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Boleto Bancário is the most significant voucher payment method in Brazil. As Boleto's format remains unchanged since its creation 25 years ago, it was up to payment providers to find solutions for it to meet the modern society's needs.
Read now: Everything You Need to Know About Boleto
If in the beginning this payment method could only be paid physically, in cash, at lottery agencies, bank branches or ATMs, nowadays Brazilian customers can pay their Boletos through the internet, mobile banking apps or even using e-wallets.
During my workshop at the EBANX Summit 18′, I was able to bring some internal data that shows that, even though the looks of a Boleto have been exactly the same for all these 25 years when we look at ecommerce in Brazil, boleto usage numbers are still relevant.
NeoAtlas research revealed that 35.5% of all online purchases in 2017 were made using Boleto as the payment method; if we narrow that down to the preference of customers when shopping at cross-border ecommerce, the number goes up to 50%, EBANX internal data.
That means we have a really outdated payment method being chosen by Brazilians as a preferred method of payment on ecommerce to this day.
The need to have a deep understanding those customers that prefer Boleto over credit cards became apparent to us, so in 2017 we ran a survey with our customers who had paid with boleto.
Here's what we've got.
Who uses boleto?
One of the most relevant findings was that 71% of Boleto users actually have a checking account, meaning that they have access to a debit card (and probably to credit cards) so they could pay for their online purchases using such methods if they wanted, but they'd still prefer to pay with Boletos.
The actual unbanked population in Brazil that uses Boleto represents only 15% of our customers, a much lower number.
The same research also revealed that most of the people who choose to pay with Boleto here at EBANX are actually working-age, comprehending both people who saw the rise of the internet and are connected today, and those who weren't even born in a world without the web.
So, even though all signs point to a young connected population that trusts the internet enough to use their Credit Cards, their actions still point to a high distrust making them choose Boleto Bancário as a payment method.
Why do they choose Boleto Bancário?
To validate our assumption, we asked the surveyees why Boleto is their preferred method of payment and we got a few different reasons. Here is what they have answered:
1. Safety (38.8%): Brazilians usually don't trust the internet enough to put their credit card information on ecommerce websites. They prefer going with a payment method that might take longer and require more effort but that they know will keep their information safe.
2. Discounts (38.5%): Before ecommerce, store owners would give a 5 to 10% discount to customers if they were to pay with Boleto in order to stimulate them to switch from credit card installments, a very common habit in Brazil. The motivation behind this? Getting the purchase's full amount in a one-time payment as opposed to several smaller ones, and also having more security since Boleto is a risk-free method. Thus, for merchants, it made sense to take a small hit on profit in exchange for those perks. This practice is still seen today in physical stores and some Brazilian online shops are also using it, getting users familiarized to this practice.
3. Time (26.6%): After a Boleto is issued, the customer has a few days before the due date to actually pay for it. For merchants, this is a bad thing due to stock management for example, but Brazilian customers like this feature, according to our survey. Customers do a lot of impulse buying, meaning they don't necessarily need or want the product they are purchasing. For that reason, when they are impulse buying, boleto allows them to have more time to think their purchase through. It happens even more frequently when merchants charge in foreign currencies: consumers will issue a Boleto when they see a foreign price that looks good for them but will use the time until the due date to research alternatives on other websites.
4. Financial Planning (20.7%): And lastly, very tied to the previous aspect is financial planning. Because people are buying things without necessarily checking prices first, they will choose Boleto because the extended due date also allows them to check their own bank accounts and see if they can actually afford the products. Another aspect to this reasoning is the surprise factor that afflicts a lot of Brazilians every month when they do a lot of impulse-buying using their credit cards. With a credit card, consumers don't see how much money is going out of their accounts and how much is left, and at the end of the month when the credit card bill arrives, a lot of them might be surprised with the high amount spent. To avoid that feeling, Brazilian customers can choose Boletos to give themselves the chance to be better prepared.
We know for a fact that 50% of our customers will take all these factors into account and choose to pay for their purchases with Boleto. And yet, at the end of the day, only 30% of all purchases actually end up being converted. So, we have decided to study what was wrong and then implement some changes.
Current payment flow
The majority of our users issuing Boletos are doing so on mobile devices (52.7%), but their conversion rate (~15%) is much lower than that of those who issue Boletos on desktop devices (~30%).
Taking a better look at the payment flow, we have realized that the desktop version of a Boleto is a pretty simple HTML that adapts to the user's screen and looks pretty similar to the original Boleto we print up to take to a lottery store. It is something familiar and recognizable for any Brazilian.
On a mobile device, on the other hand, the same layout makes it impossible for the customer to read anything; there is no way a customer could easily find the numeric code to actually copy it and paste it on a bank's app to continue the payment flow, and the barcode showed in the bottom has no utility whatsoever due to the nature of the HTML.
To validate our theory that this layout wasn't good for mobile devices, in 2017 we decided to test it out. We've created a simple Boleto template specific for mobile devices that would focus on making the payment flow easier for those customers.
Without being too complex or well thought-out, the conversion rate of our pilot merchants went up by 15% just by making sure the client could see what really matters: the due date, the total amount, the code, and the shortcut button for him to copy the code easily. The results we've got validated our assumption that the payment flow on mobile devices for Boletos is a huge problem.
Boleto EBANX 2.0
Our Boleto 2.0 was created to make life easier for both customers and merchants alike. Because Boleto Bancário was created before the internet, major banks had to simply adapt their apps to process payments in this method, which made the flow less than acceptable. Any particular bank can decide to handle it in a different way, but overall there are several ways a customer can pay for a Boleto Bancário with their bank app directly at the time of the purchase:
• Opening the boleto on a desktop computer and the bank app on their mobile phone, the user can scan the barcode on the desktop boleto with the bank app's functionality on their phone.
• Copying the numeric code from the boleto and pasting it on their bank apps.
• Simply filling the numeric code from the boleto on their bank apps.
• On mobile devices, the user can choose to save a boleto as a PDF file and open it with their bank app that will automatically recognize all the payment information.
Some banks might allow all of these options, some only one or two, and some might not even allow any of them.
Because Brazilians buy online on impulse, we believe that having the easiest payment flow possible is key to maximizing conversion, which is why our new Boletos will bring at first sight every single information the customer needs to continue on their payment flow instantly, no matter the device they are using or what flow they prefer to go through with the payment.
Bottom line, paying for your purchase shouldn't be a hassle, no matter the payment method you have available or which one you prefer to use. Our Boleto 2.0 makes sure customers can pay for their vouchers more easily, anywhere, anyhow, anytime, while providing a better conversion rate to our merchants. If you want to know more about this new feature, or what financial barrier we will be breaking next here at EBANX, come talk to us.


text: Take a look at a selection of events and entertainment around Saint-Gilles-Croix-de-Vie, Saint-Hilaire-de-Riez and Brétignolles-sur-Mer in the French department of Vendée. To prepare your holiday at our campsite, check out the calendar of events: festivals, theatre, exhibitions, guided tours, concerts, shows, fairs, markets, sports... A long list of ideas for outings with family or friends! To make sure you don't miss any of the major events in the Vendée, visit the website of the Saint-Gilles-Croix-de-Vie region Tourist Office.

