay when you blow a deadline or don't follow through on what you said you would do.
"Urgent things usually get done," explains Jeremy Redleaf, co-founder of productivity company CAVE DAY. "It's those important goals that don't have deadlines that we really have to watch. Send a friend a list of important tasks every month and pay them $1 for each one you don't complete. We've seen this lead to some remarkable results in our community."
10Identify your values.
This may be a big-picture way of thinking about productivity, but especially as we begin a new year and you consider what changes you'd like to make in your life, it's good to think about what really matters to you before you start worrying about tackling those daily to-dos.
"Values are aspirational and cannot merely be checked off like a goal," explains clinical psychologist Stephanie J. Wong, Ph.D. "However, they can help us lead more authentic and productive lives. Ask yourself, 'Is participating in X event or doing X behavior, consistent with values or inconsistent?' This helps weed out problematic or unproductive behaviors."
It will be from these big-picture values that your day-to-day priorities and projects will flow.
11Remind yourself of your larger goals.
Setting out your values and priorities is not a once-a-year effort. Once you are clear on what matters most to you, remind yourself of that regularly. The point is to not lose sight of why you're working on what you're working on—or to decide you should move on to something else.
"Remind yourself of your larger goals and purpose to create a decision filter for your projects," says leadership coach Megan Accardo. "We all have the same amount of hours in the day, but we need to be clear about what we are saying yes to because that means saying no to something else."
12Use a digital task list to keep your mind clear.
Keeping your to-dos in your head usually means you either forget them, or you keep turning them over in your head without actually doing anything about them—which prevents your brain from focusing on more worthwhile things. Sometimes a simple written list can do the trick, but Frank Buck, author of getting Organized!: Time Management for School Leaders suggests getting a little more sophisticated.
"I use a free web-based tool called Remember the Milk, along with the companion mobile app," he says. "Every time a task comes your way, put it on the list with a due date for when you want to see that task again."
13Put repeating tasks on autopilot.
"We all have tasks that need to be done at the same time every year or every month," says Buck. "Put them on your digital task list with a date and how often they should repeat. They'll automatically show up at the right time."
That may be changing the batteries in the smoke alarm or calling to check in on an important client you don't have urgent business with but want to stay in contact with.
14Capture your to-dos as they come in.
Your day will inevitably bring on an onslaught of new things you need to get done. Just as you finish one project or move something forward, four more things pop up that need to be addressed. Buck has some tips for that.
"Use a paper journal and your digital task list to handle the flood of incoming information," he says. "Trap the details of phone calls and meetings in the journal. Later in the day, look at everything you wrote, and make decisions about the 'to-dos.' Put the results of the thinking on your digital task list."
15Turn projects into "next actions."
You've no doubt heard the advice that you can more effectively get to work on a major project by breaking it into "smaller parts." This is true, up to a point, Buck says, but it might be more useful to think of every project as a series of "next actions," instead. That is, ask yourself, what is the next action that needs to be taken to move this forward? If you've got a thesis to write, the next step might be checking out a book on the topic at the library or just researching which books to check out. Instead of thinking about the giant, amorphous project that needs to get done, clarify what you can actually do right now, and take that action.
"Work those small next steps into your task list for each day," says Buck. "The secret is to word them clearly so they are easy to do."
16Get more specific about your to-do list.
Hand-in-hand with turning "stuff" into "actions" is getting clear about whatever it is you actually want to do. Instead of spending mental energy thinking "I really need to revamp that website," you're far better off thinking a little more deeply, to answer the question, "What exactly is it I want to do with the site?"
"When writing down goals or tasks, always try to be as descriptive as possible," says Raven Beria, founder of brand consultancy Brandalaxy. "With clear and concise goals, you'll feel less resistant to starting—and that's typically the biggest hurdle in the first place."
Beria adds that when you're finished, you'll feel more fulfilled since when tasks are kept vague, you could end up doing a tremendous amount of work and never really feel like you've made any "progress."
17Get organized the night before a big day.
"Many people often scramble in the morning to find their keys, wallet, phone, etc," says Wong. Instead of beginning your day with this rushing around, she suggests you instead "prepare everything you need for the next day, the night before the specified day. This will reduce the risk of being late for an important meeting or dropping your children off at school."
It will also mentally prepare you for what you will be doing the next day. You will wake up with your mind already primed to tackle whatever you have on the agenda and will feel a few steps ahead with all of your things packed and ready.
18Use a Tickler File to get your desk clean.
And speaking of getting organized, let's talk about what you're going to do about all that junk on your desk. Buck suggests a tool for tackling the clutter of things you will need to reference down the line: a Tickler File.
"Much of the desk clutter comes from papers you need some time in the future," he explains. "With a set of hanging files labeled 1-31 (for each day of the month) and 12 more folders behind them (one for each month of the year), you have a place to put paperwork needed in the future. When you open today's folder, there's everything you decided you want to do today."
19Schedule time for deep work.
While many of our tasks are quick items we can take care of in a few minutes, there are also those things that require some serious concentration. One's productivity needs to set aside time during the week for this kind of "deep work."
"That means no social media access, no e-mail, no phone," says Priya Jindal, founder of Nextpat. "Figure out what you want to do during these sessions (about two hours twice a week) and then show those deliverables."
20Designate one meeting-free day a week.
Speaking of cutting out distractions, one of the greatest killers of productivity during one's day is too many meetings. While they can often be a good opportunity for face time with colleagues, it's important to limit the time you spend in meetings each day to avoid losing productive work hours.
"Proactively choose a day per week to have no meetings," suggests Amber Christian, founder of productivity software Wonderly Software Solutions. "Maybe it is Meeting-less Monday or Frustration-Free Friday. Pick a day that can be devoted exclusively to work. Give your meeting-less day its own theme, so that it mentally establishes a place in your mind and becomes a priority. By establishing this habit, it will allow you more time for deep work to devote to getting your critical projects and priorities done."
21Build routines into your day.
"At the beginning of the day, plan out one key priority that you need to get done during the day," suggests Christian. "Now, schedule it on your calendar. Every single workday. This will help you get in the habit of making sure your top priority is done each day."
At the very least, get into a steady routine that gives the start of your day predictability and energy—perhaps with a brief morning workout, an affirmation, or reading a chapter of a book you're enjoying. The repetition will prime you for the day to come.
22End your day by emptying your brain.
Making a morning to-do list has its value, but it may be more productive to take this kind of inventory at the end of your day instead.
"Even on the good days, many to-dos or follow-ups will come into your mind," says Christian. "As part of your transition to evening, brain dump out any open loops on to your to-do list."
You will find that by putting it down on paper, you feel a greater sense of control over the many incomplete items you have left and will be better prepared to tackle them the next day.
"It's like closing the door on your work-day," as Christian puts it.
23Ask for help.
No matter how productive you may be, no person can do everything alone, nor should they. Truly productive people know the power of asking for help when it would be of value.
"To-do lists can be effectively completed if you identify who could help you with specific tasks," says Wong. "Do you need to drop a book off at the library? Perhaps your significant other works closer than the library than you? Is a co-worker more effective than you in organizing inventory, and has more time to dedicate to the task?"
You're surrounded by resources that can help you be more productive—don't be afraid to tap into them.
24Learn to say "no."
While it can feel easier at the moment to agree to whatever you are being asked, in the long run, for the sake of that relationship and your own productivity, you are better off getting comfortable saying "no" when you know it's not something you can swing.
"This may sound crazy and self-interested, but in this busy world, no one can put his or her productivity on the stake to please someone," says Jessica Chase, sales and marketing manager for Premier Title Loans.
25Focus on one important thing.
Your list of things to get done is always longer than you'll really be able to tackle in a day—or in a year if you're being honest with yourself. And while different people have their preferences for how many things you should really try to tackle in a given day, Accardo suggests keeping it to just one.
"Focus on one important project for the day, and secondary projects only if necessary," she says. "Multitasking dramatically reduces productivity."
26Manage your energy as well as your time.
Productive people have a fine-tuned sense of when they are at their sharpest, and most likely to get the best performance out of themselves. For many, that's in the morning, while others prefer tackling big projects later in the day. Whatever your preference, plan your projects accordingly so you're getting the higher-level thinking done at times when your mind is sharpest, and save the mindless filing or emailing for when your brain is on autopilot.
27Schedule breaks.
Being productive doesn't mean powering through hours and hours of work nonstop. Nobody works well that way, and 2014 research from Stanford University and elsewhere has shown that planning breaks as part of your daily routine can make you work more creatively and productively.
"Schedule positivity breaks to get unstuck," suggests Accardo. "Since we know our mind works like a muscle, we need to intentionally schedule regular breaks—ideally every 60 to 90 minutes. Many productive people find themselves stuck, take a break, and come back with a terrific new idea! It is also a good moment to practice gratitude and increase your positivity."
28Build rest and rewards into your schedule.
Similar to breaks during the day, you also should take your fun and relaxation as seriously as you take your work—and that means drawing a stark line between your "personal" time and your professional hours.
"Markdown your self-care and social appointments in advance so you can give yourself permission to find enjoyment," says Accardo.
And when you are taking these breaks, be sure to fully enjoy them, experiencing them at the moment rather than letting your mind wander to the work waiting for you when you get back. Enjoying yourself this way will allow you to work better when you return to the office.
29Practice the Pomodoro Technique.
If you're looking for a more formal way to approach your breaks, considerer the Pomodoro Technique. Named for the tomato-shaped kitchen timer that helps practitioners time their day, this approach basically breaks down your hours into 30-minute cycles.
"We work continuously for 25 minutes with maximum attention, and make a 5-minute break in between," explains Jacimovic. "I think this method is very efficient because it gives us time to rest frequently, restart, and fill our batteries."
30Look at the big picture.
While every project requires taking care of numerous next actions to get it to a place of completion, it's also important for one's productivity to have a clear picture of what all this work is for.
"Focus on the outcome you want," advises Rusty Gaillard, a life coach with Silicon Valley Dreambuilders. "If you want the promotion, get clear on what it really takes to get the promotion. Most of the things on our to-do lists don't get us the outcome we want."
Picturing the final product will help you make better decisions about how to get there, while also inspiring you to keep working toward your goal.
31Get rid of digital clutter.
Look at your browser: Does it have a dozen tabs open even though you're only using one? How about your desktop: Are there six documents open when you aren't actively working on any of them? It's time to close a few.
"Operating systems and software updates have made it easier for us to cram more and more content onto our screens concurrently," say Foram Sheth and Nicole Wood of Ama La Vida, a Chicago-based career coaching company. "Eliminating clutter is also an unequivocally good thing. All of those pages and documents will still be there when you're actually ready to attend to them. Give yourself the time and space to get to where you need to be on individual tasks rather than thinking you can complete everything at once."
32Check email only at designated times during the day.
For many, email is something that is just always open, so you can respond the moment a message comes through. But how often is that really necessary?
"Beyond the obvious distractions from our mobile devices, we're also bombarded with email notifications on our laptops and work computers," Sheth and Wood said. "With what we already know about the issues with distractions and our focus, creating set times throughout your day to check emails will help you keep your concentration on the task at hand rather than jumping sporadically from thought to thought."
They suggest developing a schedule (and adjusting it as needed) for when you're going to check your emails and making sure notifications are shut off when you are working on other things.
33Optimize your inbox.
It's not the size of your inbox—it's the way you use it.
"Turn off things that it does to distract you, like pop up notifications and chimes. Anything that you can answer in two minutes or less do so. Otherwise, push to your calendar, delegate, or delete," says Jindal. "Anything else should be filed as part of a task list."
She adds that you should also know that it's not necessary to respond to everything, and certainly not immediately.
"Being able to quickly triage an inbox and then focus on tasks instead of responses makes you far more productive than sending back a response with no substance," she says. "You also save hours by ensuring that you triage efficiently."
34Get off social media.
Email is bad enough as a distraction, but social media platforms are even bigger killers of time and productivity.
"Unless you work in social media, try and limit your social media use," says James Dyble, managing director of Global Sound Group. "From my research, I have found that browsing social media regularly is a huge drainer of productivity. The reason is that there is so much happening on social media. Therefore, your mind is all over the place."
35Embrace airplane mode.
When you're at a movie, play, or preparing for takeoff, and smartphone distractions are explicitly prohibited, you turn your phone to airplane mode. So why not extend this approach to other aspects of your workday?
"Not only will the focus-grabbing messages and alerts stop, but you will be less inclined to mindlessly check your phone with the knowledge that nothing new will be there under that setting," say Sheth and Wood. "Putting your phone onto airplane mode and out of sight altogether will allow you to be much more present in your work and with anything else that you need to accomplish."
36Use apps to improve time management.
For those of you who feel like going straight to airplane mode is too much of a plunge, Sheth and Wood recommend downloading usage apps, which allow you to set limits and restrictions on any apps on your phone, including messages and other highly distracting functions.
"Apps like these also give you the important (and sometimes shocking) data as far as how many times you're unlocking your phone and the total amount of time spent on it," they say.
37Track your habits.
Checking email and social media are just a couple of bad habits you need to keep in check when trying to have a productive day. But what about the good habits you are trying to make part of your daily routine?
"Use a habit tracking system and check a box for every day you do the habit," suggests Beria. "There's a lot of science behind tracking down habits. For one, it feels great to know you're keeping the checkmarks going. Two, it's a self-accountability system, especially when you place your habit tracker somewhere it's visible at all times."
Beria adds that this process of self-discipline will eventually provide you with the most rewarding results, instilling an internal motivation in you to continue the positive behavior.
38Make a timer part of your toolkit.
It's not just about keeping track of your habits, but also about keeping track of how long said habits are taking. Whether you are using the Pomodoro technique or prefer some other approach, a timer can be a major help toward becoming more productive.
39Beware of decision fatigue.
Just as you should be careful about over-booking your day, you also do not want to pack in too many decisions or projects that will cause your mental energy to drain and make you unable to deal with important choices later in the day.
"Decision fatigue is a real thing," says Accardo. "The brain works like a muscle and gets fatigued as the day goes on. For this reason, we need to tackle our most important project first. Write the name of the project you'll spend the first few hours of the day working on and then get to it straight away."
40Know when to step away.
If you find that you are hitting a wall on a particular task, consider trying to stop and move on to something else.
"So often we get caught in trying to finish up something that we can't see the forest anymore, which can result in errors or boredom," explains Jindal. "Walking away physically and doing something slightly different, whatever that might be, can help our brains pull on new threads, open our eyes to a slightly different perspective, and give our minds some rest so that it can get back to the grind when you return."
This can be part of a formal break that you take every 45 minutes or a more informal change of setting when you find yourself hitting a slow patch in your work.
41Try a change of scenery.
This shifting of gears can sometimes work best when you physically move from one place to another.
"Do you ever find yourself sitting down at your desk with the intention of 'getting work done' only to realize half an hour later than you're still procrastinating?" asks Yaz Purnell, founder of personal finance website The Wallet Moth. "It's easy for this kind of procrastination to become a habit in which we associate our desk and typical work environment with boredom and stagnation. Changing your scenery by heading to a co-working space, coffee shop, or just taking a five-minute walk to get some fresh air outdoors can make all the difference in helping you shift from procrastination into work mode."
42Schedule a "CEO date."
Racheal Cook, CEO, and founder of the CEO Collective suggests a weekly "CEO date" to get a handle on productivity. But that doesn't mean meeting with the actual CEO of your company.
"This dedicated time on your calendar helps to plan and prioritize your week by design," says Cook. "It's an opportunity to track progress against your bigger plan for the year, determine if you're on or off track, and make the adjustments needed to reach your goals."
43Give yourself a scorecard.
Following the logic of approaching your work as if you are the CEO of your own life, Cook also suggests assigning dollar-per-hour values to specific tasks, to ensure you utilize your resources correctly.
"Score tasks from $10/hour all the way up to $10,000/hour," she says. "For instance, $10 tasks could include admin work in the office, while in the home it could be unloading the dishwasher. Delegate these tasks to secretaries, or in the home to your children. As you make your way up the chain, $10,000 tasks should be focused on your highest value skillset."
44Time blocks your tasks.
Different tasks and projects require different parts of your brain and different resources, so it makes sense that you will be more effective by doing as much as you can to group similar tasks together.
"Break up each day of the week into themes that help you reach your five core tasks," says Cook. She defines these as "determining the mission and vision, guiding the values and culture, creating the strategic plan, leading the team, and making the big decisions," but they can vary depending on your particular demands and ambitions. For example, Cook breaks up her week by devoting one day entirely to her clients and another to creating content.
45Use recurring appointments.
We are creatures of habit and as much as we can do to build routines into our days and weeks, the more likely we will create positive habits that stick.
"Use repeating appointments to work on projects that take long periods," suggests management coach and consultant Amie Devero. "For example, create an appointment every Wednesday at 3 p.m. for two hours to write that novel you've been planning to start since college."
46Streamline your calendar.
Just as you should optimize your inbox and to-do list, your calendar should also be approached in a way that maximizes its value to your personal productivity. While every calendar is ideal for tracking appointments and providing reminders, there is more that you could be doing with yours.
"For example, when scheduling a meeting in Google Calendar, it automatically generates a Google Meet code so that you can simply click the link and the conference is set up and waiting for you to join," explains Mark Webster, co-founder of marketing education company Authority Hacker. "No extra scheduling, no need to send invites or worry about people being in the wrong place at the wrong time. This is a powerful tool for streamlining scheduled meetings, particularly video conferences."
There are many other ways you can get more out of your Google Calendar (here are 25 to get you started).
47Track how you spend each minute.
As you become more productive, you gain a greater appreciation for just how much can get accomplished with a minute here and a minute there—or, on the other hand, how quickly a sense of accomplishment can drain away when these minutes slide by in useless meetings or time-sucking habits.
Webster recommends manually tracking how each minute is spent.
"These minutes add up," he says. "That is why I'm always thinking about the long-term implications and how I can make these small tasks even more productive."
48Get a week-long perspective.
Many of these tips have focused on how to make the most of a day or even an hour, but there is great productive power in taking a week-long perspective, looking at how your time is spent. Entrepreneur Romi Neustadt, author of the forthcoming You Can Have It All Just Not at the Same Damn Time!, suggests creating a weekly plan.
"Make a list of everything you do in a week—and I mean everything—and how long you spend doing it," she says. Then label each task based on its function, importance, and appeal. After that, Neustadt says, delete or delegate everything you "hate doing" or "think you should do." She recommends spending 20 minutes doing this before the start of every week.
49Differentiate between daily actions and long-term goals.
Beyond looking at your day or week, you will also want to do a monthly review of how you are progressing on your bigger-picture goals.
"While goals can be important, you often don't have control over when you reach them," says Trevor Lohrbeer, founder of Day Optimizer, an app that helps people plan their day. "By focusing on your actions daily, you create the necessary momentum required to achieve your goals. Focusing on your goals once a month them helps you direct that momentum and ensure you're continuing to head in the right direction."
50Acknowledge your progress.
Productivity isn't only about work, work, and more work. To ensure you have the momentum to move forward, you have to step back and see how far you've come.
"Your productivity is to a large extent connected to your self-confidence and self-trust," explains Yoram Baltinester, consultant and executive coach with Decisive Action Workshops. "Nothing bolsters these attitudes more than acknowledging progress. Make sure to reflect for a few moments at the end of the day about the progress you made."
When you fail to make direct progress, Baltinester adds, you're still gaining experience that will translate into better odds for success in the future. So even being unproductive can produce some valuable results.
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gunnerpalace · 7 years
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(Art by @gabecebro, used with permission and originally posted here; if you like it, please go show your appreciation!)
GROUNDED! - A Bleach AU Idea Revised
You might’ve seen the original idea for Grounded! before. Long story short, it’s evolved significantly since that post was made. Namely, I (among others) fell for YoruIchiRuki as an AU OT3, so it’s now the start of a much longer series of adventures for the three. So, I’ve decided to publicly expand upon the idea as originally presented.
