No need to read the email text except for Sloan! But do watch the video below,
if you are interested in this subject!
Just like the FAKE hit job on HCQ by the very prestigious publication, THE
LANCET, that published a fake study that had to be subsequently retracted, but
the damage was already done and the WHO, FDA, etc... used that report to
prohibit MDs from prescribing it to their patients and only allowed it to be
used in a hospital setting, knowing perfectly well what Dr. Zelenko had
published, that this treatment was most effective when given at the early onset
of the infection to prevent the virus from multiplying inside our cells with
the aid of zinc, so of course, the results coming from those studies were not
positive, they were just using HCQ w/o the zinc and they were using it on
people that were on forced ventilators(which we now know is the wrong therapy
and caused many unnecessary deaths)... this is not just incompetence, there was
and is a concerted effort to shut down the economy by creating fear and even
panic, so that the People can be conditioned to give up their civil rights and
to become dependent on the government to save them from the boogey man via this
vaccines, ONLY!
Here is an interview that you will not see on CNN, MSNBC or Fox News with Dr.
Robert Malon, the one person who probably knows more than anybody alive about
this mRNA gene therapy technology that has been rehashed to make our cells
produce trillions of "spike proteins" in the hope we would create antibodies to
then and so they can call it a "vaccine". The reason why he's an expert on this
technology is because he was the first one to envision it and knows its
limitations. I would strongly suggest that you watch and listen very carefully
what this guy, Dr. Robert Malon, has to say and see if it makes sense to you.
Don't go and try to google what the Establishment Drug Cartel with Big Tech as
allies, will say about him, just examine what he's saying and make up your mind
based on that, he is who he says he is and I see no ulterior reason why he
would not be telling the truth:
EXPLOSIVE Truth About Vaccines & COVID w/Inventor Of mRNA Vaccine Technology,
Robert Malone
|
|
|
| | |
|
|
|
| |
EXPLOSIVE Truth About Vaccines & COVID w/Inventor Of mRNA Vaccine Techno...
|
|
|
A true lover of wisdom has hands too busy to hold on to anything! He learns by
doing and every pebble in the path becomes her teacher! Oink
On Thursday, September 16, 2021, 09:26:40 AM EDT, Sloan com> wrote:
This article does not recognize even a whiff of ivermectin being effective
against the modern yellow fever, but it does delve in depth to the ivermectin
overdose
scene:https://www.npr.org/sections/coronavirus-live-updates/2021/09/04/1034217306/ivermectin-overdose-exposure-cases-poison-control-centers#:~:text=Race-,Poison%20Control%20Centers%20Are%20Fielding%20A%20Surge%20Of%20Ivermectin%20Overdose,falsely%20claim%20treats%20COVID%2D19.
| | Poison Control Centers Are Fielding A Surge Of Ivermectin Overdose Calls :
Coronavirus Updates : NPRThe nation's poison control centers saw a 245% jump in
reported exposure cases from July to August as more people take the
anti-parasite drug that some falsely claim treats COVID-19.www.npr.org |
From: Domingo Pichardo <dpichardo3@xxxxxxxxxxx>
Sent: Wednesday, September 15, 2021 8:03 PM
To: Sloan Bashinsky com>
Subject: Re: Finally, Inexpensive Ivermectin is getting some fair, objective
scientific coverage! Not true, Ivermectin(unlike HCQ) is effective at all
stages, even prophylacticaly... why don't you actually read the study before
commenting and repeating CNN/MSNBC bullshit... or should I say Cow and Horse
shit! Those stories were debunked as fake news... no emergency room filled with
Ivermectin overdose could be found!
A true lover of wisdom has hands too busy to hold on to anything! He learns by
doing and every pebble in the path becomes her teacher! Oink
On Saturday, September 11, 2021, 11:33:29 AM EDT, Sloan.com> wrote:
Yep, and then there are people taking ivermectin dosages given to cows for
treatment of C-19 and even to prevent catching it. From what I have read, it is
most effective in early-stage infection treatment.From: Domingo Pichardo
<dpichardo3@xxxxxxxxxxx>
Sent: Wednesday, September 8, 2021 7:40 PM
Subject: Finally, Inexpensive Ivermectin is getting some fair, objective
scientific coverage!