subset: commoncrawl


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Monday, December 16, 2013
Meanwhile on Israel's Lebanese Border
On December 15, an Israeli jeep was driving along the Israel-Lebanese border near the coast, in a quiet area, which hadn't seen war for decades. Suddenly a shot rang out. A warrant officer fell dead, but he wasn't killed by a "terrorist." Apparently he had been shot by a uniformed soldier of the Lebanese army. Let's consider this situation under the America's supposed security protection of Israel.
Is Lebanon going to court martial this soldier? Is the United States going to demand that he be punished? Will the United States do anything? Remember that the U.S. will be subsidizing Iran, and who knows what else. Moreover, the United States will try to restrain any Israeli actions. This person is going to get away with murder, and no one will criticize him, but rather compliment him.
This is going to pose daily questions of U.S. policy (true I know this is a Lebanese not Palestinian soldier, but the principal is the same). What if the soldiers had been a few dozen miles away? The United States is obviously going to regret this action but is not going to do anything. It will try to restrain Israel. And meanwhile Lebanon, Syria, and other countries are going to act like they are at war with Israel, but the United States will not allow Israel to act like it is at war with them.
How about if Hizballah had shot the soldier. This means that an Israeli soldier was shot by what is a de facto ally of the United States. After all, the United States has likely provided Iran with some 20 billion dollars, cut sanctions, and won't do anything about the situation. What do Israelis gain? A "frequent friar [Hebrew for sucker] card"?
Does the United States want to get into this situation, the middle of an Arab-Israeli conflict that has gone on for 66 years? As I have pointed out many times, this will be a disaster.
The current stage of peace negotiations are the following: The U.S. has offered American troops to be in the West Bank and Gaza Strip for 10 years. How many soldiers will there be? What is their designated mission? Do you really think the U.S. will have thousands of soldiers in Israel and Palestine for a decade? I don't believe this will happen. I repeat, either this will be a disaster or will not happen.
Here is an interesting option. Suppose the Obama administration draws negotiations out to the end of 2014? Certainly parties would like to do that; they are in no hurry. Then negotiations are drawn out during the campaign, and then the day after voting, they collapse. Wouldn't the Democratic Party achieve a great voter turnout, considering the Arab-Israeli conflict and the Iran conflicts are solved? And then Obama would announce that U.S. interests cannot make the concessions to create peace. In other words, he would get the value of the campaign slogans but then does not deliver.
In other words, if you want this conflict, you can keep this conflict. Don't be surprised at this prediction.
Posted by Rubin Center at 6:02 PM
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The Clapham Common Management Advisory Committee (CCMAC) is a community-led group that works in partnership with Lambeth Council on the management of Clapham Common. We aim to ensure that Lambeth Council runs the Common as well as possible and balances the needs of all its users. We want the Common to be a resource for all, forever as outlined in the Clapham Common Masterplan.
What do we do?
We provide community input on the maintenance of the Common, discuss plans that affect the Common, such as applications for licenses for events or redevelopment of facilities, raise funds, and decide how they should be spent. We develop plans and define what we believe should be the Council's priorities for the Common.
How do we work?
The main committee of the CCMAC meets once a month. At these meetings, we review and discuss reports from the Park Manager, and from our own working groups that focus on current challenges and opportunities. Our membership and our way of working is defined in our constitution (insert as hyperlink), which has been adopted by Lambeth Council.
Our working groups include:
- The Management Plan Working Group is working with Lambeth Council on its ideas about how to run the Common with greater community input and how to raise money for the Common through funding bodies like the Heritage Lottery Fund.
- Regular users of the Common will notice that it is always evolving – hence the changes at Mount Pond and the new wetlands at Eagle Pond. Old trees die and need replacing, new trees and bulbs are planted that suit the natural ecology. Trees, Landscape and Ecology Working Group focuses on trees, but also the wider ecology and landscape of the Common. The group also meets with the Council's officers, to review issues of immediate local concern, such as waterlogged pitches, and over the longer term the tree replacement strategy (Insert as hyperlink to strategy document).
- The 'Green Waste Depot' on Windmill Drive is where green waste from the Common and Kennington Park is taken to be composted. Over the years, with good reason, the site has been nicknamed 'the dump', but this is all about to change. The Green Waste Depot Working Group has been developing plans with Lambeth Council for the site to be cleaned up. Improvements to the green waste recycling process operated by Veolia are underway, and as a result free compost will be made available to the local community.
In addition, with the help of funding raised by Bandstand Beds, part of the site will be reclaimed to create a community food-growing space with raised beds and a polytunnel. The plant propagation hub will be available for use by local residents, schools and food-growing groups. Work on the site should be completed by the autumn.
The Events Working Group's role is to encourage a diversity of scale and theme of events on the Common and to make sure that major events do not adversely impact on the Common and the local community.
Key successes
Skate Park
The original skate park was in need of improvement. We were approached by local younger people to support their efforts to secure funding from the London Marathon Fund and the Met Police to revamp the skate park. The refurbished skate park opened in July 2012 and is now one of the best skate parks in south London.
By the late 90s, this much-loved destination was showing it its age. The CCMAC developed a management plan for the Bandstand and the surrounding area and used it to secure funding from English Heritage (now Historic England) to restore it to its former glory. In 2011, it was fully refurbished and it is now the heart of the Common, providing a wonderful venue for a programme of events throughout the summer.
Fitness trail
Following a successful application by Lambeth Council and the CCMAC, the fitness trail was funded through a £54,000 grant from the London Marathon Trust, as well with developer contributions. The trail was completed in August 2014 with fitness stations designed to appeal to a wide range of users and needs, from gentle stretches to gruelling work outs
Table tennis tables
The CCMAC worked with LB Lambeth to secure a £3,000 grant from Sport England to fund the installation of two table tennis tables. Lambeth Council provided additional funding to prepare the ground the tables stand on.


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You take your medications as prescribed. You see your doctor regularly and are good about sticking to your arthritis treatment plan — all key steps to helping to ease symptoms and prevent disease progression. But the everyday choices you make — like how active you are and how you handle stress and fatigue — affect your joints, too. And sometimes, seemingly inconsequential habits may derail your good efforts. It helps to be aware, so you can make adjustments if needed. Here are some surprising habits that could be hurting your joints when you have arthritis:
1. Drinking coffee concoctions
Consider the white chocolate mocha from Starbucks: a grande topped with whipped cream contains almost 15 teaspoons of sugar and 500 calories. Order yourself a Dunkin' caramel-flavored frozen coffee and be prepared to slurp down 36 teaspoons of sugar and more than 700 calories. Those fancy brew-mabobs and other sugar-sweetened beverages (like sodas and flavored fruit drinks) are no good for you, for lots of reasons. First: Added sugar promotes inflammation in your body, says registered dietician Cat Taylor, LD, CSSD, with Nutrition on Demand.
"Higher levels of pro-inflammatory markers circulating in the blood can lead to chronic inflammation, which over time can damage organs and body tissues, including your joints," she says. Plus, those empty calories won't satisfy your hunger. Research shows regularly consuming sugar-sweetened drinks is linked to greater weight gain and obesity, which can make arthritis symptoms worse.
No one's saying you can't treat yourself every now and then, but drinking these regularly isn't doing your joints any favors.
2. Not getting enough activity (even a few minutes of walking here and there)
Gentle physical activity won't make your joints worse. In fact, the exact opposite is true — whether you have osteoarthritis (OA), rheumatoid arthritis, or psoriatic arthritis. Research shows when done correctly, even a little bit of exercise can help decrease arthritis pain and stiffness. That's because any sort of movement helps lubricate the joints — kind of like oil on a creaky hinge. Daily activities, such as sweeping the kitchen floor or talking the dog for a stroll, also help.
So does doing some stretching every day — even if you have a flare of RA or an increase in OA pain, says Wayne Johnson, MD, orthopedic surgeon and assistant clinical professor at the University of Oklahoma. Simple movements to help you stay active can help diminish some of the pain and maintain range-of-motion. Check out these range-of-motion stretches you can start doing every morning.
3. Having a consistently negative outlook
When you're hurting, it's easy to think the pain is permanent and there's nothing you can do. That mindset, however, may actually make your pain worse and last longer. An important part of your treatment plan is your own outlook on life. Talk to your doctor if you're feeling frustrated. They may have ideas about how to cope or refer you to someone who can help. These tips from mental health experts on coping with chronic illness are also a good place to start.
4. Opting for turf, not surf…
You prefer steak to salmon and burgers over branzino — and that's ok now and then. But red meat, as well as poultry and full-fat dairy, contains saturated fats. A diet high in saturated fat is associated with an increase in inflammatory blood markers and a decrease in anti-inflammatory blood markers, explains Taylor. "By tailoring your fat intake to include more omega-3 fatty acids and fewer saturated and trans fats, you can alter your body's inflammatory state, and in turn help your joints," she says.
Enter the surf: Fatty fish — such as salmon, mackerel, trout, herring, sardines, anchovy and branzino — contains the most active form of omega-3 fatty acids. Eating 3 to 6 grams a day of omega-3s could reduce the pain of inflammation from RA, according to a study published the journal Nutrition. Don't love fish? Other non-fish omega-3 sources include walnuts, chia seeds, and flaxseed.
5. …And the side of fries instead of veg
Researchers at Harvard found that after potato chips, potatoes may contribute to more weight gain per serving than any other food — and French fries were by far the worst offenders. Extra weight can exacerbate inflammatory arthritis. Plus, it can put increased pressure on your joints — particularly your knees, says Christopher Morris, MD a rheumatologist with Arthritis Associates in Kingsport, Tennessee. For every pound a person weighs, about five pounds of stress goes through the knees with every step, he explains. For a 250-pound person, that equates to nearly two-thirds of a ton of stress on the joint.
"The good news is that weight loss really makes a difference," says Dr. Morris. For example, losing as little as 11 pounds can decrease the progression of knee OA by 50 percent. One way to shed pounds: eat tons of brightly colored veggies. They're low in calories, high in fiber (so you feel fuller, longer), and provide nutrients that may help fight inflammation. Here are more tips for losing weight when you have arthritis.
6. Skipping strength training
You'll walk around a track, swim laps, or go biking to help control your weight and fight fatigue. You may do yoga or range-of-motion exercises to improve flexibility. But the idea of weight training seems like too much for your arthritic joints. The truth? It's not, as long as it's done correctly and at the right level for you.
Strength exercises build strong muscles to help support, stabilize, and take some of the load off worn-out joints. In one research review on older adults with OA, researchers found strength training reduced pain and improved strength and function. Other studies have shown similar benefits for those with inflammatory arthritis. Strength training can include doing body-weight exercises, using elastic bands, hand-held weights, or weight machines. Talk to your doctor about the safest way to work exercise into your treatment plan. Here are examples of strength exercises for your knees, strength exercises for your shoulders, and strength exercises for your hips.
7. Smoking
Awful for you a million different ways, including these: Smoking is linked to an increased risk for developing RA; continuing to smoke if you have RA can make symptoms worse. You may be less likely to experience remission if you smoke, research shows. Smoking contributes to inflammation in the body and makes some arthritis drugs less effective. It may also keep you from doing things that can help you feel better, like exercise. Talk to your doctor about strategies to help you quit smoking.
8. Stashing kitchen gadgets in the cabinets
You like everything to have a place — nothing wrong with that. But for the blender you use make your daily smoothies, the "right" place may be your kitchen counter. And your go-to electronic jar opener should be stored in a top drawer. Set up your home to make life a little easier on you, particularly on the more difficult days, say experts. In the kitchen, bathroom, and bedroom, keep everything you use often within easy reach. And use specialized assistive tools throughout the day — zipper pulls, spring-action scissors, and long shoe horns to help conserve energy and ease pain. These tips can help make cooking easier, and these tips can help with other household chores.
9. Never saying no
Drinks after work and meeting the family out for dinner sounds great — in theory. But when you have a chronic condition like arthritis, there will be times when your body needs rest to stay healthy. Maybe you're experiencing a flare or feeling particularly fatigued. Know your limits, and don't force yourself to push past them — no matter how guilty you may feel for bailing or how thick your loved ones are laying it on. Here are more tips for handling social plans without the guilt.
10. Facebooking before bed
Or maybe you tend to text, scroll through news sites, or get sucked in to shopping on Amazon. The what you on do on your device doesn't matter; the fact that you're on one does. Using electronics at bedtime stimulates your mind, making it harder to fall and stay asleep, according to the National Sleep Foundation. You need good rest with arthritis. Researchers at the University of Pittsburgh found that poor sleep quality is linked to more severe pain and fatigue, as well as higher levels of depression in people with arthritis. Log off at least 30 minutes before you want to hit the sack, and wind down with a warm bath or good book instead.
11. Not asking for help or support
Arthritis can be a lot. The pain and disability or loss of function can take a toll on your emotions, increase your levels of stress, and lead to depression or anxiety. A research review published in the journal Arthritis Research & Therapy suggests stress may trigger an RA flare. Though researchers are still trying to understand the connection between arthritis and stress, what we do know is that seeking support can improve how well you cope and manage your condition. Tell family members and friends how you are feeling, and how they can help when you're feeling particularly overwhelmed. Connect with others who have your same condition through a support group in your community or online (our Facebook group and Twitter chats are great outlets). Talk to your doctor if you think you could have symptoms of depression or anxiety.


