#clinical trials training

[ccrpsorg]

Introduction to Clinical Trial Training

The field of clinical research has seen a significant rise in demand over recent years, with the evolving landscape of the pharmaceutical and biotechnology industries playing a significant role. A clinical research associate (CRA) is a crucial part of the clinical trial process, as they are responsible for overseeing the well-being of subjects and ensuring that the study complies with regulatory requirements. With the clinical research market set to experience growth, it's essential to have a thorough understanding of clinical research training, encompassing its components, course options, and benefits.

I. Clinical Research Training: Background and Importance

Before diving into the specifics of clinical research training, it's necessary to understand what clinical research is and its importance in the field of medicine. Clinical research refers to the systematic study of potential new drugs, medical devices, and techniques to establish their safety and efficacy before they can be approved for use by regulatory authorities. In simple terms, clinical research aims to ensure that new treatments and therapies are both safe and effective for human use, protecting the public from potentially harmful side effects or complications.

Clinical research, thus, plays a key role in the process of bringing novel medical treatments to market. It is a multifaceted process that requires a range of skill sets, from data analysis to ethics and compliance. Clinical research associates (CRAs) are responsible for managing clinical trials and ensuring that they adhere to relevant laws and ethical guidelines. As such, clinical research training equips potential CRAs with the necessary skills to excel in their roles and contribute to the safe development of new therapies and medical products.

II. Components of Clinical Research Training

Clinical research training typically comprises several essential components, each designed to provide a comprehensive understanding of the clinical research process. Some of the critical elements of clinical research training include the following:

1. Basic Principles of Clinical Research: An overview of the fundamentals of clinical research, including the phases of clinical trials and the importance of randomization, blinding, and placebo controls.

2. Good Clinical Practice (GCP): A thorough understanding of GCP guidelines set by regulatory authorities like the International Council for Harmonisation (ICH) and the Food and Drug Administration (FDA) to ensure the safety, integrity, and quality of clinical trials.

3. Protocol Development: Training in the design and development of clinical trial protocols, with an emphasis on creating study objectives, inclusion/exclusion criteria, and the types of assessments required.

4. Ethics in Clinical Research: In-depth exploration of ethical considerations in clinical research, including informed consent, institutional review board (IRB) approval, and data protection.

5. Regulatory Compliance: Gaining a comprehensive understanding of the role of various regulatory authorities in the clinical research process, and ensuring compliance with relevant regulations.

6. Data Management and Biostatistics: Knowledge of essential data management techniques, including data collection and validation, data quality control, and the application of biostatistics in clinical research.

7. Clinical Trial Management: Training on the roles and responsibilities of the clinical trial team and best practices in trial management, including site selection, patient recruitment, and study closeout.

8. Safety Reporting and Pharmacovigilance: An understanding of safety reporting requirements and the importance of pharmacovigilance in maintaining patient safety throughout the clinical trial.

III. Clinical Research Training: Course Options and Certifications

Numerous clinical research training programs are available for those wishing to enter or advance within the clinical research field. These programs typically cater to diverse educational backgrounds and levels of expertise, ensuring that all prospective CRAs have access to the necessary training. Courses generally range from short-duration workshops to comprehensive diploma or degree programs.

One popular and widely recognized accreditation is the Clinical Research Associate (CRA) Certification. Obtaining this certification demonstrates a commitment to excellence and professionalism in clinical research. Several organizations offer clinical research associate certification online, making it an easily accessible option for many individuals.

In conclusion, clinical research training is essential for anyone wishing to pursue a career in clinical research. It equips learners with the skills and knowledge necessary to conduct and manage clinical trials, ensuring public safety and helping to bring life-enhancing treatments to market. With various course options available, including the Clinical Research Associate Certification Online, gaining the required qualifications is more accessible than ever before.

#clinical trials training #clinical trial training #clinical trial manager training #citi clinical trial training #clinical trial administrator training #clinical trial agreement training #clinical trial assistant training #clinical trial associate training #clinical trial audit training #clinical trial budget training #clinical trial coordinator training #clinical trial investigator training #clinical trial management system training #clinical trial management training #clinical trial management training courses #clinical trial project management training #clinical trial protocol training #clinical trial site training #clinical trial training program #clinical trials monitoring training #clinical trials sas programming training #clinical trials training courses #edc training clinical trials #iata training clinical trials #medical device clinical trial training #medical device clinical trials training #nida clinical trials network free gcp training #nida clinical trials network gcp training #nih clinical trials training #oncology clinical trials training

[aspiretechsoft]

#clinical sas certification course in pune #clinical sas programming course in pune #clinical trials certification course in pune #clinical sas training in pune

[seokshinedk]

Powering my way through the day with both coffee AND green tea. Today warrants some double-dipping.