INTRODUCTION
Ichigo is fascinated with a jet-haired flight attendant he weirdly keeps running into. Okay, well, that was true the first half-a-dozen times. Then he pulled some favors and found out who she was and what her route was. What? They just wind up flying together a lot and staying in the same layover cities pretty often. There’s nothing wrong with that, it’s just a coincidence. He’s never even talked to her really, except to occasionally ask for a Coke. She probably doesn’t even know he exists.
Or perhaps Rukia does, but thinks much the same.
But for every awkward problem in the world, there’s an equally awkward solution! Enter Yoruichi—that’s Captain Shihōin to you, buddy—who’s never met someone she wanted to bed that didn’t wind up there the next morning.
When all three of them wind up stuck during a layover because of the worst blizzard in a century, Yoruichi happily plies her wiles on Rukia, only to soon discover she’s stepped into a thorny situation. Feeling more than a little guilty, because she really likes Rukia, she decides to adopt a new pet project: she’s going to get the two of them together, hell or high water.
There's just one problem: nothing ever works out that cleanly or easily.
SETTING
Grounded! takes place in an alternate universe (AU) from Bleach. While Bleach is essentially a "secret history” of our world, Grounded! occurs in a familiar but historically divergent reality.
The short version is that it takes place in a North America that resembles the setting of the film Big Hero 6, with a fusion of Japanese and American sensibilities and cultures.
The long version is a little more complicated. Our divergence begins in late 1580s Japan. Toyotomi Hideyoshi ultimately does not adopt Oda Nobunaga's vision of invading Ming China through Joseon Korea, determining it to be infeasible. Instead, after unifying Japan, he decides to deal with Japan's excess of military strength through seafaring raids and invasions (much like the Vikings and Normans in outcome), rather than an extended ground campaign.
Drawing from the experiences of the wokou pirates of the Sengoku period, samurai are dispatched to other nearby targets instead: against the Ainu in Hokkaido (which is occupied much earlier than historically), Taiwan (which becomes "Japanese Formosa," with both the Dutch and Spanish being held off some decades later), the Philippines, parts of Indonesia, the Bruneian Empire, the Jurchens in the Ussuri region, Sakhalin, the Kurils, and Kamchatka... It isn’t long until some of these spearheads arrive in Hawaii and Alaska, and soon the North American West Coast. Word eventually gets back about the bounty of these areas, along with raiding opportunities on Spanish galleons, and the center of focus shifts dramatically.
Thus, the Japanese are the ones to colonize the West Coast of the continent, pushing inward as far as the Rocky Mountains. The fertile terrain and easy access from the Pacific draws settlers much faster than historical settlement from the east. Discoveries of gold occur much earlier, and the region as a whole develops much more rapidly. It’s at this time that the great families such as the Shihōin, Kuchiki, and Shiba gain their wealth and stature. Eventually, they develop ideas of their own, and much like their equivalents in the British colonies on the East Coast later will, they guide the colony to independence.
This West Coast nation later comes into contact with those same British colonies, and there is much trade and cross-pollination between them, with heavy infusions of Mexican, Anglo, and later continental European settlers into the region, creating a cosmopolitan atmosphere.
Eventually, the great families conspire to assist the British colonies in achieving their own independence. Faced with hostile colonizing powers across each ocean (namely, Japan and Britain), the two ally, and eventually federate together into a single country occupying what in our world is Canada and the United States. (For the sake of convenience, this will still be addressed as “the United States,” but it is rather different internally.) Much of the rest of history goes roughly the same, with the West and North crushing the South in the Civil War, participation in WW1 and WW2, and engagement in a Cold War with the Soviet Union that ends in the early 2000s. (I can’t be bothered making too elaborate of a timeline; things are different, but similar enough.)
It’s February of 2017. By this point in time, the Shihōin, Kuchiki, and their peers have a reputation akin to the Rockefellers and Rothschilds of the East Coast, although their wealth is older and significantly more substantial: they regard their East Coast Anglo counterparts as petty nouveau riche in comparison. The Shiba seem to have retreated from the public eye.
Grounded! proper takes place in Calgary, in what we’d call Canada, although it’s somewhat different. All of the main characters reside in what we’d know as the Seattle-Tacoma metropolitan area, although in this setting it’s known as Murakumo (叢雲, "cloudbank") and is a much, much larger city.
(For the record, San Diego is Heisui [平水, "calm water"], Los Angeles is Aozora [青空, "blue sky"], San Francisco-Oakland is Miyako [都, "capital"], Portland is Fūsawa [豊川, "rich river"], and Vancouver is Shiroyama [白山, "white mountain"]; the relationship between Murakumo and Shiroyama, and their degree of urbanization, is like Tokyo and Yokohama, or Osaka and Kobe.)
The great families maintain their primary compounds in Miyako, although they have presences pretty much everywhere, and can often be found in places such as the equivalents of Malibu, Palm Springs, and Las Vegas, as well as in New York and Martha’s Vineyard. (They love sticking it to their East Coast counterparts and the new suits who think they run things.)
DRAMATIS PERSONÆ
Yoruichi Shihōin - 32 years old (January 1, 1985). Wealthy scion. Ex-fighter jock. Consummate hedonist. Born to privilege, she was never one for the boardroom and bucked tradition, joining the Navy straight out of college and gaining acclaim both as their first female fighter pilot and first female ace. But the military life was never for her either, and a lucrative offer from an airline stole her away from them—not that she ever needed the money. It’s more that it was a fun and free way to see the world... and more besides. Yoruichi fought in something like the equivalent of the Gulf War for the Navy, flying an F-14D, although it took place much later (circa 2008; she joined at 22 and left at 28). She met Kisuke shortly after leaving. She lives alone in a condo, although she visits him often before the events of the story. She still has all her resources as a Shihōin, but avoids going home at all costs.
Ichigo Kurosaki - 24 years old (July 15, 1992). Young buck. Newbie lawyer. Angsty type. Coming from a middle-class background and having fought his way to the top through grit and determination, he’s hungry to prove... something. He just doesn’t know what yet. The latest hire to a vast and prestigious law firm (”Prism”), and specializing in corporate law, he’s really the newest gofer on the jet-set lifestyle, delivering documents and briefs all over the world. It doesn’t often leave him a lot of time for other pursuits. Ichigo lost his mother Masaki at the age of 9 to a freak accident that would later influence his decision to pursue a career in law. He has his own small apartment, but visits his family’s home often. His sisters still live there while attending the local (yet prestigious) Murakumo University, same as he did.
Rukia Kuchiki - 26 years old (January 14, 1991). Youthful sprite. Veteran Stewardess. Feisty upstart. Rukia’s past is known to very few, and she was adopted into the Kuchiki family under still mysterious circumstances in her early teens, after which she mostly grew up in elite educational institutions. She only entered the family business a few years ago. Her connection to the top of the food-chain doesn’t mean a cushy job though—she’s expected to work her way up. She’s been around the world more times than she’s been around the sun, but there are certain things she’s still yet to find. Kaien Shiba died saving her after she fell into a pond through thin spring ice when she was 16. She lives with her brother in the family’s compound in Murakumo.
Byakuya Kuchiki - 34 years old (January 31, 1983). Lonely widower. Tireless industrialist. Overprotective brother. The latest heir to the Kuchiki family and CEO of the massive Kuchiki International, he tirelessly seeks to expand his company's rule over the friendly skies, and further the fortunes of his extended family. Unfortunately however, sometimes even a CEO with a controlling interest has to bow to the stockholders. Byakuya set out to chart his own course, away from the prying eyes of the Kuchiki elders, wanting to make a name and a fortune for himself as independently as he could. His selection of Murakumo was no accident. He was briefly married to Hisana, who died of a rare genetic condition; he fulfilled her last wish of adopting Rukia and developed an enduring interest in biotech research as a result. He has his own vast estate, on what in our world is Mercer Island.
Kūkaku Shiba - 31 years old (October 1, 1985) Reclusive heiress. Aspiring artist. Restless soul. The daughter of old-money that fell off the grid, she’s interested in applying her family’s wealth toward some noble end. Ironically, the social circles she runs in are small and she’s wound up in the orbit of her departed brother’s nemesis, while her eccentric uncle keeps refusing to return her calls. That is, whenever she can make one, when Yoruichi’s not on the line about this or that conquest or stop... Kūkaku allowed the prominence of the Shiba to decline markedly after Kaien’s death and the departure of her uncle, Isshin; the Shiba were never as prominent as the other families, and most of their assets are now shuttered. Still, she holds a vast amount of wealth at her fingertips. She lives in a stately penthouse condo with her brother Ganju and their two butlers, and spends most of her time there.
There will be some additional minor characters popping up who will be familiar to everyone.
Kisuke Urahara - (37 years old, December 31, 1980) owns a bar (”Free Radical”) in Murakumo. In his early 20s he ditched working on his doctoral thesis at MIT to join both CIAs (the Culinary Institute of America and the Central Intelligence Agency) for a number of years, before moving across the continent and dabbling in mixology, molecular gastronomy, and brewing. He’s Yoruichi’s closest friend after Kūkaku, as well as her on-again, off-again lover, although their relationship is rather loose and fluid.
Rangiku Matsumoto - (30 years old, September 29, 1986) another flight attendant (albeit a senior one; a Chief Purser) for Kuchiki International, she’s more than a little familiar with Yoruichi, having flown with her before and having had an extended adventure with her on at least one occasion. They’re quite friendly and tend to hang out some during their journeys when teamed up, but aren’t really close friends off the job. She views it as not just her job to watch over the younger flight crew, but her duty.
Izuru Kira - (26 years old, March 27, 1991) Yoruichi’s long-time co-pilot, they’ve been working together for two years, with her serving as his mentor. Very staid and by-the-book, he’s the professional counterpart to her wily and by-the-seat-of-her-pants style, and often the focal point of her and Rangiku’s shenanigans. He’s the proud owner of an out-of-style painter’s brush mustache and has managed to keep it despite several attempts by them to shave it off.
Yoruichi, Kūkaku, Byakuya, Kisuke, and Rangiku grew up in an environment more like that of our 1980s, while Ichigo, Rukia, and Kira grew up in a climate that was more like the 1990s.
In addition, there are others who’ll pop up as background characters, such as: Isshin, Karin, and Yuzu Kurosaki (as, of course, Ichigo’s family); Shunsui Kyōraku, Jūshirō Ukitake, Retsu Unohana, Nanao Ise, Isane Kotetsu, Kiyone Kotetsu, Sentarō Kotsubaki, and Hanatarō Yamada (as staff at Prism, Ichigo’s law firm; Shunsui,  Jūshirō, and Retsu are the senior partners); Renji Abarai (alluded to only; Rukia’s college boyfriend and one-time first lover); Suì Fēng and Marechiyo Ōmaeda (possibly alluded to only for now; Yoruichi’s former junior wingman, and her Radar Intercept Officer, respectively); and probably more (including Tatsuki Arisawa, Uryū Ishida, and Yasutora “Chad” Sado). Even more characters will appear in cameos, such as Gin Ichimaru (a national network weatherman) and Sōsuke Aizen (an anchor for the same).
SYNOPSIS
Day 1: On their first night stuck in Calgary, Yoruichi decides she’s going to take the opportunity to unwind, and goes to find and approach Rukia. At this same time, Ichigo finds himself unable to do the same, and drowns his sorrows for the evening, having already informed his firm of his situation. Rukia is initially wary and uncertain for various reasons, but Yoruichi makes it clear she’s not trying to abuse her position or pressure her, and that Rukia can stop or leave at any time if she feels uncomfortable.
Rukia eventually decides to go with Yoruichi to her suite out of curiosity more than anything else. They shower and spend time relaxing in the tub together, with Yoruichi endeavoring to put Rukia at ease. When she finally tries kissing Rukia, the latter is surprised to find she enjoys it. They spend some more time talking, and eventually dry off by a fireplace, slowly beginning to become more intimate. Ultimately, they make love, with Yoruichi leading at first, and fall asleep together.
Day 2: They wake up pleasantly the next morning, and have a room service breakfast, getting ready together. Rukia isn’t quite sure what to do, but knows she doesn’t want to just leave. Yoruichi finds she doesn’t want that either, and offers to spend the day together. Rukia enthusiastically agrees, and they explore what the airport has to offer, going to a spa and salon together, having lunch, doing some shopping, seeing a movie, and having something of a date night.
They’re settling in for a second evening together when Rukia gets a call from Rangiku saying that the stewardesses have been looking for her, and want her to come hang out the next day. Rukia reluctantly agrees, before turning her attention back to Yoruichi. Ichigo spends the day dealing with his work and helping Prism compensate for the fact he can’t get to where he needs to be, but still finds time to mope in the evening.
Day 3: The morning goes much the same, with Rukia reluctant to leave. Yoruichi gently shoos her, telling her they can always meet up again if she wants. She cheekily lends Rukia a toy and sends her off with a kiss. Afterwards, Yoruichi calls Kūkaku—whom she knows has been associating with Byakuya lately—to gossip a bit. Kūkaku is nonplussed at hearing the news, but knows it’s hopeless to try and stop Yoruichi. Soon after the call, she meets with Byakuya to discuss a corporate art installation he wants to commission.
It isn’t long after lunch when Rangiku shows up to interrogate Yoruichi, having deduced what’s happened from Yoruichi and Rukia’s absences and the change in Rukia’s mood. She informs Yoruichi about the situation between Rukia and Ichigo, which she and the other flight attendants have been aware of, and leaves Yoruichi to stew in what she’s inadvertently stepped into, thinking it to be karmic comeuppance for once.
After a brief period of self-loathing and reflection, Yoruichi decides to try and fix it by approaching Ichigo, and calls Kūkaku for moral support. Kūkaku is a bit snippy because she’s in the middle of a casual lunch with Byakuya, but something about the guy Yoruichi is talking about also sounds vaguely familiar. Yoruichi quickly finds her nerve despite Kūkaku’s warnings, and goes to find Ichigo. Byakuya invites Kūkaku to dinner the next evening.
Yoruichi discovers she has a lot of work to do if she’s going to get Ichigo and Rukia to meet smoothly, and tells Rangiku to keep Rukia distracted, telling Rukia herself that she thinks she’s coming down with a cold. She spends the evening putting the moves on Ichigo, gradually convincing him to go along with her for dinner and a movie, before doing much the same as she did with Rukia. She eventually gets him to relax and open up, and beds him too.
Day 4: Ichigo’s morning with Yoruichi is rather less serene than Rukia’s two were. Still, Yoruichi manages to once more put him at ease. She elects to spend the day in with him, as she has quite a lot to teach him if she’s going to trust someone special like Rukia to him. While he naps in the afternoon, she once more calls Rukia to put on a show of being sick, and calls Kūkaku again. Kūkaku soon figures out Ichigo is, in fact, her cousin Ichigo, and rapidly puts together what a problem this is becoming, as Yoruichi has somehow involved herself with both a Kuchiki and a Shiba at the same time as she, a Shiba, is also dealing with a Kuchiki—that very evening, in fact.
She warns Yoruichi in no uncertain terms, but Yoruichi assures her it’ll all work out before hanging up as Ichigo wakes. Kūkaku can’t reach her again. Rukia becomes a bit morose that evening as she begins to wonder if Yoruichi is intentionally avoiding her, and finds she really misses Yoruichi’s company in every way. Yoruichi puts Ichigo through his paces into the night. Kūkaku and Byakuya have a surprisingly fun dinner, that then becomes having drinks and drawing closer together, until going home is the furthest thing from Kūkaku‘s mind.
Day 5: Yoruichi wakes up as usual and has breakfast by herself, letting Ichigo sleep in. She texts Rukia to try and arrange meeting up for lunch, and soon gets an affirmative reply back. She ruminates on her plan as she gets ready, deciding it’s best to be blunt and direct. Kūkaku and Byakuya have a pleasant and lazy morning together that she teases him relentlessly about. Ichigo wakes up late in the morning, having been exhausted the previous day, and Yoruichi encourages him to get dressed to join her for lunch. Starving, he agrees.
Rukia and Ichigo are shocked to see each other at lunch. Yoruichi sincerely apologizes to Rukia, but chastises Ichigo somewhat, before introducing them, telling them how she learned about them and making the case that they belong together—after all, she’d know better than anyone! The meeting goes less well than Yoruichi had hoped, and both Ichigo and Rukia excuse themselves, heading off alone. Yoruichi is left at the table wondering if she really has messed everything up.
Another call to Kūkaku has Yoruichi learning about her situation with Byakuya, to her infinite amusement and Kūkaku’s chagrin. Byakuya deduces something is going on despite affording Kūkaku privacy for her call, given how she’s yelling, but he doesn’t pry—yet. Their example gives Yoruichi hope in persevering, but Rukia and Ichigo don’t return her texts or calls. The two spend the afternoon and evening thinking about her and each other.
That night, there’s a knock on Yoruichi’s door, and she finds Rukia outside. Rukia asks if she can come in, and after Yoruichi apologizes much more profusely, they wind up cuddling and comforting one another, before they fall asleep together. Ichigo also has a visitor: Rangiku. She invites herself into his room and makes herself comfortable in a chair, having figured out what’s going on, and begins to tell him what she knows about Rukia. Kūkaku spends another evening with Byakuya, although this time she’s a bit distracted by what’s going on, which he notices. They spend the night together again.
Day 6: Yoruichi and Rukia go to breakfast, only to be surprised when Ichigo joins them and takes a seat. They sit in silence for awhile before Yoruichi speaks up and reiterates her case. She offers to help them out if they need her to, to the horror of both. Sensing a change in their attitudes, she holds up her hands in wry surrender, leaving the two alone.
Ichigo and Rukia watch her leave before turning their attention to one another, and have a moment of awkward silence, then look away. Rukia tries to break the ice when Ichigo suddenly dismisses what Yoruichi said, yet asks her out to lunch. Surprised, she agrees. They wind up idling together and chatting until then, and after lunch, she asks him out to dinner and a movie. He also agrees.
Yoruichi, meanwhile, is communicating with Rangiku to sorta kinda spy on them as best they’re able, and in the afternoon she decides that her plan is a success. She phones Kūkaku in triumph, only for Kūkaku snap and hang up on her. Byakuya finally approaches Kūkaku, carefully noting her agitation and offering to listen. Not wanting to lie to him, and also discerning the importance of acting if it turns out Yoruichi has succeeded, Kūkaku begins to explain what happened to the Shiba, who her nearest relatives are, and what exactly has been occurring during the blizzard. Byakuya isn’t happy, but also knows he can’t do anything about it, and appreciates her honesty. He decides to wait and see what happens, and make whatever moves he has to later.
Yoruichi goes out to party with her flight crew. Despite her alcohol intolerance, she winds up having more than a few drinks.
Ichigo and Rukia have a lovely—if animated—evening, and they’re at Rukia’s hotel room, ready to part, when she invites him inside. He goes along with her, and they mutually decide to repeat how Yoruichi started out things with them. They soon discover they’re great and mind-blowing, and stay up until the early hours of the morning before collapsing in a heap together.
Day 7: Ichigo and Rukia wake up late and laze with one another, continuing to explore and get to know one another in various ways: talking, cuddling, and making love. Rukia eventually circles around to the fact that Yoruichi was right, which Ichigo grudingly admits.
Yoruichi, meanwhile, spends her seventh day resting, having thoroughly worn herself out physically and emotionally over the past week. She’s also nursing a hangover from the night before. For the 84th time, she swears off ever drinking again, and deliberately distracts herself from thinking of the two lovebirds, for reasons she doesn’t want to think about either.
Kūkaku spends the day away from Byakuya, working on her art and mulling over whether she really wants to get involved with him. He’s charming, and respectful, and the sex is amazing, but... it’s complicated. And Yoruichi hasn’t done much to help. She needs a little time to process it. She tries reaching Isshin yet again (as she periodically does) and when she can’t, she finally decides to do something about it, heading to the Kurosaki residence personally.
