Autonomic neural blockade may represent a unique way to manage postoperative visceral pain and associated symptoms following minimally invasive weight loss surgery, according to a new report in JAMA Surgery.
The novel technique targets blockade of sympathetic and parasympathetic pathways by injecting local anesthetic into the areolar tissue surrounding selected autonomic plexuses. Although the researchers have primarily used the technique during laparoscopic sleeve gastrectomy, they said it could potentially expand to other minimally invasive procedures in the future.
The researchers, led by Jorge Daes, MD, of the Division of Minimally Invasive and Bariatric Surgery at Clínicas Portoazul e Iberoamérica, in Barranquilla, Colombia, have published several recent papers on findings from a pair of clinical trials involving more than 200 patients.
In the first trial, published in 2022, the group found patients undergoing sleeve gastrectomy experienced no complications from the injection and had better control of postoperative visceral symptoms.
Eric Pauli, MD
A second study, published in September, found patients who received the block at the beginning of the case required less intraoperative narcotics and anesthesia than those who got it at the end of the case, said Eric Pauli, MD, the David L. Nahrwold Professor of Surgery at Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania, and a co-author on the initial paper.
“I believe we demonstrated that these blocks are doing something. There seems to be an effect on intraoperative pain control,” Pauli said.
Postoperative outcomes have improved with the advent of minimally invasive techniques, enhanced recovery protocols, and regional pain management, Daes’ group said. But these approaches do not always address visceral pain and gastrointestinal symptoms, which can compromise patient recovery, particularly after laparoscopic sleeve gastrectomy.
Autonomic neural blockade may offer advantages by controlling visceral pain and reducing such gastrointestinal symptoms as postoperative nausea and vomiting (PONV). What’s more, the technique offers such other potential intraoperative benefits as hemodynamic stability and reduced anesthetic and opioid requirements, thereby minimizing the risk for opioid-related complications, they reported.
In the initial trial, the researchers assessed the effectiveness of laparoscopic paragastric autonomic neural blockade on pain and associated symptoms in a randomized, double-blind clinical trial of 145 patients undergoing laparoscopic sleeve gastrectomy. Participants all received transversus abdominis plane block, with or without the novel technique.
Autonomic neural blockade was associated with a significant reduction in pain, PONV, sialorrhea, and analgesic requirements in the first 24 hours after the procedure. Notably, the total number of opioid doses was more than three times greater in controls at 1 hour (14 doses vs 5 doses) and 8 hours (34 doses vs 10 doses). These differences were largely gone by 24 hours.
In the second study, the researchers examined how the timing of the nerve block affected its performance. In this case, all participants received the block, either at the beginning or at the end of laparoscopic sleeve gastrectomy.
Patients who received the anesthetic block at the onset of surgery consumed significantly less intraoperative remifentanil and sevoflurane than those who received the block at the end of the procedure. Both groups demonstrated comparable patterns of recovery after surgery. A post hoc analysis of these results revealed the block reduced analgesic consumption and effectively alleviated pain and PONV regardless of the timing of administration.
In a third study, Daes and his colleagues compared autonomic neural blockade in laparoscopic sleeve gastrectomy patients using either bupivacaine plus dexamethasone or liposomal bupivacaine. Here they found that while both combinations were effective at reducing pain and PONV 24 hours after surgery, liposomal bupivacaine seemed to be more effective in managing nausea and vomiting.
Complications observed during the series were minor, most noticeably self-limited bleeding at the injection site. Intravascular injection is also a possibility, one that demands careful application of the local anesthetic.
Pauli said expansion of the technique to other surgical procedures is possible. “Dr. Daes now uses the block routinely on gallbladder patients and hiatal hernia patients,” he said. “One of the things that he proposes is that the block can be performed in any surgery involving any organ.”
“For the cost of some local anesthesia and IV tubing, you greatly enhance the patient experience by eliminating a lot of the symptoms that accompany surgery,” Pauli added. “And if you could take even a handful of patients who might stay overnight because of their nausea and vomiting symptoms and turn them into an outpatient stay, you’ve freed up a hospital bed and reduced the workload on nursing and OR staff.”
Hilary P. Grocott, MD, an expert in regional anesthesia at the University of British Columbia in Vancouver, British Columbia, Canada, said autonomic neural blockade has potential to improve clinical care. However, he said the method requires more study to determine its efficacy for more than just the immediate postoperative period.
“The technique is certainly a novel approach to an age-old problem,” Grocott told Medscape Medical News. “Though it shows great promise, its true value is somewhat uncertain due to the relatively short-lived duration of the block’s effect.”
Pauli reported receiving personal fees from Becton Dickinson, Medtronic, Boston Scientific, Actuated Medical, Cook Biotech, Neptune Medical, Surgimatix, Noah Medical, Allergan, Intuitive Surgical, ERBE, Integra, Steris, and Vicarious, and royalties from UpToDate, Wolters Kluwer, and Springer outside the submitted work. Grocott had no relevant financial disclosures.
Michael Vlessides is a best-selling author, biographer, and medical journalist in Canmore, Alberta, Canada.
As the leaves begin to turn orange and gold, Milwaukee transforms into an autumn wonderland. The crisp air invites residents and visitors alike to embrace the seasonal charm through a variety of activities that celebrate the best of fall.
As KJ from Brew City Dads says, “The Milwaukee area comes alive in fall, with seasonal activities perfect for all ages. The city hosts a variety of autumn festivals and harvest markets offering delicious food and fun entertainment. Families can explore nearby pumpkin patches, enjoy apple picking, or take in the beautiful fall colors at one of several nearby parks or state forests.”
No matter if you’re a local looking for new experiences or a new resident ready to explore the city in the fall, this Redfin article will guide you to enjoying all the fall things to do in Milwaukee, WI.
Interested in moving to Milwaukee? Check out:
Homes for sale in Milwaukee, WI | Apartments for rent in Milwaukee, WI | Houses for rent in Milwaukee, WI
Courtesy of Forest Exploration Center
Milwaukee in autumn, explore Milwaukee’s scenic outdoors
Milwaukee’s outdoor spaces come alive in the fall, offering stunning backdrops for activities. With parks like Lakeshore State Park and the Milwaukee County Zoo’s expansive grounds, the city provides ample opportunities to soak in the autumn scenery.