#text #setting a bad example for my voice clients but that’s ok they don’t need to know that #I still dunno how to feel abt my morning school placement… #I feel bad cause I know the SLP needs a lot of support and I don’t mind giving that..it’s why im there #but im also…gonna be making mistakes and having trial/error with the kids #esp since I haven’t had child clinic yet…cause it’s one thing to learn in class vs. hands on #& idk if they’re expecting more from me cause I am a grad student..?? #idk…but I do need to ask her abt getting more visual supports for the mod-severe kids #cause like…has anyone tried to ask the teacher abt this or…?? #it still kills me that the aides aren’t trained at all but that’s…out of my control lol #anyway just gotta get through the next school and focus on voice dx tonight #the girls and I are Stressed abt that but all we can do…is our Best :))))

[turacozsworld]

Turacoz was named after a brightly colored bird Turacos, found in sub-Saharan Africa. The quality of not migrating despite of hardships drew us to this name.

#turacoz careers #turacoz #Scientific Communication #Clinical Trial Support #Real-world evidences #Advisory Board #Regulatory Affairs #Pharmacovigilance Support #E-learning Support #Training Workforce Solutions #helth #helthcare #turacoz medical writing #turacoz it company

[no-psi-nan]

Saiki's life if this character wasn't in it:

Nendo: Hell on earth, canonically (according to the light novels). Saiki series gets canceled, leading to Saiki rampaging out of control. All of Saiki's classmates also end up twisted.

Kaido: Might not have reunited that little girl with her dog, which led to an important friendship lesson. Saiki x Nendo rumors would be stronger since now they'd seem like a couple instead of a friend trio. Uhhh... Saiki would've been forced to attend that party they were late to... Saiki might have had to visibly intervene the 2 times Yumehara was in trouble, which would have left her still crushing on him and causing a rivalry between her and Teruhashi.

Yumehara: Teruhashi seems to go evil in every universe where Yumehara is not around or is not her friend, so even though she doesn't do too much to Saiki directly, an untamed Teruhashi would be causing LOTS of problems. Also she's the one who lead to all of Saiki's friends vacationing at the foot of the volcano so that would've been a problem avoided lol.

Hairo: A lot less sports shenanigans to be sure. The armed robbery probably would've been successful. Saiki's summer schedule would have also remained pretty empty that one year lol.

Teruhashi: Honestly this would immediately eliminate like 50% of Saiki's problems. No Teruhashi, no Kokomins, no Saiko, no Makoto, and Imu would not be a problem for him either. Deserted island arc avoided too. However, Yumehara never falls for Kaido and the Occult Club fails to launch, so no Yumehara + Arisu friendship. Saiki would've gotten to watch that movie, which might have left him more comfortable wearing the germanium ring sometimes. 🤔 Maybe him missing an important thought could have caused a problem eventually??

Mera: Makoto would have been on the plane to the Okinawa trip so maybe Saiki would've let it stay grounded instead of fighting the storm hsfjdlshfks. Café Mami would've closed probably, which might have had more repercussions since Saiki goes there often. No clinical trial episode. Saiki might've not grown to trust Aiura as much if they didn't fix the Mr. Mera situation together.

Kuboyasu: Saiki might have had to reveal his powers to Kaido 🤔 He only let the bullies approach at all because of Kaido's thoughts about liars, which were spurred by Kuboyasu though. Possibly Kaido would have had this thought process eventually anyways, which would then make Saiki stop being his friend and reject future friendships even more.

Toritsuka: Would Saiki have been able to defeat the robot clone without Toritsuka's help? Would Saiki have been able to win the cat tank episode without any help, especially if the Toritsuka fight had been replaced with a family member as hostage or something? Who would've pretended to be Saiki during the volcano arc? Also Toritsuka told Saiki about the Hii situation before anyone got killed and was the one who solved Hii's problem permanently(?) so if Toritsuka hadn't helped then there probably would've been a lot more Hii problems for Saiki to solve.

Kusuke: Well, Saiki would be an only child with no limiters and powers growing out of control... Would he have been able to eventually learn to control his powers without the interference of the limiters? Or might have he been driven mad by it, or fled the planet to escape all the noise?? Truly hard to say...