Therapeutic Advances:
Meta-analysis of 15 trials found that ivermectin reduced risk of death compared
with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73;
n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in
a trial sequential analysis using the same DerSimonian–Laird method that
underpinned the unadjusted analysis. This was also robust against a trial
sequential analysis using the Biggerstaff–Tweedie method. Low-certainty
evidence found that ivermectin prophylaxis reduced COVID-19 infection by an
average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less
certain evidence. Low-certainty evidence suggested that there may be no benefit
with ivermectin for “need for mechanical ventilation,” whereas effect estimates
for “improvement” and “deterioration” clearly favored ivermectin use. Severe
adverse events were rare among treatment trials and evidence of no difference
was assessed as low certainty. Evidence on other secondary outcomes was very
low certainty.
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are
possible using ivermectin. Using ivermectin early in the clinical course may
reduce numbers progressing to severe disease. The apparent safety and low cost
suggest that ivermectin is likely to have a significant impact on the
SARS-CoV-2 pandemic globally.
Keywords: ivermectin, prophylaxis, treatment, COVID-19, SARS-CoV-2
.
Just consider all the lives and suffering we could have avoided if only money
and power were not the Gods we worship!
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are
possible using ivermectin. Using ivermectin early in the clinical course may
reduce numbers progressing to severe disease. The apparent safety and low cost
suggest that ivermectin is likely to have a significant impact on the
SARS-CoV-2 pandemic globally.
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic
Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical
Guidelines
Andrew Bryant, MSc,1,* Theresa A. Lawrie, MBBCh, PhD,2 Therese Dowswell, PhD,2
Edmund J. Fordham, PhD,2 Scott Mitchell, MBChB, MRCS,3 Sarah R. Hill, PhD,1 and
Tony C. Tham, MD, FRCP4Author information Copyright and License information
DisclaimerThis article has been cited by other articles in PMC.Go to:
Background:
Repurposed medicines may have a role against the SARS-CoV-2 virus. The
antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has
now been tested in numerous clinical trials.
Areas of uncertainty:
We assessed the efficacy of ivermectin treatment in reducing mortality, in
secondary outcomes, and in chemoprophylaxis, among people with, or at high risk
of, COVID-19 infection.
Data sources:
We searched bibliographic databases up to April 25, 2021. Two review authors
sifted for studies, extracted data, and assessed risk of bias. Meta-analyses
were conducted and certainty of the evidence was assessed using the GRADE
approach and additionally in trial sequential analyses for mortality.
Twenty-four randomized controlled trials involving 3406 participants met review
inclusion.
Therapeutic Advances:
Meta-analysis of 15 trials found that ivermectin reduced risk of death compared
with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73;
n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in
a trial sequential analysis using the same DerSimonian–Laird method that
underpinned the unadjusted analysis. This was also robust against a trial
sequential analysis using the Biggerstaff–Tweedie method. Low-certainty
evidence found that ivermectin prophylaxis reduced COVID-19 infection by an
average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less
certain evidence. Low-certainty evidence suggested that there may be no benefit
with ivermectin for “need for mechanical ventilation,” whereas effect estimates
for “improvement” and “deterioration” clearly favored ivermectin use. Severe
adverse events were rare among treatment trials and evidence of no difference
was assessed as low certainty. Evidence on other secondary outcomes was very
low certainty.
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are
possible using ivermectin. Using ivermectin early in the clinical course may
reduce numbers progressing to severe disease. The apparent safety and low cost
suggest that ivermectin is likely to have a significant impact on the
SARS-CoV-2 pandemic globally.
Keywords: ivermectin, prophylaxis, treatment, COVID-19, SARS-CoV-2Go to:
INTRODUCTION
To date, very few treatments have been demonstrated to reduce the burden of
morbidity and mortality from COVID-19. Although corticosteroids have been
proven to reduce mortality in severe disease,1 there has been little convincing
evidence on interventions that may prevent disease, reduce hospitalizations,
and reduce the numbers of people progressing to critical disease and death.