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Wednesday, January 9, 2013
What did I tell you about laurel wreaths?
One Love Photo has the cutting-edgiest brides.
14 comments:
Even Mary Crawley wore one at her wedding on the season premiere of Downton Abbey.ReplyDeleteReplies
for realz? i guess i really should be watching that show.Delete
- AnonymousJanuary 9, 2013 at 10:44 AM
You should. For realz^100.Delete
except that Mary's wasn't really laurel, it was a headband with a laurel leaf design.Delete
Also, we've just finished season 3 over here in the UK, you will not even believe it! but no spoilers.
- AnonymousJanuary 9, 2013 at 10:42 AM
Huge fan of that dressReplyDelete
Is a laurel wreath + pixie haircut combo doomed to look goofy? I can't find a photo anywhere of a wreath with anything other than an updo or long bohemian hair situation.ReplyDeleteReplies
I'm always jealous of people who can pull off woodsy weddings like that; they are really pretty. I know I'll never be able to :SReplyDelete
I'm too distracted by the gorgeous sleeve detailing on her dress to notice the wreath.ReplyDelete
Isn't she lovely!!! I think it was eucalyptus or something? All I know is that I couldn't stop taking photos of it! Thanks for the link :) Much appreciated! Oh and our Kauai bride was wearing those vegan peep toe shoes, confirmed! I'll post some shots soon!ReplyDelete
This comment has been removed by the author.ReplyDelete


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How the CARES Act Could Yield Tax Benefits for Charitable Giving
By Carl Trevison and Stephen Bearce
How the CARES Act Could Yield Tax Benefits for Charitable Giving
Many individuals are looking for ways to give back during the coronavirus pandemic. What you may not know is that the Coronavirus Aid, Relief, and Economic Security (CARES) Act contains provisions that could make it easier to take tax deductions on charitable donations in 2020.
Here are possible charitable giving options that you may want to consider.
Charitable contribution changes in the CARES Act
For 2020, there's no income limit on the deduction of cash gifts to eligible charities, excluding donor-advised funds or other supporting organizations. (The deduction for cash gifts to donor-advised funds is still limited to 60% of adjusted gross income.)
- • If you're in a position to make generous gifts, you could potentially offset all of your taxable income for 2020.
- • Likewise, cash gifts could potentially be used to offset Roth IRA conversion income or capital gains realized upon the sale of a concentrated position or real estate.
- • The CARES Act waived required minimum distributions (RMDs) in 2020—but qualified charitable distributions (QCDs) are still allowed for anyone age 70½ or older from a Traditional and Inherited Traditional IRA.
Determining the best way to give
Given the expanded options available, you may want to consider one or more of the following:
- • QCDs. Distributions are tax-free and not included in adjusted gross income. Future RMDs may be smaller since distributions lower the year-end balance, which could result in future tax benefits if tax rates increase in later years.
- • Cash gifts to eligible charities. These may be deductible up to $300 in addition to the standard deduction. This is a benefit to those who do not itemize deductions. You may offset up to 100% of adjusted gross income if you itemize your deductions, providing a current tax benefit.
- • Stock gifts. These provide a current tax benefit if you itemize your deductions; they also allow you to avoid taxation on the stock's appreciation. Deductions for stock gifts are limited to 30% of adjusted gross income when contributing to public charities.
Before taking any action, consult with a tax advisor to help determine the best possible outcome.
Wells Fargo Advisors and its affiliates do not provide tax or legal advice. Please consult with your tax and/or legal advisors before taking any action that may have tax and/or legal consequences.
This article was written by/for Wells Fargo Advisors and provided courtesy of Carl M. Trevisan, Managing Director-Investments and Stephen M. Bearce, First Vice President- Investments in Alexandria, VA at 800-247-8602.
Investments in securities and insurance products are: NOT FDIC-INSURED/NOT BANK-GUARANTEED/MAY LOSE VALUE
Wells Fargo Advisors is a trade name used by Wells Fargo Clearing Services, LLC, Member SIPC, a registered broker-dealer and non-bank affiliate of Wells Fargo & Company.
© 2019 Wells Fargo Clearing Services, LLC. All rights reserved.


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This is the extended version of the second annual Golden Gauntlet Graffiti Battle that was held in Brooklyn.
This video includes the battle & trophy. This event that pits graffiti artist against graffiti artist in an artistic competition
was sponsored by boweryboogieuncapped, Scrap Yard, Crimefaces, Universe City and SMASH Industries.
Produced by Fine Art Fotos & Video
Video by Flint Gennari
Edited by Christopher Raimonto
Fine Art Fotos Blog
This is the extended version of the second annual Golden Gauntlet Graffiti Battle that was held in Brooklyn.
Please visit FineArtFotosVideo.com.
Please call us at 917-273-7883 for all your photo and video needs.
I will be very happy to do something for you.
New York City, On 77th Street near York Ave, construction is being done. A school and Memorial Sloan Kettering Cancer Center Hospital are going up with work to be completed in Spring 2019. Adco Electric is wiring the buildings.
McCoys VS. the HatFields
Still alot of work to be done before the grand opening of all the stores on Aug 16. 2016
Fines will be $3200 per day for each unfinished store. While some are nearly done, seems to be a lot of work left to do. I can predict much over time.
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The 4430 was a compact, nimble, and powerhouse of the 70s that fit all farming needs. Pedal tractor features stamped steel construction, authentic John Deere trade dress, chain drive, pedal power, and adjustable seat and steerable front wheels. No batteries required; some assembly required.
Weight limit: 80 lbs., ages 3+.


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|Home > Anique
♀ Anique
What does Anique mean?
Anique as a name for girls is of Hebrew derivation, and Anique means "He (God) has favored me". Anique is a version of Anna (Hebrew): Latinate variation of Hannah.
STARTS WITH An-
VARIANT Anneke
RELATION VIA ANNA AniaCREATIVE FORMS
Anique Ariella (A.A.), ..
How popular is Anique?
Anique is an uncommon first name for women. Anique is an equivalently rare surname too for both adults and children. (2000 U.S. DEMOGRAPHICS)
Which version is better?
Ania and Anna (#54 VIA LATEST LIST) are the prominent variation forms of Anique (NOT RANKED) listed in the Top 2000. These forms of Anique were favored a century ago (MEDIAN #1001) and are now much less widespread (#1027, DOWN 91.5%), with the form Anna becoming less in vogue. (2018 BIRTH STATISTICS)
Similar Names
Anique is alike in pronunciation to Anouk and Unique. Other recommended sound-alike names are Amice, Aneese, Ange, Angie▼, Anica, Anice, Anicka, Anika▲, Anikee, Aniko, Anis, Anisa▼, Anisah, Anise, Anisha, Anissa▼, Anke, Annice, Annise, Annus, Danique, Janique, Jonique, Monique▼, Ranique, Tonique and Uniqua. These names tend to be more frequently used than Anique.See names in meaning and etymology.


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Nebraska: Jon Bruning Goes on the Air Against Bob Kerrey
Welcome home, former Sen. Bob Kerrey.
Only two days after the Nebraska Democrat changed his mind and jumped back into the state's Senate race, state Attorney General and GOP frontrunner Jon Bruning is welcoming him into the race with a new ad slamming Kerrey for his New York City residency.
The New York City line of attack has been widely anticipated, and Republicans used it against Kerrey while he was weighing his run. The ad describes the two candidates as "far apart on the issues as Nebraska and New York City," while overlaying images of the New York City skyline.
The narrator describes Kerrey as a "New York liberal" and highlights votes he took during his previous time in the Senate in the 1990s.
It also includes a photo of Kerrey linking him with retiring Sen. Ben Nelson (D).
The initial ad buy is $70,000. That may not be a lot in many states, but in Nebraska, it's a sizable sum.
And while the Bruning ad looks to the general election, he still has to beat state Treasurer Don Stenberg in the GOP primary. Stenberg has had the support of outside conservative groups. State Sen. Deb Fischer is also running for the Republican nod.
In light of Kerrey's entrance into the race, Roll Call Politics recently changed its rating of this race to Leans Republican.


