5701 s mopac expressway
Are you guys ready for this Sunday’s Bike for Brain Health along the DVP/Gardiner Expressway?
2023.05.31 23:44 Domane338 Are you guys ready for this Sunday’s Bike for Brain Health along the DVP/Gardiner Expressway?
2023.05.31 16:07 ReanimatedYT Who Signs VA Form 21-4138?
| || | submitted by ReanimatedYT to VeteransBenefits [link] [comments]
So, common sense is telling me, whoever the buddy statement is from, they would be singing the statement confirming that what they are saying is true. However, the thing that is throwing me off, is that on the Declaration of Intent page, it states signature of Veteran/Beneficiary
. The reason this is throwing me, is because the buddy statement could be from somebody whom is not a veteran. In this instance, the veteran would be me. And as far as beneficiary, I would also be the beneficiary, not the individual making the statement as they have nothing to gain from this. So am I signing the form stating that the statement is truthful to the best of my knowledge? Sorry if this is a stupid question. Thank you! https://preview.redd.it/gt1080zzs73b1.png?width=1630&format=png&auto=webp&s=bf68efe1967f98e0cfa66335fd60eab2cc5a413b
2023.05.31 13:46 Sherry_23 M3M Capital Walk: Where Luxury and Convenience Converge, Presented by Onkar Real Estate Solutions
Introduction: M3M Capital Walk
, an extraordinary commercial project in Sector 113, Gurgaon, is redefining the concept of upscale retail and office spaces. Developed by the renowned M3M Group in collaboration with Onkar Real Estate Solutions, this project offers a perfect blend of luxury, convenience, and world-class amenities. With its prime location, contemporary architecture, and commitment to excellence, M3M Capital Walk is poised to become a landmark destination for businesses and shoppers alike.
Discovering M3M Capital Walk: M3M Capital Walk stands as a testament to architectural brilliance and impeccable design. The project offers a diverse range of retail and office spaces that cater to the evolving needs of businesses. From high-end boutiques and fine dining establishments to modern office spaces, M3M Capital Walk presents an unparalleled opportunity for enterprises to thrive in a dynamic and vibrant environment.
Prime Location Advantage: M3M Capital Walk sector 113
, Gurgaon, enjoys a strategic location that provides easy accessibility to major road networks and key destinations. Its proximity to the Dwarka Expressway ensures excellent connectivity to Delhi and other parts of the National Capital Region (NCR). Businesses operating in M3M Capital Walk can leverage the advantages of a prime location to attract customers and establish a strong presence in the market.
Unmatched Amenities: M3M Capital Walk Gurgaon
offers a host of amenities that enhance the overall experience for businesses and visitors. With state-of-the-art facilities, ample parking space, and 24/7 security, the project ensures a safe and hassle-free environment. The beautifully landscaped surroundings and well-designed common areas provide an inviting ambiance, creating an exceptional experience for everyone.
Onkar Real Estate Solutions: Your Trusted Partner: Onkar Real Estate Solutions
, a renowned name in the real estate industry, has partnered with M3M Group to bring M3M Capital Walk to fruition. With its expertise and customer-centric approach, Onkar Real Estate Solutions has established a strong reputation for delivering exceptional projects. The company’s commitment to quality, transparency, and customer satisfaction ensures a seamless and rewarding experience for businesses and investors.
Investing in M3M Capital Walk: Investing in M3M Capital Walk is a lucrative opportunity for businesses and investors looking to capitalize on Gurgaon’s thriving commercial market. The project offers a range of retail and office spaces that cater to various requirements and budgets. Backed by the expertise of M3M Group and Onkar Real Estate Solutions, investing in M3M Capital Walk ensures a secure and rewarding investment with potentially high returns.
Conclusion: M3M Capital Walk in Sector 113, Gurgaon, developed by M3M Group in collaboration with Onkar Real Estate Solutions, is set to redefine the commercial landscape of the city. With its prime location, exceptional amenities, and contemporary design, M3M Capital Walk offers an unparalleled opportunity for businesses to thrive and grow. Whether you are an entrepreneur seeking a premium business address or an investor looking for a lucrative commercial property, M3M Capital Walk is the perfect choice. Partner with Onkar Real Estate Solutions to embark on a remarkable journey towards success at M3M Capital Walk.
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2023.05.31 13:25 Sherry_23 Hero Homes Luxurious Living in [City Name] Onkar Real Estate Solutions
is a real estate project in Gurgaon, India that offers premium residential apartments. Located in Sector 104 on the Dwarka Expressway, Hero Homes promises a luxurious living experience to its residents. The project is being developed by Hero Realty Ltd., which is a subsidiary of the renowned Hero Group.
The location of Hero Homes couldn’t be better as it enjoys easy access to various key areas of Gurgaon and Delhi. Hero Homes Dwarka Expressway
is situated just minutes away from Indira Gandhi International Airport and Dwarka Metro Station. Apart from that, the locality has excellent connectivity to other parts of NCR through major highways such as NH-8 and Kundli-Manesar-Palwal (KMP) Expressway.
Hero Homes boast world-class amenities that ensure comfortable living for its residents. The complex features beautifully landscaped gardens, a swimming pool, a gymnasium, a jogging track, a tennis court, a basketball court, and much more. Additionally, there are ample parking spaces available for both residents and visitors.
Not only does Hero Homes Gurgaon
offer luxury living spaces but also promotes eco-friendly practices through rainwater harvesting systems and solar-powered lighting fixtures throughout the complex.
Onkar Real Estate Solutions are one of the leading real estate agencies operating in Gurgaon offering services like property buying/selling/renting etc. They have been associated with some top-notch projects in Gurgaon including Hero Homes Sector 104
All things considered; if you are looking for a premium lifestyle apartment in Gurgaon then look no further than Hero Homes! With exceptional amenities coupled with prime location advantages — it’s hard not to fall in love with this place at first sight!
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2023.05.30 19:32 StayAtHomePhysicist PSVR2 and a weak stomach
I just got a PSVR2 and tried it out for the first time yesterday afternoon. I have a history with older VR mentioned in some thread back when the PSVR2 first came out, but the short version is it (Oculus DK2) turned my stomach inside out for 2 days after just ~20 minutes.
I didn’t have high hopes for this but the 30 day free return means even if it doesn’t work out I won’t be out any cash so I’m giving it a shot.
I’ve been playing with a Logitech G29 and sitting in an OpenWheeler Gen3 so right now only the VR is new. For my first driving experience I chose a stock Eunos Roadster on Tokyo Expressway. I drove for about 8 minutes at city / highway speeds and felt a bit of stomach churn from the hill at the first turn but it was mostly okay. The feeling of sitting in the car and being able to look around the interior was phenomenal (until I got a little too far from the driver’s seat and was met with a green wire frame and black void). I felt a bit queasy for the rest of the day after stopping and I’m still feeling it a tiny bit now 24 hours later but I’m going to try again tonight.