Ivermectin is a well-known medicine that is approved as an antiparasitic by the
World Health Organization and the US Food and Drug Administration. It is widely
used in low- and middle-income countries (LMICs) to treat worm infections.2,3
Also used for the treatment of scabies and lice, it is one of the World Health
Organization’s Essential Medicines.4 With total doses of ivermectin distributed
apparently equaling one-third of the present world population,5 ivermectin at
the usual doses (0.2–0.4 mg/kg) is considered extremely safe for use in
humans.6,7 In addition to its antiparasitic activity, it has been noted to have
antiviral and anti-inflammatory properties, leading to an increasing list of
therapeutic indications.8
Since the start of the SARS-CoV-2 pandemic, both observational and randomized
studies have evaluated ivermectin as a treatment for, and as prophylaxis
against, COVID-19 infection. A review by the Front Line COVID-19 Critical Care
Alliance summarized findings from 27 studies on the effects of ivermectin for
the prevention and treatment of COVID-19 infection, concluding that ivermectin
“demonstrates a strong signal of therapeutic efficacy” against COVID-19.9
Another recent review found that ivermectin reduced deaths by 75%.10 Despite
these findings, the National Institutes of Health in the United States recently
stated that “there are insufficient data to recommend either for or against the
use of ivermectin for the treatment of COVID-19,”11 and the World Health
Organization recommends against its use outside of clinical trials.12
Ivermectin has exhibited antiviral activity against a wide range of RNA and
some DNA viruses, for example, Zika, dengue, yellow fever, and others.13 Caly
et al14 demonstrated specific action against SARS-CoV-2 in vitro with a
suggested host-directed mechanism of action being the blocking of the nuclear
import of viral proteins14,15 that suppress normal immune responses. However,
the necessary cell culture EC50 may not be achievable in vivo.16 Other
conjectured mechanisms include inhibition of SARS-CoV-2 3CLPro activity17,18 (a
protease essential for viral replication), a variety of anti-inflammatory
effects,19 and competitive binding of ivermectin with the viral S protein as
shown in multiple in silico studies.20 The latter would inhibit viral binding
to ACE-2 receptors suppressing infection. Hemagglutination via viral binding to
sialic acid receptors on erythrocytes is a recently proposed pathologic
mechanism21 that would be similarly disrupted. Both host-directed and
virus-directed mechanisms have thus been proposed, the clinical mechanism may
be multimodal, possibly dependent on disease stage, and a comprehensive review
of mechanisms of action is warranted.
Developing new medications can take years; therefore, identifying existing
drugs that can be repurposed against COVID-19 that already have an established
safety profile through decades of use could play a critical role in suppressing
or even ending the SARS-CoV-2 pandemic. Using repurposed medications may be
especially important because it could take months, possibly years, for much of
the world's population to get vaccinated, particularly among LMIC populations.
Currently, ivermectin is commercially available and affordable in many
countries globally.6 A 2018 application for ivermectin use for scabies gives a
direct cost of $2.90 for 100 12-mg tablets.22 A recent estimate from
Bangladesh23 reports a cost of US$0.60—US$1.80 for a 5-day course of
ivermectin. For these reasons, the exploration of ivermectin's potential
effectiveness against SARS-CoV-2 may be of particular importance for settings
with limited resources.24 If demonstrated to be effective as a treatment for
COVID-19, the cost-effectiveness of ivermectin should be considered against
existing treatments and prophylaxes.
The aim of this review was to assess the efficacy of ivermectin treatment among
people with COVID-19 infection and as a prophylaxis among people at higher risk
of COVID-19 infection. In addition, we aimed to prepare a brief economic
commentary (BEC) of ivermectin as treatment and as prophylaxis for COVID-19.25
Repurposed medicines may have a role against the SARS-CoV-2 virus. The
antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has
now been tested in numerous clinical trials.