Saiko: Deserted island arc avoided as well as the Saiko manor Kokomin siege. Volcano situation wouldn't have needed a redo, though the lack of hotel room might've caused other problems. No changes to the bathroom at PK Academy.

Aiura: Saiki is stuck in high school forever, since it took 10 clones, the original Saiki, and Aiura's perfect predictions to stop the eruption. Also Yumehara probably would have died when after getting that death mark since she and Saiki would've been at their respective homes at the time it activated. Oh, and the train crash would have happened as well. Saiki probably would've blamed himself for these deaths and/or would've had to do time leaps to fix them, if possible. Actually it's unknown whether Saiki can defeat death marks without knowing about them / without Aiura's intervention. The fortune telling customer would've died too but that wouldn't have been Saiki's problem. That one guy wouldn't have found his soulmate in Africa probably 🥺

Satou: Well there would be less light in Saiki's life. Also Saiki would've had to spend a lot of time interfering with Hii's situation, which could have possibly gotten Saiki killed eventually, since he did get a death mark dealing with her.

Imu: No Teruhashi mixer scene or forcing Teruhashi to acknowledge her feelings. None of that really affects Saiki's life though tbh?

Akechi: Less trauma probably. However, his example of what a good and fun game can be also led Kusuo to reconciliation with his brother, which meant that Kusuke helped with the volcano. 🤔 Hard to say whether it would be a net positive or not!

Hii: Ok, she's pretty much caused nothing but problems and was only around for like 2 episodes. No relationship chain diagram though, and that was peak comedy!

👇🏾 Lmk if I missed anything in the notes or reblogs!

#saiki k #saiki no psi nan #sknpn #the disastrous life of saiki k. #tdlosk #nopsi meta

[afeelgoodblog]

The Best News of Last Year

1. Belgium approves four-day week and gives employees the right to ignore their bosses after work

Workers in Belgium will soon be able to choose a four-day week under a series of labour market reforms announced on Tuesday.

The reform package agreed by the country's multi-party coalition government will also give workers the right to turn off work devices and ignore work-related messages after hours without fear of reprisal.

"We have experienced two difficult years. With this agreement, we set a beacon for an economy that is more innovative, sustainable and digital. The aim is to be able to make people and businesses stronger," Belgian prime minister Alexander de Croo told a press conference announcing the reform package.

2. Spain makes it a crime for pro-lifers to harass people outside abortion clinics

Spain has criminalized the harassment or intimidation of women going for an abortion under new legislation approved on Wednesday by the Senate. The move, which involved changes to the penal code, means anti-abortion activists who try to convince women not to terminate their pregnancies could face up to a year behind bars.

3. House passes bill to federally decriminalize marijuana

The House has voted with a slim bipartisan majority to federally decriminalize marijuana. The vote was 220 to 204.

The bill, sponsored by Democratic Rep. Jerry Nadler of New York, will prevent federal agencies from denying federal workers security clearances for cannabis use, and will allow the Veterans’ Administration to recommend medical marijuana to veterans living with posttraumatic stress disorder.

The bill also expunges the record of people convicted of non-violent cannabis offenses, which House Majority Leader Steny Hoyer said, “can haunt people of color and impact the trajectory of their lives and career indefinitely.”

4. France makes birth control free for all women under 25

The scheme, which could benefit three million women, covers the pill, IUDs, contraceptive patches and other methods composed of steroid hormones.

Contraception for minors was already free in France. Several European countries, including Belgium, Germany, the Netherlands and Norway, make contraception free for teens.

5. The 1st fully hydrogen-powered passenger train service is now running in Germany. The only emissions are steam & condensed water.

Five of the trains started running in August. Another nine will be added in the coming months to replace 15 diesel trains on the regional route. Alstom says the Coradia iLint has a range of 1,000 kilometers, meaning that it can run all day on the line using a single tank of hydrogen. A hydrogen filling station has been set up on the route between Cuxhaven, Bremerhaven, Bremervörde and Buxtehude.

6. Princeton will cover all tuition costs for most families making under $100,000 a year, after getting rid of student loans

In September, the New Jersey Ivy League school announced it would be expanding its financial aid program to offer free tuition, including room and board, for most families whose annual income is under $100,000 a year. Previously, the same benefit was offered to families making under $65,000 a year. This new income limit will take effect for all undergraduates starting in the fall of 2023.

Princeton was also the first school in the US to eliminate student loans from its financial aid packages.