Local photographer Michael of Mb Squared Photography shares, “For all you nature lovers out there, be sure to add Seven Bridges Nature Trail at Grant Park, in South Milwaukee, to your fall adventures list. This isn’t a huge trail, though just the right size for an afternoon with the entire family. Fall is by far my favorite time of the year to wander its trails. From the parking lot(s) down through the woods, wander the seven bridges, to the edge of Lake Michigan. It’s so secluded you’ll almost forget you’re ten minutes from the city. It’s certainly one of my favorite Milwaukee sights.”
One of the most heartwarming sights during this season is the increase of dog walkers enjoying the parks. As the cooler temperatures set in, the joy of seeing pets running through piles of leaves is a reminder of the simple pleasures of fall.
As Off Leash MKE shares, “Fall is an ideal time to explore and hike Milwaukee’s dog-friendly parks and trails. A must-do activity for new residents with dogs is visiting local gems like the Menomonee River Parkway, Grant Park’s Seven Bridges, and the Forest Exploration Center. These spots offer a stunning mix of fall colors, scenic beauty, and plenty of space for your dog to explore and sniff. We recommend using a long line, giving your dog the freedom to safely enjoy the natural surroundings.” For those looking to socialize their dogs or enjoy a guided adventure, Off Leash MKE offers group dog hikes that provide even more opportunities to explore these fantastic trails while your dog gets exercise and makes new friends.
Additionally, Tails N’ Trails also invites you to consider them, sharing, “Tails N’ Trails Pets stands out in the pet service industry by offering your pets more personalized care. We strive to build a relationship with your pet, which helps us build a foundation of trust to pave the way for obedience, leash etiquette, recall practice, and proper socializing.”
For those looking to immerse themselves in Milwaukee’s natural beauty this fall, the Forest Exploration Center in Wauwatosa is a must-visit destination. As Emily Glaser from Forest Exploration Center highlights, “The Forest Exploration Center in Wauwatosa is a 67-acre mature hardwood forest that features a one-mile self-guided nature trail. This accessible trail loop for hiking and nature observation offers visitors of all abilities the opportunity to be immersed in the forest ecosystem. Explore forest ecology and climate-adaptive research happening in this unique urban woodland through birdwatching, wildlife monitoring, and season-driven guided experiences.”
For a unique way to soak in the beauty of fall, consider exploring the Milwaukee Urban Water Trail. Mike Schroeder from Milwaukee Riverkeeper, suggests, “As the fall season unfolds, we highly recommend a paddle on theMilwaukee Urban Water Trail, where you can enjoy the fall colors from a unique perspective! Taking a hike around the Milwaukee River Greenway also lets you experience the natural beauty surrounding us – even in the heart of the city! Milwaukee’s ‘emerald necklace’ stretches for six miles of the Milwaukee River, with over 28 miles of hiking, biking, and water trails, linking 12 public parks.”
Jessica Del Toro from Friends of Wehr recommends, “Visit Wehr Nature Center located within Whitnall Park 9701 W. College Ave, Franklin, WI. Visit 220 acres of nature preserve with 5 miles of trails and explore the accessible park features, including a 1-mile All Abilities loop trail with a hard surface boardwalk, an accessible pier overlooking Mallard Lake, and an observation blind.The Friends of Wehr, the nonprofit partner of the Wehr Nature Center, supports Wehr’s mission of inspiring current and future generations to explore and value the natural world. Our commitment is to create a welcoming environment for everyone, regardless of age, ability, or background. A place for all seasons, a place for everyone.”
Another standout destination for fall fun is Thompson Farm in nearby Bristol, WI. As Halie Hart from the farm shares, “Step into a world of fun and excitement at Thompson Farm, where families can embark on a day filled with unforgettable experiences and interactive activities in the heart of nature.” With a sprawling 4-acre adventure farm featuring over 10 attractions — from a giant playground and bounce pillows to a corn maze and trike track—there’s something for everyone.
Plus, you can pick raspberries and pumpkins to take home! On weekends, the Fall Festival adds even more excitement with live music, tasty food from a taco truck, face painting, and a beer garden. It’s the perfect spot to celebrate autumn with family and friends!
Spooktacular fun: Halloween and fall activities in Milwaukee
As the leaves fall, the city transforms into a hub of Halloween excitement and overflows with fall things to do in Milwaukee. Whether you’re looking to get your adrenaline pumping with ghostly adventures or simply want to soak in the seasonal charm, Milwaukee offers a variety of activities that celebrate the magic of fall.
Kim Frankenhoff from Out & About Wisconsin, a site that helps you find what is going on in Milwaukee shares multiple suggestions. “What better place for a ‘not so scary’ Halloween than at the Milwaukee County Zoo, where Boo at the Zoo encourages everyone – no matter what age – to get into costume on Oct. 17-20. Visitors can enjoy everything from live pumpkin-carving exhibitions and light shows to animal talks, a trick-or-treat trail, and stilt walkers.”
Additionally, “Dia De Los Muertos, translated as the “Day of the Dead,” celebrates life and the return of spirits to the living world at Milwaukee’s Mitchell Park Domes on Oct. 25. The entire Desert Dome is decorated, as dancers, local food and art vendors, and craft-making opportunities abound.”
Another fun event is made just for vintage car lovers. “At its new location, Milwaukee’s Gateway Classic Cars is holding its Caffeine & Chrome: Trunk or Treatevent on Oct. 26. Enjoy classic cars, caffeine, and pastries, along with the opportunity to dress up in your spookiest attire!”
A thrilling Halloween experience awaits at Cedarburg Haunt! This spooky attraction promises chills and thrills as you explore. They state, “We are open for our 17th year of scaring you silly! The ticket price is $20 for The Haunt. New this year is our escape room for an extra $5 admission fee. Hours of operation: 6:00-10:00 pm Fridays and Saturdays October 11-26.” With a reputation for being one of the scariest spots in the area, it’s perfect for those looking to embrace the Halloween spirit.