After dinner in Rukia’s room, ichigo and Rukia fall back into one another before another spell of conversation. The subject turns to Yoruichi and how utterly ridiculous everything has been. They swap stories about her, realizing how much fun they had with her. They gradually decide they “owe” her, and they plot about their "revenge,” with Rukia calling Rangiku to try and enlist her help.
Day 8: The blizzard is finally on track to lift enough for flight operations to resume in the afternoon. However, Yoruichi’s flight crew has no intention of leaving just yet. Rangiku has already reported up the chain of command that Yoruichi and Izuru are too ill to fly, and their passengers have already been reassigned to other flights—not that either knows. She goes to personally “distract” Izuru—she’s never found him unattractive, and it’s a perfect opportunity to once more try and get rid of that damn mustache of his.
Ichigo and Rukia, meanwhile, turn up at Yoruichi’s suite, surprising her just as she’s about to leave in her flight uniform. They guide her back inside, with just a bit of gentle manhandling, while Ichigo explains they’re not going anywhere. Yoruichi quickly figures out what’s going on and doesn’t put up too much of a struggle. Ichigo and Rukia really intend to show off and treat her, rather than teach her a lesson, but they also want to lead and have it to be something she’ll never forget. Having remembered her initial offer, they make her watch them before freeing her to play with them too. They spend the whole day together, celebrating each other.
Kūkaku, meanwhile, has dragooned Isshin into admitting to Karin and Yuzu that the Kurosaki are really a branch of the Shiba. Having stayed overnight with them at their request, she begins formally reengaging the Shiba’s assets as the leader of the family. One of her first decisions is to shift management of some of the family’s assets to a different law firm: Prism. In so doing, she requests they be handled by her cousin: Ichigo. She then sets about wiping out Karin and Yuzu’s student loan debt, assigning aside resources to do the same for Ichigo, and beginning to create reasonable endowments for them, before scheduling another date with Byakuya.
News quickly reaches the senior partners of the sudden addition of several billions of dollars of assets to Prism’s portfolio, and the attendant discovery that one of their newer employees is in fact a Shiba. Although Ichigo has essentially been excused from work due to the blizzard, they’re all surprised that no one can reach him. Regardless, they immediately set about arranging a promotion for him to fulfill Kūkaku’s request. The opportunity simply can’t be passed up.
Day 9: Ichigo and Rukia wake with Yoruichi and have breakfast. Ichigo is already scheduled to return to Murakumo since there’s no point in continuing on to his original destination (someone else was dispatched in his place), as are Yoruichi’s air crew for the same reason. They’re all taking the same flight back.
Ichigo finally turns his cell phone back on to discover a deluge of text messages and voice-mails regarding his heritage and promotion from his family and work. Yoruichi and Rukia look on with different degrees of surprise, before calling Kūkaku and Byakuya, respectively. Yoruichi gossips some, though she doesn’t reveal what happened the prior day; Byakuya asks Rukia about her involvement with Ichigo, which Rukia affirms. Neither set of parties knows the other are in the same room.
After the call ends, Byakuya and Kūkaku have a brief conversation regarding the events, during which Byakuya produces and approves a promotion request that Rukia had submitted to human resources, leaving it with one of his secretaries. They go out to lunch together.
Rukia and Ichigo eventually go their separate ways to get their things, meeting back up with Yoruichi at their gate. The flight home is routine and uneventful. They all part amicably at Murakumo’s terminal, with Ichigo and Rukia knowing they’ll see each other again soon. Yoruichi goes home to sleep for another age, only to find she can’t. She’s missing... something... and doesn’t want to admit to herself that it’s them. Lonely, she goes to Free Radical to seek Kisuke’s company, ultimately asking if she can sleep in his bed. His answer is always “Mi casa es su casa.”
Epilogue: A little over two weeks later, Ichigo and Rukia show up outside Yoruichi’s apartment together. She’s surprised to see them at first, as she’s been trying her best to move on (to no avail), only for her mood to darken once they reveal they feel differently and want her to join them on a proper vacation. They move as one on the issue, having had plenty of opportunity to discuss it.
For the first time in quite a long time, Yoruichi finds herself emotionally compromised, only to in turn be stunned by the sincerity of their offer. Ichigo and Rukia calm her through touch and offer to stay the night, and Yoruichi happily agrees.
PROMOTIONAL SNIPPET (The Beginning)
Airports exist as liminal spaces—the constant transience of their occupants leaves echoes in the fabric of their reality. That held especially true in the quiet gloom of a mid-February twilight at Calgary International Airport, with a blizzard howling down from the north and cancelling all flights in and out. The floor to ceiling windows that normally offered a view of the mountains and the international gates only showed featureless gray.
Yoruichi had already clocked out. They’d received their final forecast for the evening—the low pressure system was nearly stationary, projections estimated several feet of snow by morning, and wind chill was going to go well below zero—and the front was expected to pound the area for several days. It was only going to disperse when a Chinook wind swept in from the west to knock it out. She, her crew, their passengers, and many others besides, were all grounded, and would be for the foreseeable future.
They were fortunate that the airport had recently finished a massive upgrade program. The terminal had been radically expanded to accommodate international traffic and more besides, which was the entire reason her flight was there. But the airport had also gained several in-terminal hotels and other amenities, which was good, because based on the reports, even travel as far as the city proper would be impossible. Everyone stuck had been billeted rooms—she'd gotten a suite.
Yoruichi sighed and turned away from the gray-out. It wouldn't be long until sundown.
Being stuck on the ground for so long was going to make her tetchy—she’d never liked being tethered. She mused over joining the rest of her crew for a drink in one of the lounges, but decided to instead act on a thought she'd been harboring. She was going to seek out one crewmember in particular—one she knew wouldn’t have joined the others in their giddy celebration.
Rukia would have found somewhere to be alone.
Yoruichi had captained flights for Kuchiki International—so big it didn't have to advertise it was an airline, because everyone already knew—for three years, ever since leaving the Navy. Despite that, her current crew was relatively new to her other than her co-pilot, Kira, and one of the stewardesses, Rangiku—they'd only been together for six flights.
She'd become acquainted with them as usual, but Rukia had always stuck out to her—not least because Yoruichi knew who she was. Rukia tried to keep quiet about the fact she was a Kuchiki, often claiming she simply happened to share the last name, but Yoruichi knew better.
She hadn't hung out with Byakuya during her last trip home, a decade ago—he'd already set off on his agenda of world conquest—and hadn't really talked to anyone but Kūkaku while she was there, but she'd kept in touch with the same. She'd also gotten letters from Yūshirō annoyingly often. Between the two, she knew Byakuya had adopted a sister under mysterious circumstances, one whom looked like him, and whom Kaien had given his life to save from a frozen lake. It didn't take a genius to piece together that was Rukia.
That fact alone made her intriguing—she was Byakuya's sister, and Yoruichi and Byakuya had always had an interesting relationship. Although he was two years her senior, she'd loved teasing him since their first meeting so long ago. What sort of interactions might she have with his sister?
But it was also nothing so hypothetical.
Put simply, Rukia was stunning in a refined way, and her beauty and elegance were nothing like skin-deep. Yoruichi hadn't had much opportunity to talk with Rukia one-on-one, but she'd seen her in groups and knew how the rest of the crew treated her. Rukia was by turns tough and compassionate, level-headed and whimsical, and always smart, even if she tended to be quiet about it. She had an attitude, but not an attitude problem.
To Yoruichi, Rukia seemed both pretty and lively. She imagined Rukia was fun in other ways too, and she'd had never been one to walk away from fun if she could help it. Since they had at least a few days to kill, she saw no harm in making a pitch, and that was exactly what she intended to do.
She made her way out of the concourse toward the terminal proper.
Rukia would probably be somewhere high up, away from the bustle of the nearest bars and lounges—she seemed to like heights. Yoruichi began considering places to check as she made her way toward the hotel they'd been booked into. Stopping there would give her a chance to change into something more comfortable, and Rukia was likely at its observation lounge too.
-―-
Ichigo was in a different hotel, sitting windowside at its observation lounge. His chin was cupped in one hand, and he idly swirled a cocktail glass around with the other. He considered another building, dim and gray through the snowfall. He knew Rukia was there because he'd started his evening there, only to have spotted her sitting alone at the bar when he'd walked in. He'd seen her far too many times to ever mistake her for anyone else, from any angle, and he'd immediately left.
With a sigh, he shut his eyes and downed the rest of his Blood and Sand. You're pathetic, he thought.
Ichigo had encountered her the very first time he'd boarded a flight for his law firm. He'd instantly been captured by her eyes, but the extent of their interaction had been asking her for a Coke. He'd noted her nametag: Rukia.
They'd kept bumping into one another after that. He didn't run into her on every flight, but it happened often enough that he noticed. She never seemed to remember him, but he wasn't so sure that was the case, given his hair. At any rate, they'd never had a chance to really talk—and he wanted to talk to her for some reason.
His firm wasn't unfamiliar with Kuchiki International—which was why all their flights were chartered through them—so he knew some people who knew some people. He'd pulled a few strings and used a few details to find out some things about her. Her full name was Rukia Kuchiki. It didn't take a genius to figure out she was related to the CEO. Her routes usually brought her back to Murakumo, which was both Kuchiki International's hub city and where he lived too. It wasn't surprising they ran into each other so frequently.
It wasn't that Ichigo hadn't tried putting her out of mind, but he couldn't. He hadn't really wanted to cyberstalk her or something, but his curiosity had gotten the better of him. He'd poked around a little more and found her Facebook and Instagram rather easily. She was a year older than him. She had a strange love of rabbits, but otherwise seemed pretty normal and down-to-earth. She looked great in winter wear, and... everything really. She was single.
And now he was stuck in an international airport with her for god knows how long, and yet he couldn't even approach her at a bar. This was the perfect opportunity. What was it all for if he didn't have the nerve?
He considered the building across the way again for a long time, then sighed and called a waiter over for another cocktail.
PROMOTIONAL SNIPPET (The Ending)
Yoruichi turned and crossed her arms under her chest. "What's that got to do with me?" Her voice was strained.
Ichigo blinked as he saw the set of her shoulders and how tightly she was squeezing her biceps. Tension radiated off her.
Rukia noticed the same and looked to Ichigo before her expression became sympathetic. She was the one to start forward first.
He followed in her wake.
Rukia walked around in front of Yoruichi and brought her hands up to clasp the back of hers. "Hey..."
Yoruichi only met her gaze for a moment, then looked decisively to one side.
Ichigo lightly grasped her sides at the waist, standing behind her. "We miss you." It was a plain and unornamented truth.
Yoruichi's eyes narrowed and she hunched up her shoulders as if wracked by a chill. "Don't be ridiculous."
Rukia reached up to cup Yoruichi’s cheeks, finding the woman’s skin warmed her hands like the sun. She gently tried to turn her head so they’d face each other again. "Who's being ridiculous?"
Yoruichi frowned and set her expression hard, focusing intently on some point off to the side. When she spoke her voice carried the gravitas of authority: “What the fuck are you doing?”
Rukia blinked and automatically drew her hands back in confusion.
Ichigo likewise released her as he felt her go rigid.
Yoruichi closed her eyes. “I can understand wanting to pay me back, but you did that already! Do you think I was bullshitting you?! You’re perfect for each other! Hell, it’s like you were designed to be together! You’re like yin and yang, black and white! Why are you trying to ruin it, you idiots?!”
Ichigo and Rukia found each other before glancing at Yoruichi and looking to either side.
“Do you think I’m stupid?” Yoruichi’s tone was low, but in the quiet that had descended over the room it was more than loud enough.
The attention of the couple was instantly upon her again.
Yoruichi clamped her hands around her upper arms tighter yet, letting out a brief, harsh laugh. Her voice grew quieter still. “Do you think I’m stupid enough to believe that there’s any place for me in that kind of thing...?”
A moment passed. Then another.
Rukia bit her lip and looked to Ichigo.
He met her gaze. A decision flickered between them and he turned his attention to Yoruichi, delicately taking hold of her waist again.
She blinked her eyes open in surprise only to freeze as Rukia’s hands returned to her cheeks.
Rukia once more tried to turn Yoruichi’s head—succeeding given her preoccupation—and studied her intently. Yoruichi’s voice had been steady but there was no mistaking the gleam at the outer corners of her eyes. She carefully brought her thumbs up to wipe the tears away.
Yoruichi’s eyes widened in response and she was suddenly aware of her heartbeat hammering in her ears. She looked up, needing to focus on anything but the concern Rukia was radiating for her. "I just wanted you to be happy," she whispered. There was no space for her in that picture. No room.
Ichigo moved closer so he was lightly pressed to her back, and brought his forehead down to rest against the top of her head, burying his nose against the start of her ponytail. The citrus scent of her hair put him at ease and his arms naturally slid around her waist. "Then come with us."
She shivered at the contact but didn't try to pull away.
Rukia released Yoruichi's hands and slid her arms around her neck, hugging her and pushing her back against Ichigo. The sudden rush of the aromas that so defined Yoruichi filled her thoughts and she found herself relaxing at it. "Please?"
Yoruichi shut her eyes. "But..."
"We'd like you to be there," Ichigo insisted.
"And we know you'd like it too," Rukia whispered.
Yoruichi clenched her jaw before dropping her chin so she leaned against Rukia, unfolding her arms. She got one hand around to the back of Rukia's head and brought the other up onto the back of Ichigo's.
They both pressed closer to her and started to brush at her reassuringly.
A faint shudder once again rippled through Yoruichi; she only slowly relaxed.
The three of them stood together for quite a long time before Rukia turned her head to consider the inside of the apartment. There was a couch not too far away. She looked back toward Yoruichi and Ichigo. How distraught their mentor was had come as a surprise—if she'd known, she’d never have let them wait even as little as they had. She took Yoruichi’s wrist and started to gently tug her toward the couch.
Yoruichi blinked her eyes open, looking to Rukia uncertainly.
Ichigo noticed and let her go, taking her other wrist and moving around to stand beside Rukia. They shared a look and he likewise beckoned Yoruichi forward.
After looking between them, Yoruichi followed, letting them guide her to her couch.
Ichigo sat first, Rukia getting next to him, and the two of them drew Yoruichi down onto their shared lap space, taking her into an embrace.
Yoruichi sank into the comfort of them. She… she’d missed them—so much.
Rukia turned and lowered her head, softly kissing at Yoruichi’s neck to comfort her.
Ichigo did the same, getting his face below her ponytail to plant little smooches along the back of her neck.
Yoruichi clenched her jaw again, this time to keep from vocalizing. She knew the difference between reassurance and sensuality well enough—especially with them—but being with them in such a close and intimate fashion again stirred her soul. Sharing space and touch with them felt like… like finally coming home.
Ichigo gave her the lightest nip and his eyes flickered open to find Rukia’s.
She glanced at him and one of her hands brushed across his in the course of slowly roving over Yoruichi’s sides. She soon shut her eyes and busied herself at where the woman’s neck met her jawline.
He brought his lips to Yoruichi’s ear. “We can stay the night.”
Yoruichi pushed her chin down against Rukia’s hair and didn’t hesitate to say “Yes.”
FUTURE DEVELOPMENTS
The sky’s the limit. I envisioned they’d go on a tropical vacation next, and eventually get a place and all move in together. There are some things already set afterwards, but there’s another post about that.
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paleorecipecookbook · 7 years
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New Hope that Alzheimer’s Can Be Prevented—and Even Cured
Dr. Bredesen is an internationally recognized expert on neurodegenerative disease. He held faculty positions at UCSF and UCLA and directed the Program on Aging at the Burnham Institute. He joined the Buck Institute in 1998 as its founding president and CEO. Two of his recently published papers include “Reversal of cognitive decline in Alzheimer’s disease” and “Inhalational Alzheimer’s disease: An unrecognized—and treatable—epidemic.” I interviewed Dr. Bredesen for a podcast a year ago, and I’m excited to bring you more information about his program and his new book. If you have a loved one with Alzheimer’s—or who is just starting to get forgetful—The End of Alzheimer's is a fantastic resource.
1. What’s wrong with the conventional approach to Alzheimer’s disease?
The conventional approach to Alzheimer’s disease does not address the actual cause—the contributors to this complex chronic illness, which may be dozens and vary from person to person—and attempts to improve symptoms with a monotherapy, a single drug. This is something like trying to patch 36 holes in your roof by putting a patch over one hole and finding that water is still coming through the other 35 holes. In addition, the conventional approach is a one-size-fits-all approach, when a personalized, precision approach is needed, based on the different critical targets for each person. Finally, the conventional approach is often backward—the surprise is that the very amyloid that is associated with Alzheimer’s disease is a protective response to insults such as microbes and toxins. Therefore, any attempt to remove the amyloid should be preceded by the removal of the insult(s) that are inducing this protective response.
Have a loved one with Alzheimer’s? Be sure to check out this new resource. #alzheimers
2. What led you to a functional/evolutionary perspective on AD?
This came directly from the test tube, from years of basic laboratory research—we had no idea when we started that we would end up with a functional medicine approach. We were studying the molecular biology of APP, the amyloid precursor protein that gives rise to the amyloid-beta that collects in the brains of patients with Alzheimer’s disease. Surprisingly, we found that APP functions like a molecular switch—when it is cleaved at the alpha site, two peptides are produced (sAPPalpha and alphaCTF) that support neurite outgrowth, neuronal survival, and synaptic maintenance—essentially, these support memory. Conversely, when APP is cleaved at the beta, gamma, and caspase sites, it yields four peptides (sAPPbeta, amyloid-beta, Jcasp, and C31) that mediate neurite retraction, synaptic reorganization, and ultimately, neuronal death—essentially, these support forgetting. In other words, the two supportive peptides are “synaptoblastic,” whereas the four retractive peptides are “synaptoclastic.” We then wanted to know what determines this critical balance—a plasticity balance—and it turned out that dozens of parameters affect this balance, many quite directly. For example, vitamin D, estradiol, testosterone, NF-kappa B (as part of the inflammatory response), BDNF (brain-derived neurotrophic factor, which increases with exercise), sleep (which helps to clear the amyloid-beta, among many other effects), and dozens of others, all affect this critical balance. Therefore, we realized that we needed to measure all of these parameters for each person in order to determine what is contributing to cognitive decline or risk for cognitive decline.  Then we need to address each contributor—to reduce the synaptoclastic signaling and increase the synaptoblastic signaling. This is a functional medicine approach, so we realized that the basic research had shown us that, for a complex chronic illness such as Alzheimer’s disease, a functional medicine approach makes mechanistic sense. This has been supported now by hundreds of patients who have shown positive responses to this approach to cognitive decline.
3. Can AD be prevented and even reversed?
Yes, contrary to the current dogma, Alzheimer’s disease can be prevented, and the cognitive decline associated with AD can be reversed, although in the late stages of the illness this becomes progressively more difficult and less common. However, there is a large window of opportunity—about a decade of SCI (subjective cognitive impairment), when people note cognitive changes yet still score normally on cognitive tests; then often several years of MCI (mild cognitive impairment), when cognitive testing shows abnormalities, yet people are still capable of doing ADLs (activities of daily living); then early in the course of full-blown Alzheimer’s disease.  Therefore, it is important to seek evaluation and treatment as early as possible.
4. You’ve proposed five different types of AD. What are they, and how are they distinct?
Type 1 is inflammatory (“hot”), and the inflammation may be due to pathogens or other inflammatory factors such as trans fats. Type 2 is atrophic (“cold”) and is associated with reductions in trophic support such as nerve growth factor, brain-derived neurotrophic factor, estradiol, vitamin D, and other trophic, hormonal, or nutritional support. Then there is a common combination of type 1 and type 2—type 1.5, or glycotoxic (“sweet”)—that combines the inflammation of high glucose (e.g., via AGEs, advanced glycation endproducts) with the trophic loss of insulin resistance. Type 3 is toxic (“vile”) and is associated with exposure to toxins such as mycotoxins (e.g., trichothecenes or ochratoxin A) or chemotoxins (e.g., mercury). Type 4 is vascular (“pale”) and is associated with reduced vascular support. Type 5 is traumatic (“dazed”) and is associated with previous head trauma.  The typical symptoms and signs of these types are described, and clinical cases are described, in the book. Not surprisingly, many people have combinations of these types, so we have developed a computer-based algorithm that calculates the percent contribution from each type. This then helps to develop the optimal therapeutic program for each person, and again we use an algorithm to generate an initial program.
