The Tomorrow War, opening on Amazon Prime this week, is a big, dumb, beautiful blockbuster starring Chris Pratt as a time-traveling ex-soldier science teacher battling aliens who look like giant killer lice. I appreciate a film that takes big swings, and The Tomorrow War is the Babe Ruth of narrative conceits.

Pratt plays Dan Forester, an Iraq War veteran and current high school science teacher who learns, during a Bane-style interruption of a climactic moment of the soccer World Cup, that scientist/soldiers from 30 years into the future are locked in a losing battle with a species of pestilential, man-eating aliens known as white spikes (I prefer their older stuff).

In 2051, humanity is down to its last 500,000 people, but theyve figured out how to open a rudimentary wormhole into the relatively recent past. Theyre using this bridge, like two rafts on a running river (because time only moves in one direction) to draft the manpower future humanity needs to fight off the aliens from the most abundant source of it: the pre-alien invasion past. In other words, the future folk need present people to fight The Tomorrow War. Get it? You get it.

One day, while trying to convince a classroom full of defeatist high school kids that science is the key to their future (theyre rightly a little lukewarm on the idea of dutiful self-improvement knowing theyre all probably just going to get eaten by aliens in 30 years) Forester gets an amber alert on his phone demanding that he report to the draft board. A group of fresh-faced, curiously attractive doctors and soldiers from the future order Chris Pratt to take off his shirt for unclear reasons and affix him with a metal wrist cuff that will both facilitate his time jump and alert the authorities if he tries to desert.

So it is Forester is forced to leave behind his modest life and adorable family (which includes precocious daughter and beautiful wife played by a mostly-wasted-on-this-minor-role Betty Gilpin) to join a rag-tag crew of regular Joes about to be sacrificed to the future bugs. This crew includes characters played by Sam Richardson (Veep, Detroiters) and Mary Lynn Rajskub (Its Always Sunny, Brooklyn Nine-Nine) part of a larger, weirdly-effective Tomorrow War strategy of casting comedic actors in not overtly-comedic roles.

Presumably, these are just actors director Chris McKay knows from his past comedic work, directing The Lego Batman Movie, Robot Chicken, and working in the animation department under Lord and Miller. While there isnt anything overtly parodic about The Tomorrow War, which is mostly a straightforwardly earnest alien drama, you can tell McKay is having a blast making it, which helps make a lot of the silliness work. McKay and screenwriter Zach Dean are constantly finding the distinction between corny dialogue that makes you groan and corny dialogue thats so perfectly on-the-nose that its kind of brilliant. Im just trying to save my daughter, Forester explains to a fellow grunt, And if I have to save the entire world to do it, so be it.

Thats a corny line that couldve been the tagline to dozens of movies, from most of the Seagal/Neeson/Willis ouvre to Ben Stillers Scorcher franchise from Tropic Thunder. Yet the Russian nesting doll of spoiler-y plot conceits that The Tomorrow War constructs to justify it are almost avant-garde. The Tomorrow War manages to combine the best bits of Edge Of Tomorrow, Arrival, Armageddon, Alien, Independence Day, and God knows what else in the kind of movie that Michael Bay or Roland Emmerich wouldve directed in their primes if theyd had more talent.

People whove speculated about Chris Pratts transformation from chubby comedy guy to ripped action hero, and his apparent religious awakening along with it (Pratt is or was a member of Hillsong, the same celebrity megachurch that baptized Justin Bieber) will find endless fodder in The Tomorrow War. Pratt plays a scientist-soldier-teacher who is essentially defined by his faith in a brighter future and his willingness to stick his neck out for others. Hes also a crack shot with a submachine gun, a supportive father, and an expert troop motivator. Did I mention the strong jaw and washboard abs? Image conscious Will Smith was known to only play heroes for a big chunk of his career, but Pratts babyface act in The Tomorrow War is so relentlessly ingratiating that it puts Will Smith to shame. His character is so thoroughly heroic that there are times when The Tomorrow War feels like a pro-Chris Pratt propaganda film produced by the Church of Scientology.

Clocking in at 140 minutes, a less-bold version of The Tomorrow War would feel overlong or padded, but The Tomorrow War doesnt, partly owing to at least three distinct phases. Theres Forester the reluctant soldier, Forester the single-minded scientist, and Forester the unlikely leader of a band of Arctic explorers, which includes his estranged, doomsday prepping, Vietnam veteran father, played by JK Simmons (who Im not sure is even old enough to be a Vietnam veteran?). Each phase individually wouldve had enough content to fill the entirety of lesser movie. But every time it seems to paint itself into a narrative corner, The Tomorrow World blows through a wall with high explosives or invents a just-plausible-enough interdimensional portal.

Most of the movie is so ridiculous that you figure no finale could possibly do it justice. Yet even after time travel, alien invasion, biological weaponry, and an arctic expedition, The Tomorrow Wars finale manages to be plausibly grand, even compared to what came before it. Never before has a streaming release so capably evoked Summer blockbuster.

The Tomorrow War is streaming on Amazon Prime July 2nd. Vince Mancini is on Twitter. You can access his archive of reviews here.

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'The Tomorrow War' Is A Big, Dumb, Beautiful Blockbuster - UPROXX

House to probe Capitol riot, over GOP opposition

WASHINGTON (AP) Sharply split along party lines, the House launched a new investigation of the Jan. 6 Capitol insurrection on Wednesday, approving a special committee to probe the violent attack as police officers who were injured fighting Donald Trumps supporters watched from the gallery above.

The vote to form the panel was 222-190, with all but two Republicans objecting that majority Democrats would be in charge. The action came after Senate Republicans blocked creation of an independent commission that would have been evenly split between the two parties.

Ahead of the vote, Democratic House Speaker Nancy Pelosi told lawmakers in the chamber: We will be judged by future generations as to how we value our democracy. She said she preferred that an independent panel lead the inquiry but Congress could wait no longer to begin a deeper look at the insurrection that was the worst attack on the Capitol in more than 200 years.

As the vote was called, Pelosi stood in the House gallery with several police officers who fought the rioters and with the family of an officer who died, hugging several of them. One of the officers, Michael Fanone of Washingtons Metropolitan Police, said he was angry at Republicans for voting against an investigation after he almost lost his life to protect them.

I try not to take these things personally, but its very personal for me, Fanone said.

PHARR, Texas (AP) Republican lawmakers traveled to Texas to cheer former President Donald Trump as he paid a visit to the southern border Wednesday and hammered the Biden administration for its immigration policies amid a decades-high spike in border crossings.

Trump, who was joined by more than two dozen House members, also continued to spread lies about the 2020 election as he participated in a border briefing and visited the wall he championed in a trip that was strikingly similar to the many hed taken here while president.

Biden is destroying our country. And it all started with a fake election, Trump railed as he stood at the border, an American flag hoisted by a crane waving above him. Trump has persisted in falsely claiming he won in November, even though state and federal election officials, his own attorney general and numerous judges have said there is no evidence of the mass voter fraud he alleges.

Coming fresh off his first rally since leaving the White House, the visit underscored the extent to which Republicans, both nationally and in the states, continue to embrace Trump as the leader of their party. And it demonstrated anew how much the GOP has taken up Trumps signature issue of immigration as the party looks to recapture control of Congress in next years midterm elections.

Trump was invited to South Texas by the states governor, Greg Abbott, who is up for reelection next year and is considered a potential 2024 presidential candidate. After facing criticism for his handling of the COVID-19 pandemic, Abbott has taken up Trumps immigration mantle, vowing to continue building the southern border wall that the Biden administration has suspended.

SURFSIDE, Florida (AP) Crews searching for survivors in the ruins of a collapsed Florida condo tower have built a ramp that should allow the use of heavier equipment, potentially accelerating the removal of concrete that could lead to incredibly good news events, the state fire marshal said Wednesday.

Since the sudden collapse of the 12-story Champlain Towers South last week in Surfside, rescuers have been working to peel back layers of concrete on the pancaked building without disturbing the unstable pile of debris.

Miami-Dade Assistant Fire Chief Raide Jadallah told family members of those missing Wednesday that a ramp built onto the pile overnight allowed rescuers to use a crane on sections that were not previously accessible. He said that improves the chances of finding new pockets of space in the urgent search for survivors.

We hope to start seeing some significant improvement in regards to the possibility of (finding) any voids that we cannot see, Jadallah said.

In an interview with Miami television station WSVN, State Fire Marshal Jimmy Petronis described the ramp as a Herculean effort that would allow crews to leverage massive equipment to remove mass pieces of concrete, which could lead to good results.

NEW YORK (AP) TV actor Allison Mack, who played a key role in the scandal-ridden, cult-like group NXIVM, was sentenced to three years in prison Wednesday on charges she manipulated women into becoming sex slaves for the groups spiritual leader.

Mack best known for her role as a young Supermans close friend on the series Smallville had previously pleaded guilty to the charges and began cooperating against NXIVM leader Keith Raniere. Prosecutors credited her with helping them mount evidence showing how Raniere created a secret society of brainwashed women who were branded with his initials.

At her sentencing in Brooklyn federal court, Mack renounced the self-improvement guru.

I made choices I will forever regret, she said, also telling the judge she was filled with remorse and guilt.

I am sorry to those of you that I brought into NXIVM, she wrote in a letter filed with the court last week. I am sorry I ever exposed you to the nefarious and emotionally abusive schemes of a twisted man.