(TLDR) Does anyone, especially people who were able to overcome their motion/simulator sickness, have any recommendations for cars and tracks to try out that won’t turn me into a vomit fountain?
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2023.05.30 17:00 bikeforbrainhealth Baycrest Bike for Brain Health on the DVP this weekend
Put the pedal to dementia prevention at the Mattamy Homes Bike for Brain Health in support of Baycrest this weekend. The Don Valley Parkway and Gardiner Expressway go traffic-free this Sunday, raising funds to defeat dementia. We will ride, rain or shine!
Recreational and endurance riders have the choice of three distinct routes: 25km, 50km and 75km. New for this year is the addition of a timed 75km route for competitive distance riders.
Registration is still open for this once-a-year fundraising event: www.bikeforbrainhealth.ca
Already registered? Make sure you have your Bike Kit and keep fundraising!
Bike kits contain bike plates and other important information to get you on the DVP. Riders who live in the GTA and met the fundraising minimum before May 25 will receive their kit in the mail. Riders who haven’t met the fundraising minimum can:
- Pick up their event kit this week (full schedule here: https://bikeforbrainhealth.ca/event-day/
) and get immediately en route on June 4
- Pick up their kit on event day in the Enercare Centre (but give yourself extra time)
Raise at least $1000 to earn the 2023 Fearless Fundraiser Jersey and other exclusive perks. Learn more here: https://bikeforbrainhealth.ca/fearless-fundraise
Put your mind and body to it. Let’s defeat dementia.
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2023.05.30 12:56 godrej146noida Avail Pre-Launch Discount at Godrej Luxury Apartment 146 Noida!
| || |Godrej Sector 146 Noida Expressway submitted by godrej146noida to u/godrej146noida [link] [comments]
is a luxurious residential project that offers the best of modern amenities and features. Located in Noida, this project has been developed by Godrej Properties Ltd., one of India's leading real estate developers. It comprises 2BHK, 3BHK and 4 BHK apartments with sizes ranging from 995 sq ft to 2520 sq ft. The apartments are designed keeping in mind the needs and lifestyle preferences of today’s modern family living in urban cities like Delhi NCR region. https://preview.redd.it/m32m36y99y2b1.jpg?width=2048&format=pjpg&auto=webp&s=6b509ca4407215ea62e7dd0920bed56960835a6b Godrej property Sector 146 Noida
offers world-class facilities such as 24x7 security services with CCTV surveillance, power backup for common areas & lifts, swimming pool & gymnasium etc along with various sports activities including badminton court , basketball court , yoga/meditation area for its residents to enjoy a healthy lifestyle . In addition to these amenities there is also an exclusive clubhouse which includes a multi cuisine restaurant , spa facility etc offering complete relaxation . Furthermore it provides easy access to all major transport links such as metro station nearby making it convenient for families who need quick access into other parts of the city or even outstation trips easily accessible through expressways connecting Greater Noida - Yamuna Expressway & Faridabad – Ghaziabad – Meerut Highway (FGM). https://preview.redd.it/2yvr94oa9y2b1.jpg?width=720&format=pjpg&auto=webp&s=16c36f02e3edf11752750489b07f7dabe4138298
Godrej Sector 146 Noida Expressway promises luxury living at its best! With top quality construction standards combined with aesthetically pleasing design elements makes this property truly stand out among others similar projects around NCR Region . Apart from providing excellent connectivity options via roads/highways; close proximity towards malls /schools /hospitals make life easier while still enjoying a peaceful environment away from hustle bustle yet still connected within reachable distance when needed most !More help visit my site:- https://luxuryresidences.co.in/godrej-sector-146-noida
2023.05.30 11:44 Appropriate-Oven-641 Unlocking the Potential: Why Wadala is Emerging as the Ideal Real Estate Destination
Wadala, a vibrant suburb located in the heart of Mumbai, is swiftly transforming into a sought-after real estate destination. With its strategic location, excellent connectivity, and a slew of infrastructure developments, Wadala has become a hotbed for real estate investments. Among the prominent residential projects in this area, Dosti Eastern Bay by Dosti Realty developers stands out, offering an exceptional living experience. Let’s delve into why Wadala is emerging as the ideal real estate destination, with a focus on flats for sale in Wadala, 2 BHK in Wadala
, projects in Wadala, and 3 BHK in Wadala.
One of the key factors driving the popularity of Wadala is its excellent connectivity. The suburb enjoys seamless connectivity to various parts of Mumbai through major roadways such as the Eastern Freeway, Sion-Panvel Expressway, and the Eastern Express Highway. The proposed construction of the Wadala-Kasarvadavali Metro Line and the Monorail extension will further enhance connectivity within the suburb and make commuting easier for residents.
Wadala’s strategic location has also made it a preferred choice for homebuyers. Situated close to key business districts like Bandra Kurla Complex (BKC) and Lower Parel, Wadala offers a convenient commute for working professionals. Additionally, the suburb is in proximity to educational institutions, healthcare facilities, shopping malls, and entertainment hubs, ensuring a well-rounded lifestyle for its residents.
For those seeking flats for sale in Wadala
, Dosti Eastern Bay is an exceptional residential project that offers contemporary living spaces. The project features well-designed 2 BHK and 3 BHK apartments that are thoughtfully crafted to cater to the needs of modern families. The spacious interiors, premium fittings, and panoramic views make Dosti Eastern Bay an ideal choice for those looking for a comfortable and luxurious living experience in Wadala.
Apart from Dosti Eastern Bay, the locality boasts several other noteworthy projects in Wadala
that have contributed to its real estate boom. With a mix of premium and affordable housing options, Wadala caters to a diverse range of homebuyers. The presence of renowned developers, coupled with the availability of modern amenities and facilities, has added to the allure of Wadala as an emerging real estate destination.
Wadala’s transformation goes beyond residential developments. The suburb is witnessing a surge in commercial and retail projects, attracting businesses and creating employment opportunities. This growth has led to an increase in demand for residential properties, making Wadala a lucrative investment option.
Investing in Wadala not only offers excellent residential options but also promises high appreciation potential. The suburb has witnessed significant capital appreciation in recent years, making it an attractive choice for real estate investors. The continuous infrastructure developments, coupled with the overall growth of the suburb, ensure that Wadala’s real estate market will continue to flourish in the coming years.