A great addition to your spooky experience comes from Aaron of Trove Arts, who shares his excitement about the event, “Immerse yourself in INTO THE SHADOWS, an evening of captivating tales and art history from the dark and macabre in a secret and mysterious Art Parlour! A truly original recipe for spooky fall fun!
INTO THE SHADOWS is an intimate, immersive adventure blending art history with a splash of historical fiction, a few ounces of decadent-themed N.A. elixirs, a dash of a fun art lesson, a pinch of mystical magic, and one eye of newt!”
Courtesy of Pine Hill Orchard
Seasonal delights: Milwaukee’s farms and farmers markets
Fall is here, and that means it’s time to enjoy the fun and flavor of local farms and apple orchards! Just outside Milwaukee, you can pick your own apples, explore pumpkin patches, and taste fresh, delicious produce. Perfect for families and friends, these farms offer hayrides, corn mazes, and festive events that celebrate the season.
Matthew Lesch from Pine Hill Orchard says, “Pine Hill Orchard is a 3rd generation family business that started in 1978. We feature 48 different apple varieties, award-winning apple cider, caramel apples, our delicious Pine Hill Crunch apple pie, raw local honey, and Wisconsin maple syrup. Our retail stand is located in the Kettle Moraine just northwest of Milwaukee. The Ice Age trail is close by and offers miles of beautiful scenic trails that show off the Wisconsin foliage in the fall. We have picnic tables for your enjoyment and use from August to November. Our “bag your own” part of the stand is a local favorite, choose your apples and fill your bag.
Additionally, Genevieve Weston of Westons’ Antique Apple Orchard shares, “Westons ‘ Antique Apple Orchard offers up to 50 apple varieties in their Orchard Store which is open Saturdays 2 to 5 and Sundays 12 to 4 through October. Guests can walk through the orchard as well as buy cider, apple cider donuts, and more.”
Milwaukee’s farmers markets offer a fantastic opportunity to discover fresh, locally-grown produce, homemade treats, and unique artisan goods. Strolling through you’ll find everything from crisp apples and pumpkins to homemade items, all while supporting local farmers and artisans. Wedding & lifestyle photographer Janelle Adamson states, “Don’t miss out on the South Shore farmers market, farmer’s market, where you can pick up fresh produce and autumn-themed treats! It’s a perfect way to soak in the season and get a feel for the local community.” The market is a beloved local destination that showcases the best of Milwaukee’s fresh produce and artisanal goods. Located in South Shore Park, this market offers a vibrant atmosphere where visitors can find a variety of seasonal fruits, vegetables, and handmade products from local vendors. With live music and community events often featured, it’s not just a place to shop; it’s a gathering spot for families and friends to enjoy the sights and sounds of the season.
Farmer’s markets are all over, luckily Jack Hamrick from Foraged shares, “Foraged is the only online resource that has compiled information on every farmer’s market in the USA. A great activity for anyone in Milwaukee is visiting a farmers market! Here’s our collection page on farmer’s markets in Milwaukee.”
Ryan Laessig, creator of Milwaukee Makers Market invites you to stop by to visit and support the maker community. The market is a celebration of creativity and community. It’s not just an artisan fair; it’s a chance to showcase the amazing work of local creators. Curated by Ryan Laessig, each market offers a warm atmosphere where small business owners can share their products and connect with fans and fellow makers.
A wonderful addition to your fresh produce and product adventures is stopping by 414loral, a charming flower shop to buy fresh flowers. Jenna Resendiz shares, “414loral is more than just a flower shop in the heart of Bronzeville. They use mindful and sustainable practices to make sure their community and planet thrive with a mission to foster collaboration, flower fun, and give back to their neighborhood. You can visit their cozy brick-and-mortar on North M.L.K. Drive every Saturday, 10 am to 3 pm, for a build-your-own-bouquet experience with a flower bar lush with locally grown seasonal blooms in a music-filled shop with warm scents and even warmer staff.”
If you’re like me, you’re always on the lookout for ways to make your adventures more affordable and enjoyable. That’s why I collect points and miles. They help me travel longer, better, and cheaper.
Today I want to talk about a card that’s been growing in popularity over the past few years: the Capital One Venture X Rewards Credit Card. It’s designed for travelers who want to easily rack up miles without having to keep track of bonus categories.
And, in the past couple of years, they have really improved the card. It’s one of the main cards I use now because I love their travel portal, their transfer partners, and all the perks that come with the card.
With a hefty sign-up bonus, premium travel benefits, and an impressive rewards structure, the Venture X is worth considering if you’re looking for a new card. Here’s everything you need to know about the card and why I think you should consider getting it:
What is the Capital One Venture X Rewards Credit Card?
The Capital One Venture X Rewards Credit Card is a travel rewards card issued by Capital One. What I love about this card is its miles system. For every dollar you spend, you earn two miles, which (along with the lower-fee Capital One Venture Rewards Card) is unique among travel credit cards. There’s also no additional cost for up to four authorized users, making this a good option for families who need several cards.
In addition to earning at least 2x miles on every purchase, you can earn miles the following ways:
75,000 bonus miles when you spend $4,000 on purchases in the first three months after opening the account
10x miles on hotels and rental cars booked through Capital One Travel
5x miles on flights and vacation rentals booked through Capital One Travel
Other Perks and Benefits of the Capital One Venture X
Aside from earning miles, the Venture X packs a punch with its range of perks:
$300 travel credit when booking through the Capital One portal
Up to $120 credit for Global Entry or TSA PreCheck
Unlimited complimentary access to Capital One, Priority Pass, and Plaza Premium lounges
10,000 bonus miles every year, starting on your first anniversary
$100 experience credit and other premium benefits with every hotel and vacation rental booked from the Premier Collection
Travel insurance coverage, including primary car rental insurance, trip interruption and cancellation, and luggage reimbursement
No foreign transaction fees
With an annual fee of $395, it’s also the cheapest premium travel card out there (plus, if you can use the $300 travel credit, that brings the fee down to a manageable $95).