Areas of uncertainty:
We assessed the efficacy of ivermectin treatment in reducing mortality, in
secondary outcomes, and in chemoprophylaxis, among people with, or at high risk
of, COVID-19 infection.
Data sources:
We searched bibliographic databases up to April 25, 2021. Two review authors
sifted for studies, extracted data, and assessed risk of bias. Meta-analyses
were conducted and certainty of the evidence was assessed using the GRADE
approach and additionally in trial sequential analyses for mortality.
Twenty-four randomized controlled trials involving 3406 participants met review
inclusion.
Therapeutic Advances:
Meta-analysis of 15 trials found that ivermectin reduced risk of death compared
with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73;
n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in
a trial sequential analysis using the same DerSimonian–Laird method that
underpinned the unadjusted analysis. This was also robust against a trial
sequential analysis using the Biggerstaff–Tweedie method. Low-certainty
evidence found that ivermectin prophylaxis reduced COVID-19 infection by an
average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less
certain evidence. Low-certainty evidence suggested that there may be no benefit
with ivermectin for “need for mechanical ventilation,” whereas effect estimates
for “improvement” and “deterioration” clearly favored ivermectin use. Severe
adverse events were rare among treatment trials and evidence of no difference
was assessed as low certainty. Evidence on other secondary outcomes was very
low certainty.
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are
possible using ivermectin. Using ivermectin early in the clinical course may
reduce numbers progressing to severe disease. The apparent safety and low cost
suggest that ivermectin is likely to have a significant impact on the
SARS-CoV-2 pandemic globally.
Keywords: ivermectin, prophylaxis, treatment, COVID-19, SARS-CoV-2
Go to:
METHODS
The conduct of this review was guided by a protocol that was initially written
using Cochrane's rapid review template and subsequently expanded to a full
protocol for a comprehensive review.26
Search strategy and selection criteria
Two reviewers independently searched the electronic databases of Medline,
Embase, CENTRAL, Cochrane COVID-19 Study Register, and Chinese databases for
randomized controlled trials (RCTs) up to April 25, 2021 (see Appendix 1–3,
Supplemental digital content 1, http://links.lww.com/AJT/A95); current
guidance25 for the BEC was followed for a supplementary search of economic
evaluations. There were no language restrictions, and translations were planned
to be performed when necessary.
We searched the reference list of included studies, and of two other 2021
literature reviews on ivermectin,9 as well as the recent WHO report, which
included analyses of ivermectin.12 We contacted experts in the field (Drs.
Andrew Hill, Pierre Kory, and Paul Marik) for information on new and emerging
trial data. In addition, all trials registered on clinical trial registries
were checked, and trialists of 39 ongoing trials or unclassified studies were
contacted to request information on trial status and data where available. Many
preprint publications and unpublished articles were identified from the
preprint servers MedRχiv and Research Square, and the International Clinical
Trials Registry Platform. This is a rapidly expanding evidence base, so the
number of trials are increasing quickly. Reasons for exclusion were recorded
for all studies excluded after full-text review.
Data analysis
We extracted information or data on study design (including methods, location,
sites, funding, study author declaration of interests, and inclusion/exclusion
criteria), setting, participant characteristics (disease severity, age, gender,
comorbidities, smoking, and occupational risk), and intervention and comparator
characteristics (dose and frequency of ivermectin/comparator). The primary
outcome for the intervention component of the review included death from any
cause and presence of COVID-19 infection (as defined by investigators) for
ivermectin prophylaxis. Secondary outcomes included time to polymerase chain
reaction (PCR) negativity, clinical recovery, length of hospital stay,
admission to hospital (for outpatient treatment), admission to ICU or requiring
mechanical ventilation, duration of mechanical ventilation, and severe or
serious adverse events, as well as post hoc assessments of improvement and
deterioration. All of these data were extracted as measured and reported by
investigators. Numerical data for outcomes of interest were extracted according
to intention to treat.