In conclusion, Wadala’s rise as an ideal real estate destination can be attributed to its excellent connectivity, strategic location, and ongoing infrastructure developments. With its seamless connectivity, proximity to key business districts, and a wide range of residential projects, Wadala offers a promising living experience. For those seeking flats for sale in Wadala, Dosti Eastern Bay by Dosti Realty developers provides an exceptional choice with its well-crafted apartments. Whether you are looking for a 2 BHK or 3 BHK in Wadala
, the suburb has a variety of options to cater to your needs. As Wadala continues to unlock its potential, it is poised to become a thriving real estate hub in Mumbai.
This article is already posted on medium.com Ref URL: https://email@example.com/unlocking-the-potential-why-wadala-is-emerging-as-the-ideal-real-estate-destination-11b720ddd522
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2023.05.30 08:05 Inframantraofficial Godrej 101 Sector 79 Gurgaon - Godrej Properties New Launch
| || |Godrej 101 Sector 79 Gurgaon Godrej 101 submitted by Inframantraofficial to u/Inframantraofficial [link] [comments]
is one of the luxury developments in Gurgaon by Godrej Properties. Located in Sector-79 Gurgaon, it offers lavish 2 and 3 BHK Apartments with the floor plan size from 1383 to 2366 sq.ft. As the name specifies 101, it offers you not one or two but 101 reasons to live luxury and inspired life. This premium project is IGBC Silver pre-certified. Spread over 10.5 acres of land, it comprises 7 towers and a total of 404 apartments.
It reflects innovation, flexibility and sustainability along with style, grace and beauty. The surroundings are absolutely stunning with vast greenery, fresh breeze and positive vibes. There are beautiful gardens and parks for kids and old age people to sit, play, talk and relax. The neighbourhood has all the lavish amenities such as restaurants, schools, hotels, colleges, hospitals etc. Godrej 101 Gurgaon
at New Golf Course Road has been designed by the highly skilled and expert architects to show creativity and innovation in every project’s aspect. These luxury apartments are equipped with all the state of the art amenities and features like kids open play area, yoga and meditation centre, an exclusive clubhouse, fully equipped gyms under the same umbrella. Godrej 101 Sector-79 Gurgaon
has easy connectivity to NH-8, Sohna Road, Dwarka Expressway, popular schools and hospitals.
Check out the complete details here: www.ggnproperties.in
Contact Now: +91 9069142141
2023.05.30 03:04 Bubzoluck [22 min read] Differences that Divide Us - The role of Racial and Sex based Medicine
| || | submitted by Bubzoluck to SAR_Med_Chem [link] [comments]
Hello and welcome back to SAR! First off, I apologize for the hiatus in blog posts but had some things pop up and now I am clear! Alright off to the good stuff: For most things in life there are few reasons why one person of a particular sex or race would be more well suited to a particular job than another person of a different sex or race. Afterall, the quality of a cup of coffee would be just the same from a Black female barista with 10 years of experience as an Asian male barista with 10 years of experience. But medicine is a bit different; we do see differences because of sex or race that are important to understand, acknowledge, and factor into the diagnosis. Obviously a male isn’t going to have pregnancy on the differential diagnosis and prostate cancer isn’t a factor for female patients. The differences in Pharmacokinetics
of a drug, a disease, or treatment can vary wildly between the sexes or between races. So today I want to look at the differences that we are only now starting to realize and the emerging role of Pharmacogenomics
as the next horizon for medicine. So the big question is: you got something big in your genes or are you just happy to see me? :P Disclaimer
: this post is not designed to be medical advice
. It is merely a look at the chemistry of medications and their general
effect on the body. Each person responds differently to therapy. Please talk to your doctor about starting, stopping, or changing medical treatment.
Because I am a pharmacist I want to center our discussion on the drug choices and attributes influenced by sex and race but in order to do that we have to lay a foundation. The processes that move drugs from a pill into your body are broadly referred to as ADME
but there is a hidden L step that is just as important to talk about as well. The lifecycle of a drug, LADME, are the five major processes that affect a drug inside the body. Let’s look:
- Liberation - When you swallow a tablet, the pill as a whole isn’t magically absorbed through the intestinal wall, it has to break down and liberate the drug from the dosage form. Liberation is the process of how the vehicle (what the drug is administered as) is broken down so the drug is free floating inside the body. This is also where we can see differences in timing such as extended release or immediate release products. It also governs other forms too like tablets you can chew or patches you apply onto the skin.
- Absorption - Now that the drug has left the tablet, it needs to move from the GI tract space into the body proper. The mucous membranes inside the intestine have a HUGE surface area allowing for many substances to be absorbed quickly and efficiently. How well a drug is absorbed plays a major factor in how well the drug’s action is. What if you're administering an oral (PO) antibiotic but the patient has diarrhea and they move the drug too quickly through the intestines? Can we be sure it was all absorbed? This is why we have alternative administration pathways like intramuscularly (IM), subcutaneous (SubQ), intravenous (IV), rectally (PR), vaginally (PV), optically (OU), and more. Each gets the drug inside the bloodstream where it can then get to the place it needs to go.
- Distribution - Speaking of getting where it needs to go, we have distribution. Once the drug is absorbed and dumped into the bloodstream, it needs to go to the place where the receptor, channel, or structure is for it to have action. Some places are easier to get to like highly vascularized (lots of blood vessels) areas like skin, the liver, and kidney while others are a bit harder such as the heart tissue, lungs, and brain.
- “How does the drug know where to go?” It doesn’t! It will go everywhere in the body but that doesn’t mean that it will have action there. One good example is with Carbidopa, a dopamine receptor agonist used for Parkinson’s (oh look a post!). When a person take’s Carbidopa orally, it's absorbed into the blood and starts to distribute throughout the body generally. We want it to go to the brain to alleviate Parkinson's symptoms but it can also activate dopamine receptors in the periphery where it causes dizziness and constipation (I highly recommend reading the post if you want to learn how).
- Metabolism - Eventually the drug has to leave the body and metabolism is the first step in that process. Metabolism has two phases: phase 1 is responsible for deactivating the drug by modifying the structure of the drug in a way where it cannot fit inside the receptor anymore. Phase 2 takes the deactivated drug and makes it very water soluble so that it can leave the body extremely easily. The rate of metabolism is dependent on many different factors and is highly specific to each person which is why we do large pharmacokinetic studies in drugs before they are ready to be on the market. Failure to understand how a drug is metabolized can lead to toxicities from drug accumulation OR give too little a dose because the drug is metabolized so quickly.
https://preview.redd.it/5f8b8yxq9v2b1.png?width=490&format=png&auto=webp&s=64cd2ed43f824a34992bd51a7ed6ff322f4c1f70 5. Elimination
- The last step in the drug lifecycle is elimination or how it physically gets out of the body. The majority of drugs leave via urine of which the kidney is responsible for that process. Having a working kidney is key for correctly dosing a drug because an underworking kidney may not eliminate the metabolized drug fast enough causing it to accumulate. There are other pathways too; fecal excretion (through biliary elimination) is another major route but some drugs can be eliminated via the lungs (such as alcohol, which is why it can be detected in a breathalyzer), through breast milk (which is why understanding drugs in pregnancy is SUPER important), sweat, saliva, and sebum.