7. Humpback whales no longer listed as endangered after major recovery

Humpback whales will be removed from Australia's threatened-species list, after the government's independent scientific panel on threatened species deemed the mammals had made a major recovery. Humpback whales will no longer be considered an endangered or vulnerable species.

Climate change and fishing still pose threats to their long-term health.

Some other uplifting news from last year:

A Cancer Trial’s Unexpected Result: Remission in Every Patient

California 100 percent powered by renewables for first time

Israel formally bans LGBTQ conversion therapy

Tokyo Passes Law to Recognize Same-Sex Partnerships

First 100,000 KG Removed From the Great Pacific Garbage Patch

As we ring in the New Year let’s remember to focus on the good news. May this be a year of even more kindness and generosity. Wishing everyone a happy and healthy 2023!

Thank you for following and supporting this g this newsletter

Buy me a coffee ❤️

#best news of last week

[cosmereplay]

Kaladin Didn’t Invent Therapy (And Why That’s Actually Great)

“...You need someone to talk to, Noril, when the darkness is strong. Someone to remind you the world hasn’t always been this way; that it won’t always be this way.” “How do you … know this?” Noril asked. “I’ve felt it,” Kaladin said. “Feel it most days.” - Rhythm of War, Ch. 25 Devotary of Mercy

I’m writing as someone with a background in psychotherapy and peer support, and I'm bursting with excitement about one of my favourite topics. You can imagine why I love Kaladin’s arc in Rhythm of War so much! I actually yelled out loud when I read some of these parts the first time.

I’ve seen people online saying and making jokes that Kaladin invents therapy, and while that could eventually be true, what Kaladin actually invented in RoW is mental health peer support. Psychotherapy as most people would understand it simply doesn’t exist yet on Roshar. However, peer support is a legitimate modality for healing on its own merits. Even more importantly for the story, peer support is something Kaladin would personally really benefit from, and it fits his narrative arc way better than therapy would.

1. Therapy as we know it won’t exist for a while yet.

“We need to study their responses, use an empirical approach to treatment instead of just assuming someone who has suffered mental trauma is permanently broken.” - Rhythm of War, Ch. 25 Devotary of Mercy “Someone needs to talk to them, try different treatments, see what they think works. What actually helps.” - Rhythm of War, Ch. 25 Devotary of Mercy

Obviously, Kaladin has not been educated in battle shock or melancholia or any other diagnosis. In Alethkar there's hardly any knowledge to be had on the subject. Even now in real life, research into effective interventions for various diagnoses is still ongoing, over 100 years after modern therapy was founded.

Building an empirical knowledge base* will take time, not to mention the years it will take to train new therapists across Roshar in how to provide interventions specific to various issues. Therapy as we know it today generally includes time in mentorship with another therapist, so in a way, the first therapist isn't a therapist. 😅 In the meantime, there are people who need help today, including Kaladin.

Peer support can fill that gap because its knowledge base is different. Peers bring their expertise, which is their years of trial and error, successes and failures - their lived experience. Peer facilitators need to know the basics of managing a group, and they have to be willing to share their own experiences and learn from the group. Thus, training peer leaders is relatively quick, and incredibly scalable and adaptable across cultures and many issues/diagnoses.

2. Peer Support is a distinct path to recovery that doesn’t require an expert in therapy.

Kaladin located six men in the sanitarium with similar symptoms. He released them and got them working to support each other. He developed a plan, and showed them how to share in ways that would help...Today they sat in seats on the balcony outside his clinic. Warmed by mugs of tea, they talked. About their lives. The people they’d lost. The darkness. - Rhythm of War, Ch. 33 Understanding “While you can’t force it, having someone to talk to usually helps. You should be letting him meet with others who feel like he does.” - Rhythm of War, Ch. 25, Devotary of Mercy

Kaladin is already positioning himself to align with the values of peer support. Some of these values overlap with therapy, such as dignity, respect, inclusion, hope, and trust. What makes peer support different is a particular emphasis on equal relationships, self-determination, and personal growth (Peer Support Canada, 2022).

In peer support, the group facilitator is not considered an authority like a therapist would be. A peer leader may be further on the road to recovery, but they may not be. They are expected to listen and grow just like any other group member.

Because the leader of the group is also a learner, peer support groups tend to be more collaborative and open-ended. Everyone in the group has something they can take out of it and something to give. Everyone in the group is responsible for managing their own self care, and everyone in the group is responsible for the direction of their own growth. This is different from most therapy groups, which often have a specific focus or goal that the therapist is responsible for implementing. And speaking of responsibility...