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I am a strong believer in education. And, I am a strong believer that often times, we learn from relating to personal stories from people we know.
If you are a follower of our journey here in Missouri Lost & Found Paws, you know that one of the activities we have a zero tolerance for is judging others.
One of the most common judgments we see is jumping to conclusions about a pet's physical appearance.
I would like to share a personal story with you. This is Rufas. I came to know him 8 years ago as he belongs to my ex. Rufas is now a 12.5 year old mastiff/lab mix topping in at 94 lbs. He often lives with me along with his sis, Kandi, a doxie.
Rufas has been diagnosed with osteocarcoma a few weeks back. I took him to Mizzou to identify our options. I am pursuing palliative care for him which means pain management. He has a significant lump on his right front leg, at the site of the cancer in his bone. This is not a tumor but rather his body reacting to the pain from the cancer. He was on 4 weeks of pain meds before heading to Mizzou.
He had radiation therapy ten days ago for pain management. The swelling has decreased about 30%.
Why am I sharing his story? If he was lost and then found, and given the comments I often see in our group, I am rather convinced he would be deemed 'neglected' by an outsider. I can tell you with certainty he is not. People would jump to the conclusion that he has an ignored growth or tumor. It is not a tumor you are seeing. This is a soft tissue swelling due to pain that the meds were not effective enough to treat.
My running medical bills also prove that he is not neglected. His ailment is not ignored. He is not suffering. He is not forgotten.
He is sick. He is being managed. He is loved. He is being monitored closely by his docs. He is fighting cancer.
Please. Do not assume lumps and bumps mean a found pet is grossly neglected. Sometimes, the kindest thing we can do is to manage pain until the scenario worsens.
Give all found pets, especially the ones found in questionable state, a chance to be reunited with their loved ones. They deserve to be with their loved ones in their final months, weeks or days.
Shuma, President, Missouri Lost & Found Paws
–with his sis, Kandi
–with his step sis, Mollie
— at Mizzou for consultation
— this is not a tumor, but rather soft tissue swelling resulting from pain due to the ineffectiveness of weeks of pain medications
— reduction in tissue swelling ten days after radiation therapy
Please. Don't judge. Help us get lost pets home..


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I am just wondering, if the only thing that is important to you is the fact that you are a part of the group known only as "Offspring of Former Slaves," why is it that the first thing that you do is get rid of your "Slave Name?"
Doesn't that seem to remove your exclusive membership from the club?
Please take the time to comment.
Monday, February 04, 2008
Blackuary 4.5 - 2008
Posted by Paul Mitchell at Monday, February 04, 2008
Labels: Blackuary 2008


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The 10 Silliest Snow Day Superstitions You Believed as a Kid
Remember when a snow day meant sledding followed by hot chocolate and a cartoon binge? No wonder we would try anything—and we do mean anything!—to get it to snow.
This Is What School Pictures Looked Like 75 Years Ago
Getting every student in the class to look at the camera and smile has always been a challenge.


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Welcome to HCL Domino Volt
Welcome to the HCL Domino Volt® documentation.
Video Tutorials
The HCL Domino Volt tutorial section contains two tutorials to help you learn to use Volt. Click on a link to view a specific topic covered in the tutorial.
Volt on Docker
The following topics contain information on how to successfully deploy an HCL Domino Volt server using a Docker-compatible Red Hat Universal Base Image (UBI).
Installing Volt
The following topics contain information on how to successfully install HCL Domino Volt.
Uninstalling Volt on Linux
To uninstall Volt on a Domino server running on a Linux operating system, complete the following steps.
The following topics contain information on how to build and efficiently use applications in HCL Domino Volt.
Creating an application
This topic gives a general overview of the application creation process, from opening the HCL Domino Volt interface to launching a completed application.
Creating an application from an excel spreadsheet
Domino Volt allows you to create an application from an excel spreadsheet, automatically creating the widgets and importing the data found in the spreadsheet.
Styling your application with a custom theme
Style the colors, fonts, and other characteristics of the application by creating or importing a custom theme.
Moving items in an application
Form items are not static after they are added to a form. You can move items around on a single page, duplicate form items, and move items between pages on your form.
Creating an accessible application
When you create an application, the following information helps you make it accessible for users with disabilities.
Enabling dynamic layout
When you build applications, you can now set the display width of your Domino Volt application. Setting this feature reduces or removes the need for horizontal scrolling when you have an unknown or limited amount of space.
Globalization features
The following information describes the languages formatting features supported by HCL Domino Volt .
Creating rules in your application
Rules help you gather the correct information from users and organize your information after data is entered in a form or app page. You can create composite rules that govern how your form or app page - and the data in it it - behaves.
Labeling data, performing data analysis, and exporting data
You can add labels to data elements in your application that become the label in the export file.
Incorporating services into your applications
The following topics describe how to incorporate services into your HCL Domino Volt application.
Adding formulas to your application
Use formulas to assign values to items on an HCL Domino Volt form or app page. They are divided into two categories: Item Formulas, which list formulas created from the Properties panel, and General Formulas, which list complex formulas created from the Settings tab.
Adding specialized items
You can use specialized form or app page items to style text, echo text back, create dynamic lines, or add HTML.
Managing the files associated with your application
You can upload a variety of files, such as images, for use with your application. Managing these embedded files is done in the Files section of the Settings tab
Volt document integration
HCL Volt's document integration feature lets you use previously built PDF files and populate them with data captured by Volt in a Volt form.
Adding Stages to an application
It is often desirable to have an application, or form, transition through a set of phases or stages. At each stage the form might be used by different people in different roles. The form also might be presented in a slightly different manner in each stage, such as having some items or pages hidden, or in a read-only state.
Deploying applications and viewing responses
After an HCL Domino Volt application is built it must be deployed. After it is deployed, you can supply users with the URL of the application so they can launch it. After users submit completed forms, you can view the responses.
When building applications, user roles require various levels of security access. A manager is able to review submitted forms, but an administrator can delete them. The following topics describe how to set security levels for all levels of users.
Defining basic security roles for users
Create roles for users in your organization so they can work with data that is relevant to them.
Assigning users or groups to roles
Give the users in your organization permission to work with the data relevant to them by assigning them roles.
Setting Stage permissions
Setting Stage permissions defines the Create, Read, Update, and Delete permissions for each role in a stage.
Assigning users to maintain the application
To define who can edit an HCL Domino Volt application, use the design settings in the Access tab.
Setting up security for anonymous access
Using the correct permissions, you can allow anonymous users to access a form.
The following topics contain information for HCL Domino Volt admins.
Controlling who creates HCL Volt applications
To configure who can create and delete applications, you need to modify the Access Control List (ACL) for VoltBuilder.nsf.
Volt configuration settings
Volt configuration settings are in VoltConfig.nsf in the volt folder of your Domino data directory (volt/VoltConfig.nsf). Use the Notes client or the Domino Administrator client to modify a configuration setting.
Core Domino server configuration
HCL Domino Volt is an add-on to the core HCL Domino server. Volt runs in the context of the Domino web server (HTTP process). Therefore, Volt is affected by the underlying Domino server configuration. This topic covers some of the core configuration settings that may affect Volt.
Upgrading from prior releases
Beginning with Volt 1.0.2, all Volt NSF files set the database property Don't Maintain Unread Marks as default, which should improve performance. NSF files created in prior versions of Volt are not changed.
Volt Cleanup process
Volt Cleanup primarily purges orphaned Builder attachments, orphaned application attachments, and old Preview databases. Prior to release 1.0.3, this process was done by the Volt Cleanup Agent.
Enabling basic authentication for HCL Volt API requests
If form-based authentication is enabled, you will see an HTML form for authentication instead of a pop-up window. This topic provides instructions on how to disable HTML form-based authentication for the HCL Volt server API URL paths and enable basic authentication.
HCL Link integration
HCL Link provides a platform for data and application integration.
You can extend the functionality of HCL Domino Volt through the use of customized cascading style sheets, Javascript APIs, and REST APIs, and Service Oriented Architecture modifications.
Using custom style sheets
HCL Domino Volt allows the use of custom CSS themes that can be uploaded into an application to style the user interface to meet customer needs.
The documents in this section provide reference material and samples for HCL Domino Volt .
REST API reference
The REST API can be used by other programs to communicate with Domino Volt.
The following topics provide reference information about adding services to HCL Volt.
Embedding items in an iframe
You can use iFrames to embed charts and applications in a web page.
Embedding API
The Embedding API is used to embed a Volt form directly in another webpage without using an <iframe>. The Volt form is inserted into the DOM of the hosting page and can be interacted with using the JavaScript API or any custom JavaScript. Additionally, the style of items in the form can be customized by the CSS of the hosting page.
Creating customized Cascading Style Sheets
You can apply your own custom Cascading Style Sheet (CSS) to the rendering of your HCL Domino Volt application. To create a custom theme, you must be familiar with the basic concepts of CSS.
The following topics contain information on troubleshooting and known issues for HCL Domino Volt.
Known issues
This topic describes known issues that apply to all HCL Volt devices.