Obviously there are major differences in LADME between males and females—after all it's hard to insert a drug vaginally in a male. But now that we have a general idea of what the drug is going to be doing, let’s dive into each section and talk about the sexual and racial differences we see at each step.
Liberation—”Liberty, equality, fraternity, or death; - the last, much the easiest to bestow, O Guillotine!”
When we think of liberation I want you to think of two things: getting the drug out of the formulation (such as the tablet or capsule breaking down in the stomach) and where that breakdown happens. These two factors are hugely important when we think about how the drug will eventually get absorbed—after all if you can’t liberate the drug correctly then there is no chance that it will be absorbed and then be utilized by the body. First let's talk about formulations:
- In your daily life you’ve probably come across different formulations of drugs. Here we are going to look at the most basic of them: Immediate Release (IR), Delayed Release (SR), and Controlled Release (CR) also known as Extended Release (ER). The main differences between these different forms is how quickly the tablet moves from a solid lump sitting in your stomach to dissolved particles. The slower it releases then the slower the drug dissolves into your stomach and the slower it will eventually get absorbed. Initially all drugs were formulated as Immediate Release because we had little understanding of the utility of longer dosing formulations as well as we didn’t have the technology to do it. There are a whole bunch of different types of Extended Release types each with different uses and drawbacks and choosing which is best for your drug is extremely important for deciding what works best. At the end of this section is a diagram that shows all the different kinds of formulations.
- But for now I want us to focus on the graph of drug liberation curves. The graph is divided into three zones with two very important barrier points: the Minimum Effective Level (MEL, aka MEC) and the Minimum Toxic Level (MTL aka MTC). Essentially if the curve of the line, representing the concentration of the drug in the body, is below the Minimum Effective Level then there isn’t enough drug to exert its action and we have Subtherapeutic levels in the body. Over time, the tablet dissolves more and more and the concentration continues to rise more and more and we pass the MEL into the Therapeutic Window where we see the action of the drug. In general we can say the higher you are in the Therapeutic Window, the greater the therapeutic effect there is or in other terms, the higher the dose the bigger the effect. Finally if you go above the Therapeutic Window you pass through the Minimum Toxic Level and enter into drug toxicity levels. Now, toxicity is a bit of a harsh word because this doesn’t mean we are going to see death but rather side effects due to too great of an effect of the drug. For example, say you are taking a drug that lowers blood pressure but due to changes in the tablet liberation the concentration rises above the MTL and your blood pressure drops a little too much and you get dizzy.
- In the first graph we can see how drug design impacts the speed of liberation. Let’s say that we have 100mg of a drug that we are trying to put in the body. Using an Immediate Release formulation would result in a much quicker liberation and thus absorption into the body but we can see that it peaks very quickly and then drops off very quickly. So you may only get a few hours of usefulness out of the drug. Compare this to the Controlled Release system which peaks much slower but also declines much slower too, remaining much more Therapeutic for a longer period of time. We can see this in Adderall used for ADHD—most people will take an Extended Release (ER) formulation in the morning so that they get many hours of sustained therapeutic benefit while they are at school or at work. You can see one method of how the beads inside the Adderall capsule are made—called Pelletization. Essentially an inert core is layered with different chemicals/drugs to build an “Onion” of layers [insert Shrek reference].
- So wouldn’t extended release always be better because we avoid the toxic levels of a drug? Not necessarily. To give an example of one of my patients, this person was a 911 operator who would take their Adderall XR every morning at 8:30am and work from 9am to 6pm every day. For them, their Adderall would start to wear off at 4pm, so they would get 7 hours of benefit. But what abouts the last two hours of the work day? They can’t be distracted in their job else it costs lives and taking another Adderall XR would mean they are wired until 11pm. No good. This is where the utility of IR formulations come in—this person can take an IR dose at 4pm when the Extended Release starts to wear off and boost their levels back into the therapeutic range and get 3 or 4 hours of benefit but have it be gone by the time they go to bed.
- So hopefully you can see the utility of choosing different release systems now, but what about the second point: liberating in the right place in the body. Well some drugs are more effective if they are absorbed later in the digestive tract where it is less acidic versus the stomach. So some drugs may have better absorption if we can release them further towards the intestines than immediately dumping them into the stomach for absorption. This is where the utility of Delayed Release (DR) systems comes in. Drugs that are considered Acid Labile or sensitive to acid else they degrade are preserved better if they can liberate from the tablet in a less acidic environment. A great example of this is Omeprazole (Prilosec) which is used for decreasing the production of stomach acid to treat acid reflux or GERD—problem is that Omeprazole itself is very Acid Labile and if it enters the stomach unprotected then it degrades fairly quickly. This leads to the use of Omeprazole DR formulations where it is coated in substances that resist acid breakdown like Shellac or Sodium Alginate, thus allowing for the Omeprazole to be liberated in the small intestine where it is more likely to be absorbed.
- This is all well and good but how does this relate to sex and race? Well one of the major differences between males and females is that females have a more acidic stomach than males making their stomach environment much more acidic. In addition the Gastric Emptying Time, or how long it takes for substances to move from the stomach into the small intestine for absorption, is significantly longer in females. These two factors mean that females taking a drug that is Acid Labile are more susceptible to degradation in a female than in a male. This means the utility of an Enteric Coated drug which would resist stomach acid would be much more beneficial in a female than in a male. Let’s look at a specific example: the drug Carbidopa is used in Parkison’s to treat the tremors associated with the disease. In younger females, the peak blood concentration for Carbidopa is 22 minutes later than males of the same age. As a female ages and goes through menopause that time to peak becomes more and more similar to males meaning not only are we seeing variability in sex but also in age.
- Another example is looking at the effect of a drug's natural acidity with the relative acidity of that person. Ketorolac (Ketorol) is a non-opioid pain medication used for moderate-severe pain in people where an opiate may not be preferred. The problem with Ketorolac is that it is extremely acidic naturally and it can cause ulceration of the stomach lining if someone has a very acidic stomach environment like a diet filled with acidic food. What we find is that males can have a Ketorolac dose 36% times higher than females because their stomachs are naturally less acidic meaning that they can handle a more acidic drug without the negative side effects like acid reflux or ulceration.