5. Where have you seen the biggest impacts in terms of diet, lifestyle, and functional medicine treatment with AD?
The key is that the whole program works together, so there is a threshold effect, just as is seen with cardiovascular disease treatment. There seem to be major effects of reversing insulin resistance, optimizing sleep, exercising regularly, eliminating toxic exposures (especially for Type 3 AD), optimizing hormonal support (including bioidentical hormone replacement), optimizing nutrition (e.g., avoiding high homocysteine, low vitamin D, low vitamin B12, low magnesium, etc.), addressing pathogens (e.g., Borrelia), reducing inflammation (but most importantly, removing the cause(s) of the inflammation), optimizing brain training, and reducing stress.
6. What role does genetic testing play in the functional approach to AD?
Genetic testing plays an important role, and although there are hundreds of SNPs (single nucleotide polymorphisms) that are associated with AD, the most important genetic test for AD risk is ApoE: for those with zero copies of ApoE4 (e.g., those who are ApoE3/3), the lifetime risk of developing AD is about 9 percent; for the 75 million Americans with one copy (e.g., ApoE3/4), the lifetime risk is about 30 percent; and for the seven million Americans with two copies (ApoE4/4), the lifetime risk is well over 50 percent. This has led to a conventional approach of avoiding the determination of ApoE genotype, with the claim that there is “nothing” one can do about it. This is no longer the case, and therefore the goal is for everyone to know their ApoE status, to get on an active prevention program, and to make Alzheimer’s disease a rare disease. In addition, for those with a strong family history of AD, especially for early onset AD (before 65 years of age), it is important to determine whether there are familial Alzheimer’s disease-associated mutations in APP, presenilin-1, or presenilin-2.
7. What are the most important steps people can take to reduce their risk of AD?
The most important thing to do is to get a “cognoscopy”—in other words, just as everyone knows that he or she should have a colonoscopy when turning 50, it is a good idea for everyone over 45 to have an analysis of biochemistry (what is your homocysteine, fasting insulin, hs-CRP, etc.?), genetics (ApoE4 positive?), and function (how are you scoring on a quick, simple test that can be done online). These tests will tell you where you stand, and from there, you can address the very items that are placing you at risk, such as inflammation, insulin resistance, poor nutrition, suboptimal hormone levels, toxin exposure, etc.
8. Where can people find practitioners that have been trained in your approach?
We have now trained more than 450 practitioners from seven different countries and all over the United States, and there will be more than 1,000 by the end of this year. We are training practitioners in our protocol (ReCODE, which is for reversal of cognitive decline) in collaboration with the Institute for Functional Medicine. You can find these practitioners at the website mpicognition.com.
9. What are you most excited about in terms of future developments? What challenges are we facing?
It is important to emphasize that we are just at the very beginning of all of this—literally the dawn of treatable and preventable Alzheimer’s disease. This is the same thing that is occurring with the use of functional medicine for other complex chronic illnesses—unprecedented improvements are being seen in type 2 diabetes, hypertension, cardiovascular disease, multiple sclerosis, lupus, rheumatoid arthritis, and other illnesses. There is a tremendous amount of development remaining to do—how do we optimize outcomes? For those who improve but then plateau at less than their normal cognition, how do we enhance improvement? How do we achieve better results for those who are late in the course of Alzheimer’s disease? Can we achieve similar results for the one million Americans with Lewy body dementia? How do we address other neurodegenerative diseases, such as ALS (Lou Gehrig’s disease) and Parkinson’s disease, optimally? There are exciting developments that should help to address these questions: the analysis of neural exosomes by Prof. Ed Goetzl and his colleagues has offered the ability to evaluate brain chemistry with a blood sample. Prof. Milan Fiala has described the “phagocytosis index,” which also shows evidence of Alzheimer’s disease pathophysiology in a blood sample and offers real-time follow-up of metabolic improvement that associates with cognitive improvement. More sensitive tests for chronic pathogens, for biotoxins and chemotoxins, for barrier breaches (gut, blood-brain, etc.), and for optimal microbiomes (especially gut, oral, and rhinosinal) should all play important roles in the evolution of functional medicine approaches to neurodegeneration, as well as improved, precision medicine programs that include optimization of immune responses, stem cells, and neurotrophin delivery—not a silver bullet, but silver buckshot.
Source: http://chriskresser.com August 23, 2017 at 04:57AM
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tweetadvise · 8 years
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Decisions without Data?
Recently, I talked about among the searchings for of the survey Marketing's Moment: Leading the Disturbance, performed by the Association of National Advertisers (ANA). An extremely extensive survey, it observed that the scale and also intricacy of the disruptive forces today need that organizations "undertake substantial improvements instead than incremental adjustment." I could not agree even more and will continuously write a series of blog posts recommending solutions, actionable understandings to speed up the transformational process, as well as demonstrate that Search Engine Optimization continues to be an important foundational component of digital marketing.
Decisions without Data?
A considerable finding of the survey was reported as complies with: "The majority of marketing professionals recognize that information and analytics are the trick to attending to a more complex landscape, 96 percent stated the ability to make data-informed choices is their most-needed capacity to react efficiently to disturbances. However, greater than one-third of companies are not using data to make decisions, as well as nearly half say they still do not have the appropriate analytics in place.”
These percentages make me stop and also pull in a deep breath. It is exceptionally challenging to obtain 96 percent of individuals to settle on anything. To place this in perspective, it is uncommon for winners of UNITED STATE Presidential elections to win 51 percent of the popular vote. With 96 percent of marketers agreeing on the requirement for data-informed choices, just what are the barriers as well as just how could they be removed?
A Rose by any other name …
One of the biggest barriers, which provides rather the aesthetic picture, is the HiPPO. A phrase created by Andrew McAfee, major research scientist at MIT's Facility for Digital Business, it explains choice making based upon the "state so" of the Highest Paid Individual's Opinion, also when that point of view is not notified by data evaluation and frequently is developed in the lack of other vital qualifications.
He, and also lots of others in the technology area, could be amazed to learn that they have a very early and also unlikely ally on this point, none apart from the very early 20th century rules specialist, Emily Blog post. In instance you are asking yourself, no, I have not been spending my time reading rules books lately, but a household good friend with a passion in history mentioned the resemblance in between her declarations and the principle of HiPPO and finding such point of views from varied thinkers can be really instructive.
In a book entitled Etiquette, she writes in 1922 "Why a male, since he has millions, should presume that they confer omniscience in all branches of expertise is something which may be left to the psycho therapist to address, however a lot of those tossed much in contact with millionaires will agree that a perspective of infallibility is regular of the reasonable bulk ... subjects he does neglect are bosh ... his prejudices are, in his viewpoint professional criticism, his taste flawless, his judgment foolproof, ..."
Clearly HiPPOs have actually existed in all ages, possibly by others names, and not smelling so sweet.
I believe we owe Andrew McAfee a fantastic deal of thankfulness for creating an umbrella term that could cover any person from elderly executives, high ranking political leaders, or probably one of the most aggressive, yet not necessarily the very best informed individual, as recognizing an issue that could result in a solution.
In fairness, numerous senior-level people got to their positions due to the success that they brought to their particular organizations, but as Emily has aimed out, this does not confer omniscience in all branches of understanding neither does it generate infallible judgment. It certainly does not replace validated discovering and also evidence-based advertising. Prior to I offer an example of effective evidence-based marketing, I wish to inform a cautionary tale.
A Cautionary Tale
In an instead unvarnished short article, Forbes asks the inquiry What Occurs When a HiPPO runs Your Company?
The writers tell the story of Ron Johnson, brought in as a CEO to revitalize the 111-year-old store J. C. Penney, however rather, they report that within a mere seventeen months, the adhering to occurred:
The company shed through almost $1 billion in 17 months, taking its cash equilibrium from $1.8 billion to $930 million
Revenue dropped by 25 percent in 2012, for a loss of virtually $1 billion
The business's market capitalization dropped by virtually 50 percent on Johnson's watch
I'm not here to kick sand in Mr. Johnson's face. He's definitely dealt with repercussions, yet I make certain you prefer to pick up from somebody else's loss of almost $1 billion than your own.
What were his major mistakes?
Johnson neglected data, including marketing study information that revealed customer preferences
Johnson chose not to experiment, test, and also examine new approaches before instituting them nationwide, therefore missing the opportunity to uncover that the new approaches pushed away dedicated customers
Johnson insisted to the employees that there were just two kinds of individuals, skeptics as well as believers, hence instilling worry and silencing any person that would give him with the fact valuing the unfavorable influence of Johnson's foolish decisions.
After Johnson was terminated from J. C. Penney, Bloomberg Business Week wrote "6 months after Johnson vanished, J.C. Penney has nearly improved the illusion that he was never ever there in any way. All that's missing out on has to do with $1 billion."
Okay, now you understand exactly how not to lose a billion bucks. Now allow's consider evidence-based marketing.
An Evidence-Based Marketing Success Story
Brownells, a specific niche mail order enterprise in company more than seventy years with over 50,000 specialty things, tested itself to do the following: rise conversions, help customers to find exactly what they are trying to find amongst the 50,000 things, also when they do not know exactly just what they are seeking, and also suggest products for upsell and cross-sell opportunities.
To meet these goals, Brownells adopted as well as implemented Adobe Analytics and Adobe Target remedies with extensive SEO capabilities. Deploying functionalities such as A/B/N and also multivariate testing, rules-based targeting, as well as website search/merchandising Clayton Whipple, eCommerce Director noted: "Adobe Advertising Cloud is so instinctive to function with that marketing professionals can, generally, established up tests, analyze outcomes, and make adjustments by themselves. Here are the impressive outcomes:
An general lift in incomes by 10%
Increased profits each visitor by 17% with relevant recommendations
Improved earnings per visitor by 7.8% through maximized price placement
Increased presence into on-line visitor actions as well as preferences
Gained control over information collection and recommendations
Supported wider advertising and marketing methods and also objectives
The proof is clear: Evidence-based advertising, underpinned by Search Engine Optimization, functions. Your remarks and insights on this prompt subject would certainly be most appreciated.
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kuwaiti-kid · 4 years
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Savology Review – How You Can Get a Free Financial Plan in 5 Minutes
As a financial geek, I’m always on the lookout for cool programs that will make budgeting and financial planning easier.
If I find them, it’s a bonus if these programs are offered free of charge – and are actually worth my time. (And does not hound you to buy investments, yes I'm talking about you Personal Capital)
Recently I was contacted by an employee of Savology who asked me to review their new product that was launched in early 2019. I was promised Savology could provide me with a personally tailored financial plan that would only take me five minutes to complete.
The plan was going to provide me with actionable insights on how to improve my retirement, current budget, liabilities, and estate planning.
With such an extensive list of financial criteria, could they really deliver all of this in only five minutes of my time?
Introducing Savology
When I first heard about Savology, I was skeptical, to say the least. There have been many fly by night applications that are invented and promise the latest and greatest financial planning strategies – only to leave me disappointed. Proper financial planning software is often costly, so at first, I was not optimistic about this new free financial planning company.
I was a financial planner years ago, and I understand the complexities of personally tailored financial plans. To properly provide the most relevant information, a vast amount of information needs to be evaluated.
Financial Planning In The 21st Century
As we move through this digital age, the old way of writing a financial plan on paper and balancing a checkbook is becoming a thing of the past.
Savology made it a goal to provide a solid financial plan for just about everyone, especially those of us who have short attention spans. The company promises a free financial plan in five minutes or less.
Savology’s primary audience is the millennial market, but they offer advice for all generations. The founder and CEO of the company, Spencer Barclay, quickly realized that millennials were woefully unprepared for future retirement, let alone any recessions that come their way.
Spencer found that 70% of millennials do not even have $1,000 in their savings account, and most don’t have life insurance.
How Savology Is Different
From my prior experience in the financial planning business, most online companies either tell you what you’re doing wrong without actionable steps to fix it, or they provide advice for hundreds, if not thousands, of dollars in consultation fees.
You usually get what you pay for. Free applications are a waste of time, and paid programs usually hurt your pocketbook more than help you.
Savology aims to buck this trend by offering free financial plans with simple steps to meet your personal finance goals. Spencer and the team at Savology created the software to empower millennials by giving them power and control over their unique financial situation without sacrificing the things they value.
Savology Focus Areas
Since each person’s financial goals are different, Savology focuses on addressing some of the most important and detrimental financial topics to measure. The platform evaluates each person’s financial position in regards to:
Emergency Fund
Debt Payoff
Current Saving Rate
Estate Planning
Optimizing Taxes
Using Insurance To Lower Risk
Key Metrics And Evaluations
In addition to the above listed actionable items and measurements, Savology provides each user with additional reporting criteria:
A Financial Report Card – A one-stop shop to see how your current financial situation is compared to where you should be.
Key Performance Indicators – In every personal finance plan, there are core individual finance building blocks that need to be in place. These indicators evaluate your unique financial building blocks.
Additional Education – While Savology focuses on short bursts of information and actionable items, they back up their findings, citations, and references for further learning.
Recommended Companies (Providers) – Much of personal finance is “do it yourself,” but there are several sections that require professional guidance and services. For instance, if you need term life insurance, Savology recommends some of their trusted partners to provide you the necessary financial services. You are not obligated to use their partners, but if you’re looking for guidance, this is something Savology offers.
Milestones – To keep you engaged, Savology has incorporated a rewards type of system that requires you to do certain actionable items to unlock additional features. By challenging you to stay involved, they aim to make you successful by using a gamification type model.
FinTech Is Here To Stay
Financial Technology (FinTech) is the future of financial planning. Millennials have embraced this technology and are continually challenging software companies to come up with better and more efficient ways to reach objectives. Savology is no different and has risen to the challenge.
How Savology Works
As stated earlier, Savology is free software that will give you an easy to follow plan to meet your personal finance goals. It’s more than a budget tool – it provides a comprehensive insight into your complete financial outlook and risk.
1. Starting Your Plan
By creating a brief profile with only your basic information, Savology allows you to edit and amend your plan depending on financial changes. I was pleasantly surprised that Savology did not want my last name, social security number, or even my birthday. I could create my financial plan by remaining mostly anonymous.
I was able to create my first financial plan by answering a series of automated questions that focused on my current savings, debt, retirement, and estate planning progress (or lack thereof). After spending about five minutes answering the questions, I was able to move on to my personalized financial plan.
2. Reviewing My Results
The second step involved providing me information about my current financial progress based on what I wanted to achieve in the future. My own retirement goals were analyzed and judged according to my time horizon.
The results gave me a financial plan that I could follow to achieve my desired results as well as a financial report card. The report card judged my current progress based on where I wanted to be versus where I actually was in my financial plan.
Finally, specific, actionable items and recommendations were provided to me to get me started. Rather than merely saying, “you need more life insurance,” Savology showed me how much life insurance I should have based on my liabilities and debt. Also, I was provided a series of term life insurance companies that could assist me in meeting my financial goals.
3. Analyze Your Progress
Because Savology does not tie directly into your retirement or bank accounts, you are required to update any progress you make manually. Personally, I hate software that requires connecting to my personal banking institutions, so while this requires a bit of work, I would rather keep my bank account secure.
Savology uses your login to store your provided information so you can keep track of your progress.
Staying Engaged Through The Process
Actionable items, such as creating an emergency fund or opening a retirement account, are some of the first steps Savology focuses on. When you complete the beginning steps of your financial plan, additional items are unlocked for you to complete.
For instance, adding additional life insurance may be the best route after your retirement account is opened. By using a systematic step system to get you on track, Savology focuses on making it easy and fun to get your finances back on track.
So What’s The Catch?
We all know that nothing in life is free, so why would Savology offer all of this at no cost? I dug a little deeper into the company and found that they make money from the companies they recommend as part of the actionable items.
As a consumer of the program, this did not bother me because I was not required to use their suggested partners to receive my personal finance information. With each company that was recommended to me, I could do my own research and either go with their recommendation or a different company.
However Savology;
1) Provides in-depth reviews and details about each provider, helping alleviate the time to research
2) It only includes providers on the platform that are able to help users make progress. Each provider is vetted and used by Savology personnel beforehand.
3) Not all of the providers compensate Savology. Some providers are recommended because of the benefit they provide to your plan.
In essence, I found that Savology was genuinely free for the consumer, and the partners paid for referrals. This is what you call a “win-win.”
The Bottom Line
Overall, I was quite impressed with the Savology platform. It provided a comprehensive financial plan for me and made me aware of several areas I could improve. Also, it really was “free” and didn’t require me to input a bunch of my personal information to get the results.
I recommend you give Savology a try to see how you are doing on your own financial path. You have nothing to lose, and you may be surprised to find there were certain things you have neglected to address in your plan.
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Diet Doctor Podcast #4 – Dr. Joseph Antoun
We have a fascinating discussion about fasting. And fasting is such a hot topic right now, but what exactly does it mean? There’s intermittent fasting, there’s time restricted eating, there’s short-term fasting and long-term fasting. So what do they mean and what do they mean for you as an individual? Where are you going to get your biggest bang for your buck, so to speak?
Because we all want the maximum amount of benefit for the least amount of effort. And when it comes to fasting it’s a little confusing, people are thrown around terms like mTOR and AMP kinase and PKA and… We want to know what this means for our health, whether it’s for treating diseases, preventing diseases, promoting longevity and our health span and we get into all of that with Dr. Joseph today.
So I really hope you enjoy this episode, it’s a hot topic that touches everybody, something everybody can do today to help improve their health. So thanks for listening, if you want to learn more you can go to DietDoctor.com. Find more about me at lowcarbcardiologist.com and about Dr. Joseph Antoun at L-Nutra.com. Thanks again and enjoy this interview. Thank you so much for joining us at the DietDoctor podcast.
Dr. Joseph Antoun: Thanks for having me today.
Bret: So here we are at the Mindshare Summit, this is a great event and you were on stage yesterday presenting on the future of health. And you’re presenting on fasting. Now I’d say there are probably a few years too late to talk about the future of fasting, it seems like fasting is here and am curious…
Now you’re a doctor, you have your medical degree, but you went into business and then found your way to L-Nutra, this company producing a fasting mimicking diet. So I’m curious, give us a little background on your progression and how you got to this point.
Joseph: It all started when I was doing my rotations in med school and I found out that the healthcare we were giving was not ideal. I was frustrated with two things. Number one, we’re not giving solutions that heal the body or trying to diagnose a symptom or identify a symptom trying to find the reason for it and then which disease and then give a pill or give a medical or surgical treatment. We were not doing anything to keep people healthier longer.
And the second call was… there was a little bit of discrimination whether you have the ability to pay, whether you can access the best medication or the most expensive one or not. That kind of created a frustration in me and I wanted to really go out and help changing the healthcare systems around the world into giving fair access to medicine and to healthcare regardless of their ability to pay. But also to bring a big innovation in healthcare that keep people healthier longer rather than sicker longer.
Bret: So I guess you have sort of two different ways you’re approaching this. One is from the healthcare reform side, which you are very involved in, and the second is with the innovation of a fasting product, the fasting mimicking diet. So what specifically drew you to fasting as the path to help people with their health?
Joseph: Yes, so the first thing in my journey when I finished my med school is I went into health policy and public health study. I did my health policy at Harvard then I did my public health at Hopkins and I wanted to start a career in really finding what is the next big thing that’s going to heal or prevent a disease for billions of people around the world. And the first path in this journey and a lot of professors and advisors said, “Well first learn the biotech sector. Learn how we discover, how we bring innovation in healthcare.”