Using Your Capital One Miles
Capital One miles can be redeemed in a few ways. One is by booking travel directly through Capital One’s portal. While I usually don’t recommend booking through credit card portals, to fully benefit from the Venture X’s travel credit, you’ll need to book at least $300 worth of travel this way.
Another option is to use your miles to get reimbursed for any travel purchase. For 90 days after making such a purchase, you can reimburse yourself at a redemption rate of one cent per mile. After 90 days, and for all other purchases, you can use miles as cash back, at a redemption rate of 0.5 cents per mile (but avoid doing this, as it’s not a good value).
However, you’ll get the most out of your miles by transferring them to Capital One’s 15+ airline and hotel partners. While the actual value varies based on what you book, you can usually find airline and hotel redemptions worth much more than the aforementioned one cent per mile. (The process is pretty straightforward and can be done through your Capital One account.)
Here are Capital One’s current travel partners:
Accor Live Limitless
Aeromexico Club Premier
Air Canada Aeroplan
Air France/KLM Flying Blue
Avianca LifeMiles
British Airways Executive Club
Cathay Pacific Asia Miles
Choice Privileges
Emirates Skywards
Etihad Airways Guest
EVA Air Infinity MileageLands
Finnair Plus
Qantas Frequent Flyer
Singapore Airlines KrisFlyer
TAP Portugal Miles&Go
Turkish Airlines Miles&Smiles
Virgin Red
Wyndham Rewards
Using transfer partners is a game-changer if you’re looking to maximize the value of your miles. That’s why, unless I find a super cheap flight or hotel room (less than $150 USD), I always transfer miles to Capital One’s travel partners. That’s especially true when booking business class flights or fancy hotel rooms. You just get more value for your money.
Plus, with tools like point.me and Awayz (search engines that help you find the best flights and hotels to book with miles), it’s easier than ever to find the best redemption options.
Pros of the Capital One Venture X
Substantial welcome offer
2x miles on every purchase
$300 annual travel credit
15+ transfer partners
Travel accident and car rental insurance
Up to a $120 credit for Global Entry or TSA PreCheck
Access to Capital One and Priority Pass airport lounges
No foreign transaction fees
Cons of the Capital One Venture X
Steep $395 annual fee
Must use Capital One’s Travel Portal to take advantage of some benefits (e.g., 10x miles per dollar on hotels, vacation rentals, and rental cars)
Transfer partners are a bit lacking (no US airlines and not the best hotels)
Who is this card for?
The Capital One Venture X is best for frequent travelers who want a straightforward card with a higher earning rate on all purchases. If you frequently fly and stay in hotels, and are willing to pay an annual fee for premium benefits, this card is tailored for you.
Who is this card not for?
On the flip side, if you’re not a frequent traveler or don’t spend enough to offset the $395 annual fee, the Venture X might not be the best fit. It’s also not ideal if you’re looking for a card with a high rewards rate in specific categories like dining or groceries.
If you travel occasionally or prefer a lower annual fee, you might want to pick another card that better aligns with your spending habits and travel frequency. Because there is no right card — only the card that’s right for you!
***
The Capital One Venture X Rewards Credit Card is a powerhouse for those who travel often and want to enjoy top-tier perks. Weigh the pros and cons to see if it’s the right fit for your travel lifestyle but I bet it is! Like I said in the intro, it’s one of my favorite cards and I definitely recommend getting it.
Book Your Trip: Logistical Tips and Tricks
Book Your Flight Find a cheap flight by using Skyscanner. It’s my favorite search engine because it searches websites and airlines around the globe so you always know no stone is being left unturned.
Book Your Accommodation You can book your hostel with Hostelworld. If you want to stay somewhere other than a hostel, use Booking.com as it consistently returns the cheapest rates for guesthouses and hotels.
Don’t Forget Travel Insurance Travel insurance will protect you against illness, injury, theft, and cancellations. It’s comprehensive protection in case anything goes wrong. I never go on a trip without it as I’ve had to use it many times in the past. My favorite companies that offer the best service and value are:
Want to Travel for Free? Travel credit cards allow you to earn points that can be redeemed for free flights and accommodation — all without any extra spending. Check out my guide to picking the right card and my current favorites to get started and see the latest best deals.
Need Help Finding Activities for Your Trip? Get Your Guide is a huge online marketplace where you can find cool walking tours, fun excursions, skip-the-line tickets, private guides, and more.
Ready to Book Your Trip? Check out my resource page for the best companies to use when you travel. I list all the ones I use when I travel. They are the best in class and you can’t go wrong using them on your trip.
Brazilian butt lifts may be a popular cosmetic surgery trend, but Jason Kelce has confessed he doesn’t love the look.
The retired NFL player, 36, weighed in with his opinion on BBLs while chatting to brother Travis, 34 ,during the Wednesday October 16 episode of their “New Heights” podcast.
“I’m not gonna lie, I’m not a fan of the BBLs. It looks OK for like a couple of years maybe, but then that thing that starts saggin’ and it looks like you got a diaper on the backside of you. It’s not a good look,” Jason said.
Related: See Baby Pics of Travis Kelce, ‘Are You Smarter Than a Celebrity?‘ Costars
Travis Kelce and his celebrity classmates from Are You Smarter Than a Celebrity? were always ready for their close-up, judging by their adorable childhood photos. In photos exclusive to Us Weekly, Kelce and some of the star-studded guest stars on Are You Smarter Than a Celebrity? including Nikki Glaser, Garcelle Beauvais, Lala Kent, Natasha Leggero […]
Instead, Jason suggested people who wanted the look to try to obtain the results in a way that doesn’t require going under the knife.
“Just do some glute bridges!” he suggested. “You can build the wagon naturally, you don’t need the synthetics. Just doesn’t have the right shape. It just looks bad. When the hamstrings don’t match your a–, it doesn’t look good…You can’t just add to the a–, and then you got weak-a– hammies.”
The topic arose on their podcast after they discussed Travis learning what a BBL was during his new gig as host of Amazon Prime Video’s Are You Smarter Than a Celebrity?