- On a racial standpoint we see similar outcomes. It is reported that individuals of Asian descent have a lower acid output compared to Occidental patients. Part of this can be related to the relative smaller body habitus (weight and height) in the Asian population but there is also a decreased expression of acid-producing tissues in the Asian population than other races. When quantified it appears that Asians have about 60% the acid secretion of Caucasians which is a clinically significant difference when considering drugs that need a more basic environment. For example, Levothyroxine (Synthroid) is taken one hour before breakfast because we want the least acidic environment possible, which happens when the body has no food in it. What we find is that Asian populations need up to 55% smaller doses of Levothyroxine compared to non-Asians. Kinda interesting eh?
Is that a polymorphism in your pocket?
Originally I was going to look at each part of LADME individually but kept running into a problem when trying to separate the drug processes into silos. While Liberation is distinct from the rest of the process, ADME cannot really be separated into its components in a way where I can tell the story efficiently. As such we will focus on the poster drugs that are significantly affected by race and sex and then talk about the larger implications in therapeutic development. Now clearly there are drugs that are used in one sex over another, for instance you aren’t going to find Atosiban
used to delay labor in a male or Sildenafil
(Viagra) for erectile dysfunction in a female. Now that being said they do have other uses but you get the point—so if I talk about a drug please know that I may be talking about a specific indication as well. So with that in mind, let’s jump in!
https://preview.redd.it/t743qrdnav2b1.png?width=415&format=png&auto=webp&s=ab664f0523de9b7ade071ad07840698074dc1715 https://preview.redd.it/hdrinkpxav2b1.png?width=743&format=png&auto=webp&s=cc11930d2c0922801d093b2976afdb2d15df2d78 BiDil finds a home among Black patients
—Hypertension, or high blood pressure, is one of the most common conditions across all races and sexes and is usually referred to as the “Silent Killer” because, well, it doesn’t hurt. Unlike liver failure or an infection, you won’t really see any symptoms of high blood pressure but after a decade of not treating it people do develop critical end organ damage: heart failure, kidney damage, liver damage, etc. Imagine that your veins are like a garden hose; if you put your thumb over the end of the hose the velocity of the water coming out of the hose increases meaning that there is more force. So if you have higher blood pressure, you have higher force hitting your organs. So the medical community has developed countless ways of lowering blood pressure to help save our organs and we can group those medications into a couple categories.
- For the majority of the population we follow a pretty tried and tested protocol of drugs: first up we would use Diuretics which physically decrease the amount of fluid that is in the blood vessel. In the hose analogy this is like if you had a leak halfway up the hose lowering the amount of water exiting the hose at the end. Now there are dozens of diuretics but most people are familiar with Furosemide (Lasix) and how it makes people urinate more (y’know, to get rid of the fluid). If someone needs another agent we turn to drugs like the Angiotensin Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARBs). The ACEs (like Lisinopril, Enalapril, or Benazepril) and ARBs (Valsartan, Olmesartan, etc.) work by inhibiting the ability for a protein, Angiotensin, from connecting with the blood vessel wall. Angiotensin’s main job is to make the blood vessel smaller which would increase blood pressure—these drugs inhibit the action of Angiotensin thus preventing it from raising blood pressure. And our final category are drugs acting on the heart: Calcium Channel Blockers or Beta Blockers. While generally more helpful in situations like heart failure than hypertension, these drugs slow down the heart’s ability to pump blood which then lowers the force that the blood is acting on the blood vessels and organs. In a way it's like turning the faucet on the garden hose letting out less water into the hose.
- So to summarize, the majority of people will benefit most from a Diuretic (which lowers the amount of fluid in the blood vessel), an ACEi or ARB (which prevents the blood vessels from getting smaller), and/or a CCB or BB (which lower the output of the heart).
https://preview.redd.it/iqua3w32bv2b1.png?width=343&format=png&auto=webp&s=8aeed509a15f83057db180b80eaf8b70b983a16d Hydralazine vs Isosorbide Mononitrate
- Enter the Venous Dilators which work by directly expanding the blood vessel size. These drugs are normally used in situations where the blood vessel is obstructed, such as during a heart attack or stroke, due to a clot. Administering a Venous Dilator would expand the blood vessel allowing the blood to wiggle around the clot and relieve the symptoms of the heart attack or stroke. Two of these drugs are Hydralazine and Isosorbide Dinitrate which are used by all sexes and races to prevent the progression of a heart attack and stroke which have very good success. Both of these drugs are fairly old: Isosorbide Dinitrate was discovered in 1949 while Hydralazine was discovered in 1949 and showed fairly good efficacy for decades.
- Enter two doctors, Jay Cohn and Peter Carson, who wanted to market a new combination drug Hydralazine/Isosorbide Dinitrate (BiDil) in 1989 for congestive heart failure. The FDA said sure, go do a trial and so the duo set out to prove that BiDil was a good option for the general population. They tested their combination in a trial called Vasodilator-Heart Failure Trial (V-HeFT) against the gold standard Enalapril (ACEi) and found that BiDil was…bad. Like really bad, in fact they had to stop the trial early because it would have been unethical to keep people on the BiDil rather than on the known treatment. So V-HeFT didn’t show that BiDil was a good option for the general population except among one subpopulation: Black patients. When you look at the use of Enalapril (and other ACEi) in Black patients we find that the efficacy is quite low. As it turns out, people of African descent have a lower response to drugs like ACEi and ARBs compared to non-Africans meaning that they are worse options for a Black person. So a patient that wasn’t responding well to a Diuretic and needed a second agent would get little help from an ACE/ARB drug. And at this point in time there were no CCB or BB!
- So Cohn and Carson’s drug application for BiDil was rejected in 1997 because the statistical analysis in their multi-racial study was quite bad. On the recommendation of one of the FDA’s advisory committees they stratified the data on racial lines and discovered a significant difference in response among Africans vs non-Africans. They started a new trial and enrolled 1050 African men and women showing a 43% decrease in mortality and a 39% reduction in hospitalization against placebo. They reapplied for BiDil and in 2005 the FDA approved the first ever race-based drug. To this day if you go to BiDil’s prescribing page in a drug database it will include a specific race designation because it’s only approved for a specific race. Importantly too national organizations like the American College of Cardiology and American Heart Association endorse this race based recommendation for Black patients.