So I joined a company called Eli Lilly and Company or mainly known as Lilly for most people and this is where I learned the business of how you innovate, how you launch product and how you make them accessible to people around the world. And after that journey, my second hunger which was for something that would really change the world, I was looking for something like that.
And I actually met a CEO of a company called the Buck Institute for Research on Aging. And he asked me a question that changed my life. And the question he asked me was… He said, “Dr. Antoun, as an expert in health policy and public health why the healthcare system still treats or think about the top four killers today as if they’re completely independent? Meaning Alzheimer’s, cardiovascular disease, diabetes and cancer. So why you still treat them independently?”
I was like, “What do you mean? They’re completely independent diseases.” And he said, “If they were really independent, why you don’t get Alzheimer’s at age 20? Why you don’t get your first cardiovascular or heart attack at age 22?” You actually get most of these diseases at later stage of life. So the mother of these diseases is really aging. And the way you age and the quality at which you age determines the onset of these diseases.
And he said, “For an ideal public health system to really keep people healthier longer “the system should focus on how we age. “And if we have people age healthier longer then we’re pushing the onset of these chronic disease to later stage in life.” And that was a fascinating statement for me and I started looking into aging as a field and I started to look into are there technologies, is there research in aging that is bringing any product or any service?
Bret: So how long ago was that?
Joseph: That was almost 7 years ago today. In my big search I start traveling the US looking for a lab or looking for a technology in aging, because I knew how the healthcare system works, I knew how reimbursement policy works. And you need a service, you need a product for them to consider and then to reimburse or to price and create a track for it.
And aging up until today is not recognized as… I mean is a physiological natural process but it is a driver of a lot of diseases, so even with the FDA we don’t have a track for aging to reimburse the technology for aging or even to approve it. And I started looking around and traveling across the US trying to find any intervention that can help us age healthier and everyone was pointing actually at the University of Southern California and specifically at the leader of the longevity Institute over there, his name is Prof. Valter Longo.
And he spent all his life working on understanding how we age and how we can slow down or the pace of aging, optimizing the quality of aging. And one of his big discoveries was that fasting could be a very impactful way to slow biological aging. So we took a trip, we met in San Francisco Valter and I, professor Longo along with Brian Kennedy, the CEO of the Buck Institute. And it was an unbelievable meeting where the three of us allied and decided to bring fasting to the market and launch a marketer on fasting in aging which didn’t exist at that time.
Bret: Yeah, that was a fateful day for sure. So the joke around fasting though is, “How to build a business around telling people not to eat anything?” That’s the joke.
You can’t sell anything, you’re taking things away. So for that reason it almost seemed like nobody wants to research it, nobody wants to promote it.
But then you have groups like Jason Fung and Megan Ramos up in Canada with the intensive dietary management program having great success with fasting. And you took another approach of saying, “Let’s give food, so people aren’t completely fasting, but food that mimics a fast.” And then you have some science behind this as well. So lead us through the science a little bit of what you have to backup.
Joseph: Fasting is critical actually to balance our life and the way we age. If you think about it humanity lived with fasting for hundreds of thousands of years. It was imposed on us because food was scarce and think about it 1 million years ago or 300,000 years ago, when we didn’t have readily food available, we didn’t have refrigeration and a supply chain of food. And our ancestors had to search for food and it wasn’t always available especially at winter times and difficult times and wartime.
So fasting lived with us for such a long period that it became part of our diet. And then after that comes religion. All top five religions actually agree on one word which is “fasting”. It’s not even “prayer” because you have “meditation” in some religious, but fasting is the common denominator. So religion actually carried fasting over even when food became available. And it was just up until the last 100 or 200 years when we lost this practice.
Or we kind of do it in a short-cutted way and we feast after the fast, so we’re not really fasting. And we lost that tradition and now we eat multiple times a day. And you remember, you know, in the 90s the big recommendations, you eat small portions every few hours, which is you know today proven not to be an optimal way.
Bret: Promoted by the snack industry for sure.
Joseph: Yeah, and you end up eating every little bit every day multiple times and your body is just storing fat, your body is just growing faster and is aging at a faster rate. And this is why we see the onset of the chronic diseases happening at earlier stage of life. We see a lot of people now with cancer at age 40 and 50, with diabetes at age 40 and now childhood diabetes which is really a very serious issue that we need to deal with.
So fasting really plays a great role into counterbalancing this unhealthy lifestyle and the body uses it as a period to recover from the damage is happening to the body and we’re going to talk I guess in more details about types of fasting and which one is for what. But you’re asking me about our approach. So USC, the University of Southern California, specifically the Longevity Institute, has been receiving a lot of grants from the National Institute of Health to look at fasting and aging and to understand what is the ideal way of fasting.
And there’s a short term fasting I will talk more about it or intermittent fasting, but then they identified that longer-term fast, especially if you reach five days, is really important for fasting to not only help you lose weight and have metabolic effects, but actually to intervene at the cellular level and the way the cells function and actually even change some of the nature of the cells from existing cells to stem cells and push the stem cells in the body.
And in order to reach five days when you went to human trials or when USC went to human trials, and asked people to fast for five days, compliance was very little as you can expect. It’s so difficult for us today in this environment of food and marketing and deliveries to have people fast for five days. So the Longevity Institute then thought about a way to mimic fasting with food.
And the National Institute of Health and a lot of donors were very receptive to this idea because not only that allows fasting to become practical now, but it actually makes it safer. You don’t want a person on the third or fourth day of fasting to feel a little bit, you know, to have a hypoglycemia or to feel a severe headache or weaning from food etc.
So the idea came about when the Longevity Institute was trying to do the cancer trials with fasting and they couldn’t really recruit people and they tagged team with Mayo Clinic in order to try to increase the recruitment rate, but it was very difficult. People could not fast for five days. So out of that necessity the fasting mimicking diet was born and they tried to look into what could be the ingredients that we can feed people and the body wouldn’t really recognize these ingredients or the hormones and the responses in the blood and then in the cell identifying the food are actually not triggered. So we call them the nutrient sensing pathway or sensing the food signals.
Bret: So looking at insulin, looking at AMP kinase, looking at mTOR, specifically measuring whether those were activated or not was sort of the core of determining if the body felt it was fasting?
Joseph: Yes, definitely. So the two most important, if you want, triggers of nutrition when you eat is our proteins and our carbohydrates. And they go into the blood and as a response to carbs you have an insulin increase and a secretion increase and in response to protein you have an insulin like growth factor or IGF increase. At the cellular level these signals translate into different pathways, the PKA the rest pathways, mostly with the carbohydrates and sugar pathway and the mTOR pathway mostly with the protein and IGF pathway.
So the goal was not to spike the blood response to food with insulin and so like growth factor and at the cellular level not to trigger the PKA, the rest and the mTOR pathways. So the body would stay in a fasting mode although it is gaining nutrients and the fasting mimicking diet not only mimics fasting but it actually nourishes the body so it has the macronutrients, it has the micronutrients, it has vitamins etc. helping the body safely move over five days and actually enhance the effect of fasting.
Bret: Very interesting and one concept that I really like about the cyclical nature of this is that mTOR gets a bad name because we say it fuels cell growth and it can stimulate cancer, but it also fuels muscle growth and allows us to grow and get stronger and prevent sarcopenia, so we don’t want it suppressed all the time, we want a cyclical nature.
So it seems that you’ve sort of rested on five days every three months, as the general recommendation. But the trial that you did was five days a month for three consecutive months and that showed a reduction in weight, a reduction in blood pressure, a reduction glucose, a reduction in IGF-I and was well tolerated. How did the transition happen from five days every month to five days every three months?
Joseph: It depends on the patient profile actually or the consumer profile. If you’re a person who you’re healthy otherwise you have a normal BMI, you’re not overweight or obese and you don’t have metabolic issues that you want to intervene on, you just want to do the fasting mimicking diet.
The product name is ProLon in the market for promoting longevity. But if you want to do that regimen to help your body age healthier, and we’re going to talk maybe a bit more about how that happens at the cellular level, then you do it once every two or three or four months. So this is you basically counterbalancing every three months if you want your lifestyle, but you already have a healthy lifestyle and you just want to do it to promote the stem cells and rejuvenation of the body.
Now if you have metabolic reasons to correct, if you are overweight or obese or you already have unhealthy levels of cholesterol or triglycerides or inflammation in the blood, you need to do a bigger intervention, so we recommend you do it once every month for three months.
And here we’re talking just five days in month one, five days in month two and then five days in month three. And once you see a correction in the weight and inflammation and other metrics – cholesterol, triglycerides, blood pressure and glucose in the blood then you can start alternating doing it once every two or three months.
Bret: I guess that’s what makes it so interesting is what’s the right protocol for each person because let’s be honest, people want the maximum benefit for the minimal effort so fasting can range from a 12-12 eating window or time restricted eating and 18-6 window, a 24 hour fast, a 3-hour fast, a 5-day fast, they’re all out there.
And the question always becomes, “Where you’re going to get the maximum benefit?” And I guess the question has to start with what are your goals? So if your goals are weight loss, if your goals are improving mental clarity, if your goals are longevity and cell rejuvenation it might be different along the way.
So some people would be perfectly well served with an 18-6 and some people will need to go a little bit longer. Now there are people who have success with a water- only five day fast and part of that is you have to be very careful about how you break the fast. Does the same hold true for the fasting mimicking diet and when you break the fast you need to take care not to sort of overdo it and overwhelm your system?
Joseph: Yes so you touch a few points about the goal and the short-term versus long- term, so maybe here if you allow me to take two or three minutes to explain the different kinds of fasting and what each does to the body so that–
Bret: Sure, I’ve been carried away and I’m going too fast here.
Joseph: This is wonderful, this is the hottest topic. I don’t know if you noticed, but this May of 2018 the Food and Health survey, official publication, showed intermittent fasting to be the number one diet in the US especially among the younger population. So from being absent on any of the reports to becoming number one ahead of paleo or keto, ahead of other diets… So it is the topic of the day.
Let’s clarify it, there’s a lot of confusion, a lot of coverage on fasting, but then you see big headlines, “Fasting reverses this, fasting does that”, and there are multiple ways of fasting and fasting is just not one thing that does everything. It depends on what kind of fast you do you get different results. So I want to start with what you alluded to which is few hours of fasting or what people still call intermittent fasting but it’s not actually… If you fast less than a day, your body doesn’t start producing ketone bodies and doesn’t really go biologically into fasting. When you fast for a few hours we call it time restricted eating.
Because what you’re doing is you’re limiting the window of time you’re eating during the day. Say you just have lunch and dinner and you limited… We call it time restricted eating because you are restricting the time of food within the window of just lunch to dinner and then you’re fasting during the night because you’re sleeping. And say you skip breakfast, so this is what you call today a 16-8 or 16 hours of fast and eight hours of food.
Time restricted eating is actually showing a lot of benefits because at least what you’re eating during the eight hours instead of just stalking those, instead of just pushing the body to grow, if you eat multiple times a day and be pushed by food, you’re counterbalancing that by a period of no food and a period where you allow the body to spend the calories that you at least ate.
So it’s a great short-term counterbalance to what you’d do in the eight hours of food and it’s actually showing good effects on maintaining healthy level of weight and other related metabolic factors.
Bret: And just to interject there, if you’re already following a ketogenic diet, that can also enhance the state of ketosis as well because you mentioned you have to go 24 hours of fasting to really get into ketosis, but if you’re already following a ketogenic diet, that’s where that 18-6 or 16-8 could be even more powerful.
Joseph: Definitely, and especially with ketogenic diets where you’re still having a certain level of proteins in the ketogenic diet and even more, so if you have animal source of proteins your body is really not getting into ketosis because it’s sensing the proteins and sensing… even the animal source triggers IGF and mTOR pathways.
So again the ketogenic diet is a big word and needs another discussion because there’s different level of ketogenic diet and some of them take really longer to get you into minor level of ketosis versus other ketogenic diet, but as you’re saying if you do the time restricted eating because you’re spending a good number of hours with no food you’re going to help enhancing getting the body into ketosis.
But here I want to say something which is really important for whomever is watching this episode which is that we’re still unsure whether you should do a 12-12 hour time restricted eating versus a 16-8. Intuitively you say, “Okay if you last longer, a 16 hours it should be better”, and this is what a lot of people are doing, again called time restricted eating, but intermittent fasting is what the street name for it is.
But there are three major epidemiological studies showing that if you skip breakfast actually there is some correlation of a slight increase in mortality and the last of which is a study in the Journal of American College of Cardiology which was published a few months ago that showed a slight increase in mortality in the Spanish population that actually skips breakfast.
Now we’re not sure of this is because they’re fasting up to 16 hours or there is a bias which is most of people who skip breakfast or many I would say of the people who skip breakfast they actually eat late at night. So we don’t know whether this was because… and the study didn’t clarify whether the same people eat late at night or not, but a lot of us today in society that skip breakfast actually stay late at night and eat late at night which is even worse than skipping or not skipping breakfast.
Bret: They also tended to be heavier and smoked more and there are definitely some confounding variables in all three of those trials.
Joseph: Exactly. So we has as experts in science are a little bit still unsure whether we should really go all the way to 16 hours or we should say, you know, 12 hours is a healthy time restricted eating. And honestly I have one basis that I always use when I make any judgment around diet which is our body is what is today because it was tailored by nature existing and certain conditions for hundreds of thousands of years.
So my first rule of thumb when I think about anything presented to me in terms of diet or lifestyle, I try to match it with how hundreds of thousands of years our body grew and what are the circumstances. And typically a family 10,000 years ago would sleep when the sun is down, stay a little bit up, have lain near some kind of fire if that existed.
And in the next morning either you save some food or you go and you find your food. And you sleep for eight, nine hours and then you wake up and you search for food and you have your breakfast. So I tend to say closer to 12 would be definitely healthy. I don’t know if the 16 is healthier or not but I tend to say it’s safe to do a 12 hours of food and 12 hours of no food.
Bret: And that’s part of the problem with when you took about longevity or about fasting, we don’t have the comparative studies, we don’t have a 12-12 compared to an 18-6 compared to a five day in the randomized studies.
Which of course is what we need to say yes definitively. So we sort of have to do the best with what we have, with N=1 experiments, with clinical experiments, with the observational studies and just kind of put it all together and kind of make our best judgment.
Joseph: I agree and the study is going to come… it’s such a hot topic, such an easy practice. The time restricted eating or time restricted feeding when you call it in mice or pre-clinical trial, it’s such a hot topic today, I’m pretty sure there’s going to be data and there’s going to be science coming up on it.
Bret: That’s why I don’t like to use time restricted feeding because it makes me feel like a mouse, like I’m in a cage. No time restricted eating, yeah.
Joseph: But the media picked up as TRF, or time restricted feeding, and we’re trying to correct… a lot of my daily job today actually is to try to clarify concepts because it’s a delicate difference between a lot of different fasting and then people use the word fast or intermittent fast or fasting mimicking diet, but then you need to go a little bit into detail.
So for example the fasting mimicking diet we have, not knowing whether you should skip breakfast or not or whether you should eat something in the morning. You know, tradition and our mom tell us breakfast is the biggest meal and then intermittent fasting now is saying to skip breakfast. So what actually we have done, we have developed a fasting mimicking bar or a fasting mimicking meal, which then you can eat in the morning, you didn’t skip breakfast, you get your nutritional ingredients for the day.
But then you actually did mimic fasting for that so we found that to be a balance between what tradition and what, you know, not skipping breakfast or what your mom says, in a balance with what today, we’re all jumping into this intermittent fasting and time restricted eating and trying to prolong a little bit for night fast.
So we called it the fast bar and you’re going to see it soon being out on the market. So that was the shortest term of fast which is few hours a day. Then when you cross a day, when you reach a day of fast, you’re really starting biologically to be fasting and this is what really is called intermittent fasting, which has different ways of doing it.
You can fast for a day twice a week or what we call the 5:2 diet, which has been described in the literature for long time and then a gentleman by the name of Michael Mosley in Europe wrote a book about it and promoted it as well. And it basically asks you to eat 500 or less calories a day, so almost not eating, this is the way how you’d fast on it. And you do two days separate a week, say a Monday or a Thursday and it is relatively easy to do.
And it helps you mostly from a metabolic standpoint. So as you can imagine, instead of having seven days of full food, on two days you’re decreasing your food intake and therefore you’ll lose some weight and you’ll have metabolic improvements as well. So when it comes to cholesterol, inflammation, the blood, triglyceride etc.
And you would have to do it therefore kind of close to eight times a month, because you’re doing it twice a week. So that’s the minor form of it you can do it. 4:3 which is three days of fasting a week or you could do the most extreme form of it is alternate day fasting, meaning one day you fast, one that you eat, one that you fast, one day you eat. This form we’re not sure it’s even a healthy form and induces in the body what we call the yo-yo effect.
One day you’re eating full, the other day you’re almost fasting and it has impact on circadian rhythm, it has impact on your lifestyle and as you can imagine the body is a system of complex system of balances and homeostasis. You don’t want to disbalance that every other day.
Bret: And it seems important that the cyclical nature has to fit in there somewhere and at some point you lose that physiological cyclical nature in the body, just sort of cease it as being continuous. And I guess is unknown where that level is but maybe every other day it crosses that line.
Joseph: I agree and a lot of diets focus just on nutrition but we should understand the body is much more than that. You have the stress level and cortisol and you have the sleep level which is another determined for our well-being. So stress, sleep, socioeconomic factors and social connections and actually being active in society, these are all as important as nutrition and exercise to keep us healthy longer.
So the alternated fasting or what we call ADF is still… we’re not sure it’s a healthy form. The 5:2 seems to be more practical, you know, it does the job of helping you counterbalance from a weight perspective and seems to be a more common, you know, easily to be observed fasting. Then you move from intermittent fasting which is again a day or two or three a week then you go to a longer, which is two or three consecutive days of fasting, what we call short-term fast or STF.
So when you fast for two or three days, yes, you’re going to lose weight. So the common denominator of every fasting you do is to counterbalance weight and lose some weight or maintain healthy weight level. So definitely when you do it you’re going to lose some weight and you’ll improve metabolic factors, but when you touch day three you’re basically inducing what we call autophagy meaning you ask the cells to… because now for two or three consecutive days there’s no food coming in or nutrients coming in the blood, then the body asks the cells to go and look for debris and intracellular debris to eat and then to get the calories from it and optimize the function of the cell.
So now for the first time with fasting you’re touching on the cellular function. And autophagy was awarded the Nobel Prize of medicine in 2016 which is really an interesting award to autophagy which is linked to fasting, so we’re really excited about that. And if you go longer than the short-term fast… the short-term fast also could have some inconvenience, especially and probably at the muscle level.
When the body goes over the day and is really looking for calories it doesn’t only burn fat but it actually goes and extracts calories from the muscle as well. And what happens on a short-term fast, two to three days, there could be fat driven weight loss but also a lean body mass potentially a bit of loss. There is not enough in the literature for us to judge there, but this is always a suspicion, because as we know when you need calories you to muscle and fat together.
Bret: And that’s why it’s so important that people keep up some level of physical activity and exercise during fasting, although maybe not their usual intensity… we’ll get to that, I know. I keep interrupting you, but we’ll get to that.
Joseph: Yeah, definitely, in the shorter-term fast your body is not the depleted, you can still do exercise and just to try to… if not decrease the muscle loss, just to keep it to maintain it. And then when you go to longer-term fast which is close to five days, which is what mainly the Longevity Institute at the University of California is focused on, they were very much interested in cellular impact of fasting.
So when you cross the two, three days is like a company with suddenly no funds. The body with no food is like a company with no money. And you know, if I delay paying a check to a company, they’re going to wait just a little bit and then cash it afterwards and then the CEO of that company is not going to take drastic action to change the operations of the company.
So this is intermittent fasting, you delay expenditure, you know, you lose some little bit of weight and you spend a little bit of the calories that you had. Or what the CEO would have done would go to the bank and live a little bit on the reserves that they have. And you live off your fat reserve. The longer you go, like the short-term fast, two to three days, so the longer you go on a company not receiving a proper amount of funds, the CEO at the leadership of the company will start to restructure the operations and optimize the operations to do the best outcome out of whatever money you still have left.