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Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency characterized by sudden cardiorespiratory collapse and disseminated intravascular coagulation.
AFE occurs in 2-8 per 100,000 deliveries and is responsible for between 7.5% and 10% of maternal mortality in the United States. [1]
Steiner and Luschbaugh first described AFE in 1941, after they found fetal debris in the pulmonary circulation of women who died during labor. Data from the National Amniotic Fluid Embolus Registry suggest that the process is more similar to anaphylaxis than to embolism, and the term anaphylactoid syndrome of pregnancy has been suggested because fetal tissue or amniotic fluid components are not universally found in women who present with signs and symptoms attributable to AFE. [2]
The diagnosis of AFE has traditionally been made at autopsy when fetal squamous cells are found in the maternal pulmonary circulation; however, fetal squamous cells are commonly found in the circulation of laboring patients who do not develop the syndrome. The diagnosis is essentially one of exclusion based on clinical presentation. Other causes of hemodynamic instability should not be neglected.
The pathophysiology of amniotic fluid embolism (AFE) is incompletely understood. It was originally believed that fetal cells and debris occluded the pulmonary vasculature. [3] Fetal material is not always found in the maternal circulation in patients with AFE, and material of fetal origin is often found in women who do not develop AFE. A study performed to investigate whether fetal squamous cells from amniotic fluid could obstruct the maternal pulmonary vasculature causing cardiopulmonary collapse, found that the mean cell count in amniotic fluid was 695 +/- 600 squamous cells per mL of fluid. The adult lung contains 480 million alveoli with 280 billion pulmonary capillaries. They concluded that even if the entire volume of amniotic fluid were transferred to the maternal circulation, the available squamous cells would only obstruct 1 in 1 million pulmonary capillary segments resulting in clinically undetectable obstruction. [4]
Clark has proposed that fetal antigens enter the maternal circulation triggering a response similar to systemic inflammatory response syndrome (SIRS) with activation of the coagulation cascade leading to DIC and inflammatory mediated suppression of myocardial function. [5]
Benson et al [6] tested 2 hypotheses concerning the pathophysiology of AFE: (1) Clinical symptoms result from mast cell degranulation with the release of histamine and tryptase, or (2) Clinical symptoms result from activation of the complement pathway. Nine women with AFE were compared with 22 women with normal labors. Serum from patients with AFE was collected within 14 hours of symptom onset and frozen. Urine was collected within 12-24 hours after symptom onset. Control patients had complement levels measured on admission, during labor, and the day after delivery. Six of the 9 women with AFE died, and all 9 required blood transfusions for disseminated intravascular coagulation (DIC). Seven women had no evidence of mast cell degranulation (ie, either urinary histamine or serum tryptase). Compared with postpartum control patients, complement levels in the AFE group were severely depressed. C3 in the AFE group was 44 compared with 117.2 in the postpartum group. C4 was 10.7 in the AFE group versus 29.4 in the postpartum group. These differences were statistically significant. This suggests that complement activation may play an important role in the pathophysiology of AFE.
Farrar and Gherman [7] reported the case of a 40-year-old multipara in active labor with acute onset of facial erythema, seizures, hypoxia, cardiac arrest, DIC, and ultimately death. Fetal squames and fibrin thrombi were found in the pulmonary tree at autopsy. Blood drawn 2 hours after symptom onset had a serum tryptase level of 4.7 ng/mL (normal < 1 ng/mL). Mast cell degranulation is a central aspect of anaphylaxis which releases large quantities of tryptase. Kobayashi et al has proposed that serum tryptase levels may support the diagnosis of AFE. [8]
A case reported by Marcus et al, [9] in which AFE developed after a spontaneous rupture of membranes. No increase in mast cells or degranulation in lung tissue was shown by Giemsa staining. Serum tryptase levels were 11.4 ng/mL (normal < 11.4 ng/mL).
As these studies show, the initiating event and the complete pathophysiology are poorly understood. Progression usually occurs in 2 phases. In phase I, pulmonary artery vasospasm with pulmonary hypertension and elevated right ventricular pressure cause hypoxia. Hypoxia causes myocardial capillary damage and pulmonary capillary damage, left heart failure, and acute respiratory distress syndrome. Women who survive these events may enter phase II. This is a hemorrhagic phase characterized by massive hemorrhage with uterine atony and DIC; however, fatal consumptive coagulopathy may be the initial presentation.
Amniotic fluid embolism (AFE) is considered an unpredictable and unpreventable event with an unknown cause. In the national registry, 41% of patients had a history of allergies.
Reported risk factors for development of AFE include multiparity, advanced maternal age, male fetus, and trauma. In a retrospective review of a 12-year period encompassing 180 cases of AFE, of which 24 were fatal, medical induction of labor increased the risk of AFE. [10] In the same study, AFE was positively associated with multiparity, cesarean section or operative vaginal delivery, abruption, placenta previa, and cervical laceration or uterine rupture. [11, 12, 13, 14]
Fong et al found that non-Hispanic blacks have more than twice the risk of developing AFE and also found a 25-fold higher risk of the condition in women with cerebrovascular disorders and a 70-fold greater risk in those with cardiac disease. In addition, the study, of 182 patients with AFE, found a strong association between AFE and renal disease, placenta previa, polyhydramnios, placental abruption, and eclampsia and with procedures such as amnioinfusion, classical cesarean delivery, and dilation and curettage. The risk of AFE was also found to rise with maternal age, with the greatest increase occurring after age 39. [1]
United States and international statistics
Incidence of amniotic fluid embolism (AFE) is estimated at 1 case per 8,000-30,000 pregnancies. The true incidence is unknown because of inaccurate diagnoses and inconsistent reporting of nonfatal cases.
In 2011, AFE was the leading cause of death during childbirth in Germany. [15]
In Australia, AFE is cited as the leading direct cause of maternal death. Estimates range from 1 in 8000 to 1 in 80000 deliveries. [16]
In the United Kingdom incidence is estimated at 1.9 per 100000 to 7.7 per 100000 deliveries. [17]
Race-, sex-, and age-related demographics
No racial or ethnic predilection has been thought to exist. However, a study by Fong et al suggested that non-Hispanic blacks have more than twice the risk of developing AFE. [1]
AFE only occurs in women.
Advanced maternal age may be a risk factor. No relationship to age has been found in the National Amniotic Fluid Embolus Registry; however, at least two studies have noted an increased incidence in women aged 30 years and older. [18, 19] One study by Fong et al indicated that the greatest risk increase occurs after age 39. [1] Another study by Lisonkova et al on the associations between maternal age and severe maternal morbidity reported that woman 35 years of age and older had increased adjusted rates of amniotic fluid embolism (AOR = 8.0, 95% CI 2.7-23.7). [19]
Note the following:
Maternal mortality approaches 80%. However, it was 61% in the US national registry, which listed 46 cases.
Amniotic fluid embolism (AFE) is the cause of 5-10% of maternal mortality in the United States.
Of patients with AFE, 50% die within the first hour of onset of symptoms. Of survivors of the initial cardiorespiratory phase, 50% develop a coagulopathy.
A population-based study using the California Office of Statewide Planning and Development database reviewed 1,094,248 deliveries over a 2-year period. Of 53 cases of AFE, 14 patients (26.4%) died and 35 patients (66%) developed DIC. [20]
Maternal survival is uncommon, although the prognosis is improved with early recognition and prompt resuscitation. The United Kingdom AFE registry reported a mortality of 37%; of the women who survived AFE, 7% were neurologically impaired. [21]
Neonatal survival has been reported to be 79% in the US registry and 78% in the UK registry. The intact infant survival rate is 70%. Neurologic status of the infant is directly related to the time elapsed between maternal arrest and delivery.
The risk of recurrence is unknown. Successful subsequent pregnancies have been reported. The recommendation for elective cesarean delivery during future pregnancies in an attempt to avoid labor is controversial.
Pulmonary edema is a common occurrence in survivors. Pay close attention to fluid input and output.
Left heart failure may occur. Some sources recommend inotropic support.
Treat DIC with blood components. Consider activated factor VIIa for severe hemorrhage. Bilateral uterine artery embolization has been successful in controlling blood loss in 2 reported cases.
Patient Education
The recurrence risk of AFE is unknown. Case reports exist of successful uneventful pregnancies after a pregnancy complicated by AFE. [22]
What would you like to print?
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Medication
- Questions & Answers
- Tables
- References


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In family hands for 275 years: Already in the 9th generation, the Benninghoven family manages the Gut Diepensiepen farm in Ratingen near Düsseldorf. Main crop: the potato.
Every year Christian Benninghoven harvests up to 1,400 tons of potatoes on the 200-hectare farm.
Whether crispy baked potato gratin, fluffy puree or classic with salt - potatoes have become indispensable in the kitchen. And there are many types of them. From floury to solid.
6 different varieties grow on Gut Diepensiepen, among them the favourites Annabelle and Allians.
In harmony with nature
Potatoes are only planted on the same field at 5-year intervals. This preserves the fertility and health of the soil. In the meantime, wheat and other cereals grow there. From March the potatoes are planted, from June the harvest can follow - depending on climate and cultivation method.
Quality management
Stones, soil and plant remains are already sorted out during the harvest. Later the fine selection takes place on the belt.
After selection, the ordered potatoes are washed and packed directly for transport.
Any potato that is not delivered goes to the cold store. The potatoes remain fresh for several weeks at a maximum temperature of 6°C - if they are stored dark and dry.
Short Distances
The farmer attaches great importance to proximity when it comes to delivery. No long distances and personal service - that is important to him. Orders are bundled so that the truck can be used to full capacity every time it travels and the routes can be planned optimally.