NEW YORK (AP) Revised vote counts in New York Citys Democratic mayoral primary show Brooklyn Borough President Eric Adams maintaining a thin lead, a day after a first attempt to report results went disastrously wrong.

The mayors race, the first city election to use ranked choice voting, was thrown into disarray Tuesday after the citys Board of Elections posted incorrect preliminary vote counts and then withdrew them hours later.

Corrected numbers released Wednesday showed Adams, a former police captain and state senator, leading former sanitation commissioner Kathryn Garcia by 14,755 votes. Civil rights lawyer Maya Wiley was practically tied with Garcia, falling just 347 votes behind in the ranked choice analysis.

The corrected results still dont paint a complete picture of the race. Nearly 125,000 absentee ballots have yet to be counted.

Adams thin lead means it is possible for Garcia or Wiley to catch up when absentee ballots are added to the mix starting on July 6.

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Nation - Daily Herald

Ah! Summer grasses! All that remains Of the warriors dreams Matsuo Bash

In the summer of 1889, Japanese poet Masaoka Shiki brought baseball to his hometown. He started with a ball, a bat and a few friends. It had been 17 years since the American professor Horace Wilson began teaching the sport to students in Tokyo. Shiki was a college student, a member of the first generation of Japanese ballplayers. He soon became famous for something else: reviving the old poetry tradition of haiku.

In simple terms, Shiki was an iconoclast, a critic, an ambitious writer who pulled from Western influences, challenged convention, pushed limits and reinvented haiku in the process. He was also a baseball player, one who loved to pitch and play catcher, who became so obsessed with the sport that he began to write poetry about it. Today he is considered one of Japans four great haiku masters. Hes also in the Japanese baseball hall of fame. He elevated two art forms by thrusting them forward.

Before Shiki died at age 34, he devoted much of his energy into examining the first haiku master, Matsuo Bash, a 17th-century poet recognized as Japans greatest. Like many Japanese writers, Shiki read Bashs masterpiece, The Narrow Road to the Deep North, a travelogue of his journey into the remote wilderness of northeast Japan in the late 1600s. Its a legendary piece of Japanese literature, a work that later inspired the Beat Generation. Bash traveled on foot. The trip took five months. Along the way, he ventured to the town of Hiraizumi, in what is now Iwate Prefecture, still a rural area in the north.

If you travel to Iwate today, you will find statues of Bash, tributes to his journey and inscriptions of his haikus. But if you stay a while, you will also find baseball.

Its where Shohei Ohtani grew up.

On April 26, Shohei Ohtani did something that no one had done in a century: He stepped on a pitchers mound and started a game for the Angels while leading the American League in homers. Ohtani was the first to accomplish this since Babe Ruth, who pulled it off for the last time on June 13, 1921, but as always with Ohtani, the fine print was more fascinating than the headline. The day before, on April 25, he put a baseball into orbit in Houston, launching a 440-foot homer at Minute Maid Park. The day before that,he homered while making his first cameo in left field. And the dayafterhis start, he was back in the lineup at designated hitter.

But on the day he started? That was light work. He collected two hits, drove in two runs, scored three times, lasted five innings on the mound, struck out out nine and earned the win, which made him the first pitcher in either league to have two hits, three runs and nine strikeouts since Luis Tiant in 1967. A pretty complete game of baseball, Angels manager Joe Maddon said, a statement which was both technically correct and underscored the difficulty of capturing the Ohtani experience with words.

One hundred and forty years after Horace Wilson brought baseball to Japan, 131 years after Masaoka Shiki crafted his first poetic tribute, and a hundred years (give or take) after Ruth cemented the game as Americas pastime, Ohtani, a 26-year-old from Iwate Prefecture, is threatening to break the sport, to push the limits of what was thought possible, to redefine our conception of a baseball star. This is at once obvious to the baseball layman and also hard to fully grip. Ohtani is 6 feet 4, and he looks as if his bodily proportions were designed for blueprints in a baseball laboratory. His frame could fit in a Terminator movie. He throws 101 mph and he hits 470-foot homers, sometimes on the same night. And after three seasons in America, after Tommy John surgery and a pandemic slowed his ascent, he is finally showing the skill set that made him the most tantalizing baseball prospect on earth.

If he is not the most valuable player in the sport, he is no doubt the most gifted. If he were just a hitter or just a pitcher, he would still be an All-Star candidate and a hero in his home country. But he is both, a composite sketch of the sports great players, a borrower of styles, a surrealists idea of a baseball player, a starting pitcher with a 2.58 ERA in 11 starts and a designated hitter with 28 homers and an OPS+ north of 170. He is a cartoon character out of Japanese anime. He is the big kid from Little League. He is ruthlessly efficient with his body, at once mechanically sound and graceful, wielding a bat as if Bryce Harper grew up worshiping the elegance of Ichiro Suzuki.

Justin Upton, a teammate on the Angels who has spent five seasons playing with Mike Trout, has deemed Ohtani the most talented player Ive ever seen. Mets starter Marcus Stroman called him a mythical legend in human form, while Kevin Durant stopped a torrid NBA playoff run to weigh in. Different breed, he tweeted. Leury Garca, a White Sox utility player who watched Ohtani terrorize his club in April, offered more subtle praise: Oh, he nasty.

Rick Ankiel, one of the few men in recorded history who has made the major leagues as a pitcher and a hitter (though, notably, not at the same time) describes Ohtani as being in his own world, as far as ability. Joe Maddon, his manager, notes day after day: Nobody has ever done this before.

Ohtani is the type of player who strains the imagination and inspires wonder among his fellow players. He also raises philosophical questions about the future of his sport: Is he the first of a new and rare superstar archetype (once in a generation, perhaps?)? Or, is he a unicorn? Is he the latest master in a proud Japanese baseball tradition based on endless training and self-sacrifice? Or, is he reinventing the form? And, finally, there is a question for us, the audience:

Is it possible to properly appreciate something weve never seen before?

Before Shohei Ohtani came along, the last Japanese professional player to be an All-Star as a pitcher and hitter was Junzo Sekine. He was a wisp of a human, 5 feet 7 and 130 pounds, an avatar for many Japanese players of his day. In the spring of 1966, he traveled to the United States and spent a month with the Yankees at spring training. He wanted to learn a new culture.

Sekine had started his career as a pitcher for the Kintetsu Pearls (later the Buffaloes) in 1950. He spent seven seasons on the mound, transitioned to first base, and became something like the Rick Ankiel of 1950s Japan. He was solid at both roles, fundamentally sound and productive, but it was his versatility that impressed. When his career ended, he dreamed of managing, so he sought knowledge from the best baseball franchise in the world, the club that had produced Babe Ruth, the original two-way standard.

When compared to its American counterpart, Japanese baseball remains a culture unto itself, a thriving system with its own history, traditions and beauty, a sport that did not change the locals so much as bent to their will. When the game first arrived in the late 1800s, the Japanese had no concept of recreational leisure sports. They didnt even have words to describe them. Every thing was a martial art, says Robert Whiting, a Tokyo-based author who has chronicled Japanese baseball for decades.

Japanese baseball, then, came to be influenced bybushid, the moral code of honor developed by the samurai warrior class. As it spread, the sport grew as a tool for education. It was regimented and militaristic, a game that taught lessons in suffering and sacrifice, a reflection of the society it had charmed. A century later, as Ohtani came of age in Iwate, the old influences remained softened, of course, by modern advances and progressive attitudes but still vital to the endeavor.

Sekine had grown up in that culture in the 1930s and 40s, immersed in the philosophy of unending practice daily training, thousands of swings, hundreds of pitches during one bullpen session. Still, there was one thing in common with the major leagues: nobody dared to pitch andhit at the same time.

This was mostly because of the hellish demands on pitchers. In the 1950s and 60s, Japanese hurlers undertook extraordinary workloads, even by the standards of the day. Hiroshi Gondo, a pitcher for Chunichi, threw a record 429 innings in 1961, inspiring the Japanese version of Spahn and Sain and pray for rain. (It included more rain and more Gondo.) As Whiting says, The pitchers threw so much that it was unrealistic to expect them to do anything else.

The Japanese adored Babe Ruth. He had visited the country during a goodwill tour in 1934. The locals packed stadiums and shouted Banzai Babe Ruth! But they did not have an analog for him; there were no two-way legends who transcended the sport. Of course, if the Japanese would have studied Ruths career, they would have noted that even the Babe found playing both ways to be a hindrance. Ruth managed to log double duty for parts of only two seasons with the Red Sox, in 1918 and 1919 (with some later mound cameos for the Yankees). Waite Hoyt, a teammate in Boston and New York, would call Ruths 1919 season the year of the Great Experiment. Newspapers debated his role. The year before, Ruth had expressed doubts that anyone could do both.

I dont think a man can pitch in his regular turn, and play every other game at some other position, and keep that pace year after year, Ruth told the writer F.C. Lane of Baseball Magazine in late 1918. I can do it this season all right, and not feel it, for I am young and strong and dont mind the work. But I wouldnt guarantee to do it for many seasons.

Ruth was sold to the Yankees before the 1920 season and became a full-time slugger. And for the next hundred years, his prophecy largely proved true. (There were a collection of two-way stars in the Negro Leagues, including Charles Wilber Bullet Rogan and Ted Double Duty Radcliffe.)