So this is where the body is trying to do the same, it’s asking the cells to optimize their function with the short-term fast. Now if you go longer on day four and five, again going back to the example of the company, now you have to let go on the long- term, you know, and proper funding. You start letting go some of the employees and sometimes the ones that are not the most efficient and you empower and you live off the critical employees who are the real, you know, the most cost effective for the company.
And the body does the same thing when you cross day three of fast. On day four and day five we’re seeing, especially in mice trials and initial human trials, we’re seeing the body actually pushing the stem cells. Every organ has what we call stem cells which are young cells. They are there, to what we know historically, to help the organ heal from maybe physical damage. So if you cut your skin, or you go into a car accident, you know, you wait for few days and you heal from that.
So physical exercise, physical damage triggers the stem cells to repair. What we did not know is that if you stress your body enough with fasting, the absence of food, on day four and five the body pushes the stem cells to try to replace elderly cells or cells with any damage. And the goal is to bring more cost-effective younger cells rather than carry a little bit of a deadweight at the cellular level, not at a fat level, but now we’re still stressed on a five day fast that actually we try to get off the deadweight from a cellular standpoint.
Bret: So just to clarify, it wasn’t up to the five-day fast where the organ started to shrink, you started to get rid of some of the cells and that was the re-feeding where the stem cells came out and were produced or were they already been produced during the fasting stage?
Joseph: Yes this is great point. They started to be produced on day four and five, but then after you do the re-feed, they are actually bringing nutrients to these new stem cells to even flourish. But they start to proliferate at day four and five, at least this is what we’ve seen in most of the trials.
Bret: So mice trials, not yet human trials.
Joseph: No, in humans. So in mice actually three days of fast is equivalent to five days in human. And we have published an article in Cell Metabolism, if I’m not mistaking in 2014, and what it shows we had 39 patients, it wasn’t only preclinical, we had 39 patients and we showed a very high spike of stem cells circulating the body, we call them SPC or Mesenchymal circulating stem cells.
So we did show that the human trials and now we’re doing a lot of trials on even diseases and fasting to show whether the stem cells on day four and five and then after re-feeding flourishing, do they try to actually intercept or reverse a disease state? So we are really excited, we have 24 ongoing human trials now.
Bret: 24? And you already have data on multiple sclerosis and on autoimmunity reactions in humans, right?
Joseph: In humans there’s one data coming from Charité University in Berlin where they did fasting mimicking diet on cycle followed by a Mediterranean diet and it showed an improvement in quality of life in humans with multiple sclerosis. And now we are starting trials on MS, on multiple sclerosis, where we’re doing the fasting mimicking diet for several cycles.
Bret: So you brought up a good point there. They were doing a five day fast followed by a Mediterranean diet. So does it matter what you eat the rest of the time? Is this a cure-all that you can go back to your muffins and bagels and donuts and as long as you do your five days of fasting you’re good, or what do you see the science saying now?
Joseph: It does matter. There is no one-size-fits-all when it comes to different people, different bodies, different needs, but now even more important different diseases, so if you have MS you’re different than if you have cardiovascular disease and you’re different if you have Alzheimer’s so definitely…
You know, what they studied which is one cycle of fasting mimicking diet and then Mediterranean diet, it was just to test the safety on the fasting mimicking diet and the feasibility and then you know coming from Berlin, from Charité, they would look at the Mediterranean diet which is very popular there and considered a healthy long- term trial. It wasn’t really aimed specifically at multiple sclerosis.
Maybe you can have the fasting mimicking diet plus the ketogenic diet to be tried on such a disease, but is it was a grant given for such a protocol to see the safety on the fasting mimicking diet with multiple sclerosis and then what could be, you know, a daily diet which is a Mediterranean one that is mainly observed there, what the combination would do.
Bret: Yeah, there’s such an emphasis on protein, too much protein, not enough protein, because we obviously need it especially as we age and get older. I would love to see that kind of trial with a five day fast, with a high protein ketogenic, a low- protein ketogenic and see what kind of difference you see versus a more sort of a Mediterranean diet and see if there’s a difference between those and what kind of effects the fast has in each person… that would be fascinating.
Joseph: Yeah, definitely, and the results will differ depending on people, their bodies, but also their objective. If you were an athlete or say a bodybuilder and you specifically want to build muscles or you got a competition or you want to look good, you want to look perfect, you are going to consume a bit more proteins. Is not that we recommend it from the longevity perspective, but it’s what you’re going to do to push your muscle to grow.
And in that case you want to do from time to time a fasting mimicking diet to counterbalance the effect of protein in your body, so when your muscle grow… this is something really important for public health, when you’re over consuming proteins you’re pushing your body to grow. And the body grows towards it and it ages. When you grow you’re pushing aging and I always use this example, you know, the big muscular athletes, you don’t see them living to 100 or 105. And actually most of them, we lose them a little bit earlier than others.
They don’t become centenarians in most cases if you want. And the body is biologically pushed. You know, they inject testosterone growth factors and they actually eat a very high level of proteins. This is really triggering aging in the body. And it’s a very important discussion I think because we reacted to sugar in the 80s and 90s because it led to diabetes epidemic and we jumped on protein.
Protein is another nutrition component to the body and pushes the body to grow and age the same way insulin does. It’s is not by chance that when you eat sugar insulin increases and then when you eat protein we call the molecule that increases insulin “like growth factor”. So they are both growth factors to the body.
And when you grow biologically, it’s like kicking the pedal in the car. You drive faster and you get sooner to the end. And what we are interested in our research is really how to keep people healthy longer and how to promote longevity and more importantly health span. And a lot of recommendations you see coming from USC and Prof. Valter Longo and the Longevity Institute as how to help people stay healthy longer.
It’s not necessarily to build muscle and be buff on the short-term. So yes, as you’re saying for some people you want to do fasting mimicking diet cycles with ketogenic diet, depending on their goal, and others you want to give more proteins if they really want to build muscle etc. So where I’m trying to build a point is different needs for different people and here you can tailor even further with the genetics and the microbiome and a lot of other details as well.
Bret: And age plays into that as well, because as we age we probably do start to need more protein just for maintaining our muscle mass and preventing sarcopenia. So how does this fast factor in as we age about 65, above 70 versus those who are 20, 30, 40?
Joseph: That’s a great point and actually the need for protein intake varies throughout your lifecycle. And we call it almost a U-shape where from age 0 to age 18 you definitely want to have protein. You want to give your kids milk and meat, etc, because they’re growing vertically even though their organs are growing, the body is growing.
And then after that the more you age the more… you have enough cells in the body that age enough or carry DNA damage enough that if you keep pushing them like proteins and during the replication, during that push because their age or they have damage they’re more prone to do a mistake and become cancerous cell. So as a mid- age adult, if you want, in my opinion is age 40 to 60 or 35 to 60, this is the peak of the risk of having high-protein diet, but enough age cells and cells are prone to the mistake to become cancerous.
But as you say when you grow older and you’re 70, 80 or 90 at that point the level of cell replication in response to food drops. So even if you eat the proteins the cells are not the mTOR pathways are not super active and doesn’t push cells to high-frequency for applications. So yes you have a lot of aged and damaged cells but actually they don’t respond to protein signals.
And this is where going back and having a good intake of protein is really important because you need to maintain muscle at that age, the risk of cancer is not as big as when you’re a mid-adult agent. And we see this even epidemiologically. People don’t die at age 90 and 100 from cancer, but mostly cardiovascular and Alzheimer’s etc. The cancer peaks at certain age, but then start dropping afterwards.
Bret: Interesting, it’d be interesting to see more data on that for sure. So as we’re touching on that then let’s transition to say, “Who is this not right for?” People are going to listen and want to run right now and do cyclical five-day fast. Who would you say, “Hold on, don’t rush to do this. Maybe is not right for you”?
Joseph: Yes so two years ago the first fasting mimicking diet was… a little bit less than two years it was launched on the market under the name of ProLon for promoting longevity… It’s a box, you get it through your physician or if you’re healthy enough you pass a self-assessment online and you can buy it. It’s five days of food that gets delivered to you and you eat it and your body remains in a fasting mode. It is not for everyone to do.
So definitely if you’re a pregnant woman you definitely do not want to fast the baby or fast during the pregnancy. If you are very old, if you eat it at an older age like we were talking, say an 80-year-old… you want to have high protein diets. You don’t want to fast your body probably at that age. If you’re a child not necessarily you need to fast, you need to grow.
And we have cautions as well. I mean definitely if you have allergies to some of the ingredients of the fasting mimicking diet. It is a plant-based natural diet, but some people still have allergies to nuts, or macadamia, or to cashew or two some of the ingredients. And there is a big, you know, watch out and hear if people have diabetes… We have a lot of research published on diabetes.
We haven’t done the human trials yet and a lot of people try to actually use it for diabetes. There’s a big cautioning in here. Should not do it you have a risk of hypoglycemia if you’re actually using insulin or using blood lowering sugar. So as much as we look forward in the future to further studies on diabetes, there’s definitely a warning here to not use it in this regard.
Bret: Yeah, that’s a great point because a lot of diabetes medications are where we can get into big trouble with fasting in general or even time restricted eating and then a five-day fast for sure. So I like that you have a sort of behind the safety wall of a physician that has to be from a physician and if someone wanted to try a five day water fast, I’d tell them same thing, “If you’re on medications do not do it until you confer with your doctor.” I think it’s very important.
Joseph: I mean water fast has as a bit more warning, because it’s an extreme state of “there’s no food” versus the fasting mimicking diet, so I agree with you. With water fast it’s going to be a little more difficult, have less compliance and now you step into it, if there is heat you don’t want to drive on water fast with high temperature etc. So it’s a little bit more extreme for folks who can do it–
Bret: If it’s hot. It’s that just for risk of dehydration?
Joseph: Yeah, dehydration, and then hypoglycemia when your body is spending a lot of calories or if you do some kind of exercise, because you’re really having almost no calories when you do pure water fast. You’re a little bit more prone to safety issues.
Bret: Yeah, and then you hear the stories of people doing three, four-month fasts and it’s remarkable, not that we would ever recommend it, but just that someone can do it, just the physiology of the human body is amazing that he can even do that but obviously under very, very careful guidance.
Joseph: Yeah, and I get a lot of questions about “Why five days, why not 10 days?” And I, not knowing in the past… in my past I actually have done a couple of weeks of fast, three weeks and I just wanted to experiment with it but I had no clue about the science at that time.
Bret: Interesting.
Joseph: But we discover why I would recommend five days because you actually eluded that re-feeding is important. So instead of doing a long-term fast where even the stem cells trying to rescue, the body gets depletes because then you need to feed them as well. Everything gets shut down and depleted when you go on a long-term fast.
So yes, you have metabolic gains, you would not be obese on a long-term fast, you’re going to decrease inflammation, you’re going to improve your cholesterol, but you’re going to lose on the lean body mass, you’re going to lose muscle and bone density etc.
What we have found out in our research because we have tested shorter terms of fast which again we decided to go with the five days, because of the rejuvenation happening on day four and five, but then we recommend that you stop at five, sometimes six, sometimes seven, depending on the diseases, for autoimmune diseases we try to go longer because you do need to heal a damaged organ at that level.
So the MS trials for example that would be for seven days most probably, six or seven days. But then the re-feeding is as important so that you re-feed the stem cells. So the cyclicity is more important than the length and doing it cyclically multiple times and feeding the body again helps preventing the body from getting depressed or depleted on the long term.
Bret: That’s a great point. The cyclical nature I think is what’s so important here and you have different ways to do it. But as long as you stick with the cyclical cycle and find out what works for you, I think that’s a great point. Now I know you’re in a hot demand here at the conference, I want to be respectful of your time and thank you for coming to spend time with us at DietDoctor podcast. Any last words for our listeners and of course where can they go to learn more about you and L-Nutra?
Joseph: Well, thank you very much for hosting me today, I love this topic. I think the University of Southern California and the researchers are bringing back fasting in a practical way and this is what excites me the most. Every day you hear about a different diet, about new ways of doing things and a lot of it is fueled by interest or marketing dollars or business.
I think for the first time in history of nutrition or one of the few times where we’re bringing back a natural phenomenon, we’re bringing back a practice that was done for hundreds of thousands of years initially a for lack of food and then afterwards carried by religion bringing it back in a natural and safe way to our life.
So I think fasting is here to stay long and we’re really excited to finding ways we do recommend people to do it in a safe way. And what we have focused is mostly on time-restricted eating and helping people go through that. And intermittent fasting definitely has its metabolic benefits and the longer you go in a safe way… and if it’s unsafe for you, you get to mimic it with ProLon or other fasting mimicking diets we’re bringing to the market. So if people want to learn more about all this, the company… if you want the reference in fasting is called L-Nutra and this is the company that actually span out from USC and is trying to bring the fasting mimicking diet to the world. And if you want to read more on ProLon you can go to prolonfmd.com for fasting mimicking diet. P-R-O-L-O-N, prolonfmd.com.
Bret: Alright, Dr. Joseph Antoun, thank you so much.
Joseph: Thank you for hosting me today.
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Source: https://www.dietdoctor.com/diet-doctor-podcast-4-dr-joseph-antoun
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garyh2628 · 6 years
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The Mega Millions jackpot paid out a record $1.6 billion last week, inspiring lots of people to revisit the age-old question: What should you do if you’re the winner of the jackpot?
Evan Sparks, a writer in Washington, DC, and a contributing editor at Philanthropy magazine, caused a stir on Twitter last week with a twist on the advice to donate your lottery winnings to charity: Start up a private foundation.
So, as the #MegaMillions jackpot reaches a record $1.6B and #Powerball reaches $620M, here’s my advice about how to spend the money in a way that will truly set you, your children and their kids up for life.
Ready?
Create a private foundation and give it all away. 1/
— Evan Sparks (@EvanSparks) October 21, 2018
He thinks it’s not just the best move for the world — it’s also a great plan for you personally. Most people who win the lottery wind up miserable, he argued, dealing with complicated taxes and constantly fending off demands for their new, not-so-limitless wealth.
The stress can be damaging, even deadly, and Uncle Sam takes his huge cut. Plus, having a big pool of disposable income can be irresistible to people not accustomed to managing wealth. https://t.co/fiHsuJyZwz 3/
— Evan Sparks (@EvanSparks) October 21, 2018
Donating the money solves that — and because of the fascinating dynamics of the philanthropy world he has observed for the past decade, a lottery winner who donated every penny would be as privileged and comfortable as one who kept the money.
Meanwhile, the private foundation is as close as we come to Downton Abbey and the landed aristocracy in this country. It’s a largely untaxed pot of money that grows significantly over time, and those who control them tend to entrench their own privileges and those of their kin. 4
— Evan Sparks (@EvanSparks) October 21, 2018
You can read the rest of the thread here.
Sparks’s tweets kicked off an online conversation about the role of private foundations in American life. This scheme for managing lottery winnings struck some people as enviable and others as infuriating. (Sparks has since expanded it into a post at Slate.)
Private foundations really do wield the power Sparks mentioned — and do both good and bad with it. They’re often vehicles of privilege without accountability. They also often invest in communities, causes, and research that no one else is investing in. Many people are increasingly considering whether we can get the good without the bad — and, if not, whether the good is worth it.
You’ve almost certainly heard of private foundations. The Gates Foundation is one. There’s a Clinton Foundation and a Trump Foundation. Vox’s Future Perfect is funded by The Rockefeller Foundation (which means it pays my salary).
And they’re not all billionaires. In 2014, there were more than 86,000 private foundations in the United States. Two-thirds have endowments of less than a million dollars, and the median is $500,000.
Is it really that easy to found a nonprofit and then live off it, as Sparks suggests? There are some restrictions, but they leave a lot of room for a comfortable upper-class life. There are laws against “self-dealing” that prohibit you from using your foundation to make loans or give gifts to family members. Those laws also encompass paying an above-market salary or offering a salary to someone who isn’t doing any work.
There’s a lot of flexibility in the definition of “market” salaries, though, and as Sparks observed, they can reach around a million dollars a year. You are not breaking the law if your salaries are reasonable, which market-rate salaries are typically presumed to be. That means salaries most people would find eye-popping are well within the bounds of the law.
Now to salaries. Per 990 filings, it is very reasonable to pay the CEO of a $1.6B foundation as much as $1 million. You can live well on a million bucks for life, plus the social prestige of running a large and generous charity. 8/
— Evan Sparks (@EvanSparks) October 21, 2018
It’s worth noting that the $1 million you pay yourself is taxed as normal, so this isn’t a loophole you can use to donate your money to yourself or get out more money than you put in. But it’s a way to secure a great gig for life.
Here’s the thing about private foundations that Sparks got at in his Twitter thread: They wield a lot of power in the nonprofit scene and they aren’t accountable for the results of their grants as long as they’re not fraudulent. That means you don’t have to be good at charity — and can even be doing harm.
Sparks highlighted the way this can entrench the privileged, calling it “basically as close as we come to Downton Abbey and the landed aristocracy in this country.” Since foundations are required to spend only 5 percent of their endowment per year — and they typically surpass that in their investment returns — they can endure for perpetuity.
At every step of the way, they’re a source of power, connections, and insulation from risk for the families that run them. And the benefits, Sparks says, are multigenerational: “Colleges will court your kids, hoping for access to grants. Nonprofits and companies will hire them. They will have prime connections. (Remember the idea that Warren Buffett didn’t spoil his kids? Except he gave each of them a billion-dollar foundation!)”
It’s problems like these that inspired Stanford philosopher Robert Reich to call foundations “an institutional oddity in a democracy” and “virtually by definition, the voice of plutocracy.”
There are other concerns, too. Sparks told me that the history of private foundations is littered with bad calls: “Private foundations can err in big ways, as some of the largest did in the early 20th century when they supported eugenic sterilization campaigns.” Inspired by the dawn of research into genetics, wealthy, influential, and progressive Americans often threw their weight behind mass sterilizations of disabled people.
Fast forward to the present day, and we see some private foundations that are using their resources to push through priorities that have attracted public criticism. The Koch Family Foundations are among those that have drawn the most attention, especially for their work discrediting climate change and stalling public transit projects.
When the leaders of a foundation are also investors or CEOs of prominent public companies, it can become unclear what is philanthropic work and what is political lobbying on behalf of a business interest. Sometimes, they’re just a vehicle for outright fraud, as New York’s attorney general has alleged of the Trump Foundation.
However, Sparks notes that the exact things that can enable foundations to throw money at causes others might consider wasteful — accountability only to the trustees, and insulation from market and popular pressures — also enable them to do critical work that no one else can do.
“Philanthropists have worked through private foundations to fund civil rights campaigns, education for marginalized kids, vaccinations for deadly diseases, and the renewal of public parks,” Sparks points out. “All of these involved investments at scale with a tolerance for short-term setbacks in pursuit of long-term success.”
The frauds and unpopular political lobbying may make headlines, but many private foundations do a lot of good. My colleague Dylan Matthews looked into the Clinton Foundation after calls to shut it down, and found it was surprisingly effective, notably negotiating lifesaving drops in the price of drugs. And while the Gates Foundation has rightly attracted lots of criticism for not valuing program effectiveness highly enough, they’ve saved millions of lives.
In fact, there might be some ways of doing good that will only happen through private foundations. If a charitable cause is obscure, small, or speculative enough, it’s unlikely to be eligible for government grants. Research into gene drives to eradicate malaria, for example — speculative when it first started and now tantalizingly close to fruition — was jointly funded by the Gates Foundation and Good Ventures, the private foundation of Facebook billionaire Dustin Moskovitz and his wife Cari Tuna. (The government does fund other malaria research and prevention efforts.)
Reich calls this the discovery case for foundations: “foundations can operate on a longer time horizon than can businesses in the marketplace and elected officials in public institutions, taking risks in social policy experimentation and innovation that we should not routinely expect to see in the commercial or state sector.”