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Dementia Researchers Commend FDA Crackdown on Supplement Hype
Quick Links
Purported miracle medicines have always been with us. In the 1800s, traveling salesmen hawked cure-all elixirs. Nowadays, companies peddle myriad supplements on the internet, often with spurious claims that they are "scientifically" proven to treat this or that chronic ailment. Some promise to boost cognition, lower the risk of dementia, and even treat Alzheimer's disease. However, these substances are not approved by the Food and Drug Administration for these indications, and data to support their claims are lacking. Researchers who spoke with Alzforum believe such supplements offer false hope while shrinking the wallets of people worried about cognitive decline and dementia.
- The FDA warned 17 companies to stop advertising their dietary supplements as treatments for AD.
- All but one quickly complied.
- The move is part of an FDA initiative to better regulate the supplement industry.
It appears the FDA has had enough. On February 11, the agency mailed letters to 17 companies it accused of illegally marketing dietary supplements as dementia treatments (see FDA press release). In response, most companies removed the language in question. The supplements included vitamins, minerals, and herbal products. They also include compounds that were previously investigated as AD treatments but showed no efficacy against dementia in large trials. Lindsay Haake at the FDA press office told Alzforum that the agency's goal is to "help consumers easily differentiate high-quality, compliant supplements from those that have not been manufactured or distributed in accordance with the law."
Across the board, Alzheimer's researchers and clinicians applauded the move. "The actions by the FDA are necessary and long overdue," Jose Luchsinger at Columbia University, New York, wrote to Alzforum (see full comment below). Caleb (Tuck) Finch at the University of Southern California, Los Angeles, agreed, "As a basic researcher, I fully agree with the FDA initiatives." In a statement, the Alzheimer's Association wrote, "It is vital that federal agencies charged with consumer protection act quickly and decisively against dishonest businesses preying on individuals affected by this devastating disease."
However, these FDA warnings by themselves may do little to stem the tide of deceptive advertising. With internet vendors and sites multiplying, new products and false claims continue to crop up faster than the agency can find them. In a February 12 JAMA editorial, Joanna Hellmuth at the University of California, San Francisco, wrote "More needs to be done on a national level to limit the claims of benefit for interventions that lack proven efficacy."
The FDA agrees. Also on February 11, commissioner Scott Gottlieb outlined a number of steps the agency will take to improve regulation of dietary supplements. "We are announcing a new plan for policy advancements with the goal of implementing one of the most significant modernizations of dietary supplement regulation and oversight in more than 25 years," Gottlieb wrote. This includes more efficient enforcement, alerting the public more quickly to unsafe or ineffective products, and working with industry to improve the safety of supplements. It is unclear what effect Gottlieb's resignation, announced March 5, will have on this initiative.
Internet Hosts Modern-Day Traveling Medicine Show
The dietary supplement market has exploded with the commercialization of the internet and global marketing. The FDA estimates that supplement sales have expanded 10-fold in the last 25 years, and amount to a $40 billion industry in the U.S. alone, with as many as 80,000 products. Worldwide, the market has ballooned to $160 billion. Brain health supplements make up more than $3 billion of the global market, and are predicted to reach $5.8 billion by 2023 (see industry forecast). The surge in sales is driven by fear of cognitive decline and dementia, as well as a desire to enhance cognitive performance at work and school.
The supplement market expanded because regulations for these products are much looser than for drugs. Under the 1994 Dietary Supplement Health and Education Act (DSHEA), products are reasonably expected to be safe and labels to be truthful and not misleading, but unlike drugs, companies are not required to test either the safety or efficacy of dietary supplements. This is because according to DSHEA and the FDA, they are considered foods, not drugs. Most supplements are naturally occurring compounds that can be found in plants, animals, or the human body. This does not mean they are healthy. Socrates, if he came back from the dead, would likely say he was killed by a cup of hemlock—an extract from a flowering herb. Furthermore, the FDA does not regulate the purity of supplements, which means they can harbor harmful ingredients or active pharmaceuticals that are not disclosed on the label, Haake wrote.
Compounding this free-for-all, companies have leeway in what they are allowed to say on labels. They can claim that dietary supplements reduce the risk of a disease or condition, or that they improve an aspect of human health, such as the immune system, without having to prove it. This is known as a structure/function claim. They may not state that supplements prevent, treat, or cure a specific disease, and product labels must include a disclaimer to that effect. Thus, a supplement could say that it improves memory or concentration, but not that it treats Alzheimer's disease.
The regulations mean companies must walk a fine line in their advertising. Some step out of bounds. For example, Nutrition Coalition in Moorhead, Minnesota, boasted that its coenzyme Q formulation "fights off degenerative brain diseases like Alzheimer's." Even when companies follow the rules, their language may mislead consumers into believing the product has more efficacy than it does, such as the claim by Earth Turns LLC in Chesterfield, Missouri, that a green tea supplement "supports healthy cognitive function." The same can be said of many foods. How is the public to distinguish between "supports healthy cognitive function" and "treats Alzheimer's?" In an email to Alzforum, Hellmuth wrote, "You can see how it could be confusing for patients and caregivers to distinguish between these two kinds of claims, particularly considering most people with Alzheimer's disease want to improve memory and concentration."
Ads bend the rules to their advantage in other ways, too. Absent scientific proof to back up claims, they lean on personal testimonials and anecdotes, and cite research in animal or cellular models as though it proved relevance for human disease. For example, Nutrition Coalition noted the ability of curcumin to inhibit amyloid aggregation in vitro, and concluded that the spice "helps fight off that horrible disease." Ads exaggerate findings, and neglect to mention study limitations. Rachelle Doody at Roche in Basel, Switzerland, told Alzforum that when she was in clinical practice, patients would often bring in newspaper ads or printouts from the internet asking about the touted benefits of some supplement for cognitive function. "If the ad mentioned patients or research in any way, or referenced the comments of an M.D. or Ph.D., patients often did not realize that it was an advertisement and not a news item," Doody wrote to Alzforum. Conversations to debunk a supplement claim then take up visit time that could be spend discussing more helpful measures, or available drug trials. Eric Siemers at Siemers Integration, who was formerly with Eli Lilly, noted, "People are very worried about AD, and companies play on those fears."
All of this creates a hall of mirrors, where consumers struggle to distinguish supplements that might be helpful from those that are a waste of money, or harmful. As one example, Hellmuth noted that high doses of Vitamin E increase the risk of stroke and death (Miller et al., 2005; Schürks et al., 2010). Neuroscientists contacted by Alzforum believe most brain health supplements are ineffective. "It is very likely that all such remedies are useless, and some are potentially hazardous," Paul Aisen at the University of Southern California, San Diego wrote (full comment below). The Alzheimer's Association notes that even if a supplement is safe to take on its own, it may interact with prescription medicines or other supplements in unpredictable ways.
The financial damage can be considerable. "Many consumers of these supplements are on fixed incomes. Retired elderly may be spending an important portion of their income on these unproven therapies," Luchsinger said. Belief in the efficacy of a supplement could dissuade people from pursuing approved AD treatments. "It would be a shame if somebody took fish oil for their Alzheimer's and not Aricept," Siemers said. Aricept is a cholinesterase inhibitor approved by the FDA to treat AD.
The Sheriff Rides In
The situation spurred the FDA to step up enforcement, Haake wrote to Alzforum. First, the agency scoured product pages, newsletters, and blogs to identify companies claiming, illegally, that their products treated dementia. On February 5, the FDA issued 12 warning letters jointly with the Federal Trade Commission, which polices deceptive or fraudulent advertising. Such letters give companies 15 days to correct regulatory violations, after which the FDA may enact penalties. Previously, in November 2018, the agency had issued five advisory letters to separate companies selling putative AD treatments. Advisory letters flag less serious violations and ask companies to voluntarily comply with regulations, but do not threaten action. Both types of letter are posted online to alert consumers to the issue.
Fourteen of the companies are in the U.S., one in Canada, one in India, and one in Malaysia. The FDA flagged multiple products from each company (see table). They span a wide range, from vitamins (particularly B, C, D, and E) and minerals such as selenium, to various herbal extracts such as echinacea root and milk thistle. The list also includes physiological compounds like melatonin and colostrum, antioxidants like glutathione, and non-essential amino acids such as L-carnitine and L-theanine, which is found in plants. Some of the products have been investigated in AD studies, including curcumin, green tea, ginkgo biloba, omega-3 fatty acids, and coenzyme Q (CoQ10). A number of companies market mixtures of these ingredients with suggestive names like Cognispark, Mind Ignite, and Memory Revitalizer.
The warning letters spell out illegal statements the FDA found on each website, including claims to treat cancer, infection, diabetes, arthritis, etc. The brain health advertising can be blatant. Sovereign Laboratories LLC in Sedona, Arizona, claimed: "Studies have shown proline-rich polypeptides [in colostrum] improve the cognitive functioning of patients with mild to moderate Alzheimer's disease." This statement appears to be based on a few small, short trials from Poland (Leszek et al., 1999; Leszek et al., 2002; Bilikiewicz and Gaus, 2004). The Canadian company BR Naturals, Innisfil, Ontario, asserted that, "A new study in the … Journal of Alzheimer's Disease supports existing evidence that coconut oil may help alleviate the neurodegenerative effects of Alzheimer's disease and Parkinson's." In actuality, the study reported that coconut oil helped preserve the health of cultured neurons exposed to Aβ (Nafar and Mearow, 2014). TEK Naturals in Mount Pleasant, South Carolina, claimed "Mind Ignite is a safe and highly effective alternative to Adderall. … Clinically shown to help diseases of the brain such as Alzheimer's and even dementia," while Gold Crown Natural Products in Miami went further when it wrote: "It is proved that melatonin supplements are used to cure Alzheimer's disease."