Travis Kelce(Photo by JC Olivera/Getty Images)
In the Wednesday, October 16 premiere of the streaming platform’s game show, a contestant told Travis she wanted to get a BBL. A confused Travis needed an explanation of what a BBL entailed — and soon found out it was a surgery that redistributes fat from a person’s midsection to their butt in order to create a fuller shape on their backside.
While Travis already has a successful sports career as the Kansas City Chiefs tight end, the athlete has garnered praise for his newfound skills as a gameshow host.
Related: Why Kylie Kelce Says Jason Kelce Has a ‘Chicken Ass’
Courtesy of Kylie Kelce/Instagram Jason Kelce knows exactly what his wife, Kylie Kelce, thinks about his backside. During the Wednesday, May 1, episode of Jason and brother Travis Kelce’s “New Heights” podcast, the 36-year-old Eagles alum shared an in-depth analysis of how butt size affects football performance. “I do think that you want more shapely […]
Speaking to Us Weekly for the new issue, guest stars Natasha Leggero and Ron Funches complimented Travis’ hosting abilities.
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“He brings his traditional golden retriever energy of a man who’s super attractive yet down to earth,” Funches, 41, said of Travis ahead of the premiere. “He is a pretty amazing gentlemen.”
Leggero, 50, agreed with the assessment, adding, “He really blew us away.”
The Are You Smarter Than game show series became popular with the 2007 premiere of Are You Smarter Than a 5th Grader? Fast forward to 2024 and celebrities are now getting involved as contestants will compete against a panel of stars to see who has the most knowledge.
What does image generative AI really tell us about our world?
Photo by Math on Unsplash
I recently had the opportunity to provide analysis on an interesting project, and I had more to say than could be included in that single piece, so today I’m going to discuss some more of my thoughts about it.
The approach the researchers took with this project involved providing a series of prompts to different generative AI image generation tools: Stable Diffusion, Midjourney, YandexART, and ERNIE-ViLG (by Baidu). The prompts were particularly framed around different generations — Baby Boomers, Gen X, Millennials, and Gen Z, and requested images of these groups in different contexts, such as “with family”, “on vacation”, or “at work”.
While the results were very interesting, and perhaps revealed some insights about visual representation, I think we should also take note of what this cannot tell us, or what the limitations are. I’m going to divide up my discussion into the aesthetics (what the pictures look like) and representation (what is actually shown in the images), with a few side tracks into how these images come to exist in the first place, because that’s really important to both topics.
Before I start, though, a quick overview of these image generator models. They’re created by taking giant datasets of images (photographs, artwork, etc) paired with short text descriptions, and the goal is to get the model to learn the relationships between words and the appearance of the images, such that when given a word the model can create an image that matches, more or less. There’s a lot more detail under the hood, and the models (like other generative AI) have a built in degree of randomness that allows for variations and surprises.
When you use one of these hosted models, you give a text prompt and an image is returned. However, it’s important to note that your prompt is not the ONLY thing the model gets. There are also built in instructions, which I call pre-prompting instructions sometimes, and these can have an effect on what the output is. Examples might be telling the model to refuse to create certain kinds of offensive images, or to reject prompts using offensive language.
An important framing point here is that the training data, those big sets of images that are paired with text blurbs, is what the model is trying to replicate. So, we should ask more questions about the training data, and where it comes from. To train models like these, the volume of image data required is extraordinary. Midjourney was trained on https://laion.ai/, whose larger dataset has 5 billion image-text pairs across multiple languages, and we can assume the other models had similar volumes of content. This means that engineers can’t be TOO picky about which images are used for training, because they basically need everything they can get their hands on.
Ok, so where do we get images? How are they generated? Well, we create our own and post them on social media by the bucketload, so that’s necessarily going to be a chunk of it. (It’s also easy to get a hold of, from these platforms.) Media and advertising also create tons of images, from movies to commercials to magazines and beyond. Many other images are never going to be accessible to these models, like your grandma’s photo album that no one has digitized, but the ones that are available to train are largely from these two buckets: independent/individual creators and media/ads.
So, what do you actually get when you use one of these models?
One thing you’ll notice if you try out these different image generators is the stylistic distinctions between them, and the internal consistency of styles. I think this is really fascinating, because they feel like they almost have personalities! Midjourney is dark and moody, with shadowy elements, while Stable Diffusion is bright and hyper-saturated, with very high contrast. ERNIE-ViLG seems to lean towards a cartoonish style, also with very high contrast and textures appearing rubbery or highly filtered. YandexART has washed out coloring, with often featureless or very blurred backgrounds and the appearance of spotlighting (it reminds me of a family photo taken at a department store in some cases). A number of different elements may be responsible for each model’s trademark style.
As I’ve mentioned, pre-prompting instructions are applied in addition to whatever input the user gives. These may indicate specific aesthetic components that the outputs should always have, such as stylistic choices like the color tones, brightness, and contrast, or they may instruct the model not to follow objectionable instructions, among other things. This forms a way for the model provider to implement some limits and guardrails on the tool, preventing abuse, but can also create aesthetic continuity.
The process of fine tuning with reinforcement learning may also affect style, where human observers are making judgments about the outputs that are provided back to the model for learning. The human observers will have been trained and given instructions about what kinds of features of the output images to approve of/accept and which kinds should be rejected or down-scored, and this may involve giving higher ratings to certain kinds of visuals.
The type of training data also has an impact. We know some of the massive datasets that are employed for training the models, but there is probably more we don’t know, so we have to infer from what the models produce. If the model is producing high-contrast, brightly colored images, there’s a good chance the training data included a lot of images with those characteristics.
As we analyze the outputs of the different models, however, it’s important to keep in mind that these styles are probably a combination of pre-prompting instructions, the training data, and the human fine tuning.
Beyond the visual appeal/style of the images, what’s actually in them?