Baseball evolved. Specialization reigned. The game grew on both sides of the Pacific. Hideo Nomo arrived stateside. The Japanese pipeline opened. Ichiro Suzuki started a revolution. The best kids in Japan came of age thinking about the major leagues. Then one day in the early 2010s, an executive from an American League team traveled to watch a high school star named Shohei Ohtani compete in Koshien, the countrys legendary national high school baseball tournament. Koshien is March Madness plus Friday Night Lights times 10. Ohtani was tall and lean and he threw 99 mph. He told reporters that he wanted to bypass the Japanese professional league Nippon Professional Baseball and head to America.

In the mind of the scout, Ohtani was one of the best Japanese pitching prospects in years. Like most high school stars, he was also a position player with intriguing bat speed and power. But the scout believed his future was on the mound.

I didnt think of him doing both, he says.

Then again, why would he? Nobody had tried in a century. Was it even possible? At least one person believed it was: Ohtani.

If necessity is the mother of invention, then the genuine fear of losing a homegrown prodigy to the United States helped birth Ohtani as a two-way player. The Nippon-Ham Fighters, one of the savviest organizations in Japanese baseball, had a plan. First, they would show Ohtani an unvarnished look at life as a minor leaguer. Then, they would convince him that he could do both. He didnt need to choose. Ohtani imagined a career without limits, his potential dictated only by his level of devotion and work. Soon, the scout returned to Japan for another trip and watched Ohtani take batting practice. He came away with one thought:

This guy is a f hitter.

On April 4, the fourth day of the 2021 baseball season, Shohei Ohtani was a hitter. He was also a pitcher. In the top of the first, he faced the Chicago White Sox and hurled a fastball 101 mph. In the bottom half, he stepped to the plate, loaded his hands, uncoiled his hips and unleashed his barrel on a belt-high fastball. The crack sounded like a bomb, as if someone had taken a sledgehammer to a tone block or tossed a rocking chair off a roof. (If you watch the replay once, theres a 100 percent chance you will watch it again.) The baseball soared 451 feet into the night sky. Ohtani, the first pitcher to bat second in the lineup since 1903, looked almost princely as he circled the bases.

Lefty Gomez once described Ruths homers as homing pigeons. The famous Japanese slugger Sadaharu Oh produced a beautiful crack withhandmadetamo-wood bats. And the legendary scout Buck ONeil once said that only Ruth, Josh Gibson and Bo Jackson could generate a sound likethat.But there remains something different about the sound that emanates from Ohtanis bat. For one, it is loud. It is also perfectly toned, the crack of the kind of textured percussion that usually demands headphones. And on the night of April 4, it was so loud that some viewers assumed it must have been enhanced by ESPNs Sunday Night Baseball broadcast.

Phil Orlins, ESPNs lead producer for its MLB coverage, assures that it was not. The sound was natural. As Ohtani swung at a high fastball from the White Soxs Dylan Cease, the high-speed collision of ball and bat was picked up by four wireless mics buried in front of home plate at Angel Stadium. It was then transmitted to a production truck, added to the broadcasts sound mix, and sent out to viewers across the country. Exactly the way it sounds if youre standing by the batting cage during BP, Orlins says.

Ohtani, of course, tends toward the maximal. When Brad Ausmus managed the Angels during the 2019 season, hed tell people to arrive early to watch Ohtani hit batting practice. It wasnt just the sound, and it wasnt just the distance, though Ohtani often put balls into the far reaches of Angel Stadium. It was the height. His power seems to have tremendous upward trajectory, almost like Darryl Strawberry, Ausmus says. He hits the ball 200 feet straight up in the air, and it goes 450 feet out.

Ohtani showed glimpses of this power as a rookie in 2018, hitting 22 homers while making 82 starts at DH, and again in 2019, as he recovered from Tommy John surgery and was limited to hitting. But after struggling in the shortened 2020 season (Ohtani called his own play pathetic), he is becoming the hitter that Ausmus saw, a technical marvel of leverage and energy transfer.

To watch Ohtani swing a bat is to see a hitter who has mastered the two most important elements of the craft: technical expertise and creative genius the science and the art. Ohtani has what master swordsmen call edge alignment, the ability to guide his weapon to the baseball at the ideal angle to maximize power and distance. He also has the ability to improvise.

Ausmus began his career playing with Tony Gwynn in San Diego and finished it playing alongside Manny Ramirez with the Dodgers. Gwynn was a modern-day Ted Williams, a man who understood the mechanics of the swing better than anyone of his generation. Ramirez was a physical virtuoso; hitting was his craft. Ohtani, Ausmus says, is somehow both at once.

When Ohtani was a rookie, Albert Pujols would watch his young teammate smash balls over the center-field batters eye, then pass along bullish scouting reports to Ankiel, his former teammate with the Cardinals. (Is it real? Ankiel remembers asking. Its everything and more, Pujols said.) Four years later, Ohtani is on pace to hit 57 homers after smashing three more in two days at Yankee Stadium. His latest power binge included a 117.2-mph blast on Monday the hardest homer of his career and 20 of his 28 homers have been struck with an exit velocity of more than 105 mph and a launch angle above 20 degrees. He leads the majors in that category, meaning nobody combines distance and height quite like Ohtani.

Its majestic, Ausmus says.

Its Ruthian.

When Ohtani was a boy in Iwate, he idolized Ichiro Suzuki and attempted to emulate him. When he joined the Nippon-Ham Fighters in 2013, he studied video of Bryce Harper, which indirectly meant he was studying the swing of Ruth, who had borrowed from Shoeless Joe Jackson and spurred the original launch-angle revolution. The connection between Ruth and Harper was drawn in 2013, when, according to the Washington Post, then-Nationals hitting coach Rick Schu studied footage of both players side by side. Identical, he told the newspaper.

To watch Ohtani is to see the same foundation the stiff front leg, the hands loading and the hips unwinding, the back foot lifting off the ground. He is not a perfect copy of Harper; duringspring training in 2018, Ohtani visited Ichiro, who suggested he lose the big leg kick he developed in Japan. He replaced it with a simple toe tap.

Ohtani has always been a blender of styles. When he was a teenage rookie with the Fighters, he peppered veteran pitcher Bobby Keppel with questions about the United States, culling information about major-league competition and the craft of pitching. When former Marlins outfielder Jeremy Hermida arrived in 2015, Ohtani quizzed him about the culture of the big leagues, the stadiums, the logistics, the lifestyle. You could tell in his mind, he had a goal, Keppel says.

The Fighters employed an interpreter and liaison for its American players. Ippei Mizuhara had grown up in Southern California and spent his childhood near Angel Stadium. For Ohtani, he offered a window to American baseball, a go-between who translated conversations with the former major leaguers on the roster. (When Ohtani chose the Angels, Mizuhara came with him.) Keppel remembered Ohtani as very polite and reserved. He was a teenager who took the time to learn Spanish phrases to connect with the Cuban players on the Fighters roster. Michael Crotta, another former major-league pitcher, likened his young teammate to Paul Bunyan. Hermida would watch bullpen sessions and batting practice and sum up the experience like this: The most natural juice Ive ever seen.

It was easy to see where Ohtani was headed. In 2016, his fourth season with the Fighters, he hit .322 with 22 homers in 382 plate appearances while posting a 1.86 ERA in 140 innings. It was more impressive to see the path he took. He was a machine, Crotta says. Before the game, he would throw a 100-pitch bullpen and jump right into a grueling, eight-minute batting practice. (In Japan, BP is timed, not based on swings.) In pregame pitchers meetings, Ohtani would sit with Crotta and Luis Mendoza, another former big leaguer, and offer the notes hed taken on each opposing hitter.

He was not afraid to speak about what he was doing or how he found success or where he struggled, Crotta says. At 18, I dont know if I would have had the stones to stand up in front of a bunch of guys and tell them how I felt about stuff.

Ohtanis studiousness his habit of taking notes and writing things down had been honed in high school, when he starred at Hanamaki Higashi High School in Iwate. Hanamaki Higashi is not a natural hotbed for baseball superstars. By Japanese standards, its considered somewhat rural, located 300 miles north of Tokyo and away from the countrys biggest population centers. The winters are harsh. When Ohtani was at the school, the baseball program led by coach Hiroshi Sasaki reflected the discipline and ideals of the old ways. Players lived in dorms and were assigned a list of chores. Training was intense.

Sasaki, however, also focused on individual growth and progressive training tools. One example: The pitchers used a swimming program to build strength and flexibility. Another: Sasaki adopted the Harada Method, a self-improvement technique, asking his players to write down their goals and list strategies to achieve them, to envision next week, next month, and where they wanted to be at age 25 or 30.

He just has a philosophy of how to coach and how to teach young boys about life, says Ema Ryan Yamazaki, a filmmaker who followed the Hanamaki Higashi program for one season in 2018 for a documentary about Koshien.

As a sophomore in high school, Ohtani set a goal to throw 99 mph (160 kilometers per hour) and sketched out a road map to get there. (According to a copy of Ohtanis high school goals obtained by the Wall Street Journal, Ohtani wrote of having a cool head and hot passion. One strategy was more straightforward: Read books.) He brought his inquisitiveness to professional baseball, where he focused on self improvement, day by day, and crafted another plan to better himself. He was a pitcher and a hitter, and he would do both until he couldnt anymore. He did everything he could to make that plan come true, Crotta says.

By 2015, Ohtani was the Fighters best starter and a part-time position player whose talent was apparent. He was also just 20, which meant he still dressed in the secondary locker room, a small nook adjacent to the weight room, where the youngest players were stuck until they gained more experience.

He just never complained, Hermida says. Never nothing. He couldnt have been more humble, more nice, smile on his face every day.

Baseball was his life, and he ate, slept, breathed baseball. Everything about it was training. How can I get better? How can I do better?

