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Devon reports first quarter results and provides guidance outlook for the second quarter and full-year 2018.

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Canadian Operations

Take a closerlook at Devon's heavy oiloperations in Canada.

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Q1 Results Outlook

Devon reports first quarter results and provides guidance outlook for the second quarter and full-year 2018.

Learn More

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GroupM wants publishers to sign a new data protection contract that could force them to share control of their audience data with the agency group, letting the agency continue targeting ads after the Princess sweat hairband Multicolour Dolce amp; Gabbana zMbHaX7g
kicks in on May 25.

If publishers don’t sign the contract, GroupM said it would cease trading with them, claiming it would mean they aren’t necessarily compliant with the GDPR. Some publishers fear GroupM is pushing them to cover its own GDPR compliance needs, while leaving liability for fines firmly with the publisher.

The media-buying giant has said it sent the Data Protection Addendum to all its suppliers and vendors “that touch personal data in any way” in the European Union.The DPA is a contractually binding set of data protection principles that publishers would be expected to adhere to under the GDPR. The contract is nonnegotiable, according to the document.

Publishers’ legal teams are reviewing the document, but five publishers Digiday spoke to are feeling rattled by the terminology in the contract, with some calling it a “Trojan horse” document that could result in the publisher having to share the control of their data with Group M, promoting the agency group to be more like what the GDPR calls a data controller (from its current position as a data processor), which is the source of customer data. A data controller is regarded as a stronger position to be in, because they can communicate directly with the customer about consent needs, whereas a data processor doesn’t have that direct line of access as it uses data from a third-party source.

A GroupM spokesperson sent the following statement: “GroupM has an extensive GDPR program of which the GroupM data addendum forms only one part. The GroupM Data Addendum was prepared for all GroupM suppliers processing personal data whether that personal data belonged to GroupM, its clients or the supplier in question. The intention of the Data Addendum is to clearly signal the GroupM commitment to data privacy and to ask our suppliers to demonstrate the same commitment.”

The spokesperson added that the contract does not seek to impose any greater liability than already exists in the law and that the agency will handle publisher questions on a case-by-case basis.

Asked about publisher concerns about cutting ties with GroupM if they don’t sign, a GroupM spokesperson sent the following statement: “The future of our relationships with suppliers will depend on the nature of the supplier in question and the processing activities it carries out and how it demonstrates its commitment to data privacy and in particular GDPR.”

The issue of who is expected to gain consent from users and take liability for it is becoming clouded as GDPR enforcement looms. Publishers are known consumer brands and the source of the data. That means they’re in the best position to obtain consent from users with whom they have a direct relationship. For agencies and ad tech vendors further along the ad supply chain, it’s harder to gain consent. That has essentially put a target on publishers’ backs, with ad tech vendors and agencies trying to use them as vehicles to gain consent so they can continue ad targeting under the GDPR.

Retropharyngeal carotid artery, right.

If the area of concern is the tonsil itself, tonsillectomy may be the best form of biopsy. See the Indications section above as well as Medscape Reference's 373 Trainers In Navy ML373NAY Navy New Balance 5NgFKkBaZM
article.

The images below depict the procedure.

Patient is placed in Crowe Davis suspension prior to biopsy to ensure appropriate exposure. Image courtesy of Brian Reilly, MD.
The tumor is noted to arise from the right tonsil and extend beyond the tonsillar pillars to the posterior oropharynx. Image courtesy of Brian Reilly, MD.
Close up of the same submucosal tumor arising from the oropharynx. Image courtesy of Brian Reilly, MD.
Injection with 1% lidocaine with 1:100,000 epinephrine prior to biopsy. Image courtesy of Brian Reilly, MD.
Defect from the biopsy with cupped forceps. Pathology was consistent with poorly differentiated squamous cell carcinoma. Image courtesy of Brian Reilly, MD.
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Biopsies may be performed in the office or operating room setting, depending on the patient’s tolerance, medical factors, extent of necessary biopsy, and location of the lesion.

Asymmetric tonsils may or may not mandate tonsillectomy, depending on risk factors, physical findings, and the comfort of the physician and patient with a watch and wait approach.