Limitations
What the models will have the capability to do is going to be limited by the reality of how they’re trained. These models are trained on images from the past — some the very recent past, but some much further back. For example, consider: as we move forward in time, younger generations will have images of their entire lives online, but for older groups, images from their youth or young adulthood are not available digitally in large quantities (or high quality) for training data, so we may never see them presented by these models as young people. It’s very visible in this project: For Gen Z and Millennials, in this data we see that the models struggle to “age” the subjects in the output appropriately to the actual age ranges of the generation today. Both groups seem to look more or less the same age in most cases, with Gen Z sometimes shown (in prompts related to schooling, for example) as actual children. In contrast, Boomers and Gen X are shown primarily in middle age or old age, because the training data that exists is unlikely to have scanned copies of photographs from their younger years, from the 1960s-1990s. This makes perfect sense if you think in the context of the training data.
[A]s we move forward in time, younger generations will have images of their entire lives online, but for older groups, images from their youth or young adulthood are not available digitally for training data, so we may never see them presented by these models as young people.
Identity
With this in mind, I’d argue that what we can get from these images, if we investigate them, is some impression of A. how different age groups present themselves in imagery, particularly selfies for the younger sets, and B. how media representation looks for these groups. (It’s hard to break these apart sometimes, because media and youth culture are so dialectical.)
The training data didn’t come out of nowhere — human beings chose to create, share, label, and curate the images, so those people’s choices are coloring everything about them. The models are getting the image of these generations that someone has chosen to portray, and in all cases these portrayals have a reason and intention behind it.
A teen or twentysomething taking a selfie and posting it online (so that it is accessible to become training data for these models) probably took ten, or twenty, or fifty before choosing which one to post to Instagram. At the same time, a professional photographer choosing a model to shoot for an ad campaign has many considerations in play, including the product, the audience, the brand identity, and more. Because professional advertising isn’t free of racism, sexism, ageism, or any of the other -isms, these images won’t be either, and as a result, the image output of these models comes with that same baggage. Looking at the images, you can see many more phenotypes resembling people of color among Millennial and Gen Z for certain models (Midjourney and Yandex in particular), but hardly any of those phenotypes among Gen X and Boomers in the same models. This may be at least partly because advertisers targeting certain groups choose representation of race and ethnicity (as well as age) among models that they believe will appeal to them and be relatable, and they’re presupposing that Boomers and Gen X are more likely to purchase if the models are older and white. These are the images that get created, and then end up in the training data, so that’s what the models learn to produce.
The point I want to make is that these are not free of influence from culture and society — whether that influence is good or bad. The training data came from human creations, so the model is bringing along all the social baggage that those humans had.
The point I want to make is that these are not free of influence from culture and society — whether that influence is good or bad. The training data came from human creations, so the model is bringing along all the social baggage that those humans had.
Because of this reality, I think that asking whether we can learn about generations from the images that models produce is kind of the wrong question, or at least a misguided premise. We might incidentally learn something about the people whose creations are in the training set, which may include selfies, but we’re much more likely to learn about the broader society, in the form of people taking pictures of others as well as themselves, the media, and commercialism. Some (or even a lot) of what we’re getting, especially for the older groups who don’t contribute as much self-generated visual media online, is at best perceptions of that group from advertising and media, which we know has inherent flaws.
Is there anything to be gained about generational understanding from these images? Perhaps. I’d say that this project can potentially help us see how generational identities are being filtered through media, although I wonder if it is the most convenient or easy way to do that analysis. After all, we could go to the source — although the aggregation that these models conduct may be academically interesting. It also may be more useful for younger generations, because more of the training data is self-produced, but even then I still think we should remember that we imbue our own biases and agendas into the images we put out into the world about ourselves.
As an aside, there is a knee-jerk impulse among some commentators to demand some sort of whitewashing of the things that models like this create— that’s how we get models that will create images of Nazi soldiers of various racial and ethnic appearances. As I’ve written before, this is largely a way to avoid dealing with the realities about our society that models feed back to us. We don’t like the way the mirror looks, so we paint over the glass instead of considering our own face.
Of course, that’s not completely true either — all of our norms and culture are not going to be represented in the model’s output, only that which we commit to images and feed in to the training data. We’re seeing some slice of our society, but not the whole thing in a truly warts-and-all fashion. So, we must set our expectations realistically based on what these models are and how they are created. We are not getting a pristine picture of our lives in these models, because the photos we take (and the ones we don’t take, or don’t share), and the images media creates and disseminates, are not free of bias or objective. It’s the same reason we shouldn’t judge ourselves and our lives against the images our friends post on Instagram — that’s not a complete and accurate picture of their life either. Unless we implement a massive campaign of photography and image labeling that pursues accuracy and equal representation, for use in training data, we are not going to be able to change the way this system works.
Getting to spend time with these ideas has been really interesting for me, and I hope the analysis is helpful for those of you who use these kinds of models regularly. There are lots of issues with using generative AI image generating models, from the environmental to the economic, but I think understanding what they are (and aren’t) and what they really do is critical if you choose to use the models in your day to day.
For our last full controller review on TouchArcade, I’ve been using the Victrix Pro BFG Tekken 8 Rage Art Edition for PC and PlayStation across my Steam Deck, PS5, and PS4 Pro for over a month now. Before I interviewed PDP Victrix about the controller and arcade sticks, I was very curious about the controller for its modular nature and also because I’ve wanted to try out another “Pro” controller after adoring the Xbox Elite (1st generation) and DualSense Edge over the years.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller – what’s in the box
Usually, controllers just ship with a cable and sometimes a charging stand. In the case of the Victrix Pro BFG Tekken 8 Rage Art Edition, you get the controller, a braided cable, a high quality protective case to house the controller and everything else it ships with, a replacement fightpad module with a six button layout for fighting games, two gates, two replacement analog stick caps, two d-pad caps, a screwdriver for use with the controller, and a blue wireless USB dongle.
The items are all neatly placed within the case which is very good quality on its own. Unlike the normal Victrix Pro BFG controller, some of the items with this one are themed to match the new Tekken 8 Rage Art Edition aesthetic. Keep this in mind as I don’t see replacements available officially for this, but I hope they start selling them soon.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller compatibility
On paper, the Victrix Pro BFG Tekken 8 Rage Art Edition Controller supports PS5, PS4, and PC. I don’t use Windows anymore, so I was curious if this would work on Steam Deck out of the box. Since I prefer the PlayStation button prompts in games, I set it to PS5 and plugged in the dongle into my Steam Deck Docking Station. It worked without issue and without needing any update.