Its possible that no player in baseball was more prepared for a quarantine. When Ohtani was with the Fighters, he lived in a spartan dormitory in Hokkaido. After joining the Angels, he moved into an apartment complex across the parking lot from the stadium. There are many ways to analyze Ohtanis insistence on efficiency and convenience, but one thing is clear: The man does not require much space. Former Angels general manager Billy Eppler once compared a younger Ohtani to Ivan Drago, the shredded Russian villain from Rocky IV, which seemed less about his physical prowess and more about his single-minded focus toward training. If Ohtani has built a brand around his talent and in Japan, its an astonishingly large brand it is one built on a simple tenet: A wholesome commitment to baseball with all his being.

He wants to be the greatest baseball player ever, Ausmus said. So he does everything he can to try and achieve that goal.

Ohtanis stoicism extends to his movement patterns or lack thereof. There is no shortage of social avenues in nearby Los Angeles. He waited until 2020 to get his drivers license. His temperament also colors his interviews. On June 8, Ohtani hit his 17th homer, a 470-foot moonshot against the Royals in Anaheim. His response to the Japanese press corps: Im glad I was able to start things on a good note with a home run.

When Ohtani debuted in 2018, reporters mined for illustrative anecdotes. They have mostly come up empty. The list of revelations includes this: Ohtani turned to video games as a way to bond with teammates. He sang a passable version of Despacito on the team bus. He took to cooking, setting a routine that was as exciting as his regimented training: One omelet, every morning. (As Ohtani told the Kyodo News in 2018, he also found virtue in solitude. You can eat quickly when you eat alone, he said.)

Whiting, whose seminal book, You Gotta Have Wa, explores the relationship between baseball and Japanese society, has described Ohtani as a baseballing monk, a happy warrior who smiles while being checked for sticky stuff. In this way, he is something close to the ideal Japanese player, a purist whose adherence to tradition causes you to see the sport in an entirely different fashion. He represents everything thats good about the Japanese approach to baseball, Whiting says.

Ohtani is so famous in Japan that earlier this season the Royals (and a few other teams) sold in-stadium signage to Nishikawa Co., a bedding company that is touting its 455th (!) anniversary. To explain his presence in Japanese culture, Yamazaki reaches into another phenomenon, the world of Japanese comics, otherwise known as manga. Hes one of those people that could be out of those stories, she says.

Yamazaki is currently filming a project in a Tokyo elementary school, where Ohtani Angels T-shirts are the unofficial school uniform. But to understand the love affair, you have to understand what Ohtani is not. He is not Ichiro, an outfielder with a dancers build, who conjured a style out of speed, contact and otherworldly coordination. He is not solely a dominant pitcher in the mold of Nomo, Masahiro Tanaka or Yu Darvish. He is everything, all at once, a physical marvel and a thinking man, a supreme talent and a grunt worker, a pitcher and a hitter, and it is no small thing that he is often one of the biggest players on the field.

I think thats a huge source of pride for Japanese people as well, she says. Hes kind of like an American version of a Japanese player.

The young grass kids get together To hit a ball

Masaoka Shiki

On June 16, in the hours after Ohtani homered for a second straight night in Oakland, Angels manager Joe Maddon found his star on the flight home. Ohtani was set to pitch against the Tigers the next night. Maddon wanted to make sure he felt good enough to hit.

Ohtani said yes. His legs felt good. The next day, he allowed one run in six innings while drawing two walks himself. He then returned to the lineup the next day and hit two more homers, which started another Ohtani Stretch, a sequence of baseball that, in any other era in the last 100 years, would have sounded made up. Ohtani homered again in the final two games of the four-game series against the Tigers, which gave him six homers in a six-game stretch, the only non-homer game coming as he lowered his ERA to 2.70. (In a previous Ohtani Stretch, earlier in June, he became the first player in the modern era to strike out 10 batters and the next day hit a homer in the first inning.) Every day, Ohtani does something that feels like it might break the coding system at Baseball-Reference. Every day, Maddon is having conversations that no American League manager has had in 100 years. This is a unique athlete, and none of us have been there before, Maddon says.

When Ohtani was a rookie, the Angels outlined a schedule that roughly approximated his workload in Japan, where he threw once a week and often took days off before and after his starting pitching assignments. Now those rules are gone. Ohtani is playing nearly every day and letting his body dictate the rest. Maddon has no preconceived notions on what is too much or too little Its observational and conversational, he says and there are no metrics or numbers to use as guideposts. I dont really think theres a math equation thats going to tell us when its the right time to use him, Maddon added.

Still, Maddon has exercised caution at times, because Ohtani is doing something thats never been done, and there is no roadmap or script to follow. When the Angels have played in National League parks, Ohtani has sat, because thats what a designated hitter would do. When Ohtani exited after six innings and 78 pitches against the Tigers on June 16, Maddon put the decision in a grander context.

Its still June, he said, and I want this guy to have one of the greatest seasons ever.

If you combined his contributions on both sides of the ball and his underrated speed Ohtani leads all major leaguers with 5.7 Wins Above Replacement, according to Baseball-Reference. He is slugging nearly .700 while opposing hitters slug just .314 against him. Absent Mike Trout, who remains out with a calf strain, he has kept his team on the far fringes of wild-card contention though Angels fans know better than anyone the limits of one brilliant superstar across 162 games.

When the Angels played in Kansas City in April, Royals catcher Salvador Prez teased Trout about his long reign as the best player in the world, which suddenly seemed in peril. Now its maybe 50-50, Perez said. Because now youve got Ohtani. The debates about the MVP award or Ohtanis value as a two-way player tend to miss an important point. Ohtani is not just measuring himself against Trout or Vladimir Guerrero Jr. or Jacob deGrom or anyone else with a valid case as the best player in baseball. Hes battling 100 years of baseball dogma. When Rick Ankiel was a young pitcher, before he flamed out and revived his career as a slugging outfielder, he once asked Cardinals manager Tony La Russa if he could get some playing time in the field. Were still trying to win, La Russa said. You know that, right?

Of course, there have always been players like Ankiel, pitchers who could hit, or hitters with great arms, players like John Olerud and Dave Winfield and Ken Brett and all the way back to Stan Musial, who signed his first professional contract as a pitcher, to Junzo Sekine, who willed himself to be a solid hitter when he could no longer pitch. There will be more, too, and it seems possible that Ohtani has changed the game, that teams will be more open to accommodating phenoms, that the demands on pitchers are less, that we will see more two-way players in the not-so-distant future. Shohei has opened the doors to do both, Ausmus says. But youre going to have look 10 years down the road.

Or maybe longer.

Once in 50 years, another general manager said.

To do what Ohtani is doing requires something more than sheer athletic talent. It requires more than an arm that can throw 100 mph and a swing that can launch baseballs 450 feet. It requires a player who will embrace the struggle, who craves the suffering that accompanies the work, who enjoys the solitude of a night alone, who keeps binders full of notes and asks questions and commits himself to baseball with all his being, who in the words of former Angels GM Billy Eppler has one thing on his mind.

He wants mastery, he once said, and hes going to stop at nothing.

In the end, in this moment and the next, there is only one Shohei Ohtani.

The Athletics Fabian Ardaya and Andy McCullough contributed to this report.

(Illustration: John Bradford / The Athletic / Getty Images)

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Shohei Ohtani is 'in his own world' ... which appears to be somewhere beyond baseball's outer limits - The Athletic

GDP per persons average annual growth is projected to fall only from 1.6 per cent over the past 40 years to 1.5 per cent over the coming 40.

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Its here, however, that business and its media cheer squad have read the fine print and are deeply sceptical: that projection of GDP growth per person rests heavily on the mere assumption that the productivity of labour (output of goods and services per hour worked) will improve at the same average annual rate in the coming 40 years as it did over the past 30 years.

And theyre right. Of all the many assumptions on which the reports mechanical projections depend, this assumption is far the most critical. As Frydenberg rightly says, improving productivity is what explains almost all the improvement in our standard of living over the decades.

And the sceptics are right to doubt that productivity will improve over the next 40 years at anything like the rate of 1.5 per cent a year. For a start, that 30-year average includes the 1990s, a decade when productivity improved at a rate far higher than experienced before or since.

For another thing, productivity improvement in recent years has been much weaker than usual.

So, purely by omission, the latest intergenerational report reminds us of the second biggest threat to our living standards: a continuing slump in productivity. (The biggest threat is the worlds inadequate response to climate change another thing the report omits to take into account.)

Whats discouraging, however, is the way the business lobby groups have used this inadvertent reminder to bang the same old self-serving drum. The productivity slump has been caused by this government and its predecessors failure to continue the economic reform program begun by Hawke, Keating and Howard, were assured.

And what reforms do they have in mind? A cut in the rate of company tax for big business and changes in the wage-fixing rules to make the labour market more flexible for employers.

This lobbying is objectionable on three grounds. First, it implies that productivity improvement depends on an unending stream of changes in government policies, which is absurd. The day reform stops, productivity stops.

Second, it shifts the blame for weak productivity improvement from the actions of the private sector in whose farms, mines, factories, offices and shops productivity either gets better or worse to the politicians in Canberra.

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Third, it seeks to disguise blatant rent-seeking as economic reform. Productivity would improve if business owners and high income-earners paid less tax, leaving the punters to pay more, and if the balance of bargaining power between bosses and workers shifted further in favour of bosses.

What this self-serving bulldust ignores is that productivity improvement has slumped in all the rich countries, not just in Australia because our pollies are so defective.