- Now this is great that we have a recommendation for a group of people that is superior to the normal regiment but there are a few complicating factors to consider. Firstly the term ‘Black patient’ isn’t really scientific—how Black does a patient need to be in order to qualify for BiDil? What kind of Black as well: African, Latin American, Caribbean, etc? Likewise this means it has to be self-reportable but what about a light-skinned Black person that was adopted and didn’t know they had Black genes? It's all very…unscientific. Recently there has been push back against this explicit race-based recommendation since other effective drugs do exist (like the CCB and BB which were discovered in 2006, one year after BiDil). There was a new study in 2022 from UCSF that talked about the role of prescribing based on race but personally I think there are too many confounders (influencing factors) like socioeconomic status to accurately say BiDil should be done away with. BiDil was shown to be effective in the Black population but how it gets applied is another story.
https://preview.redd.it/qs817v27bv2b1.png?width=570&format=png&auto=webp&s=bfb725e4bac64a0b564ac3ac9de7151b68ce3c1b https://preview.redd.it/w71a739dbv2b1.png?width=500&format=png&auto=webp&s=5fb3dd3701992dc410e32638283928e29df14859 Liver Enzyme Distribution affects Metabolism
—Once a drug is in the body it needs to be deactivated and removed eventually. This process of deactivating a drug happens during Metabolism which primarily happens in the liver via the Cytochrome P450 Enzymes
. These CYP enzymes are like little factories that take up a drug and make slight modifications that remove its ability to affect the body. Each CYP enzyme is best suited for certain drugs while some enzymes, like CYP3A4 and CYP2D6, are able to handle a higher percentage of drugs. You can see in the pie chart above that some enzymes are more important in metabolism than others.
- That being said, the distribution of the CYP enzymes is not constant from one person to another. For example, in females they have a higher distribution of CYP3A4 than males which can be thought of them having more deactivation factories than males. This means if we were to give the same dose to a female and a male the female would metabolize the drug much faster and thus have a decreased effect. This is incredibly important because CYP3A4 accounts for 30% of all drugs including birth control, many psychiatric drugs, and chemotherapeutics meaning that females would need higher doses than males, in theory. The opposite is true for CYP2E1 which is higher in males than females and is a metabolizer of ethanol (minor) and caffeine (major) which means that higher doses of both would be needed to have the same effect male vs female. Neat eh? Like there are sex differences for CYP enzymes we are starting to discover racial differences in CYP enzymes: we have identified Polymorphisms or small genetic variability among the genes that encode the CYP enzymes. Truthfully this isn’t surprising, we know there is genetic variability in genes that affect hair or eye color, so it's not too surprising that the CYP enzymes are equally affected. What is interesting is that the racial differences in CYP enzymes can lead to wildly different enzyme activity levels that lead to clinically significant differences in drug response. Or in simpler terms, some races respond better to some drugs because they have different liver enzymes!
- Let’s take a look at one drug, Amitriptyline (Elavil) used for depression and anxiety, and how Polymorphisms result in changes in response. Quickly let's take a look at the metabolism: we can see that Amitriptyline is metabolized by two enzymes, CYP2D6 and CYP2C19. If it is metabolized by 2D6 first then it converts into an inactive metabolite that is eventually removed from the body. However if it first goes through 2C19 then it is converted to an active metabolite, Nortriptyline which would extend the action of the drug than if it went through 2D6. But if it does go through 2C19 then it will be handled by 2D6 into an inactive metabolite (bottom right), so either way we need 2D6 to get rid of the drug.
- So let’s look at what happens when we mess with the metabolism of Amitriptyline through 2D6. Well if someone is a 2D6 poor metabolizer then they would be unable to clear the drug quickly and so it would hang around in the body longer—so more anti-depression activity (and side effects). We find that up to 10% of Caucasians are poor 2D6 metabolizers meaning that they would have a better response to Amitriptyline than those who are normal metabolizers. Likewise we find that up to 51% of Asians are intermediate metabolizers which has led to an overall increased response of 74%! The flip side to this are the Ultrarapid metabolizers who would clear the drug extremely quickly through 2D6 thus leading to a decreased response to Amitriptyline. Up to 29% of Subsaharan Africans are found to be Ultrarapid metabolizers meaning that Amitriptyline (and other drugs going through 2D6) is the wrong option for them.
- Looking at 2C19 we see a much different distribution among the races. Remember that 2C19 converts the drug into an active metabolite which would extend the activity of the drug—if you don’t go through 2C19 then you’d have a decreased response. So patients who are Oceanian have a whopping 89% chance to be an intermediate or worse metabolizer and so a much MUCH higher chance of decreased response to Amitriptyline. Compare this to Caucasian patients who have a 32% chance to have increased activity on 2C19 meaning a potential increased response to Amitriptyline.
- Now is it really as simple as this? No, I am glossing over some of the finer details but I wanted to show how racial differences are a major factor in how drugs affect the body. Imagine if you had a population that had an 89% chance to have a decreased effect on birth control? Or what if you were a carrier of the HLA-B*5701 gene which means you are horribly allergic to the anti-HIV medication Abacavir (like up to 20% of Indians)? This is where the next generation of medicine comes from and the Clinical Pharmacogenetics Implementation Consortium is aiming to have their CPIC genomic guidelines become standard practice. In fact I am seeing more and more patients getting their liver enzymes done so we can see what kind of response they would have, especially if they have failed multiple drugs for a condition. Take a look at the guidelines page and see how many drugs are incorporated into the recommendations.
Regardless, pharmacogenetics has major impacts on how we treat patients every day but also may be a factor in some of the clinical disasters that we see. Afterall, 53% of Africans have decreased metabolism through CYP3A4 which is the major metabolizer of Fentanyl
which may be a contributing factor why Blacks face higher overdose rates. If you haven’t, consider getting a pharmacogenomic test (many insurances will pay for it now) and unlock some secrets of your own body! Cheers!
2023.05.29 18:41 dreadfoil Thoughts on Japalachian Architecture?
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2023.05.29 15:26 AbleBird9647 Why Should You Choose Godrej Tropical Isle?
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2023.05.29 09:23 housingdream4 Bhutani Cyberthum office space
is a leading example of tomorrow’s landmarks. Cyberthum is an office & commercial project that has been recently launched by the reputed developer of commercial real estate– Bhutani Infra, located at Sector-140A, Noida Expressway, it touches 26.8 Acres and includes 2 imposing 50-story tall towers. Office and Commercial space are available in this landmark project. In addition to an ultramodern design, the project offers the best access to a metro station and an expressway, making it a desirable location for office space. Bhutani Cyberthum Sector 140A Noida
provides you with your first workplace space at a low cost. The project offers Lockable office space and a Retail market in sizes ranging from 153 sq ft forwarder. The tallest industrial tower in North India offers fine eating choices, a novel leading street retail searching destination, & an alluring unreal lake covering 6.5 acres. All retailers projected on Lower Ground Floor, Ground, and Higher Ground Floor are lockable.More Info:- https://bit.ly/3Oyvey0 Bhtani Cyber Park Bhutani Technopark Bhutani Alphathum
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2023.05.28 20:31 Longjumping_Pin5707 M21 honest thoughts?
