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Now, there's a Twitter version out there, called Twit Or Fit, brought to us by the folks behind Huddle and fav.or.it.
As far as options go, they're fairly sparse, as is the case with most Hot Or Not clones: you can choose to see girls or guys only, check out the top 10 "competitors," and opt-out of announcements of your activities on Twitter. What makes this one worth your while over the "regular" Hot Or Not is the fact that you can actually see users' last tweets as you vote for them, which makes it a sort of cool random Twitter reader.
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Unlike Twitter itself, Twit Or Fit doesn't shy from attempts at monetization; there's a banner ad at the right side; it makes me wonder when and how Twitter will start making money, but that's another story.