Michael Brennan, chair of the Productivity Commission, says the worlds economists are still debating the causes of the productivity slowdown. Theyve pointed to mismeasurement issues, a shift towards lower productivity industries, population ageing, a slowdown in the pace of technological discovery, a slowdown in the pace of technological diffusion, a plateauing of improvements in human capital, reduced rates of firm entry and exit, increased concentration and market power, lower capital investment, a shift to intangible capital and the slowing growth in global trade.

As Melinda Cilento of CEDA, the Committee for Economic Development of Australia, has noted, research by federal Treasury . . . showed leading Australian firms were not keeping up with leading global firms on productivity.

Treasury would be much better employed continuing to research the causes of our productivity slump than doing literally unbelievable projections of whats unlikely to happen over the next 40 years.

Ross Gittins is the economics editor.

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Business resorts to same old productivity bulldust - Sydney Morning Herald

Like an otaku making snap judgements about a gyaru girl, it can be easy to go into Guide to the Perfect Otaku Girlfriend: Roomies and Romance Volume thinking you know what to expect. These fixer-upper fantasies about a cute girl coming into your life to help teach you how to pick up girls have been increasing in frequency for the fanboy set, letting authors play with meta-humor and genre awareness as a self-involved selling point. The book even opens with a bit dedicated to that, starting with a scene of wifely otaku wish-fulfillment that quickly derails into an amusing detailing of how annoyingly stressful it would actually be to have too many of those taped-together tropes all at once. It sets the book up to depict something of a balancing act: Recognizing the real-world expectations one should have in trying to date someone with your own interests while also still providing enough fantasy fanservice to function as an otaku-targeted work of fiction. The result mostly works out okay, and even entertains with a couple of surprising angles, but it also takes a while to get there.

The most immediately odd factor about Perfect Otaku Girlfriend was the relationship between its two primary characters. I hesitate to refer to what Kagetora and Kokoro have at this point as chemistry; instead, the writing really does a strong job of depicting the annoyance that can follow in trying to get on with someone you share interests with but otherwise have absolutely nothing else in common. Basically, you know how in romantic comedies the lead couple-to-be will often verbally spar with each other but still come across like they have a rapport to the point that you still want to see them get together? Kagetora and Kokoro's constant arguing, undermining, and negging of each other left me absolutely not wanting to see them coupled. And to the story's credit, by the end of this first volume, author Rin Murakami really hasn't gestured too hard in that direction as the pair's ultimate destination. Instead, the arc between the two really feels more like one of growing mutual respect and understanding in spite of their constant barbs and bickering, arriving at the idea of being comrades in their ongoing efforts to help each other find dates.

There's still some push and pull regarding the question of attraction, mostly on account of Kagetora being our point-of-view character and him fighting with his inner monologue throughout the volume over how actually attracted to Kokoro he is at any given moment. These kinds of segments mostly seem to exist to illustrate the gap in taste preference between the typical male otaku of Kagetora (and thus, I suspect, the author) versus the actual style and personality Kokoro tends to put on, breaking the illusions of the various cosplay fantasy scenes she otherwise indulges in. Some of Kagetora's outspoken reactions to these scene breaks can come off abrasive, especially if you're not sympathetic to the fanboy mindset he's embodying with them, but our main character at least never comes off as terribly toxic as some of the other leads seen in similar works. He is, at worst, just something of a cringey otaku guy who does find himself more willing to learn as the story goes on, punctuated well by him regularly having to admit whenever Kokoro's right in one of her judgements or self-improvement suggestions for him, regardless of the sharp-tongued way in which she delivers it.

The characters' arcs as they work towards successfully seeking out their theoretical ideal otaku dates represent the main story Perfect Otaku Girlfriend is relating, so a lot of the mechanical plot details worked through as we get there can feel purely incidental. The largest swath of the beginning of this first volume is focused on getting to the main plot contrivance: Kagetora and Kokoro living under one roof with no parental supervision, rolling via a procession of sudden family relocations and fake-dating plots. After that, the story starts filling time with an oddly aggressive quantity of scenes of Kokoro cosplaying, or pointedly ill-fated tangential dating schemes, like Kagetora and Kokoro's pursuit of potential partners through an MMO that ends on a limp, expected punchline. Other aspects introduced are one-offs that feel equally like threads to be picked up in later volumes, or pure fanservice fantasy for the Kagetoras reading along at home, such as discovering that one of your school-mates is not only the most popular new V-tuber, but also a huge otaku just like you! That's part and parcel to the kind of genre and story this book exists in service of, but just going off this first volume, it feels like a lot of fluff and dead ends that detracts from the more compelling components of the contrasting otaku tastes of the leads and how their connection lets them communicate advice to one another.

As the actual finding dates plot picks up more in the second half of the book, Perfect Otaku Girlfriend's strengths come through better in its energy. Barbed as their dialogue may be, there is a sense that Kagetora and Kokoro genuinely have their comrade's best interests in mind in the tastes they instruct each other to cater to. And for a series like this, it's nice to see some genuine advice provided to an audience-cipher like Kagetora on the simple ways one can take care of themself in terms of making yourself more appealing and presentable than you might give yourself credit for. The idea that the pair aren't terribly compatible as potential date-partners at this point interestingly makes their efforts at assisting each other more believable and compelling. And seeing the growth of that mutual respect over the course of them helping each other, to the point that Kagetora is able to do the right thing and prematurely end his own date with what seems to be his dream girl because he knows Kokoro needs his help, is a heartening hurdle for the pair to make it over by the end. As with most good dating advice self-help stories, showing characters' growth as people is the main key to communicate for them, apart from simply becoming more appealing as a potential partner.

Rin Murakami's writing of all of this is pretty effectively communicative, not being as focused on trying to be purely dialogue-driven or overtly comic-like as other light novels I've read. The prose is descriptive without getting too bogged down in detailing a lot of the otaku-appeal touches throughout, though there are plenty of direct and obscured references to well-known franchises, as well as something of an over-reliance on the same snippets of current subculture slang (get ready to read the phrase Virgin-Killer dozens of times in a row). It all mostly works out fine, presented by an English translation that lends the right amount of flavor, especially in the distinctive dialogue between characters. It's supplemented by a few page illustrations by Mako Tatekawa which look nice enough, but seem less about providing visuals for key moments in the story, and more about just showing us what each character introduced looks like.

Guide to the Perfect Otaku Girlfriend is an indulgent book that knows the main niche it's trying to appeal to, but is inoffensive in its execution thereof that regular readers can have a fair bit of fun with it if they let themselves. It does take a bit to get going, and there are times when the ways the leads butt heads can come off as too abrasive, but in some ways, that feels like the storytelling learning and growing along with its characters. There's enough development and hooks in this volume to leave me interested in where the story would go in the future. I'd count that as a success, especially after I spent so much time at the beginning wondering when the book was going to chill out on the cosplaying and video games and actually get on with it.

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Guide to the Perfect Otaku Girlfriend: Roomies and Romance Volume 1 - Anime News Network

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New Years resolutions are often thought of as individual self-improvement goals that frequently include aspirational health and wellness, financial discipline, habit forming or breaking, and similar goals. But these aspirational, improvement-focused goals do not need to be limited to personal goals. In fact, the New Year, New You mantra applies equally to the business world. The new year is a great time to push the reflect and reset button and to use the results of this reflection to accomplish business goals, including goals related to the companys trademark portfolio. Finding time in the new year to conduct reflection in the form of an in-depth review of your trademark portfolio (often referred to as a trademark audit) can be a meaningful and important exercise for a number of reasons, including ensuring there are no significant gaps in coverage or other issues associated with your trademark portfolio that could negatively impact your business, such as compliance issues with requirements and deadlines for maintaining trademark rights, chain-of-title concerns, or improper use of trademarks that could impact the companys rights. In addition, an audit, when performed correctly, can also provide a critical roadmap for the company for its trademark portfolio going forward.

Some important considerations to keep in mind for trademark audits include:

Whatever the form, a trademark audit can be a powerful tool and should be part of your companys New Years resolutions.We hope you fulfill both your personal and business-related New Years resolutions.

Excerpt from:
New Years Resolutions Dont Have to Be about Weight Loss: Why Conducting a Trademark Audit Should Be Part of Your Companys New Years Resolutions - JD...

Introduction

Diabetes mellitus refers to a severe global public health concern. As revealed from the International Diabetes Federation (IDF), 9.3% of adults worldwide are subjected to diabetes, of which 79.4% live in underdeveloped nations, and nearly 90% developed type 2 diabetes mellitus (T2DM).1 In addition, 12.8% of adults have been reported to suffer from diabetes mellitus in mainland China.2 Diabetes patients may develop various chronic and acute complications (eg, cardiovascular diseases, renal diseases and diabetes ketoacidosis), and it was estimated that health expenses related to diabetes were 760 billion US dollars in 2019 globally and 109 billion US dollars for China, which has imposed a significant economic burden on society.1 Thus, proper disease management covering the glycemic control and blood pressure and blood lipid control with a series of self-management behaviors (eg, sensible diet, regular exercise, self-monitoring, as well as adherence to taking medicine according to physicians advice) is crucial for diabetes patients.