3. Peer Support Fits Kaladin’s Narrative Arc Better than Therapy

At his father’s recommendation—then insistence—Kaladin took it slowly, confining his initial efforts to men who shared similar symptoms. Battle fatigue, nightmares, persistent melancholy, suicidal tendencies. -Rhythm of War, Ch. 33 Understanding …he’d learned—these last few months—that his battle shock could take many forms. He was getting to where he could confront it. -Rhythm of War, Ch. 39 Invasion

I think everyone can agree that Kaladin needs to participate in therapy just as much as the other battle-shocked men he finds in the Devotary of Mercy.

However, in therapy, the focus is solely on the needs of the clients. A therapist should not be distracted by their own issues (when this happens, it’s called countertransference). Further, therapy is generally framed such that the therapist is the only expert in the room, which means therapists have a higher level of responsibility for how the clients are doing (which varies depending on the issue, the therapy modality, and the circumstances).

In his own recovery, Kaladin is working on trying to take less responsibility for others, so setting him up as a therapeutic authority could be harmful for him. In a position of authority, he might be tempted to replicate the hierarchical structure he was in before (which would impede his own growth), or try to save everyone (which could impede everyone's growth). He simply doesn’t have the mentorship or knowledge base he'd need to work through those issues before leading as an expert.

In contrast, the point of peer support is the mutual sharing of lived experience. The group facilitator is expected to share their own struggles (as a model of recovery), and allow others to support them. In the context of a more balanced power dynamic, Kaladin can give the other group members the space they need to grow, and he can pursue his own recovery without feeling like he’s letting others down. Also, he will be able to leave the group during KOWT without worrying that the group won't be able to run without him. Everyone in the group carries some responsibility for each other, so group members can come and go with less stress than a change in therapist would cause in group therapy.

This is the beauty of peer support. It can happen anywhere people with similar experiences get together. No formal education is required. What is required is a willingness to know yourself as well as you can; to share your experiences; to listen to others tell their stories; to question your own assumptions as you learn how others handle things differently; to look out for each other's safety; to care.

Peer support creates a place of belonging and a community repository of shared wisdom. Kaladin almost had it on Bridge Four, but his position of authority wouldn’t allow him to grow the way he needed. Peer support is what Kaladin needs - he needs a place where he can take off his armour among people who get it because they're struggling with similar issues, and without having a position of responsibility over them. When he (eventually**) attends the groups, they help him grow!

Anyway, that's why Kaladin didn’t invent therapy, and why I think that's great.

For the men chatting together softly, the change was in being shown sunlight again. In being reminded that the darkness did pass. But perhaps most important, the change was in not merely knowing that you weren’t alone—but in feeling it. Realizing that no matter how isolated you thought you were, no matter how often your brain told you terrible things, there were others who understood. - Rhythm of War, Ch. 33 Understanding

---

*Funny enough, empirical research could lead Rosharan researchers right back to peer support. Empirical research on Earth has shown that modern therapy and peer support have similar levels of effectiveness (for example, for depression and PTSD).

**Look who’s resisting attending the groups he founded…KALADIN!! (shakes fist in the general direction of the sky) (This is the most relatable passage for me in this whole book, by the way, helper types unite lmao):

Kaladin looked down at the table. Had it? Had talking to Noril helped? “He’s been avoiding joining in,” Teft said. “I haven’t,” Kaladin snapped. “I’ve been busy.” Teft gave him a flat stare. Storming sergeants. They always heard the things you weren’t saying. - Rhythm of War, Ch. 38 Rhythm of the Terrors

Peer Support Canada. (2022). Peer Support Core Values. Accessed from https://peersupportcanada.ca/ Jun 27, 2022.

#I shared this on reddit a while ago but it got archived so here #enjoy #this is not an april fools thing this is just bad timing on my part #kaladin stormblessed #rhythm of war #row spoilers #kaladin didn't invent therapy #peer support #stormlight archive #the stormlight archive #stormlight essay #stormlight meta #god i love kaladin so much

[mostlysignssomeportents]

Monopolizing turds

Update 31 May 2023: an earlier edition of this article identified the price of Rebyota as $20,000; this was the rumored price prior to Rebyota’s release in December  2022, when Stephen Skolnick wrote the article I referenced. When Rebyota was actually released in 2023, the average wholesale price (AWP) was $10,800. Thanks to Benjamin Jolley for catching this error, and to Stephen Skolnick for getting to the bottom of it.