On the console side, if you want to play wirelessly, you need the same dongle and to set the toggle to PS4 or PS5. I had no issues playing with it on my PS4 Pro in PS4 mode and on my PS5 in PS5 mode. In fact, since I don’t have any PS4 controller that works outside of arcade sticks with PS4 support, this is a very good bonus to have for when I want to test something on PS4 to compare with PS5.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller features
The big draw of the Victrix Pro BFG controller is the modular nature letting you work with a symmetric stick layout, asymmetric stick layout, change things up for fighting games with the fightpad, adjust the triggers, thumbsticks, and also the d-pads. The aim with this design was to allow you to adjust the controller depending on the game you’re playing. As an example, I’d use the symmetric stick layout when playing Katamari Damacy Reroll, but I might swap to the Xbox-style asymmetric layout while playing DOOM Eternal.
Being able to adjust the trigger stop is also great as I can change that when playing a racing game with analog trigger support and also go for the shortest stop when playing a game with digital trigger support. Beyond that, the multiple d-pad options are very nice, but I’ve been trying to stick to the default diamond shape one to get used to it, and I like it a lot. I wouldn’t use it for platformers though, but the other d-pad options work well here.
Since this is an official PS5 and PS4 licensed controller, it is worth noting that this has no rumble, no haptic feedback, no adaptive trigger support, and no gyro/motion control support. I don’t care about gyro much, but no rumble at all is disappointing since you have sub $30 controllers now offering decent rumble, though they aren’t PS5 compatible. I’ve been informed that third party wireless controllers for PS5 might have restrictions for rumble as well, and I’ve seen more reports from folks using other third party controllers here. Either way, this is disappointing.
The Victrix Pro BFG Tekken 8 Rage Art Edition ships with 4 paddles or well paddle-like buttons. I wish there were proper paddles you could remove though. I mapped two of them to L3 and R3 and the ones above to L1 and R1 since I use those the most in games like Monster Hunter World and also hate pressing the sticks. Having four buttons here is very good though.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller look and feel
Visually, I love the gorgeous and bright highlights and colors used on the Victrix Pro BFG Tekken 8 Rage Art Edition. It isn’t as elegant as the default black model with purple highlights, but for a themed controller it looks very good with its light blue, pink, purple, and Tekken 8 branding.
The Victrix Pro BFG Tekken 8 Rage Art Edition feels very comfortable, but it is a bit too light for my liking. The material on the main controller body ranges from feeling premium to just fine. It is a far cry from the premium feeling DualSense Edge, but that controller has that ugly glossy front plate that ruins things. The grip on this controller makes a big difference, and I’ve had 8 hour sessions with the controller wired without getting tired of holding it. It being light pays off here.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller on PS5
On PS5, there are a few things to keep in mind. This is an officially licensed controller, but you can’t turn on your PS5 with it. This seems like a limitation for 3rd party controllers on PS5, but is an annoyance to keep in mind. Beyond that, haptic feedback, adaptive triggers, and gyro are not available here. Aside from that, it has touchpad support and all the buttons I use on a DualSense controller including the share button.
Victrix Pro BFG on Steam Deck
Like I mentioned above, the Victrix Pro BFG Tekken 8 Rage Art Edition works out of the box on Steam Deck with the dongle plugged into the official Docking Station I use. It even correctly is recognized as a PS5 Victrix controller with the share button working for capturing screenshots and the touchpad working as it should in PC games that have PlayStation controller support. This was great to see as some games don’t even recognize my DualSense correctly.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller battery life
The huge advantage the Victrix Pro BFG Tekken 8 Rage Art Edition Controller or the normal one has over the DualSense and DualSense Edge is the battery life. It lasts multiple times longer than the DualSense and the DualSense Edge on a single charge. It also helps that the logo on the touchpad indicates when the battery is low. This is good for playing on Steam Deck as other controllers don’t really visually indicate when the battery is low.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller software
The software is something I couldn’t test as it is only available on the Microsoft Store and I don’t use Windows anymore. Thankfully, it works out of the box with Steam Deck, PS5, and PS4. The one thing I was hoping to see is if the controller would work on iOS. I tested wirelessly with the dongle on my iPad, wired on my iPhone 15 Pro, and also wired on my iPad Pro with no luck.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller negatives
Right now, it has a few big negatives. These include no rumble, the low polling rate, not shipping with the Hall Effect sensors, and it requires a dongle for wireless, at least for the model I have. The lack of rumble might not be an issue for some, but for a “Pro” controller, the polling rate is disappointing. There are multiple videos on YouTube showcasing this and why it is a problem as well. Comparatively, the DualSense Edge wired is massively better with its response.
As for the Hall Effect sensors, I’m glad Victrix now sells the new modules, but why do new purchases of the controller not just ship with those in the first place? Also if I were to buy either of the module color options available for my Victrix Pro BFG Tekken 8 Rage Art Edition Controller, it wouldn’t fit with the aesthetic and will not have PS5 face buttons.
Victrix Pro BFG Tekken 8 Rage Art Edition Controller Review
Having gotten well over a hundred hours of use out of the controller per platform across games like UFO 50, Street Fighter 6, Tekken 8, Persona 3 Reload, and many more, I can safely say that I love using the controller, but the few issues are annoying to see given its price point. In a lot of ways, the Victrix Pro BFG Tekken 8 Rage Art Edition has the potential to be one of the best controllers in years if it sees some fixes and changes for a potential successor. Right now, there are a few too many caveats involved for its high asking price that make sure it is very good, but not amazing. The big issues holding it back right now are the lack of rumble (which seems like a restriction from Sony), dongle requirement, additional cost involved for Hall Effect sticks, and the polling rate. These might not matter to some folks, but for a “Pro” controller priced at $200, I expected a bit more.
Victrix Pro BFG Tekken 8 Rage Art Edition Review Score: 4/5
Update: Added more information for the lack of a rumble feature.
