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I have a strange relation to Bell's inequalities, I understand (so I hope) all the maths but have lots of trouble with the implications of their violation. Currently: Say we assume QM to be realistic, it can't be local. There needs to be some sort of instantaneous signalling.

Realism means that all measurement outcomes are predetermined. So all measurement outcomes of the second EPR particles are predetermined. Why does it need a signal from the first particle if the measurement outcomes are predetermined, i.e. what message does this signal convey?