It’s been ten years — to the day! — since I first started writing about the bizarre, amazing world of turd transplants, in which a sick person receives a microbiotic infusion in the form of some processed poop from a healthy person:

https://web.archive.org/web/20130608030455/http://blogs.plos.org/publichealth/2013/05/29/why-diy-fecal-transplants-are-a-thing-and-the-fda-is-only-part-of-the-reason/

Gut biomes are one of those understudied, poorly understood medical areas that are both very promising and also full of sketchy medical claims from “supplement” companies, influencers, quacks and grifters. But in the decade since I first started tracking turd transplants (formally called “Fecal Microbiota Transplants” or FMTs), a growing body of sound science has emerged on the subject.

One thing that’s increasingly undeniable is that the composition of your microbial nation is related in significant ways to both your physical and mental health. What’s more, as antibiotic resistant “super bugs” proliferate, FMTs are becoming increasingly central to treating dangerous gut infections that otherwise stand a high chance of killing you.

“Eat Shit and Prosper” is Stephen Skolnick’s delightfully named newsletter about poop and health science. Skolnick is a physicist by training, but has a long history of collaboration with Openbiome, a nonprofit that coordinates between doctors, patients and donors to provide safe FMTs:

https://stephenskolnick.substack.com/

In an edition of Eat Shit from last December, Skolnick recounts the amazing history and dismaying future of FMTs. In 2013, the FDA announced it would regulate FMTs as “Investigational New Drugs,” which could only be administered as part of a registered clinical trial:

https://stephenskolnick.substack.com/p/a-monopoly-on-poop

At that point, FMTs were already in widespread use by docs to treat otherwise untreatable cases of Clostridioides difficile (C. diff), an antibiotic resistant bacterial infection that literally makes you shit yourself to death. These doctors were in no position to run registered clinical trials, which meant that they would have to stop using the most effective therapy they had for a potentially lethal infection.

Doctors and patients kicked up a fuss, and the FDA walked back its guidance, announcing that it would exercise “discretion” in enforcing its Investigational New Drug rule, giving a pass to docs who were treating C. diff with FMTs:

https://www.federalregister.gov/documents/2013/07/18/2013-17223/guidance-for-industry-enforcement-policy-regarding-investigational-new-drug-requirements-for-use-of

That’s where things have stood for the past decade or so. The “discretion” rule means that patients could still get FMTs, but their insurance wouldn’t cover it. But even if you had cash to pay for an FMT, your doc probably wouldn’t administer it for anything except a C. diff infection, despite the promising signs that FMT can help treat other conditions, and despite the generally safe nature of FMTs.

If your doc did give you an FMT, chances are good that they sourced their poop from Openbiome. Openbiome recruits very healthy people, gets them to poop in a bag, then processes the poop — removing nonbacterial solids, testing it for pathogens, freezing it, portioning it, and sending it to docs. All this is done at cost, and it’s not cheap: $1–2k/treatment, mostly due to cold-chain logistics (the poop is shipped at -80C).

Despite the cost, and despite the limitations on treatment, the Openbiome method has proved very reliable. Indeed, FMTs as a whole are pretty darned safe, with the most common side-effects being transient gas and bloating. In the past decade, there’ve been a total of six “adverse effects” associated with Openbiome’s 5,000+ procedures, all in severely immunocompromised people, and none conclusively linked to the treatment:

https://www.sciencedirect.com/science/article/pii/S0016508522003511/pdf

A decade into this system, the FDA has taken the next step forward — only it’s actually a step backwards.

During this intervening decade, a pharma company called Ferring has conducted clinical trials on FMTs and received approval for an FMT product called Rebyota. The process for making Rebyota is effectively identical to the process used by Openbiome: collect poop, remove solids, test for pathogens, add glycerol, freeze and ship.

The main difference between Rebyota and Openbiome’s poop is price. While Openbiome charges $1–2k per treatment, Rebyota charges $10,800

That’s some expensive shit!

Fine. Getting Rebyota through clinical trials means that insurers might start covering it, and perhaps some patients will prefer brand-name poop to open-source poop. But as part of the FDA’s approval of Rebyota, the agency also rescinded its “discretionary enforcement” guidance, making it illegal for docs to source their poop from Openbiome:

https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-policy-regarding-investigational-new-drug-requirements-use-fecal-microbiota

For Ferring, this is a monopoly on shit, one that lets them charge patients $10.8k for poop that costs $1–2k to process. The FDA does not claim that this is being done in the name of safety. Instead, an FDA official told Skonick that the goal was to “incentivize innovation without creating an access crisis.”