2023.05.27 21:42 danielogiPL Sideshow Bob Roberts review
★ Do I like this episode? Why or why not?
I love this episode, just the standard of Season 6 being extremely funny.
This is another of the show’s episodes that is built up entirely on political references, like Mr. Lisa Goes to Washington, except this episode I understood a bit more (I do like the S3 ep though). Sideshow Bob running for mayor is a neat idea, and I like how the episode both plays out realistically with him having to get Springfield to like him before actually winning, AND satires the election with how people pick the most ridiculous reasons to vote for him (Homer likes his idea of killing Selma, the elders will get a Matlock expressway, etc.).
In the meantime, I like how the episode also balances this out with the typical “Sideshow Bob hates the Simpsons” plot. It’s not exactly Cape Feare where he tried to kill Bart, but instead we have him trying to demolish the Simpson home, and with Bart, he just moves him to kindergarten. I kinda like how Bart being in kindergarten is played out realistically with him actually doing very well in it. Also, I love Lisa in this episode - she’s very devoted to proving that Bob rigged the election, with one of her motivations being to not have the family house demolished (if this were a later episode she’d probably do that because something something politics). This is the FOURTH episode in a row not counting the clipshow to have Bart and Lisa work together, I always love when the two team up. Also, shout out to Marge at one point defending her home from getting demolished, same with Homer.
Even WITH the political satire I mostly don’t get, it doesn’t stop me from enjoying the episode a lot anyways.
★ Jokes I like?
-”No sports, no rock, no information, for mindless chatter we’re your station!” And this is the first line of the episode.
-I like the transition from Homer eating donuts to Birch Barlow also eating donuts.
-The bats in the library. This gets a callback about 15 or so minutes later, when Bart and Lisa look in the library, and bats come out of nowhere. This callback had me laughing a lot, I love this joke.
-Birch Barlow badmouths Mayor Quimby, and we just see him watering his plant. “Hey, I am no longer illiterate!”
-Bart says that he’s doing a school project on fireworks, and Marge doesn’t believe him, throwing them away… then it turns out he WAS gonna do a fireworks display. Oopsie.
-Lisa asks Homer to switch the radio station, and Homer says that when SHE’s driving, they will listen to what she wants to. It then cuts to her ACTUALLY driving the car, and Homer says he can’t take it anymore. This joke makes me laugh every time, the transition is just perfect.
-”Dad, I’ll spare you the embarrassment of not knowing who Sideshow Bob is.” “Whew!”
-”Bart, your mortal enemy is on the radio!” Then it’s Dr. Demento. Bart throws away the radio in panic. “I meant your OTHER mortal enemy, Sideshow Bob.” Also, “I’m only 10 and I’ve already got two mortal enemies…”
-Matlock Expressway. The way Abe screams his name kinda gets me.
-I love the cutaway to Bob in prison. There is a ruckus going on, and Bob is casually talking on the phone.
-”Well, despite Bart’s objections, the people of South Africa can now vote in free democratic elections.”
-Moe handing out grenades to everyone at Moe’s Tavern. And then he takes them back. “Hey, who pulled the pin on this one!?”
-I love the scene with Bob evilly going towards the camera, only to fall into water. Brilliant mood swinger. “Boat’s on the other side!”
-”The next mayor of Springfield!” We just see a water dispenser.
-”No grass eating. This means you, Ralph.” Ralph has apparently actually been doing that.
-”HELP! I’M BEING ATTACKED BY UH, THINGS!”
-”No children have ever meddled with the Republican Party and lived to tell about it.”
-”And stay out of Riverdale!” The fact Homer gets kicked out of a car next to his house RIGHT AFTER Bart is just so funny. This gets a callback later when Bart says that Woodward and Bernstein’s dad wasn’t in the car reading Archie comics. “Stuck-up Riverdale punks thinking they’re too good for me!”
-The "Vote Quimby" song
is so funny, I legit forgot about this joke until rewatch but it had me laughing a lot. “It’s not the mayor’s fault that the stadium collapsed!” Cue Quimby shrugging.
-”Uh yeah yeah, I love Grimby.” Also, Milhouse covered in Quimby bumper stickers. “AAAAAAA, WHAT’S HAPPENING!?”
-Bob promises the elders that he’ll spend the afternoon listening to them. When Abe starts speaking, his face turns into an “oh God” face. Also, Abe describing the radio itself. “A, he’d say. Then, B. C would usually follow.”
-”Even though we are broadcast on FOX, there is no need for obnoxious hooting and hollering.” Cue the audience doing that.
-”I’d say Les Whinen ought to do more thinking and less whining.” Also, Bart admitting the line was good.
-I like the flames added to the recording of Quimby. It seems Channel 6 didn’t really add them for a reason, they just did.
-”I don’t agree with his Bart killing policy, but I do approve of his Selma killing policy!” Pretty sweet Homer doesn’t want Bart killed, ngl.
-Kent Brockman taking Bob’s evil laugh for him celebrating.
-”IT’S THE RAPTURE! QUICK! GET BART OUT OF THE HOUSE BEFORE GOD COMES!”
-Homer misnaming Bob as “Terwigiger”.
-Bart playing with the Flinstone phone. “Yabba dabba do, I like talking to you!”
-”I thought this was a SECRET ballot!” “Meh.”
-Smithers is in the dark, secret and all, but then Homer drives near him completely out of nowhere and reveals him. “HEY, MR. SMITHERS! :D”
-”The dead have risen, and they’re voting Republican!”
-”Alright Bob, NOW IT’S PERSONAL!” “Hey, he did try to kill me.”
-Lionel Hutz asks Bob if he rigged the election. He just says “no, I did not”. Complete silence. And then Lionel Hutz asks the kids for help.
-Bob rambling about Bart and Lisa not being able to handle the truth, and then “will you get to the point?”.
-”Aw, tomorrow we were gonna find out who the dish ran away with. :(“ “The spoon, Bart…”
★ Any problems I have with this episode?
I’m not really a politics person, so I didn’t get some of the political satire here! But that isn’t much of a problem anyways.
★ Do I have an unpopular opinion about this episode? What is it?
Nope, not at all.
★ Something I would change?
I don’t think much needs to be changed here, I like how the episode played out.
★ Rating out of 10?
10/10! I love this episode, one of my favorite Sideshow Bob episodes.
★ Anything else I want to say about this episode?
Fun fact, during the scene with Smithers, I actually predicted it was gonna be him before the lights revealed so.