Alzheimer's researchers and advocates are angered by the level of deception. "My take is that the extent of false claims made by many supplement or memory-enhancing drug manufacturers is criminal," wrote David Knopman at the Mayo Clinic in Rochester, Minnesota.
How effective is the FDA intervention? In this instance, it seems to have sparked quick action to clean up product advertising by all but one of the companies. "The site has removed the links and commentary that offended the FDA. That was never a selling feature of the products," Dennis Butts at Peak Nootropics LLC in Houston wrote to Alzforum. Alzforum requested comment from all the companies warned by the FDA bar two, for which no contact information could be found. Save for Peak Nootropics, none responded. However, their websites, accessed between February 25 and March 7, were scrubbed of the language the FDA had called out. Some websites appeared to have deleted newsletters, articles, and blog posts discussing purported medical benefits; in a few cases, the products themselves were no longer for sale. For example, The Alzheimer's Store, which sells household items to aid caregivers of people with dementia, received an advisory letter admonishing it for advertising aromatherapy as a means to boost cognition and alertness in AD patients. No aromatherapy products now appear on the site. As of March 8, one company appears to have ignored the FDA censure. This Wonderful Life New Age Shop, based in Malaysia, continues to offer products such as Dementia/Alzheimer's (Day) Synergy Oil, which claims to be "an effective non-pharmacological therapy for dementia." The company received an advisory letter.
Another recent FDA action drew a similar response. On February 19, the FDA cautioned consumers and health care providers not to use plasma from young donors to treat diseases of aging. "Such treatments have no proven clinical benefits … and are potentially harmful," the agency wrote, warning of "bad actors charging thousands of dollars for infusions." Although the letter threatened no action, one such clinic, Ambrosia Health in Monterey, California, immediately stopped treating patients. They had been charging $8,000 for one liter of young plasma.
If past regulatory actions are any guide, advertising changes prompted by official warnings do no damage to companies' bottom lines. In January 2016, the FTC fined Lumos Labs $2 million dollars for deceptive advertising of its Lumosity brain-training software, which claimed to protect against cognitive decline (Jan 2016 news). The company paid up, and the FTC doled out the money in the form of refunds to Lumos customers. Since then, Lumos Labs has changed its marketing to make more modest claims, but continues to maintain a customer base and offer new products (see 2016 Fortune article).
What Does the Science Say?
Could any of these brain health products actually help Alzheimer's patients? Gregory Cole at the University of California, Los Angeles, noted that some supplements, such as resveratrol, curcumin, and vitamin D, have demonstrated efficacy against AD-like pathology in preclinical studies and small clinical trials. However, no supplement has ever produced a clear benefit for AD patients in pivotal trials. Ginkgo biloba, the omega-3 fatty acid docosahexanoic acid, B vitamins, vitamin E, selenium, and resveratrol have all fallen short (Nov 2008 news; Nov 2010 news; Nov 2014 news; Mar 2017 news; Zhu et al., 2018).
Some companies abandoned clinical development when trials failed, only to market the compounds as "medical foods" (Oct 2009 series). Medical foods contain ingredients shown to benefit a particular disease or condition, and usually require a prescription, but they do not undergo FDA efficacy review (Morgan and Baggott, 2006). "CoQ10 is a good example of a nutraceutical with lots of interesting biochemistry in vitro, but it's been studied in Parkinson's and Huntington's and does not have clinical effects, even at doses that would cost ~$100/month at the health food store," Siemers wrote to Alzforum (Mar 2014 news).
"There is zero evidence from any reasonably rigorous study that any supplement or dietary aid has any benefit on cognitive function or decline in late life," Knopman noted. Other clinicians agreed, noting that the only time they prescribe supplements is when patients have a documented deficiency, such as for vitamin B12. A recent meta-analysis of vitamin and mineral supplements supports this position, finding no consistent cognitive benefit of supplementation for healthy adults across 28 studies (Rutjes et al., 2018).
In general, the researchers Alzforum contacted believe that the purported benefits of dietary supplements should be investigated more rigorously than current regulations demand. "Personally, I think that we owe it to the public to hold such potential treatments to the same standards of evidence that we do for pharmaceuticals when they advertise to the public directly," Doody wrote.
Philip Scheltens at VU University, Amsterdam, cited clinical trials of the nutraceutical drink Souvenaid, which he has helped run, as an example of how this should be done. In a two-year study of 311 people with prodromal AD, Souvenaid missed its primary endpoint, but met two secondary endpoints (Nov 2017 news). "I do think this is the way to test all these products, exactly as we do with pharma products, to avoid unfounded claims," he wrote (full comment below). Tobias Hartmann at Saarland University in Homburg, Germany, agreed. "Any health claim related to any intervention should be derived from an informative prospective clinical trial," he said.
One drawback is patents. Cole noted that because most supplements are not patented, they are unlikely to attract enough funding for rigorous clinical evaluation. "We need another mechanism to evaluate supplements … I believe the government should set up an internet-based, curated, evidence-reporting system that patients and their doctors can submit data to," he wrote to Alzforum (full comment below).
Bringing Order to the Wild West
What does the FDA think? While the agency has not proposed holding dietary supplements to the same standards as drugs, its recent statement outlines several steps it will take to modernize the regulation of this market. Gottlieb set up a Dietary Supplement Working Group that will develop better ways to enforce regulations, and will also create a "rapid-response tool" to inform consumers about deceptive advertising. The FDA established a public-private partnership, the Botanical Safety Consortium, to determine how best to evaluate the safety of dietary supplements. The agency plans to hold a public meeting this spring to discuss ways to foster innovation in the supplement field while maintaining safety. Finally, the FDA expressed openness to updating the DSHEA.
"It is appropriate for the FDA to continue to evolve its regulatory framework to best serve both consumers and a rapidly changing industry," Haake wrote. The agency would not make Gottlieb or other administrators available for an interview with Alzforum.
Some researchers believe revising the DSHEA is imperative. "I question the realistic impact these FDA actions can have when the DSHEA continues to allow manufacturers to make ambiguous claims of efficacy without supportive evidence … Stronger federal legislation is needed around supplements," Hellmuth wrote to Alzforum.
One example of how the DSHEA opens the door to potential harm is the burgeoning market for nootropics, so-called "smart drugs" that are purported to enhance cognition. Under DSHEA regulations for "structure/function claims," such supplements can be legally marketed as cognitive enhancers without clinical proof. One popular type is piracetam, a GABA derivative, and related racetam compounds. Others include plant extracts like forskolin, L-theanine, and bacopa monnieri. Under the DSHEA rules, even some prescription drugs fall into the nootropic category. These include modafinil and Adderall, which are prescribed for attention-deficit disorder. Websites and YouTube testimonials filmed by self-proclaimed "biohackers" promote the cognitive benefits of these supplements. In a June 2016 press release, the American Medical Association cautioned that the use of prescription stimulants to achieve a cognitive boost "is associated with a variety of adverse mental health conditions and patterns of substance misuse" while the benefits are "limited or modest at best in healthy individuals." Moreover, safety and efficacy for non-prescription herbal nootropics are unknown, the association added.
Does the FDA have sufficient resources to police the growing supplement market? While the companies that were warned have cleaned up their acts while the FDA is looking at them, similar peddlers are likely to pop up in a game of regulatory whack-a-mole. The FDA has limited staff and funding to comb through websites. "I remain concerned that the FDA lacks the authority and resources to protect patients from entities promoting pseudomedicine for dementia and brain health," Hellmuth noted. In a February 11 statement, the Council for Responsible Nutrition, the main trade association for the dietary supplement industry, based in Washington, D.C., called on Congress to appropriate more money to allow the FDA to regulate dietary supplements and "root out bad actors."—Madolyn Bowman Rogers
In general, I only recommend supplements in documented states of deficiency (for example, vitamin B12 deficiency). There is no strong support for taking vitamin or nutrient supplements in the absence of documented deficiencies for the prevention or treatment of cognitive impairment. In addition, supplements are often taken under the assumption that they are not harmful, which may not be the case. Lastly, many of the consumers of these supplements are persons on fixed incomes, such as retired elderly, who may be spending an important portion of their income on these unproven therapies. I believe that the actions by the FDA are necessary and long overdue, and I applaud its actions.
The FDA action is most welcome. Alzheimer's disease may be the single most feared disease in the aging population, and approved therapies, while modestly effective, are inadequate. So naturally millions of people seek alternative therapies, creating an enormously lucrative market for companies and practitioners to sell unproven remedies. Many people decide to spend money to try such therapies, believing that the touted benefits justify the cost and risks. In my opinion, it is very likely that virtually all such remedies are useless and some are potentially hazardous. (An exception would be the treatment of an individual with a documented deficiency, for example B12 deficiency, known to be associated with cognitive impairment.) In my view, the FDA and other regulatory bodies should move toward requirements that marketing claims for supplements be backed by rigorous clinical studies similar to those required for prescription drugs.