If there was a conflict between data reported across multiple sources for a
single study (eg, between a published article and a trial registry record), we
contacted the authors for clarification. Assessments were conducted by 2
reviewers (T.L., T.D., A.B., or G.G.) using the Cochrane RCT risk-of-bias
tool.27 Discrepancies were resolved by discussion.
Continuous outcomes were measured as the mean difference and 95% confidence
intervalss (CI), and dichotomous outcomes as risk ratio (RR) and 95% CI.
We did not impute missing data for any of the outcomes. Authors were contacted
for missing outcome data and for clarification on study methods, where
possible, and for trial status for ongoing trials.
We assessed heterogeneity between studies by visual inspection of forest plots,
by estimation of the I2 statistic (I2 ≥60% was considered substantial
heterogeneity),28 by a formal statistical test to indicate statistically
significant heterogeneity,29 and, where possible, by subgroup analyses (see
below). If there was evidence of substantial heterogeneity, the possible
reasons for this were investigated and reported. We assessed reporting biases
using funnel plots if more than 10 studies contributed to a meta-analysis.
We meta-analyzed data using the random effects model (DerSimonian and Laird
method)30 using RevMan 5.4.1 software.27,31 The results used the inverse
variance method for weighting.27 Some sensitivity analyses used other methods
that are outlined below and some calculations were performed in R32 through an
interface33 to the netmeta package.34 Where possible, we performed subgroup
analyses grouping trials by disease severity, inpatients versus outpatients,
and single dose versus multiple doses. We performed sensitivity analyses by
excluding studies at high risk of bias. We conducted further post hoc
sensitivity analyses using alternative methods to test the robustness of
results in the presence of zero events in both arms in a number of trials35 and
estimated odds ratios [and additionally RR for the Mantel–Haenszel (MH) method]
using a fixed effects model. The models incorporate evidence from single-zero
studies without having to resort to continuity corrections. However,
double-zero studies are excluded from the analysis; so, the risk difference was
also assessed using the MH method as this approach can adequately incorporate
trials with double-zero events. This method can also use a random-effects
component. A “treatment-arm” continuity correction was used, where the values
0.01, 0.1, and 0.25 were added where trials reported zero events in both arms.
It has been shown that a nonfixed continuity correction is preferable to the
usual 0.5.35 Other methods are available but were not considered due to
difficulty in interpretation, sensitivity of assumptions, or the fact they are
rarely used in practice.36–40
Trial sequential analysis
When a meta-analysis is subjected to repeated statistical evaluation, there is
an exaggerated risk that “naive” point estimates and confidence intervals will
yield spurious inferences. In a meta-analysis, it is important to minimize the
risk of making a false-positive or false-negative conclusion. There is a
trade-off between the risk of observing a false-positive result (type I error)
and the risk of observing a false-negative result (type II error). Conventional
meta-analysis methods (eg, in RevMan) also do not take into account the amount
of available evidence. Therefore, we examined the reliability and
conclusiveness of the available evidence using trial sequential analyses
(TSA).41–43 The DerSimonian–Laird (DL) method was used because this is most
often used in meta-analytic practice and was also used in the primary
meta-analysis.30
The TSA was used to calculate the required information size (IS) to demonstrate
or reject a relative reduction in the risk (RRR) of death in the ivermectin
group, as found in the primary meta-analysis. We assumed the estimated event
proportion in the control group from the meta-analysis because this is the best
and most representative available estimate. Recommended type I and II error
rates of 5% and 10% were used, respectively (power of 90%),43 powering the
result on the effect observed in the primary meta-analyses. We did not identify
any large COVID-19 trials powered on all-cause mortality, so powering on some
external meaningful difference was not possible. Any small RRR is meaningful in
this context, given the scale of the pandemic, but the required IS would be
unfeasibly high for this analysis if powered on a small difference. The only
reliable data on ivermectin in its repurposed role for treatment against
COVID-19 will be from the primary meta-analysis. Therefore, assuming it does
not widely deviate from other published systematic reviews, a pragmatic
decision was therefore made to power on the pooled meta-analysis effect