Many of the foundation-funded organizations out there doing important work are organizations that pressure the government to live up to its obligations — like the Innocence Project, which tries to overturn wrongful convictions, and the ACLU. Even the much-criticized Kochs have thrown their weight behind criminal justice reforms and the fight against civil asset forfeiture, a way local police departments prey on poor people.
Organizations with a mission of holding the government accountable can’t rely on government funding, so they rely on a vibrant charitable sector. This is related to what Reich calls this the pluralism case for private philanthropy: “foundations can help to diminish government orthodoxy by decentralizing the definition and distribution of public goods.”
And there’s another consideration when we evaluate the power of private foundations. If we’ve built a culture around philanthropy that makes giving an appealing option in the event of a sudden lottery windfall, that seems like a really good thing. We need to confront our society’s immense inequality — but there are better ways to start than by striking at the incentives for the wealthy to give their money away.
Private foundations are an integral part of how important research, pilot programs, experimentation, and lifesaving work happens. “A private foundation has the freedom to take big risks,” Sparks told me, “which will, from time to time, pay off for our whole society with huge rewards.”
And that means we need a thriving private charitable sector, even if we also need to reform its incentives, police its abuses, and ensure it doesn’t become simply a vehicle for privilege and power.
Sign up for the Future Perfect newsletter. Twice a week, you’ll get a roundup of ideas and solutions for tackling our biggest challenges: improving public health, decreasing human and animal suffering, easing catastrophic risks, and — to put it simply — getting better at doing good.
Original Source -> What should you do if you win the lottery? Start a foundation. via The Conservative Brief
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serinakemp · 6 years
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Napa Therapeutics Formed to Develop Drugs to Influence NAD Metabolism
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The involvement of In Silico Medicine in the formation of Napa Therapeutics to run drug discovery based on advances in understanding of mitochondrial metabolism in aging is an example of the premium placed on any approach that might plausibly reduce the cost and time involved in finding drug candidates. We will no doubt see a lot more of this sort of thing as computational methodologies become a plausible replacement for greater portions of the existing costly, hands-on, mechanical screening processes.
Draw a triangle in the present field of aging research with the three points set at calorie restriction mimetics, exercise mimetics, and general tinkering with energy metabolism, then efforts to increase NAD+ levels in mitochondria might be found somewhere in the midst of that space. That line of work is growing in popularity, and the early human trials of compounds like nicotinamide riboside suggest that the effect size might be worth chasing if the costs are low. (Though of course the development costs are never low for any approach that must pass through the full regulatory process).
Helping mitochondria to function more effectively in old tissues may help modestly with a variety of issues, given that faltering energy generation is a feature of aging, though it remains to be seen as to just how large the effect sizes are at the end of the day. This is not rejuvenation; this is pushing a damaged engine a little harder, this is overriding an aspect of the aged state of metabolism without addressing the underlying damage that causes that aged state. Sometimes that can work to some degree, sometimes it doesn't.
The Buck Institute for Research on Aging, Insilico Medicine, and Juvenescence Ltd announced today that they have formed Napa Therapeutics, Ltd to develop drugs against a novel aging-related target. The Buck Institute is one of the leading research centers in the world focused solely on research on aging and the elimination of age-related disease. Insilico Medicine is an AI company focused on a range of verticals devoted to aging. Juvenescence is a company focused on developing drugs to modify aging and the diseases of aging.
Napa Therapeutics is based on groundbreaking research in NAD metabolism conducted in the lab of Eric Verdin, MD, President and CEO of the Buck Institute. The Verdin lab will collaborate with Napa, using Insilico's drug development engine to speed the discovery of new compounds. "I am most...
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Earning Online Education Attractive
All around the Earth, that the numbers of men and women in college at different degrees takes pyramidal form. There are enormous numbers in the basic, but as they advance, the numbers fall, leaving only a couple in higher education. In the United States, some 65 million pupils were expected to register from K to K12 at the autumn of 2015. At precisely the exact same period, it had been anticipated that 20.2 million will be attending Colleges and Universities. It's estimated that 25 percent of new high school pupils in the U.S.A aren't able to graduate. For new students who enter schools or colleges 1 out of 3 will probably not make it into next year. This dropout out speed interrupts national growth, because a lot of do not get the complete instruction they will need to be operational in society. National development could be hugely jeopardized, if more adults get instruction, so that they become operational in society.
I am not stating that all adults that weren't fully educated aren't playing significant roles in society. There are rather prominent people in society that dropped out of college at a certain degree. Bill Gate, Mark Zuckerberg, Oprah Winfrey, by Way of Example, at some stage dropped from college. Though this list isn't exhaustive, the variety of folks who fell out of college or chose not to get increased education and became effective are still comparatively few. For many who fell out or stopped education, and couldn't become effective in their professions, it was because they lacked the knowledge they had to develop their own potential. If you check the background of people who despite falling out or quitting education are very effective, you'd find that seemed to have discovered their life's goal and pursued those goals and, even furthermore, they obtained some type of education afterwards.
Instruction as all of us know is a lifelong action. At any given time, if you fell out of college or obtained honors in your graduation, you'd require instruction. The college dropout who has found himself a vocation or obtained employment demands schooling so he can be productive, the dropout who's attained the requirement to college but has'grown past school going age' and needs to college clearly needs schooling, supervisors in addition to employees need additional education so as to maintain pace with the current fast changing world and profit improved wages and standing respectively. The conventional schooling dependent society we've made for ourselves and believes the'best', limits our pursuit for ongoing education. For a lot of folks, formal schooling ended the day that they dropped out or graduated from High School, College or University, although, engineering makes it feasible for us to sit in our homes and get superior instruction.
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As technology - computers and internet connectivity - replaced bodily classrooms and made it feasible to study by distance in real time, it seemed the problem of constant education for everybody, for example, dropout and the working class have already been solved. It seemed, and still does, that the instructor need not depart his pupils, use for study-leave or leave of absence to pursue additional education. It seemed that the fifty-year-old girl who fell out of college many decades ago could now college from house and it seemed the father could find out exactly what his daughter is studying at College with the exact same apparatus he uses to telephone her. That's what it seemed. Individuals who dropped out of college because of problems of finance and haven't since had a breakthrough wouldn't benefit, and people having the cash wouldn't wish to place their money into a certification companies and academicians alike could frown upon. So small seem to have changed for both of these groups of individuals, though online Colleges and Universities abound.
Two prime problems would be to blame. To begin with, online instruction is too expensive for its target group of students and secondly, there's the understanding that online Colleges and Universities don't offer holistic instruction like the conventional Colleges and Universities. According to Ed Vosganian - founder and CEO of College Funding 123, the price of on-campus University for undergraduate is estimated at 42,000 bucks while for the exact same group it cost approximately 21,000 bucks for online universities. By comparison we'd state it cost much less to research via online. However, we need not eliminate sight of people who largely register in online University. It's people from the lower and middle classes who elect for online universities. They comprise; the worker who has forfeited pleasure for greater qualification in exchange for greater salary, the jobless who would like to acquire employable skills, the dropout who wishes to return to college in the expectation that there'll be a brighter future, and the folks residing in the distant region of the planet, particularly in the developing world, who do not have the money to pay prices and so would need to learn and operate concurrently. To those 21,000 dollars is cash so enormous, it's quite hard to raise. You will find individuals of this higher income category who enrol in online universities, but online learning isn't popular among these because of reduced prestige as well as the myths related to online education. The internet institutions will inform youthey wouldn't place anything in your certification to prove that you obtained a unconventional instruction. This type of advertisement talks of how society worth online instruction. Online education is thought to be a inexpensive method of becoming'watered down' instruction. Online Colleges and Universities were recently considered degree mills. This perception exists, though empirical evidence tells us there is not any disparity in quality of pupils from conventional Colleges and Universities on a single hand and internet Colleges and Universities around another hand. The internet Universities and Colleges do their very best to create online learning esteemed and bring down research price, but they can't do it independently. With government intervention online learning may get prestigious and lower and middle course friendly.
Government should offer a national platform for internet education, subsidize certification, and grant scholarships and student loans for students in online Colleges and Universities. A national framework to direct the operations of online schools and universities ought to be instituted from the state, through the Department of Education or the appropriate government agency. This frame, which might be descriptive rather than prescriptive in character would explain, by way of instance, the minimal classes to be taken at a specified degree, and the general style of performance of online universities and schools without prescribing specific classes or manner of operation. Accreditation isn't only laborious for internet Colleges and Universities; it's also pricey. This price is passed to pupils, souring up app fees. In case the government makes the decision to absorb half of the price of certification, even though there's not any guarantee that the program fees will be payable, the application fee could be reduced somehow. Finally, the majority of the pupils who opt for online schools and universities don't get scholarships and student loans in the country. People who get something don't find massive scholarships and student loans such as their counterparts in conventional Colleges and Universities. Authorities must make scholarships and pupils loans available to pupils of online Colleges and Universities as it will for pupils in conventional Colleges and Universities.
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The consequences of the interventions could definitely be awesome. Providing a national platform for internet instruction would eliminate the false negative impression people have about online instruction. Many believe online learning is simple as well as the amount of credits required are far less compared to those taken in conventional learning preferences. This believing is different since there are a few badly designed online courses where certification are given after only a few missions are submitted. Such practices could be stopped, when a federal framework is designed and operationalized. A national framework provides authenticity to online learning, as a federal benchmark for online would need to be stuck to and consequently no online college or college could simply sell certification. Subsidizing Accreditation will yield three outcomes. The most apparent is thatit might decrease program fees because sum to maneuver into the pupils would be . Subsidizing certification fees would urge online Colleges and Universities to seek certification from accrediting bodies comprehend by the Department of Education or the proper state agency. Though certification isn't mandatory in certain areas of the Earth, such as the usa, some job that need state licensing wouldn't accept diploma from non-accredited Colleges and University. Prospective online learners are, typically, worried about if the can certainly work with their certifications. Government intervention could get rid of this stress and take out the negative perception people have about online instruction too. Government interventions in the kind of loans and scholarship will ease the fiscal burden and also make it feasible for people who hitherto wouldn't have the ability to college to achieve that. In sum, government intervention could go a ways to make an educated society by allowing many people to get higher education.
There are several people wanting to secure higher education through internet Colleges and Universities in order that they get knowledge and skills, or increase their understanding and abilities but can't do due to the price or the doubt of the acceptability of their certification. Government intervention in the kind of national frame for online universities and schools, subsidizing certification cost and providing scholarships and student loans will open the doorway for people who wish to research from home. Government intervention may provide the confidence that online instruction is as great as traditional university or college learning, and that their certification would be approved occupations that require state certification. It would alleviate the pressure on centers in conventional Colleges and Universities, create the well-educated citizenry required for national growth and convert the present pyramidal shape to a'near' cylinder.
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kayawagner · 7 years
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Embrace AI, NVIDIA’s Ian Buck Tells US Congressional Committee
Artificial intelligence represents the biggest technological and economic shift in our lifetime, NVIDIA’s Ian Buck told a U.S. Congressional committee Wednesday.
In testimony before a hearing of the House of Representatives Subcommittee on Information Technology, Buck, vice president and general manager of our Tesla business, said the federal government should increase research funding and adopt AI to boost the nation’s economy and improve government services.
“While other governments are aggressively raising their research funding, U.S. government research has been relatively flat,” Buck said. “We should boost research funding through agencies like the NSF, NIH and DARPA. We also need faster supercomputers, which are essential for AI research.”
Lawmakers Interested In AI
The hearing is the latest example of how artificial intelligence capabilities once thought of as science fiction are being put to work to solve a growing number of real world problems. It’s also a sign that the conversation around artificial intelligence is maturing, with lawmakers looking for ways to support and accelerate AI in a socially responsible and constructive way.
In addition to William Hurd (R-TX), chairman of the information technology committee, other representatives who asked questions included Robin Kelly (D-IL), Stephen Lynch (D-MA), and Gerald Connolly (D-VA).
The committee members expressed concerns about potential bias in AI systems, diversity in the AI workforce, defending citizens and government servers from cyber attack, and understanding how AI systems arrive at conclusions. They also asked what data the government should make available to researchers, and how federal agencies could more quickly adopt AI.
Buck said that while the public perception of AI is that it’s “rocket science,” federal agencies can begin with focused pilot projects like the Air Force’s Project Maven.
“Using AI for aerial reconnaissance holds great promise to alleviate airmen from having to stare at screens for 8 hours a day looking for a problem,” Buck said. “Image recognition is a well established technique, and can be leveraged quickly.”
Broad Support for AI
Dr Ian Buck (right),  who leads NVIDIA’s Tesla business, appeared alongside (left to right) Intel’s Dr. Amir Khosrowhahi, Georgia Tech’s Dr. Charles Isbell, and Dr. Oren Etzioni, CEO of the Allen Institute for Artificial Intelligence.
Buck appeared in a panel focused on the current state of AI and barriers to government adoption. Other panel members included Dr. Oren Etzioni, chief executive officer of the Allen Institute for Artificial Intelligence, Dr. Charles Isbell, executive associate dean and professor at the Georgia Institute of Technology, and Dr. Amir Khosrowshahi, vice president and CTO of Intel’s AI Group.
The panelists encouraged the government to invest more in AI research and promote science, technology, engineering and math (STEM) in middle and high schools.
Georgia Tech’s Isbell said the scarcity of computer science teachers was a limiting factor. “We need more teachers to develop the next-generation workforce,” he said.
The Allen Institute’s Etzioni said schools teach PowerPoint because teachers don’t know how to program. That’s a missed opportunity because 8 to 10 year olds are at the perfect age to learn computer programming.
Buck said every major federal agency — just like every major technology company — needs to invest in AI. He also recommended that the government open up more data to the research community.
Buck identified several major areas where AI could benefit the government, including cyber defense, healthcare and reducing waste and fraud.
When asked which government data should be made available first, Buck suggested healthcare data offered the greatest opportunity.
“The problem we face is too important and the opportunity is too great to not open access to healthcare data,” he said. “It has the greatest potential to actually save lives.”
The post Embrace AI, NVIDIA’s Ian Buck Tells US Congressional Committee appeared first on The Official NVIDIA Blog.
Embrace AI, NVIDIA’s Ian Buck Tells US Congressional Committee published first on https://supergalaxyrom.tumblr.com
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blockheadbrands · 7 years
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Israel: Land of Milk, Honey And Medical Cannabis
Brian Blum of Israel 21c Reports:
In August, a joint feasibility committee of the Health and Finance ministries submitted a recommendation that Israel open its booming medical marijuana business to international exports. The market could be worth as much as $4 billion a year in revenue.
In the expectation that the proposal will be approved by legislators, an Israel company – Breath of Life Pharma (BOL) – is positioning itself to become the world’s largest medical cannabis facility.
BOL’s new production, research and development campus in central Israel has a 35,000-square-foot plant, an 8,000-square-foot storage room, 30,000 square feet of grow rooms and labs, and a million square feet of cultivation fields.
BOL CEO Dr. Tamir Gedo says his firm can store enough medical marijuana to supply the entire United States. Gedo estimates that BOL will produce 80 tons of medical cannabis per year.
“Just don’t call it ‘marijuana,’” Gedo told a group of visiting journalists under high security (marijuana is, after all, a controlled substance in much of the world, including Israel).
The word “marijuana” was used by US drug enforcement agents in the 1930s to make it sound foreign and dangerous. Gedo, like most in his industry, prefers to use the plant’s real name, cannabis. He refers to BOL’s business as the growing, packaging and distribution of “medical-grade cannabis” (MGC for short).
BOL has no interest in pushing the legalization of recreational cannabis, Gedo says. Rather, BOL works toward bringing pharmaceutical-grade quality and delivery systems to purified extracts of the plant.
Because the chemical composition of cannabis flowers from different branches is not at all consistent, companies in the medical cannabis space don’t use the whole plant but instead isolate specific molecules and turn those into controlled, consistent drugs.
That can be quite a challenge: Cannabis has 142 different cannabinoids – active components – and each targets different illnesses.
The two best known cannabinoids are THC and CBD. The former is the psychoactive component responsible for marijuana’s “high.” It also helps with pain and nausea, which has made it a much sought-after medication for patients undergoing chemotherapy.
CBD, on the other hand, works on the autoimmune system and acts as an anti-inflammatory. It is being tested on inflammatory bowel diseases (including Crohn’s and ulcerative colitis) and has shown to be effective with conditions as diverse as autism, epilepsy, diabetes and heart disease. Moreover, you can’t get high from CBD.
In order to get FDA approval, a company like BOL, which was founded in 2007, must conduct the same kind of double-blind clinical trials any drug would go through. Some 120 trials are currently under way in Israel – more than in any other country.
Gedo says that if even 10 percent of trials underway at his facility result in a patentable drug, BOL could be the Pfizer of MGC. BOL’s autism trial, under the supervision of Dr. Adi Aran, director of the neuropediatric unit of Shaare Zedek Medical Center in Jerusalem, will go to the FDA in 2018. If it’s approved, a commercial drug could be available as early as 2021.
Medical cannabis drugs are delivered via pills you swallow, delayed-release gel capsules, sublingual tablets, drops, ointments, transdermal patches and metered inhalers. You don’t smoke MGC because that destroys the CBD and other components aside from THC.
 Cannabis-friendly
BOL is building on Israel’s reputation as one of the most cannabis-friendly countries in the world. Israel, which has the world’s highest ratio of cannabis users – 27 percent of the population aged 18-65 used marijuana in the last year – recently reduced penalties for recreational cannabis use to a fine.
Prof. Raphael Mechoulam from the Weizmann Institute of Science was the first to successfully isolate THC. That was in 1964. Mechoulam, now 86, is still active in cannabis research at the Hebrew University in Jerusalem, and is on the board of directors of BOL.
Testing medical cannabis on human patients has been part of the research landscape in Israel for years, but it’s nearly impossible to do in the United States. Only one facility, the University of Mississippi, is a licensed source for medical cannabis, and production is limited to just 650 kilograms per year.
“We can produce that amount in half a day,” Gedo says.
“Israel is a hotbed of quality cannabis research, because it has a much more favorable regulatory climate for doing serious scientific research on medical cannabis,” says Charles Pollack, director of the Lambert Center for the Study of Medicinal Cannabis at Thomas Jefferson University in Philadelphia.
As a result, companies are increasingly turning to Israel to conduct their phase 1 and 2 clinical trials. If you can point to previous studies done overseas, the FDA is more likely to approve a phase 3 trial in US. Of the 15 companies signed up so far to conduct their R&D at BOL’s facility in Israel, at least six are American.
And while importing cannabis into the United States remains illegal (even though 29 US states have legalized medical cannabis), if a product has FDA approval companies can circumvent that ban.
Israel is also blessed with a climate conducive to growing cannabis, BOL’s Gedo said. “The many days of sunshine make it more suitable than many parts of the US and Europe.”
  Healthy competition
BOL isn’t the only company in Israel to jump on the medical cannabis bandwagon.
Tikun Olam  was Israel’s first medical cannabis distributor and opened an American subsidiary in 2016. One World Cannabis Pharmaceuticals is working on a topical cannabis cream to treat psoriasis. NASDAQ-listed Therapix Biosciences  is deploying THC to address Alzheimer’s and Tourette syndrome. And there are others.
The Israeli firm iCAN sponsors CannaTech,  a leading medical cannabis conference and trade show that started in Israel and is now on the road to London and Australia.
While Israel’s medical cannabis industry is targeting the international market, big changes are afoot domestically. Last summer, 81 doctors completed a medical cannabis course from the Ministry of Health. And the number of licensed cultivators has increased from eight to 60, including several kibbutzim.
The aim is to open up the Israeli market from just a few dispensaries serving the entire country to allowing doctors to prescribe MGC preparations that can be picked up at a local pharmacy.
“There are 30,000 patients in Israel getting medical cannabis,” ICAN’s Saul Kaye told ISRAEL21c. “Most people know someone who’s getting it. The stigma is being removed.”