I think that anything that is unproven/not investigated for Alzheimer's disease should not be used! I never prescribe supplements, but do advise that people follow a healthy lifestyle, including meals that contain all the necessary vitamins. If deficiencies are present, for instance vitamin B12, we correct that of course. Of all the non-pharma products that I know for AD, only Souvenaid has been properly investigated in four clinical trials and in the LipiDiDiet study, but I am not the one to comment on these since I was involved as author and principal investigator of some of the studies. I do think this is the way to test all these products, exactly as we do with pharma products, to avoid unfounded claims.
In a nutshell, supplement manufacturers frequently make claims, either directly or through leaflets and media campaigns, that wildly overstate the evidence for efficacy. The most egregiously successful advertise about the benefits of orally delivered jellyfish peptides, but there are a host of less successful firms with misleading advertising. The FDA should crack down on those making false and very poorly substantiated claims. However, there are other types of supplements with substantial preclinical and mechanistic support and some clinical trial support that put them in a different class that I would call plausible but unproven. These include B vitamins to prevent deficiency, ketone-related supplements like Accera and immunomodulatory vitamin D, polyunsaturated fatty acids that give rise to resolvins, maresins, and protectins, and some plant-derived polyphenols and flavonoids.
One big problem is that like conventional drugs, many of the supplements work as interventions at early stages in animal models, which adequately model selected early stage events, but only get tested in humans in symptomatic patients. So they might work for prevention but not for treatment, and the barriers to getting FDA approval for prevention are huge. For example, resveratrol has a strong rationale, preclinical efficacy, and favorably moved CSF biomarkers for neuroinflammation in an Alzheimer's Disease Cooperative Study trial but it did not meet primary cognitive endpoints in AD patients. It appears to have beneficial activity but because it is a supplement without strong patent protection, it is not likely to ever get FDA approval. Similarly, curcumin is immunomodulatory and protective in many animal models for AD and related conditions and now in primates, and there is some limited evidence for bioavailable formulations in small clinical trials but failures with other formulations in AD patients. Because it can promote amyloid removal via the innate immune system and target oligomers, mechanisms it shares with many anti-Aβ antibodies that have target engagement in AD, this type of less-expensive immunomodulatory supplement has an intriguing mechanism-based rationale. Like other supplements, it is very difficult to get the funds to properly evaluate curcumin, but because it is a supplement, some patients and caregivers are testing it on themselves in the absence of satisfactory FDA-approved agents. There are anecdotes of remarkable symptomatic improvements with curcumin and some other supplements that encourage proper clinical trials, but even if they are done they are highly likely to be underpowered unless they can advance to proper trials in early stage AD patients via an NIA-funded cooperative consortium.
We need another mechanism to evaluate supplements. Because supplements are generally inadequately tested but available to patients, I believe the government should set up an internet-based, curated, evidence-reporting system that patients and their doctors can submit data to, and in return get an unbiased professional summary of the evidence for consideration that is better than Yelp- or Amazon-level feedback.
Supplements that can be marketed as medical foods, including omega-3 fatty acids, Fortasyn Connect/Souvenaid, and products under development by major food manufacturers, are receiving adequate trial support. As medical foods the FDA will have enough power to regulate them.
Definitely we need more randomize controlled trial evidence to back up any claims that any supplements / nutraceuticals / medical foods may improve cognitive symptoms in dementia or delay cognitive decline among individuals with normal cognition or mild cognitive impairment.
Trial results on all endpoints should be reported, regardless of them being positive or negative. And results should be interpreted objectively without biases.
Good examples in this field include the GEM study and the LipiDiDiet project.
With emerging new compounds and new formulations, clearly we need more such trials.
There is a Chinese saying well-known in Japan: "Medicines and foods come from the same sources." Indeed, hundreds of effective Chinese medications are being prescribed in Japan under health care, although the essential ingredients remain elusive in many cases. Chinese medicines are said to have survived 2,000 years of real-life "clinical trials." It is therefore possible that some diet-derived supplements may be effective.
There are, however, some problems: the ingredients of the Chinese medicines may differ depending on the site and timing of harvesting the source materials despite improvements in quality control.
Both for Chinese medicines and for commercial supplements to become relevant remedies, we need statistically significant evidence in experimental paradigms that correspond to such conditions as preclinical AD, subjective cognitive decline, pre-AD MCI, and AD. Obviously, use of pertinent animal models and recruitment of appropriate human populations must be practiced.
In addition, plasma biomarker(s) that can be used for presymptomatic diagnosis and for prognosis will accelerate our quest for answers.
The history of Alzheimer's Disease research demonstrates that getting a validated drug to market is incredibly difficult. So it is not surprising that all sorts of claims are made about alternatives, the "supplement hype" described here being one of them. Ethical guidelines for currently incurable diseases remind us that while there is room for innovation with new treatments in the absence of alternatives for patients, this should be done responsibly, rigorously, and with measured language, since claiming to have a treatment without strong data to back it up can create false hope, cause financial harm, undermine informed consent, and frustrate the production of generalizable knowledge necessary to find and validate a treatment for Alzheimer's.
In a recent article, we tackle the case of so-called "metabolic enhancement protocols" for Alzheimer's disease. We argue that their authors have overstated the evidence in favor of these interventions within the scientific and lay press, failing to communicate weaknesses in their data and uncertainty about their conclusions. We therefore offer more stringent guidelines for innovation in the Alzheimer's field.
Daly T, Mastroleo I, Gorski D, Epelbaum S. The ethics of innovation for Alzheimer's disease: the risk of overstating evidence for metabolic enhancement protocols. Theor Med Bioeth. 2020 Dec;41(5-6):223-237. Epub 2021 Jan 18 PubMed.
Make a Comment
News Citations
- Game Over? Federal Trade Commission Calls Brain-Training Claims Inflated
- Big Ginkgo Prevention Trial Comes Up Negative
- Paper Alert: Negative DHA Trial Fuels Soul-Searching in AD Field
- Older Adults Get No Cognitive Boost From B Vitamins
- In Cognitively Normal Men, Antioxidants Fail to Reduce Dementia Risk
- Medical Foods—Fallback Option for Elusive AD Drug Status?
- Coenzyme Q10 Strikes Out in Phase 3 for Parkinson's
- LipiDiDiet Data Published
Paper Citations
- Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 2005 Jan 4;142(1):37-46. PubMed.
- Schürks M, Glynn RJ, Rist PM, Tzourio C, Kurth T. Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials. BMJ. 2010 Nov 4;341:c5702. PubMed.
- Leszek J, Inglot AD, Janusz M, Lisowski J, Krukowska K, Georgiades JA. Colostrinin: a proline-rich polypeptide (PRP) complex isolated from ovine colostrum for treatment of Alzheimer's disease. A double-blind, placebo-controlled study. Arch Immunol Ther Exp (Warsz). 1999;47(6):377-85. PubMed.
- Leszek J, Inglot AD, Janusz M, Byczkiewicz F, Kiejna A, Georgiades J, Lisowski J. Colostrinin proline-rich polypeptide complex from ovine colostrum--a long-term study of its efficacy in Alzheimer's disease. Med Sci Monit. 2002 Oct;8(10):PI93-6. PubMed.
- Bilikiewicz A, Gaus W. Colostrinin (a naturally occurring, proline-rich, polypeptide mixture) in the treatment of Alzheimer's disease. J Alzheimers Dis. 2004 Feb;6(1):17-26. PubMed.
- Nafar F, Mearow KM. Coconut oil attenuates the effects of amyloid-β on cortical neurons in vitro. J Alzheimers Dis. 2014;39(2):233-7. PubMed.
- Zhu CW, Grossman H, Neugroschl J, Parker S, Burden A, Luo X, Sano M. A randomized, double-blind, placebo-controlled trial of resveratrol with glucose and malate (RGM) to slow the progression of Alzheimer's disease: A pilot study. Alzheimers Dement (N Y). 2018;4:609-616. Epub 2018 Nov 9 PubMed.
- Morgan SL, Baggott JE. Medical foods: products for the management of chronic diseases. Nutr Rev. 2006 Nov;64(11):495-501. PubMed.
- Rutjes AW, Denton DA, Di Nisio M, Chong LY, Abraham RP, Al-Assaf AS, Anderson JL, Malik MA, Vernooij RW, Martínez G, Tabet N, McCleery J. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database Syst Rev. 2018 Dec 17;12:CD011906. PubMed.
Other Citations
External Citations
Further Reading
- In Small Trial, EH301 Appears to Halt Progression of ALS
- Less Salmon, More Plaques? Link Between Omega-3s and Aβ Reinvigorates Fish Oil Debate
- Neither Exercise Nor Supplements Boost Cognition in Two Large Studies
- Cocoa Flavanols Give Memory a Boost
- Resveratrol Improves Memory in Overweight Adults
- Dietary Resveratrol Makes Little Difference to Health
- Trial Suggests Vitamin E Protects Function in Mild Alzheimer's
- Paper Alert: B Vitamins Slow Atrophy in AD Vulnerable Brain Regions


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cells slurp up fructose, US study finds
Study shows fructose used differently from
* Findings challenge common wisdom about
Pancreatic tumor cells use fructose to divide
and proliferate, U.S. researchers said on
Monday in a study that challenges the common
wisdom that all sugars are the same.
Tumor cells fed both glucose and fructose
used the two sugars in two different ways,
the team at the University of California
Los Angeles found.
They said
their finding, published in the journal
Cancer Research, may help explain other
studies that have linked fructose intake
with pancreatic cancer, one of the deadliest
cancer types.
findings show that cancer cells can readily
metabolize fructose to increase proliferation,"
Dr. Anthony Heaney of UCLA's Jonsson Cancer
Center and colleagues wrote.
have major significance for cancer patients
given dietary refined fructose consumption,
and indicate that efforts to reduce refined
fructose intake or inhibit fructose-mediated
actions may disrupt cancer growth."
article at: http://www.reuters.com


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