estimate for all-cause mortality a priori. This is more reflective of a true
meaningful difference. We used a model variance-based estimate to correct for
heterogeneity. A continuity correction of 0.01 was used in trials that reported
zero events in one or both arms. The required IS is the sample size required
for a reliable and conclusive meta-analysis and is at least as large as that
needed in a single powered RCT. The heterogeneity corrected required IS was
used to construct sequential monitoring boundaries based on the O'Brien–Fleming
type alpha-spending function for the cumulative z-scores (corresponding to the
cumulative meta-analysis),43 analogous to interim monitoring in an RCT, to
determine when sufficient evidence had been accrued. These monitoring
boundaries are relatively insensitive to the number of repeated significance
tests. They can be used to further contextualize the original meta-analysis and
enhance our certainty around its conclusions. We used a two-sided test, so also
considered futility boundaries (to test for no statistically significant
difference) and the possibility that ivermectin could harm. Sensitivity
analyses were performed excluding the trial of Fonseca,44 which was a cause of
substantial heterogeneity (but retained in the core analysis because it was at
low risk of bias). Its removal dramatically reduced I2 and D2 (diversity)
estimates, thus reducing the model variance-based estimate to correct for
heterogeneity. Two further sensitivity analyses were performed using 2
alternative random effect models, namely the Biggerstaff–Tweedie (BT) and
Sidik–Jonkman (SJ) methods.43
All outcomes have been assessed independently by 2 review authors (T.D. and
A.B.) using the GRADE approach,45 which ranks the quality and certainty of the
evidence. The results of the TSAs will also form part of the judgment for the
primary all-cause mortality outcome. The results are presented in a summary of
findings table. Any differences in judgments were resolved by discussion with
the wider group. We used Cochrane Effective Practice and Organisation of Care
guidance to interpret the evidence.46
|
|
|
| | |
|
|
|
| |
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systema...
Repurposed medicines may have a role against the SARS-CoV-2 virus. The
antiparasitic ivermectin, with antiviral ...
|
|
|
Go to:
|
|
|
| | |
|
|
|
| |
Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systema...
Repurposed medicines may have a role against the SARS-CoV-2 virus. The
antiparasitic ivermectin, with antiviral ...
|
|
|
Background:
Repurposed medicines may have a role against the SARS-CoV-2 virus. The
antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has
now been tested in numerous clinical trials.
Areas of uncertainty:
We assessed the efficacy of ivermectin treatment in reducing mortality, in
secondary outcomes, and in chemoprophylaxis, among people with, or at high risk
of, COVID-19 infection.
Data sources:
We searched bibliographic databases up to April 25, 2021. Two review authors
sifted for studies, extracted data, and assessed risk of bias. Meta-analyses
were conducted and certainty of the evidence was assessed using the GRADE
approach and additionally in trial sequential analyses for mortality.
Twenty-four randomized controlled trials involving 3406 participants met review
inclusion.
Therapeutic Advances:
Meta-analysis of 15 trials found that ivermectin reduced risk of death compared
with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73;
n = 2438; I2 = 49%; moderate-certainty evidence). This result was confirmed in
a trial sequential analysis using the same DerSimonian–Laird method that
underpinned the unadjusted analysis. This was also robust against a trial
sequential analysis using the Biggerstaff–Tweedie method. Low-certainty
evidence found that ivermectin prophylaxis reduced COVID-19 infection by an
average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less
certain evidence. Low-certainty evidence suggested that there may be no benefit
with ivermectin for “need for mechanical ventilation,” whereas effect estimates
for “improvement” and “deterioration” clearly favored ivermectin use. Severe
adverse events were rare among treatment trials and evidence of no difference
was assessed as low certainty. Evidence on other secondary outcomes was very
low certainty.
Conclusions:
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are
possible using ivermectin. Using ivermectin early in the clinical course may
reduce numbers progressing to severe disease. The apparent safety and low cost
suggest that ivermectin is likely to have a significant impact on the
SARS-CoV-2 pandemic globally.
Keywords:
A true lover of wisdom has hands too busy to hold on to anything! He learns by
doing and every pebble in the path becomes her teacher! Oink