That is, the FDA changed its guidance and put nonprofit stool banks out of business because it wants to incentivize pharma companies to perform expensive clinical trials, and it believes that these companies won’t pay for trials if they have to compete with the likes of Openbiome, which would make it impossible to charge 900% markups on poop.

Trials are important! Evidence-based medicine is important! But Ferring’s clinical trials didn’t tell us anything we didn’t already know. FMTs were already the best therapy we had for C. diff. Testing Rebyota against a placebo didn’t tell us anything new — unlike testing Rebyota against the existing therapies, e.g. product from open stool banks.

Such a trial might have given rise to a very different regulatory outcome, because the cure rate reported by Rebyota is much lower than the cure rate from Openbiome’s own interventions:

https://link.springer.com/article/10.1007/s40265-022-01797-x

That is, using the $1k poop from Openbiome seems to be much more effective than using the $10.8k poop from Ferring. But Openbiome, a nonprofit, hasn’t been able to perform the kind of rigorous — and expensive — clinical trial that Ferring funded.

This points to a significant problem with the FDA’s model. The agency wants good clinical data for the medicines it regulates, as it should, It presumes that the only way to get that data is through granting commercial exclusivity to a for-profit, which ends up costing patients vast sums, and locking many patients out altogether.

This creates all kinds of new dangers. 150,000 people/year in the US contract Recurrent Clostridium difficile Infection (RCdI). FMT increases the cure rate by 20% relative to antibiotics alone. That means that if everyone with RCdI gets a poop transplant, 30,000 extra people will get better. That’s a big number!

For well insured people, Rebyota probably represents a cash-savings — if your insurance covers the $10,800 procedure, you might pay $500 out of pocket, which is far less than the $1–2K you’d pay to get an Openbiome poop transplant. But if you’re uninsured or underinsured, the FDA’s new enforcement rules mean that you’re now on the hook for $10,800.

The FDA did carve out a loophole: if your doc or their hospital are willing to prepare the poop transplant themselves, they can administer that. On the one hand, preparing a poop transplant isn’t that hard — some people do them at home, on their own:

https://web.archive.org/web/20211015060558/https://thepowerofpoop.com/epatients/fecal-transplant-instructions/

But on the other hand, there’s been exactly one death conclusively linked to FMT, and it was from one of these hospital-prepared transplants (the patient had just had a marrow transplant for cancer that wiped out their immune system, and the donor had a novel pathogen that the hospital failed to test for).

So the FDA has created a situation where, if you can’t afford a $10,800 proprietary formulation, your only option is to convince your doc or hospital to prepare their own poop transplant, which will cost less than the $10.8k for Rebyota, but more than the $1–2k from Openbiome, which has all kinds of economies of scale. And if you do manage it, you’ll be getting a procedure that has a much worse safety track-record than the Openbiome process that the FDA just killed.

The FDA has an important role to play here, but as with so many policy questions, how the FDA plays that role depends on things that are far upstream from the agency and its decisions. The choice to fund medical trials through the promise of exclusivity — and with it, extremely high margins — puts the FDA in the position of choosing winners in the marketplace: Ferring wins, Openbiome loses.

Ironically, this is the thing that exclusivity is supposed to prevent. By using profit to incentivize medical research, the FDA is supposed to be recruiting the Invisible Hand as its partner in regulation. But exclusivity is incompatible with the idea of medicine as a public good. The tens (hundreds) of millions that Americans will pay for $10.8k poop transplants from Ferring will add up to far more than it would cost to underwrite clinical trials for an open process like Openbiome’s.

The result: both Americans’ wallets and Americans’ guts suffer.

Catch me on tour with Red Team Blues in Hay-on-Wye, Oxford, Manchester, Nottingham, London, and Berlin!

If you’d like an essay-formatted version of this post to read or share, here’s a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2023/05/29/oh-shit/#rebyota

[Image ID: A poop emoji wearing a top hat and a monocle, posed against a backdrop of e coli bacteria seen through a high-resolution microscope.]

#pluralistic #stool bank #eat shit and live #pharma #fda #regulatory capture #fecal transplants #microbiomes #rebyota #openbiome #c diff #fmt #fecal microbiota transplant

[where-dreams-dwell]

It’s almost like the Usher children *knew* they weren’t going to live long and so they intentially left no marks upon the world.