In unknown primary cervical squamous cell metastasis, bilateral tonsillectomy is recommended in combination with other areas of the oropharynx and Waldeyer ring.

Conservative use of benzocaine sprays is warranted, secondary to the risk of Clemence Colorblock Stretchknit Dress Black Solace London C6J14h3X
.

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Complications include the following:

Bleeding

Pain: This is usually minimal but typically increases with increased surface area of the mucosal defect created by the biopsy. This is more notable in tonsillectomy.

Damage to nearby structures such as teeth, lips, tongue, glossopharyngeal nerve, greater palatine neurovascular bundle, and carotid artery

Lack of diagnosis secondary to nondefinitive biopsy

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References

St Guily JL, Clavel C, Okaïs C, Prétet JL, Beby-Defaux A, Agius G, et al. Human papillomavirus genotype distribution in tonsil cancers. . 2011 Feb 7. 3(1):6. . .

I think the b 12 is just the tip of the ice burg. While addressing the b 12 is essential, it won’t help if other parts of the methylation cycle and other cycles off there aren’t helped as well. At least 50% of the population has defect in the MTHFR gene allowing decreased ability to process folic acid. They in turn need to take activated form. The genetic mutations trickle down from there. Not a lot of doctors look at this big picture. There seems to be triggers that throw this whole system off where supplements are needed then for life. As with my daughter it has come to an allergic reaction to b 12 and having to completely remove it from her diet until help with methylation cycle was addressed. Only until then was she able to handle an activated form of B12. So I saw with her a back up of B12 to allergic point (or where body couldn’t deal with excess). It seems until looking into the whole genetic makeup that you won’t be able to find all the problems to address.

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Hi C, you may be right. Could you please describe your symptoms of “allergic reaction to b12”. I know of a couple of people who have reported a reaction to methylVB12, but it was not a classical type 1 to IV hypersensitivity. Thus, there was no wheal and flare on the skin, the reaction type was very delayed, not in 15-30 minutes, and there was no generation of heat. If you lightly scratch the skin and drip some of the VB12 solution onto it do you get a classic wheal and flare reaction? As for the “trickle” process, you are right, there was a very good paper dealing with how a reduction in substrate in any of the cycle generally reduced the rate in the whole cycle. Given that there is considerable feed-back in many enzymatic reactions as well as the effect of Le Chatelier’s principle one would expect this. There is also the the added affect of improper absorption of many of the B group vitamins in conditions of folate and VB12 insufficiency. So yes you have to look at the whole picture.

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Judyj says

Chris Kresser,

I was reading a lot of information about the absorption of B12. Eight years ago, I started having numbness and tingling in my feet, feeling tired and having trouble with memory. I saw about 4 neurologists including one at Cleveland clinic. I had a few MRI’s, spinal and numerous blood tests. No one could find out what was causing this. They told me to go back to my regular physician. Two years later a family member told an internal doctor about me. I went to see him and I had another MRI and blood tests and it was was not MS, which none of the MRI’s showed MS, but he found I had a VERY SEVERE B12 deficiency. My level was an extremely low 41. Of course within these past 2 years before he found it was my B12, my conditions were getting worse. He started me on B12 injections regimin which made my level go up but unfortunately, I had permanent nerve damage.

My balance is very bad, I have numbness and tingling from the waist down extreme stiffness and spasms in my legs and feet. And in my hand too. I use the Nasal spray now which my level has been in the 700 range which my dr, is satisfied. But now I have to use a cane, or a rollater, and in the house I just hold onto things. I’m on baclofen and valium for stiffness and spasms. I’m unable to work at any job. I was evaluated at the Mellon center in Cleveland clinic. I’ve been denied soc. security disability and ssi each time I’ve applied. Now since it has been 8 years later, I still haven’t fully accepted being disabled but everyday I try my best to get things accomplished but at a slower pace. I wish somehow or way I could get my message out to people how important B12 is.

I just wanted to share my story with you. If you could email me back to let me know that you received my message.

Thank you.

Judy

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