Israel has gone so far as to publish a “Cannacopeia,” a guide to the use of MGC. “We call it the ‘Green Book,’” quipped Yuval Landschaft, director of the Medical Cannabis Unit in the Israeli Ministry of Health. Some 21 countries have requested a copy.
In 2016, more than $250 million was invested in Israeli cannabis companies and about 50 American companies have established R&D operations in Israel or partnerships with Israeli companies like BOL.
The medical cannabis industry in Israel may not eclipse high-tech, but the two share the common root of Israeli chutzpah and the belief that bucking the rules often yields the biggest payout.
When Mechoulam first wanted to study cannabis, there was none to be had. So his boss at the Weizmann Institute called a buddy at the local police station and scored a confiscated stash of 11 pounds of Lebanese hashish (also from cannabis) that the cops were planning to burn. Mechoulam hopped on a bus to pick it up.
This creative approach jump-started an entire industry. Now the only question is: how high can Israel leap? Four billion dollars in potential exports (and taxable revenue) certainly raises the bar.
TO READ MORE OF THIS ARTICLE ON ISRAEL 21c, CLICK HERE.
https://www.israel21c.org/israel-land-of-milk-honey-and-medical-cannabis/
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shapesnnsizes · 7 years
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New Hope that Alzheimer’s Can Be Prevented—and Even Cured
Dr. Bredesen is an internationally recognized expert on neurodegenerative disease. He held faculty positions at UCSF and UCLA and directed the Program on Aging at the Burnham Institute. He joined the Buck Institute in 1998 as its founding president and CEO. Two of his recently published papers include “Reversal of cognitive decline in Alzheimer’s disease” and “Inhalational Alzheimer’s disease: An unrecognized—and treatable—epidemic.” I interviewed Dr. Bredesen for a podcast a year ago, and I’m excited to bring you more information about his program and his new book. If you have a loved one with Alzheimer’s—or who is just starting to get forgetful—The End of Alzheimer's is a fantastic resource.
1. What’s wrong with the conventional approach to Alzheimer’s disease?
The conventional approach to Alzheimer’s disease does not address the actual cause—the contributors to this complex chronic illness, which may be dozens and vary from person to person—and attempts to improve symptoms with a monotherapy, a single drug. This is something like trying to patch 36 holes in your roof by putting a patch over one hole and finding that water is still coming through the other 35 holes. In addition, the conventional approach is a one-size-fits-all approach, when a personalized, precision approach is needed, based on the different critical targets for each person. Finally, the conventional approach is often backward—the surprise is that the very amyloid that is associated with Alzheimer’s disease is a protective response to insults such as microbes and toxins. Therefore, any attempt to remove the amyloid should be preceded by the removal of the insult(s) that are inducing this protective response.
Have a loved one with Alzheimer’s? Be sure to check out this new resource. #alzheimers
2. What led you to a functional/evolutionary perspective on AD?
This came directly from the test tube, from years of basic laboratory research—we had no idea when we started that we would end up with a functional medicine approach. We were studying the molecular biology of APP, the amyloid precursor protein that gives rise to the amyloid-beta that collects in the brains of patients with Alzheimer’s disease. Surprisingly, we found that APP functions like a molecular switch—when it is cleaved at the alpha site, two peptides are produced (sAPPalpha and alphaCTF) that support neurite outgrowth, neuronal survival, and synaptic maintenance—essentially, these support memory. Conversely, when APP is cleaved at the beta, gamma, and caspase sites, it yields four peptides (sAPPbeta, amyloid-beta, Jcasp, and C31) that mediate neurite retraction, synaptic reorganization, and ultimately, neuronal death—essentially, these support forgetting. In other words, the two supportive peptides are “synaptoblastic,” whereas the four retractive peptides are “synaptoclastic.” We then wanted to know what determines this critical balance—a plasticity balance—and it turned out that dozens of parameters affect this balance, many quite directly. For example, vitamin D, estradiol, testosterone, NF-kappa B (as part of the inflammatory response), BDNF (brain-derived neurotrophic factor, which increases with exercise), sleep (which helps to clear the amyloid-beta, among many other effects), and dozens of others, all affect this critical balance. Therefore, we realized that we needed to measure all of these parameters for each person in order to determine what is contributing to cognitive decline or risk for cognitive decline.  Then we need to address each contributor—to reduce the synaptoclastic signaling and increase the synaptoblastic signaling. This is a functional medicine approach, so we realized that the basic research had shown us that, for a complex chronic illness such as Alzheimer’s disease, a functional medicine approach makes mechanistic sense. This has been supported now by hundreds of patients who have shown positive responses to this approach to cognitive decline.
3. Can AD be prevented and even reversed?
Yes, contrary to the current dogma, Alzheimer’s disease can be prevented, and the cognitive decline associated with AD can be reversed, although in the late stages of the illness this becomes progressively more difficult and less common. However, there is a large window of opportunity—about a decade of SCI (subjective cognitive impairment), when people note cognitive changes yet still score normally on cognitive tests; then often several years of MCI (mild cognitive impairment), when cognitive testing shows abnormalities, yet people are still capable of doing ADLs (activities of daily living); then early in the course of full-blown Alzheimer’s disease.  Therefore, it is important to seek evaluation and treatment as early as possible.
4. You’ve proposed five different types of AD. What are they, and how are they distinct?
Type 1 is inflammatory (“hot”), and the inflammation may be due to pathogens or other inflammatory factors such as trans fats. Type 2 is atrophic (“cold”) and is associated with reductions in trophic support such as nerve growth factor, brain-derived neurotrophic factor, estradiol, vitamin D, and other trophic, hormonal, or nutritional support. Then there is a common combination of type 1 and type 2—type 1.5, or glycotoxic (“sweet”)—that combines the inflammation of high glucose (e.g., via AGEs, advanced glycation endproducts) with the trophic loss of insulin resistance. Type 3 is toxic (“vile”) and is associated with exposure to toxins such as mycotoxins (e.g., trichothecenes or ochratoxin A) or chemotoxins (e.g., mercury). Type 4 is vascular (“pale”) and is associated with reduced vascular support. Type 5 is traumatic (“dazed”) and is associated with previous head trauma.  The typical symptoms and signs of these types are described, and clinical cases are described, in the book. Not surprisingly, many people have combinations of these types, so we have developed a computer-based algorithm that calculates the percent contribution from each type. This then helps to develop the optimal therapeutic program for each person, and again we use an algorithm to generate an initial program.
5. Where have you seen the biggest impacts in terms of diet, lifestyle, and functional medicine treatment with AD?
The key is that the whole program works together, so there is a threshold effect, just as is seen with cardiovascular disease treatment. There seem to be major effects of reversing insulin resistance, optimizing sleep, exercising regularly, eliminating toxic exposures (especially for Type 3 AD), optimizing hormonal support (including bioidentical hormone replacement), optimizing nutrition (e.g., avoiding high homocysteine, low vitamin D, low vitamin B12, low magnesium, etc.), addressing pathogens (e.g., Borrelia), reducing inflammation (but most importantly, removing the cause(s) of the inflammation), optimizing brain training, and reducing stress.
6. What role does genetic testing play in the functional approach to AD?
Genetic testing plays an important role, and although there are hundreds of SNPs (single nucleotide polymorphisms) that are associated with AD, the most important genetic test for AD risk is ApoE: for those with zero copies of ApoE4 (e.g., those who are ApoE3/3), the lifetime risk of developing AD is about 9 percent; for the 75 million Americans with one copy (e.g., ApoE3/4), the lifetime risk is about 30 percent; and for the seven million Americans with two copies (ApoE4/4), the lifetime risk is well over 50 percent. This has led to a conventional approach of avoiding the determination of ApoE genotype, with the claim that there is “nothing” one can do about it. This is no longer the case, and therefore the goal is for everyone to know their ApoE status, to get on an active prevention program, and to make Alzheimer’s disease a rare disease. In addition, for those with a strong family history of AD, especially for early onset AD (before 65 years of age), it is important to determine whether there are familial Alzheimer’s disease-associated mutations in APP, presenilin-1, or presenilin-2.
7. What are the most important steps people can take to reduce their risk of AD?
The most important thing to do is to get a “cognoscopy”—in other words, just as everyone knows that he or she should have a colonoscopy when turning 50, it is a good idea for everyone over 45 to have an analysis of biochemistry (what is your homocysteine, fasting insulin, hs-CRP, etc.?), genetics (ApoE4 positive?), and function (how are you scoring on a quick, simple test that can be done online). These tests will tell you where you stand, and from there, you can address the very items that are placing you at risk, such as inflammation, insulin resistance, poor nutrition, suboptimal hormone levels, toxin exposure, etc.
8. Where can people find practitioners that have been trained in your approach?
We have now trained more than 450 practitioners from seven different countries and all over the United States, and there will be more than 1,000 by the end of this year. We are training practitioners in our protocol (ReCODE, which is for reversal of cognitive decline) in collaboration with the Institute for Functional Medicine. You can find these practitioners at the website mpicognition.com.
9. What are you most excited about in terms of future developments? What challenges are we facing?
It is important to emphasize that we are just at the very beginning of all of this—literally the dawn of treatable and preventable Alzheimer’s disease. This is the same thing that is occurring with the use of functional medicine for other complex chronic illnesses—unprecedented improvements are being seen in type 2 diabetes, hypertension, cardiovascular disease, multiple sclerosis, lupus, rheumatoid arthritis, and other illnesses. There is a tremendous amount of development remaining to do—how do we optimize outcomes? For those who improve but then plateau at less than their normal cognition, how do we enhance improvement? How do we achieve better results for those who are late in the course of Alzheimer’s disease? Can we achieve similar results for the one million Americans with Lewy body dementia? How do we address other neurodegenerative diseases, such as ALS (Lou Gehrig’s disease) and Parkinson’s disease, optimally? There are exciting developments that should help to address these questions: the analysis of neural exosomes by Prof. Ed Goetzl and his colleagues has offered the ability to evaluate brain chemistry with a blood sample. Prof. Milan Fiala has described the “phagocytosis index,” which also shows evidence of Alzheimer’s disease pathophysiology in a blood sample and offers real-time follow-up of metabolic improvement that associates with cognitive improvement. More sensitive tests for chronic pathogens, for biotoxins and chemotoxins, for barrier breaches (gut, blood-brain, etc.), and for optimal microbiomes (especially gut, oral, and rhinosinal) should all play important roles in the evolution of functional medicine approaches to neurodegeneration, as well as improved, precision medicine programs that include optimization of immune responses, stem cells, and neurotrophin delivery—not a silver bullet, but silver buckshot.
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denisalvney · 7 years
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New Hope that Alzheimer’s Can Be Prevented—and Even Cured
Dr. Bredesen is an internationally recognized expert on neurodegenerative disease. He held faculty positions at UCSF and UCLA and directed the Program on Aging at the Burnham Institute. He joined the Buck Institute in 1998 as its founding president and CEO. Two of his recently published papers include “Reversal of cognitive decline in Alzheimer’s disease” and “Inhalational Alzheimer’s disease: An unrecognized—and treatable—epidemic.” I interviewed Dr. Bredesen for a podcast a year ago, and I’m excited to bring you more information about his program and his new book. If you have a loved one with Alzheimer’s—or who is just starting to get forgetful—The End of Alzheimer's is a fantastic resource.
1. What’s wrong with the conventional approach to Alzheimer’s disease?
The conventional approach to Alzheimer’s disease does not address the actual cause—the contributors to this complex chronic illness, which may be dozens and vary from person to person—and attempts to improve symptoms with a monotherapy, a single drug. This is something like trying to patch 36 holes in your roof by putting a patch over one hole and finding that water is still coming through the other 35 holes. In addition, the conventional approach is a one-size-fits-all approach, when a personalized, precision approach is needed, based on the different critical targets for each person. Finally, the conventional approach is often backward—the surprise is that the very amyloid that is associated with Alzheimer’s disease is a protective response to insults such as microbes and toxins. Therefore, any attempt to remove the amyloid should be preceded by the removal of the insult(s) that are inducing this protective response.
Have a loved one with Alzheimer’s? Be sure to check out this new resource. #alzheimers
2. What led you to a functional/evolutionary perspective on AD?
This came directly from the test tube, from years of basic laboratory research—we had no idea when we started that we would end up with a functional medicine approach. We were studying the molecular biology of APP, the amyloid precursor protein that gives rise to the amyloid-beta that collects in the brains of patients with Alzheimer’s disease. Surprisingly, we found that APP functions like a molecular switch—when it is cleaved at the alpha site, two peptides are produced (sAPPalpha and alphaCTF) that support neurite outgrowth, neuronal survival, and synaptic maintenance—essentially, these support memory. Conversely, when APP is cleaved at the beta, gamma, and caspase sites, it yields four peptides (sAPPbeta, amyloid-beta, Jcasp, and C31) that mediate neurite retraction, synaptic reorganization, and ultimately, neuronal death—essentially, these support forgetting. In other words, the two supportive peptides are “synaptoblastic,” whereas the four retractive peptides are “synaptoclastic.” We then wanted to know what determines this critical balance—a plasticity balance—and it turned out that dozens of parameters affect this balance, many quite directly. For example, vitamin D, estradiol, testosterone, NF-kappa B (as part of the inflammatory response), BDNF (brain-derived neurotrophic factor, which increases with exercise), sleep (which helps to clear the amyloid-beta, among many other effects), and dozens of others, all affect this critical balance. Therefore, we realized that we needed to measure all of these parameters for each person in order to determine what is contributing to cognitive decline or risk for cognitive decline.  Then we need to address each contributor—to reduce the synaptoclastic signaling and increase the synaptoblastic signaling. This is a functional medicine approach, so we realized that the basic research had shown us that, for a complex chronic illness such as Alzheimer’s disease, a functional medicine approach makes mechanistic sense. This has been supported now by hundreds of patients who have shown positive responses to this approach to cognitive decline.
3. Can AD be prevented and even reversed?
Yes, contrary to the current dogma, Alzheimer’s disease can be prevented, and the cognitive decline associated with AD can be reversed, although in the late stages of the illness this becomes progressively more difficult and less common. However, there is a large window of opportunity—about a decade of SCI (subjective cognitive impairment), when people note cognitive changes yet still score normally on cognitive tests; then often several years of MCI (mild cognitive impairment), when cognitive testing shows abnormalities, yet people are still capable of doing ADLs (activities of daily living); then early in the course of full-blown Alzheimer’s disease.  Therefore, it is important to seek evaluation and treatment as early as possible.
4. You’ve proposed five different types of AD. What are they, and how are they distinct?
Type 1 is inflammatory (“hot”), and the inflammation may be due to pathogens or other inflammatory factors such as trans fats. Type 2 is atrophic (“cold”) and is associated with reductions in trophic support such as nerve growth factor, brain-derived neurotrophic factor, estradiol, vitamin D, and other trophic, hormonal, or nutritional support. Then there is a common combination of type 1 and type 2—type 1.5, or glycotoxic (“sweet”)—that combines the inflammation of high glucose (e.g., via AGEs, advanced glycation endproducts) with the trophic loss of insulin resistance. Type 3 is toxic (“vile”) and is associated with exposure to toxins such as mycotoxins (e.g., trichothecenes or ochratoxin A) or chemotoxins (e.g., mercury). Type 4 is vascular (“pale”) and is associated with reduced vascular support. Type 5 is traumatic (“dazed”) and is associated with previous head trauma.  The typical symptoms and signs of these types are described, and clinical cases are described, in the book. Not surprisingly, many people have combinations of these types, so we have developed a computer-based algorithm that calculates the percent contribution from each type. This then helps to develop the optimal therapeutic program for each person, and again we use an algorithm to generate an initial program.
5. Where have you seen the biggest impacts in terms of diet, lifestyle, and functional medicine treatment with AD?
The key is that the whole program works together, so there is a threshold effect, just as is seen with cardiovascular disease treatment. There seem to be major effects of reversing insulin resistance, optimizing sleep, exercising regularly, eliminating toxic exposures (especially for Type 3 AD), optimizing hormonal support (including bioidentical hormone replacement), optimizing nutrition (e.g., avoiding high homocysteine, low vitamin D, low vitamin B12, low magnesium, etc.), addressing pathogens (e.g., Borrelia), reducing inflammation (but most importantly, removing the cause(s) of the inflammation), optimizing brain training, and reducing stress.
6. What role does genetic testing play in the functional approach to AD?
Genetic testing plays an important role, and although there are hundreds of SNPs (single nucleotide polymorphisms) that are associated with AD, the most important genetic test for AD risk is ApoE: for those with zero copies of ApoE4 (e.g., those who are ApoE3/3), the lifetime risk of developing AD is about 9 percent; for the 75 million Americans with one copy (e.g., ApoE3/4), the lifetime risk is about 30 percent; and for the seven million Americans with two copies (ApoE4/4), the lifetime risk is well over 50 percent. This has led to a conventional approach of avoiding the determination of ApoE genotype, with the claim that there is “nothing” one can do about it. This is no longer the case, and therefore the goal is for everyone to know their ApoE status, to get on an active prevention program, and to make Alzheimer’s disease a rare disease. In addition, for those with a strong family history of AD, especially for early onset AD (before 65 years of age), it is important to determine whether there are familial Alzheimer’s disease-associated mutations in APP, presenilin-1, or presenilin-2.
7. What are the most important steps people can take to reduce their risk of AD?
The most important thing to do is to get a “cognoscopy”—in other words, just as everyone knows that he or she should have a colonoscopy when turning 50, it is a good idea for everyone over 45 to have an analysis of biochemistry (what is your homocysteine, fasting insulin, hs-CRP, etc.?), genetics (ApoE4 positive?), and function (how are you scoring on a quick, simple test that can be done online). These tests will tell you where you stand, and from there, you can address the very items that are placing you at risk, such as inflammation, insulin resistance, poor nutrition, suboptimal hormone levels, toxin exposure, etc.
8. Where can people find practitioners that have been trained in your approach?
We have now trained more than 450 practitioners from seven different countries and all over the United States, and there will be more than 1,000 by the end of this year. We are training practitioners in our protocol (ReCODE, which is for reversal of cognitive decline) in collaboration with the Institute for Functional Medicine. You can find these practitioners at the website mpicognition.com.
9. What are you most excited about in terms of future developments? What challenges are we facing?
It is important to emphasize that we are just at the very beginning of all of this—literally the dawn of treatable and preventable Alzheimer’s disease. This is the same thing that is occurring with the use of functional medicine for other complex chronic illnesses—unprecedented improvements are being seen in type 2 diabetes, hypertension, cardiovascular disease, multiple sclerosis, lupus, rheumatoid arthritis, and other illnesses. There is a tremendous amount of development remaining to do—how do we optimize outcomes? For those who improve but then plateau at less than their normal cognition, how do we enhance improvement? How do we achieve better results for those who are late in the course of Alzheimer’s disease? Can we achieve similar results for the one million Americans with Lewy body dementia? How do we address other neurodegenerative diseases, such as ALS (Lou Gehrig’s disease) and Parkinson’s disease, optimally? There are exciting developments that should help to address these questions: the analysis of neural exosomes by Prof. Ed Goetzl and his colleagues has offered the ability to evaluate brain chemistry with a blood sample. Prof. Milan Fiala has described the “phagocytosis index,” which also shows evidence of Alzheimer’s disease pathophysiology in a blood sample and offers real-time follow-up of metabolic improvement that associates with cognitive improvement. More sensitive tests for chronic pathogens, for biotoxins and chemotoxins, for barrier breaches (gut, blood-brain, etc.), and for optimal microbiomes (especially gut, oral, and rhinosinal) should all play important roles in the evolution of functional medicine approaches to neurodegeneration, as well as improved, precision medicine programs that include optimization of immune responses, stem cells, and neurotrophin delivery—not a silver bullet, but silver buckshot. New Hope that Alzheimer’s Can Be Prevented—and Even Cured published first on https://chriskresser.com
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