A good diabetes education program is capable of sufficiently motivating patients to develop self-management behaviors, improve the blood sugar levels of patients and reduce the risk of chronic and acute complications.3 The structured education, for its standardized, practicable and replicable characteristics, has been recommended by the global and national guidelines to help patients manage diabetes.47 Diabetes education in mainland China has long been unsatisfactory, and the study on structured education for diabetes patients in the nation remains preliminary.8,9 To our best knowledge, a nurse-led structured education program developed by our research team previously, recognized as the first well-designed program for Chinese T2DM patients not on insulin therapy, has been confirmed to be feasible and acceptable.8,9 Subsequently, the structured education program was supplemented by complying with self-efficacy theory, and a six-month follow-up multicenter randomized control trial was performed, with the positive results of metabolic outcomes and psychosocial aspects,10 thereby strongly evidencing the effectiveness of the self-efficacy-focused structured education program (SSEP) among Chinese T2DM patients. However, as with some other studies on diabetes education,1113 the short-term effect rather than the intermediate- and long-term effect of the SSEP was identified.

Moreover, as indicated from a systemic review and meta-analysis, a self-efficacy-focused education program may positively impact blood sugar level and psychosocial indicators in the short term (36 months) follow-up.14 However, several studies reported that the effect of diabetes education lasted only 36 months, and it would attenuate subsequently;1518 for instance, a meta-analysis of 16 randomized contrail trials reported that the HbA1c improvements in the 36 months, 612 months and above 12 months reached 0.49%, 0.44% and 0.07%, respectively.16 Thus far, what the intermediate- and long-term effects of the SSEP for Chinese T2DM patients are remain unclear. Thus, this study aimed to assess the benefits of SSEP among T2DM patients not on insulin at a twelve-month follow-up.

The research refers to a robust multicenter, parallel, superiority, randomized controlled trial performed in four hospitals in China. The four hospitals, with levels not above grade III-B, were chosen by convenience sampling. The study was conducted from April 2017 to December 2018, and the recruitment of participants was conducted between April to November 2017. Patients were recruited if diagnosed with T2DM, aged between 1875 years, with their HbA1c in the past 12 weeks no less than 7.5%, as well as not on insulin in the past three months. Patients being pregnant or preparing for pregnancy, with psychological problems or cognition disorders, or developing severe diabetes complications, or participating in other researches if they reported or the nurses or the physicians registered were excluded here. The sample of the original study was calculated based on a standard deviation of HbA1c (1%) in the target population, an inter-group difference (0.4%), the two-tailed power (0.8), alpha (0.05) as well as attrition rate (20%). So, one hundred and nineteen patients were required in each group respectively after calculation.

The recruitment of participants was completed by a physician and research nurse in each hospital. The research nurse, acting as the coordinator of the research in each hospital would explain the research aim, process, risks and benefits and others to the patients after they were referred from the physician. Subsequently, the patients would be registered and included by research nurses after they agreed to be recruited by the study. The block randomization with blocks of eight was conducted at the patients individual level to split the patients at a ratio of 1:1 to an intervention or control group. The random allocation sequence generated with programming of SPSS 17.0 (Armonk, NY: IBM Corporation) by the researcher was sealed in opaque envelopes. The research nurse was charged with grouping. When the recruitment number of patients reached eight, each patient got a serial number, and the research nurse opened an opaque envelope to figure out the group the patients belonged to. All the research staff in the respective center received the training before research began as well as the monitoring by the central researchers every three months. The details of trial design, research sample, participants, recruitment and enrolment, randomization methods, intervention, outcome measures, quality control and others were previously reported in the other publication.10

The development of the SSEP complied with the guidelines of T2DM in China, related literature and the findings of patients needs assessment.8,19 In addition, SSEP followed a sound theoretical foundation.8,19 It abided by a series of educational theories, ie, the basic principles of curriculum and instructions by Tyler, the taxonomy of educational objectives, as well as the principles of adult learning.8,19 Subsequently, SSEP was further founded on self-efficacy theory based on a series of existing studies.8,10,14,20 The SSEP was composed of four structured curriculums and regular follow-ups. The program consisted of a written curriculum, and it was delivered by the trained registered nurses and physicians to ensure the quality of a range of research centers. SSEP was delivered in a group format (with 48 patients in the respective group), one time per week and continued in four weeks, and the one group education would begin when the number of group members reached 48 patients after the recruitment and grouping were completed. After the four-week modules, patients received follow-ups by face to face/telephone format every three months. The contents of follow-up covered the patients self-management behaviors aspects and individualized problems posed by the patients.21 Each module lasted for nearly 6090 min, and each follow-up was basically 1015 min. The program aimed to promote patients recruited in the learning, motivate patients to change, develop and sustain self-management behaviors by primarily stressing the enhancement of patients self-efficacy. Moreover, the contents of the structured curriculums and the program training were reported elsewhere.10

The control group received the routine education reported in an existing study.10 This primarily covered the individual face-to-face diabetes education presented by physicians during each medical clinic visits, as well as the conventional class education delivered by physicians and nurses per month. In addition, the follow-up/3 months was offered by nurses via face-to-face/telephone.

The metabolic and psychosocial outcome indicators were measured at baseline, three, six- and twelve-month follow-ups when the patients received medical visits in the clinics. The indicators of the plasma lipid profile were only measured at baseline, six- and twelve-months. All the outcome measures were completed by the trained nurses in the respective research center. Metabolic outcomes covered HbA1c, weight, body mass index (BMI), waist circumference (WC), blood pressure (systolic pressure, BP; diastolic pressure, DP), as well as plasma lipid profiles (triglycerides, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C). HbA1c referred to the primary outcome, and the other indicators were the secondary outcomes in the study. The indicators in the intervention group (IG) and control group (CG) were investigated at the identical time point. HbA1c and plasma lipid profiles were drawn from the medical records in four hospitals. Weight, height, waist circumference and blood pressure were manually measured with the identical instruments.

Moreover, psychosocial outcomes included diabetes self-efficacy (DSE), diabetes self-management (DSM) behaviors, diabetes knowledge and diabetes distress, which were evaluated by employing the validated Chinese version scales or questionnaires. The DSE was assessed based on a nine-item and five point Likert-type scale of Self-efficacy for Diabetes, as translated by Wei et al.22 DSM behaviors were evaluated according to a eleven-item and eight point Likert-type scale of the Summary of Diabetes Self-Care Activities, which was validated by Wan et al.23 The diabetes knowledge was measured by employing a ten-question Diabetes Knowledge Questionnaire, which was translated by Liu et al.24 Diabetes distress was assessed by using a seventeen-item and six point Likert-type scale of Diabetes Distress, as validated by Li et al.25 The indicator measurements were further elucidated in the previous publication.10 Furthermore, the basic demographic information of participants (eg, age, gender, marital status, employment status, educational level, individual monthly income and medical insurance) and diabetes-related information (eg, T2DM duration, years of taking medicine, diabetes medication use and diabetes-related complications) were collected by employing the self-designed questionnaire at baseline. The diabetes medication use was also collected at 12-month follow-up point.

The study was confirmed to comply with the guidelines outlined in the Declaration of Helsinki. The research was authorized and managed by the Review Board of Peking University (IRB0000105217031). Moreover, it was registered in China (ChiCTRIOR17011007). The study was initiated after the ethical approval and the official admission letters were gained from each research center. Furthermore, the informed consent was conducted by the research nurse, and all the participants signed the written informed consent forms after agreeing to be recruited by the study.

The data analysis was conducted with SPSS 25.0 (Armonk, NY: IBM Corporation) and base on intention to treat (ITT). Descriptive statistics were adopted to present the demographic characteristics of the participants. Inferential statistics covered independent t-test and chi-square tests to determine consistency of the demographic characteristics, diabetes-related information and the comparison of diabetes medication use. Robust generalized estimation equations with an unstructured form were exploited to process the repeated measurement data. The variables of group and measurement time were fitted as a major effect as well as an interaction, and baseline data were adjusted in all estimating models. The missing data for the indicators of TC, TG, LDL-C and HDL-C were assumed randomly lost, and they were not substituted. The value of P, below 0.05, was considered statistically significant.

Two hundred and sixty-four of 265 patients received the 12-month follow-up. One patient was lost during the follow-up due to falling to their death and the data in the 12th month was substituted by the last follow-up time. In addition, the data of HbA1c, weight, waist circumference, blood pressure, diabetes knowledge, diabetes distress, diabetes self-efficacy and DSM behaviors were collected from 264 patients. Moreover, the data of TC, TG, HDL-C, and LDL-C in the 12-month were collected from 207, 207, 204, and 203 patients, respectively. Furthermore, this study, focusing on the 12-month follow-up time point, is a part of studies on the topic of the self-efficacy-focused structured education program. In the existing study,10,21 the demographic characteristics, and the comparisons of age, gender, marital status, education level, employment status, individual income, medical insurance, years of taking medicine, medication use and diabetes complications that was comparable between the two groups were reported. The flowchart of the participants is displayed in Figure 1.

Figure 1 The flowchart of the participants.

The interaction effect of group by time for the primary outcome of HbA1c was significant (P < 0.001). And the main effect of time, and the main effect of group were significant (P < 0.001). In comparison with the control group, HbA1c in the intervention group was ameliorated significantly (1.13%, 95% CI: 1.42%, 0.83%, P < 0.001) with considering the baseline, measurement correlation, and the interaction effect of group by time. The variations in the primary outcome of HbA1c during the 12-month follow-up are listed in Table 1.