Instead of simply pushing the data for 3rd party cookie depreciation again, Google announced that they will no longer phase out third-party cookies in Chrome. While this may seem like a big sigh of relief for advertisers and publishers, it’s important to note that even though they are abandoning this move, Google is proposing a different approach that will also impact your ability to target users and track conversions. Similar to the move Apple made a few years ago, Google’s alternative plan is to give Chrome users a new, informed choice when it comes to their privacy settings.
Chrome users will get new privacy control options. “Users can set their privacy preferences to apply across their web browsing activities”. Although the full impact of this change is unknown, there is an assumption that as users are presented with more control options around their privacy settings, that more will opt-out of cookie tracking, and it will be harder to track and reach these audiences. Google continues to test Privacy Sandbox APIs, and in the long term, many still expect 3rd party cookies to phase out and be replaced by different technology.
GCommerce recommends clients continue to focus on ways it can prepare for a more privacy centric web experience. As users opt-out of tracking and our ability to retarget and track all conversions continues to grow, it’s important to focus on growth strategies around 1st party data and truly understand where your audience is spending their time online to understand the best channels to buy media and gain awareness to potential guests.
Here are a few things to consider for your hotel in a more privacy centric web:
1. Focus on 1st party data collection for retargeting – although conversion tracking gets harder as users opt-out of tracking, the larger concern falls around retargeting and getting your ads in front of the right audience. Consider Facebook lead gen campaigns and on-site email capture forms.
2. Dive into your guest CRM data and develop a robust customer profile to help guide your targeting and media placement decisions.
3. Set up a Consent Management Platform on your site – also known as a cookie banner, these ensure you can control how cookies track visitors on your site as they pertain to local privacy law compliance (think GDPR for European visitors and CCPA for California). Tip: Go with a Google certified CMP like CookePro or OneTrust to easily enable Google Consent Mode. This helps platforms like Google Ads and GA4 estimate and model conversions even as visitors opt-out.
4. Use Keyword targeting intent across platforms on Google Search and beyond – continue to lean on the specific intent that keyword targeting in search provides. But did you know you can also use keyword targeting across other media types? Consider testing contextual targeting in display, and TikTok just rolled out search campaigns using keyword targeting on its platform.
5. Test new audience targeting partners that generate audiences based on 1st party data, such as Adara, Azira, Navigator, and more.
Need help creating a privacy centric hotel marketing strategy? Reach out to GCommerce Solutions today.
In a world dominated by screens, getting kids excited about reading is a challenge. PMI Kids’ World wants to change that. Its new line of miniature collectible toys, Booksy, is using the power of play to make reading engaging and exciting for kids again.
Booksy is a unique collection that merges the thrill of collecting toys with the educational benefits of reading. Each miniature figure pops open to reveal a tiny, readable book that’s the perfect size for little hands. Each Booksy offers not just imaginative play, but an opportunity for young readers to grow their literacy skills, explore new stories, and express their creativity.
Hit the books and the sewers with this crimefighting minature. | Source: PMI Kids’ World/The Toy Insider
Have a monstrous good time reading these “tails!” | Source: PMI Kids’ World/The Toy Insider
When they aren’t saving the world, the PAW Patrol curls up with a good book. | Source: PMI Kids’ World/The Toy Insider
While the digital age has put infinite knowledge into everyone’s pockets, the constant temptation of a screen allows kids to abandon other activities. Instead of reading the latest novel or doing a craft, kids are scrolling. According to researchers, only 33% of United States fourth graders in 2022 could read proficiently. Booksy is bridging the gap between engaging play and intellectual growth.
The core collection is based on PMI Kids World’s original characters: the Monster Tales. These quirky, adorable creatures are full of personality to inspire kids’ creativity. Each tiny book is illustrated and fully readable to introduce kids to the unique world of the monsters. The stories offer a screen-free and imaginative way to enjoy playing with their toys. As readers build their miniature library, they can display their collection in the Monster Tales bookcase. Get ready to stack those shelves!
No book is too big, no pup is too small! This November, familiar faces from popular kids’ television series Teenage Mutant Ninja Turtles and PAW Patrol will join the Booksy family. This new chapter in the Booksy story features daring pups Chase and Sky of PAW Patrol, as well as the heroes in a half-shell Raphael and Michelangelo. Each miniature Booksy of the character will come with a tiny story set in their respective universes. By including characters and stories that matter to kids like these, Booksy is making literacy more approachable and compelling to young kids than it ever was before.
Booksy PAW Patrol and Booksy Teenage Mutant Ninja Turtles will hit Walmart stores on Nov. 12, but you can add Booksy Monster Tales to your bookshelf at the link below!
BOOKSY MONSTER TAILS
Dive into the world of Booksy Monster Tails with this 1-pack dome collection. Each figure includes a legible miniature book filled with kid-related life lessons featuring over 40 pages of colorful illustrations and storytelling. These articulated, themed toys are also designed for interactive play. Collect them all to uncover each character’s captivating story, distinct personality,…
Already a Booksy reader? Show off your collection with the Monster Collector Display bookshelf available below.
BOOKSY BOOKSHELF MONSTER COLLECTOR DISPLAY
The Booksy Bookshelf Monster Collector Display Set is the perfect way to begin a child’s Booksy collection, including 1 Monster Bookshelf, 1 Exclusive Booksy Figure, and 1 Unique Book for the young reader and collector. Each Booksy figure packs a tiny fully readable book! Layered with fun and playful illustrations, these unique stories create a…
Trade in your iPad mini 6 at Best Buy to buy the iPad mini 7 – Image credit: Apple
Best Buy is throwing a massive Apple trade-in event, and its iPad mini deals deliver trade-in values higher than what Apple offers on several models.
If you have a last-gen iPad mini 6 and are eager to upgrade to the 7th Generation, it’s worth checking out Best Buy’s trade-in offer for your particular model. The sweet spot is the $350 value for the 256GB iPad mini 6 Wi-Fi, which is $120 more than Apple’s $230 trade-in incentive.
You can put the money toward a new iPad mini 7, which is available for preorder at Best Buy. The Apple Authorized Reseller also has competitive deals on MacBook Pro and MacBook Air models.