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2023.05.27 21:18 Bbybat222 PWBPD going thru breakup, how do I move on?
For the past week I’ve been sobbing and I feel like I’m detoxing, To be clear I’ve never done drugs, I’m traumatized beyond repair by my father being an addict. But my long time partner of a year has broken up with me in the most traumatic matter (by leaving me in the middle of Chicago (they had a panic attack so they had to leave) (because we were at an anime convention)and breaking up with me over a text message, right before I had to go on a busy traffic ridden expressway, let’s just say that I didn’t drive too safely that day) after they sent me that text I raced from Chicago to NWI (a long drive) to their house. I admit that that probably scared them away but at the same time what was I supposed to do? I was not getting any answers after the text message I had received even tho they promised to answer any questions I had about the breakup. I knocked on their door but their grandma said they weren’t there and with friends. Which I know not to be true. I tried calling their mom to see if they were ok but she said the same thing. I had to get any and all answers from their friend who had told me that they never ever want to speak to me again after pulling what I pulled and that they allegedly had been out of love with me for 4 months. So now I’m just left here to sit with whatever I can have of closure because I haven’t seen them since we both broke down in front of eachother, I haven’t been able to eat without feeling sick, I wake up in the night shaking and sweating and I also just am shaking in general because of how anxious I am, and I can barely form a coherent thought without them crossing my mind. One part of me is just ready to move on to a new person but another knows that it’s not right it’s essentially just rebounding which will not lead to good places. Oh also did I mention that this is a Lesbian relationship, meaning on top of the searing emotional pain I have from BPD but I have the added injury of this being my first lesbian heartbreak. What hurts is that I know my bpd played a factor in them leaving and falling out of love with me because they called me “obsessive” but then. Again I warned them about that, and gave them so many chances to communicate if they ever felt offput by me being the way I am because i genuinely wanted to improve on my bod for them. So again now I’m stuck here feeling like I’m just some unloveable crazy person. Can someone help me feel less awful?
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2023.05.27 14:15 godrejplot Luxury Residential Projects Sonipat Haryana
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Have you ever imagined living a life surrounded by lush greenery and complete nature? If yes, then Godrej Green Estate Sonipat is the answer to your dreams. Located in Haryana’s upcoming smart city, Godrej Green Estate Sonipat
is a first-of-its-kind residential project that offers luxurious living amidst nature. Spread over 48 acres, this project offers a variety of housing options to choose from, ranging from 1BHK to 4 BHK and even villas. It is designed to provide you with every modern amenity and comfort in a serene environment. Here's why you should consider Godrej Green Estate Sonipat as your home. https://preview.redd.it/osnoipzl8d2b1.jpg?width=1640&format=pjpg&auto=webp&s=a14bdaa4f35d88afd7835e4499b060a0131bb075 Connectivity:
Godrej Green Estate Sonipat is well connected to the rest of the city through various modes of transport. It is just a few minutes away from the National Capital Region and enjoys the proximity of a number of educational institutions, hospitals, shopping malls, and other important places. It is located in close vicinity of the upcoming Kundli-Manesar-Palwal (KMP) Expressway, making it easily accessible from Delhi and other cities in the NCR. The Smart Living Experience: Godrej Green Estate Sonipat
is an integrated township that offers a smart living experience to its residents. It has been designed with the idea of providing a safe, secure, and eco-friendly environment. The project is equipped with several amenities that make living here a delight. Some of these amenities include an aqua gym, a swimming pool, a clubhouse, a meditation centre, sports facilities, and more. The project also has a dedicated security system in place to ensure the safety of all residents. https://preview.redd.it/1hge24on8d2b1.jpg?width=1080&format=pjpg&auto=webp&s=3be928044ba914cd51cec84cc4f120a91adb790e Eco-Friendly Environment:
Godrej Green Estate Sonipat is one of the most eco-friendly residential projects in the region. It has been designed to be energy efficient and make use of renewable energy sources. The project makes use of solar energy for lighting, and rainwater harvesting systems for water conservation. It also has green spaces and gardens that make it a perfect place for nature lovers.
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2023.05.26 12:31 SEN450 what's your best time for the Tokyo grind race?
2023.05.26 10:53 Able-Hat-7421 MALL OF NOIDA 😍😍
| || |
MALL OF NOIDA 😍 submitted by Able-Hat-7421 to indianews [link] [comments]
Welcome to the Mall of Noida, Sector 98, the ultimate destination for shopping, entertainment, and now, an incredible opportunity for business owners and food enthusiasts alike!
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2023.05.26 03:26 Ok-Wafer3542 Totaled my car, but my airbags didn’t deploy?
OK here we go number two. I just had a whole long ass story and my phone deleted it as I was going to post it so I’m just gonna do the quick details for you because I’m on the verge of losing my shit lol. Got the 2021 car April 14th Minor accident April 27th with the break assist on in my car and the car didn’t stop and hit the car in front of me. May 7th getting off the expressway I wasn’t being attention and drove through the trees on the left shoulder. Front driver side looks like a T-Rex bit a huge chunk of the corner hood Tell truck driver told me to, investigate because the airbag didn’t deploy. Body shop said it wasn’t totaled, but had to wait for the adjuster. Adjuster called and said the car was totaled and I would get most of the Car paid for probably. The insurance company is picking up the car tomorrow morning and I have to go get my stuff out. Now do I have any sort of case here even if it’s just to make sure this doesn’t happen again I don’t know if I’m allowed to mention the car company but I just wanted to see if anybody could help. I am able to afford a lawyer as long as I have some sort of win lol. Can I just want a new car for free. That would be kinda cool. Hope you guys have a good day. Thank you☺️
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2023.05.26 00:47 Ok_Battle_4082 Slow car
I’m trying to do the world touring 600 challenge for the Tokyo Expressway due to it giving such a big reward. It caps at 600pp and I’m using a Civic Type R (EK) ‘98 with soft racing tires coming out to 599.33pp. The problem is I am actually getting blown out of the water in this race, I start in 20th and finish in 20th. I have all driving assists disabled and this issue really isn’t anything to do with my driving, it’s that my car is straight up significantly slower than all the other ones even though I’ve maxed my pp. Please help!
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2023.05.26 00:27 Previous_Cycle_6404 Good ole summer driving switch.
The driving has switched unfortunately. I deliver for FedEx and have to take 55 ever day. Hate two lane highways. It’s either 45 mph or 100. Witnessed the accident at exit 58 a week or two back. Hopefully everyone was okay. Saw it in my mirrors. Felt like the car in back of me hit the car in front of me but idk. Add in that stupid drain cleaning. Hopefully that’s done. Also saw the car on the expressway at exit 33 a few days ago. Not good. Be safe out there everyone please.
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