Table 1 Changes in Metabolic and Psychosocial Outcomes of Patients with T2DM at 12 Months

The interaction effects of group by time for weight, BMI, WC, TC and TG were significant (P < 0.01), whereas these were not significant for HDL and LDL (P > 0.05). The main effects of time for weight, BMI, WC, TC and TG were significant (P < 0.01), whereas these were not significant for HDL and LDL (P > 0.05). The main effects of group for weight, BMI, TC, TG and HDL were not significant (P > 0.05), whereas these were significant for WC and LDL (P < 0.05). As opposed to the control group, the secondary outcomes of WC, TC, and LDL-C were clearly improved (3.14 cm, 95% CI: 4.91 cm, 1.36 cm, P = 0.001); (0.30 mmol/L, 95% CI: 0.58 mmol/L, 0.03 mmol/L, P = 0.032); (0.25 mmol/L, 95% CI: 0.44 mmol/L, 0.07 mmol/L, P = 0.008) respectively after the baseline, measurement correlation, and the interaction effect of group by time were considered. The non-significant difference in the other secondary indicators of weight, BMI, systolic pressure, diastolic pressure, TG and HDL-C were identified between the two groups (P > 0.05). The variations of the other metabolic outcomes during the 12-month follow-up are listed in Table 1.

The interaction effect of group by time, the main effect of time and the major effect of group for psychosocial outcomes were significant (P < 0.001). As compared with the control group, an obvious increase in the indicator of diabetes knowledge was observed (mean (SE): 6.79 (0.26) vs 3.37 (0.29), 3.42, 95% CI: 2.91, 3.92, P < 0.001), and the indicator of diabetes distress was detected to decrease significantly in the intervention group (mean (SE): 25.58 (1.31) vs 30.55 (1.31), 4.97, 95% CI: 7.10, 2.83, P < 0.001) after considering the baseline, measurement correlation, and the interaction effect of group by time. The differences in the indicators of diabetes self-efficacy and DSM behaviors between the two groups also exhibited statistical significance (mean (SE): 4.42 (0.09) vs 3.55 (0.10), 0.87, 95% CI: 0.67, 1.06, P < 0.001); (mean (SE): 43.28 (1.66) vs 32.61 (1.75), 10.67, 95% CI: 7.64, 13.70, P < 0.001), respectively after considering the baseline, measurement correlation, and the interaction effect of group by time. Table 1 lists the variations in psychosocial outcomes during the 12-month follow-up.

The glycemic control for both intervention and control groups in the 3rd, 6th and 12th months during the 12-month follow-up were achieved improvements. As compared with the regimens of antihyperglycemic drugs (AHDs) in baseline, 54 (40.60%) in the intervention group maintained the same treatment regimen; 36 (27.07%) had a decrease in the use of antihyperglycemic drugs (AHDs) or use of the less effective AHDs; 43 (32.33%) had an increase in the use of AHDs or use of the more effective AHDs after 12 months. While 65 (49.24%) in the control group had not changed the treatment regimen; 25 (18.94%) decreased the AHDs usage, or changed to an AHD with weak effect; 42 (31.82%) increased the AHDs usage, or changed to an AHD with strong effect. And among them, there were five patients in the intervention group and the control group in the 12th month of the 12-month follow-up who started using insulin therapy, respectively. There was no significant difference in the medication use of diabetes between the two groups (P > 0.05).

As revealed from this study, a self-efficacy-focused structured education program (SSEP) can improve metabolic outcomes (eg, HbA1c, waist circumference, total cholesterol and low-density lipoprotein cholesterol), as well as psychosocial outcomes (eg, diabetes self-efficacy, diabetes self-management behaviors, diabetes knowledge and diabetes distress) until a 12-month follow-up. The noteworthy finding is that the improvement of HbA1c increased slightly. Besides, an unsatisfactory result is that the diabetes self-management behaviors were found to start to attenuate in the 12th month of the 12-month follow-up.

Previously, HbA1c difference at the 6-month between the intervention group and the control group was 0.740% (95% CI: 1.045%, 0.434%).10 The 12-month study increased slightly in the difference between the two groups (1.13%, 95% CI: 1.42%, 0.83%). This was superior over the findings of the existing studies on diabetes education.1518 As demonstrated from the result of the current study, the effect of the program on HbA1c could sustain until 12 months, and the effect on HbA1c was improved, which could be explained by three reasons. First, SSEP refers to a well-designed program with a structured format and theoretical driven principle. As suggested by a systemic review and meta-analysis, a program supported with structured curriculum and theory would achieve satisfactory results in blood sugar level.16 Besides, SSEP is patient-centered, culturally sensitive, by complying with on need assessments of patients and offering regular follow-up, which applies to T2DM patients in mainland China. Second, better DSM behaviors were associated with a lower blood sugar level. The intervention that is self-efficacy focused is capable of enhancing the self-efficacy of patients, and then further promoting patients to develop and maintain the DSM behaviors. Third, diabetes distress shows a close relation to cortisol or glycemic control,26,27 so the decrease in diabetes distress may be conducive to the patients glycemic control by improving the secretion of cortisol. Moreover, the diabetes medications in the 12th month of the 12-month follow-up were also analyzed, and the non-significant difference was identified between the two groups. Accordingly, the effect of medication use difference on HbA1c can be excluded. According to the UK prospective diabetes study, the improvement of HbA1c would mitigate the diabetes-related complications and premature death considerably,28 which would save considerable health expenditures.

The indicator of WC in the intervention group improved significantly in comparison with the control group. This is inconsistent with the existing studies on diabetes education.29,30 The improvement of WC might facilitate glycemic control by ameliorating insulin resistance. It was reported that WC has a close relationship with glycemic control. It was reported that compared with the T2DM patients without central obesity (< 80 cm in female and < 85 cm in the male), the insulin resistance of T2DM patients with central obesity (80 cm in female and 85 cm in the male) was more inadequate, thereby leading to high glycemic control.31 In addition, a study found that regional adipose tissue was a valid predictor of insulin resistance.32 The improvement of WC may help improve glycemic control by reducing the insulin resistance. Thus, this is probably why the indicator of HbA1c can sustain in the 12-month follow-up here. In comparison with the control group, visible improvement of TC and LDL-C was achieved in the intervention group in the 12th month, which was not observed in the 6th month. Satisfactory results in the intervention group might be attributed to the improvement of DSM behaviors, especially in the aspect of diet, and the longer term follow-up. Besides, existing studies suggested that insulin resistance and insulin dysfunction were the leading causes of dyslipidemia.33,34 The improvement of WC can alleviate insulin resistance to some extent and then facilitate the blood lipid control (eg, the TC and LDL-C). Specific to the other indicators of weight, BMI, blood pressure, TG and HDL-C, the improvements were observed in the intervention group, whereas non-significant difference was identified between the two groups.

In addition, the psychosocial outcomes of diabetes self-efficacy and DSM behaviors between the intervention group and the control group in the 12th month during the 12-month follow-up remained significant. The program was self-efficacy focused and applied a series of self-efficacy promoting strategies after finding self-efficacy as a promising point for intervention.10,20 Thus, the patients diabetes self-efficacy kept increasing. In accordance with self-efficacy theory,35 self-efficacy is a crucial predictor of human behaviors. As a result, DSM behaviors during the 12-month follow-up improved obviously. The results effectively evidenced the benefits of the SSEP in the indicators of diabetes self-efficacy and DSM behaviors in the 12th month during the 12-month follow-up. Furthermore, the mean score of DSM behaviors at the 12-month follow-up was slightly declining compared with the mean score at 6-month follow-up. It was therefore indicated that some other factors are affecting the persistence of DSM behaviors, so these factors should be determined and considered in the improvement of the SSEP.

In addition, the difference in the psychosocial indicator of diabetes knowledge was also significant during the 12-month follow-up between the two groups. This was consistent with a randomized controlled trial on structured education.36 The positive result in the study was largely attributed to the knowledge SSEP provided and the regular follow-up. A novel finding in the study was that diabetes distress presented a positive result, inconsistent with the result in the 6-month study.10 The positive effect in the 12th month during the 12-month follow-up was primarily attributed to the intervention of SSEP, which was self-efficacy theory-based. By complying with the self-efficacy theory,37 physiological/emotional arousal refers to one of the sources of information affecting self-efficacy. Thus, SSEP is patient-centered and incorporated with relevant contents and strategies in the program to relieve the negative emotion of the patients. Besides, patients negative emotion may require a longer time to eliminate, and the improvement of glycemic control may mitigate the diabetes distress of patients in reverse.

The trial involved a robust design that strongly evidenced the intermediate- and long-term effect of SSEP. Moreover, the well-designed nature and the effectiveness of SSEP made it likely to be generalized in other similar populations and settings. Besides, the data analysis complied with ITT and using generalized estimating equations to minimize the reporting bias. In addition, several limitations were found. The first one was that the 12-month follow-up remained insufficient to determine the long-term sustained effect of SSEP. The other was that the program has not undergone health economic assessment, so the generalization of the program was restricted to some extent.

The group-based self-efficacy-focused structured education program continuously impacted the metabolic outcomes (eg, HbA1c, waist circumference, total cholesterol and low-density lipoprotein cholesterol) and psychosocial outcomes (eg, diabetes self-efficacy, diabetes self-management behaviors, diabetes knowledge and diabetes distress) for T2DM patients not on insulin over 12 months. It was therefore suggested that SSEP will be an effective education model capable of being generalized nationwide. In addition, the SSEP can be referenced for managing diabetes in low- and middle-income nations and regions. Specific to subsequent studies, the long-term effect exerted by the program will be determined in depth, and the cost-effectiveness analysis of the program should be conducted. Furthermore, a further improvement of the program is worth exploring to help patients maintain DSM behaviors and HbA1c.

The authors dont intend to share any data besides that which are included in the manuscript.

Many thanks to the physicians and nurses from Wuyishan Municipal Hospital in Fujian province, Peoples Hospital of Leping City in Jiangxi province, Yanhua Hospital in Beijing, and Jimenli Primary Hospital in Beijing. The authors also thank the two hundred and sixty-five participants.

The authors declare that the consort checklist was used as a guide to report the study (Supplementary File 1).

The study was supported by Hainan Provincial Natural Science Foundation of China (820RC631, 819QN229), Young Talents Science and Technology Innovation Project of Hainan Association for Science and Technology (QCXM202019), the Project of Science Research Project in Hainan University of Higher Education (Hnky2020-36), and Hainan Health Commission Health Industry Research Project (20A200286).

The authors declare no conflicts of interest.

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[Full text] The Effectiveness of a Self-Efficacy-Focused Structured Education Prog | DMSO - Dove Medical Press

Imagine it's 2045. You start hearing rumors from your well-heeled friends about a mysterious corporation based on an undisclosed island that's offering an unprecedented service: the ability to genetically design your baby.

The baby will have some of your genetics, and some genetics from a sperm or egg donor, selected by you. But the rest of your child's genetic profile will be engineered by science. These changes will make it impossible for your child to develop genetic diseases. They'll also allow you to customize your child for dozens of traits, including intelligence level, emotional disposition, sexual orientation, height, skin tone, hair color, and eye color, to name a few.

This raises unsettling philosophical questions for some customers. "When does my child stop being my child?" they ask the corporate representatives. These wary customers are reminded of how risky it is to reproduce the old-fashioned way. The Better Genetics Corporation's motto sums it up: "Only God plays dicehumans don't have to."

This is the world described in a new science-fiction series by Eugene Clark titled "Genetic Pressure", which explores the moral and scientific implications of a future in which designer babies are becoming a major industry. The first book begins with the story of Rachel, a renowned horse breeder who befriends a billionaire client, and soon gets the funding to visit the tropical island on which the Better Genetics Corporation is headquartered.

There, corporate executives walk her through the process of designing a babyan experience that feels like an uncanny mix between visiting a doctor and designing a luxury car. The series is told from multiple perspectives, serving as a deep dive into a complex moral web that today's scientists may already be weaving.

[T]he introduction of designer babies would create a labyrinth of philosophical dilemmas that society is only beginning to explore.

Case in point: In 2018, Chinese scientist He Jiankui announced that he had helped create the world's first genetically engineered babies. Using the gene-editing tool CRISPR on embryos, He Jiankui modified a gene called CCR5, which enables HIV to enter and infect immune system cells. His goal was to engineer children that were immune to the virus.

It's unclear whether he succeeded. But what's certain is that the experiment shocked the international scientific community, which generally agreed that it's unethical to conduct gene-editing procedures on humans, given that scientists don't yet fully understand the consequences.

"This experiment is monstrous," Julian Savulescu, a professor of practical ethics at the University of Oxford, told The Guardian. "The embryos were healthy. No known diseases. Gene editing itself is experimental and is still associated with off-target mutations, capable of causing genetic problems early and later in life, including the development of cancer."

Importantly, He Jiankui wasn't treating a disease, but rather genetically engineering babies to prevent the future contraction of a virus. These kinds of changes are heritable, meaning the experiment could have major downstream effects on future generations. So, too, would a designer-baby industry, even if scientists can do it safely.

With major implications on inequality, discrimination, sexuality, and our conceptions of life, the introduction of designer babies would create a labyrinth of philosophical dilemmas that society is only beginning to explore.

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Why it's important to admit when you're wrong - Big Think

As Joe Biden takes over as president, the issue of how to deal with Russia will be one of the defining aspects of his foreign policy. Much of the Russia debate in Europe and the United States in the last decade or so has focused on whether to reset relations with Russia. This debate has come in many guises: the 2009 initial Obama-Clinton reset; the EU-Russia partnership for modernisation; the German-led Meseberg Initiative of the early 2010s; the EUs offer of selective engagement with Russia in 2016; the 2019 French-led effort to engage Russia in dialogue after a summit in Breganon.

This focus creates the illusion of a policy pendulum oscillating between phases of engagement and diplomatic hostility. But a deeper trend has been taking hold that of Russia and the West each pursuing a policy of mutual weakening. This is likely to dominate Bidens presidency and the next decade.

Throughout much of the 2000s, Russia viewed its resurgence through the prism, and expectation, of rising energy prices, economic growth and modernisation, and the creation of globally powerful state companies selling strategic resources, wielding political influence by doing so. But the 2010s led to a complete shift of strategy. Hopes of economic modernisation were all but ditched. As its economy settled into its sclerotic ways, Russias route to power through growth disappeared.

As a result, Moscow has increasingly concentrated on, arguably, a shorter route to power revival, based much less on self-improvement and much more on the weakening of its geopolitical opponents. This has taken multiple forms: courting mainstream politicians, supporting and financing all kinds of extreme left or right political parties; online disinformation and propaganda, sometimes in support of specific political forces, and sometimes simply in support of encouraging political chaos.

All of this has been topped off by a policy of peeling off allies and friends of the West, including within NATO and the European Union. Russia has gone a long way to diplomatically and economically court Turkey and Hungary, which are both NATO member states. It has also sought to weaken the West wherever possible: in EU candidate country Serbia which recently announced the opening of a Russian military liaison office at its defence ministry; in the Central African Republic where Russia supplies mercenaries and a top security adviser to the countrys president; and in Libya, Syria, the Gulf countries, Egypt, Israel, and many other states. This policy has been reasonably successful from a Russian standpoint. But it has failed in one big respect that of preventing the West from responding in kind.

Throughout much of the 1990s and 2000s, the EU and US did not aim to weaken Russia in any sense. European and American interests certainly lay in the country not being as strong as the USSR, but they still wanted it to be stronger than in the 1990s. They did not want a large failed state with nuclear weapons, threaten to upset all kinds of geopolitical balances. In 2010, after the 2008 war in Georgia but in tune with Barack Obamas own reset, the EU and Russia even launched a partnership for modernisation, whose aim was clearly to strengthen Russia economically and politically, not weaken it. Of course, the military invasion of Ukraine and annexation of Crimea in 2014 put an end to that strategy. The US and the EU introduced sanctions on Russia and sought to isolate it diplomatically. At least for the EU, the initial goal of sanctions was not necessarily to weaken Russia, but to incentivise it to stop destabilising Ukraine. As Russia continued its destabilisation tactics there, sanctions stayed and have gradually evolved, somewhat unintentionally, into a tool of weakening Russia as well. With sanctions in place, the country certainly possesses not only fewer chances to modernise its economy but also less money to invest in its military or its allies. Russia is not short of cash, but the hostile environment it has created around itself forces it to accumulate a significant war-chest for the darker days it expects ahead. The situation certainly limits its geopolitical options and Russia has been increasingly stingy when it comes to financially supporting its allies.

As both Russia and the West engaged in strategies of mutual weakening, both have also weakened themselves. The rise of populists in the US, United Kingdom, and throughout the EU has done massive damage to the credibility, cohesion, and foreign policy capacity of the West.

This self-destructive streak in Western politics has been matched only by the self-destructive streak in Russia, where its leadership has subordinated the countrys resources and economic future to foreign policy and military goals throughout large parts of the world. For now, Russia has been better than the USSR at restraining its impulse to overstretch in foreign policy, but it has still been over-exposing itself at a pretty fast rate.

The Wests self-destructive streak has been matched only by Russias self-destructive streak.

The Kremlin has been obsessed with foreign policy to the detriment of pressing domestic matters it has run Russias political and economic systems dry in the process. Russia has enough resources to stay the course for a few decades, but the longer it does so the worse the hangover will be from its foreign policy adventurism.

As the Biden administration begins to discuss Russia strategy with its European allies, this mutual weakening will probably continue. Neither Russia nor the West seem on the verge of revising their approach. Opportunities to re-engage will arise, but for that to happen one side has to feel that it is losing the race. Alternatively, both sides simultaneously need to decide that the policy is failing and both need to change course. For now, that is unlikely.

Russia thinks it has been doing pretty well in foreign policy. And from a Western standpoint, several overtures to Russia in the last decade not have not really paid off. Multiple reset offers, the freezing of NATO enlargements to Ukraine and Georgia, the decade-long repudiation of humanitarian interventions as a guide to policy, and the softening of human rights promotion policies under the presidencies of both Obama and Donald Trump have not improved relations with Russia.

So the policy of mutual weakening is likely to dominate approaches on both sides under the Biden presidency and possibly beyond. The US State Department stated in mid-2020 that, when engaging with Russia (and China), we must work to help the United States and its allies run faster in that competition, as it were, and we must also help make those who seek to compete with us run more slowly. There is also plenty of scope for transatlantic cooperation when it comes to making the alliance run faster. The road to that is, of course, through domestic political and economic transformations, which are beyond the scope of this article. But when it comes to foreign policy, one way to outcompete your adversaries is not just by rekindling the transatlantic alliance itself. It will also need to involve investing much more resource in new security partnerships with selected states from the post-Soviet space or the Middle East, while also taking steps to limit Russias ability to peel off allies and partners of the West.

The European Council on Foreign Relations does not take collective positions. ECFR publications only represent the views of its individual authors.

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How Russia and the West try to weaken each other - European Council on Foreign Relations