Camille’s speech about how none of the kids actually makes or does anything is so startling: here is a group of people given all the opportunities and access money can buy, all of whom have had this their entire adult life, and they haven’t used it to create or build anything.

You can almost sense Roderiks disappointment in them, in his speech to Perry. He has this hyper focus on what his ‘investment’ money will fund, and says that ‘Ushers change the world’. But outside of himself and Madeline, not one of them has.

Frederick took the money, if he ever got any, and probably funnelled it back into his house or the company. By the looks of it he doesn’t have anything other than his family and his job, so there’s nothing for Roderick to invest in.

Tammy funnelled the money into a lifestyle brand, but one that wouldn’t have her at the front and centre. She scathingly reveals to Bill that she selected him to be her husband based upon his brand and marketability, showing she was ready to create this new empire but with her pulling strings in the shadows. From the outside it probably looks like she hasn’t created anything at all and that it’s all Bill, using his wife’s money. On top of this, the running gag of her storyline is that her brand and ideas aren’t even original, but are ripped off of Goop. So she hasn’t made anything new, and if Goldbug has any impact at all it will be no different to another more successful, more well know product. Hardly ‘changing the world’.

Victorine has some medial training but she looks to be a supporting role to her partner within their clinic, in which Al is the talented surgeon who people come to see and Victorine is a kind of silent partner. So she decided to go into medical devices or smart medical tech, but she relies upon the ideas and skills of others. As Camille said ‘the mesh is the surgeons, that’s why she’s fucking the surgeon’. And her medical knowledge seems to be limited if she thinks just her word and some money will move their experiments into human trials. So she also hasn’t ‘changed the world’ she’s just found someone else who was trying to and co-op-ed their ideas. You could even argue she poisoned those ideas, as Al mentions that the pain medication Victorine has been supplying looks like street drugs and wouldn’t stand up in any medical paper or research study.

Camille is, like she said, spinning furiously and going nowhere. She looks skilled in her field (from the analysis scenes we get, and Madeleine’s signing off on her PR analysis post Perry’s death) but she works from the shadows and hasn’t ‘created’ anything that wasn’t there before. There have been PR spin doctors before and there will be more to come; Camille offers nothing new ans hasn’t ‘changed the world’ in any measurable way. From what little we see of her work she hasn’t recreated a PR agency, hasn’t trained up other spin doctors under her, hasn’t created a brand or company which will outlast her. She leaves nothing behind to show what her skills or talents were.

Leo is shot down quickly when he claims he makes games: he doesn’t, he gives money to people who do. So he too will leave little to nothing behind when he’s gone. His references to past boyfriends show no long lasting relationships in his life and he has no other hobbies or pursuits we know of. Like Camille he hasn’t created a company to help with game design, hasn’t trained up others within this field he claims as his own. Even with the gaming ‘world’ it sounds like he changed very little. Fredrick’s throw away comments about Leo’s flat reveal that Leo hadn’t even had input in the decoration or style of his own home: he just latches onto the styles, ideas, aesthetic of his current boyfriend and goes with their ideas and plans. It’s such a small tiny thing but he truly has no original ideas in any aspect of his life.

And finally Perry, who’s desperate for that start up money but clearly has no plans or ideas on how to use it. He’s had a year and his main idea is an exclusive whisky bar. Even this idea, for all its crude intentions, shows his lack of vision: he doesn’t understand that to get the reputation he claims his bars would have will take time. You don’t just ‘create’ a consequent free bar celebrating decadence and privilege overnight. Reputations take time and as Madeline asks ‘what will be different about this one’ to draw people in to begin with? Studio 54 (which he compares his club to). only operated for 3 years before closing: not the smartest inclusion in an investment pitch.

To be fair to Perry though, looking at what the other siblings did or didn’t do with their loan money it seems a bit unfair that his ‘Blow job whiskey bar’ was shot down so decisively and cruelty. Assuredly Leo’s ‘video game studio for just myself’, Camille’s ‘PR agency just for me with my two assistants’, Victorines ‘medical training and clinic where I help out other surgeons’, Tammys ‘subscription lifestyle brand ripped off from a celebrity’ and Fredrick’s ‘I’d just like to work with you Dad’ were all clearly given the green light. But Perry apparently wasn’t good enough. Maybe this was a reaction to Roderick getting the news he was dying as so he wanted Perrys investment at least to actually change something, but still. He might as well give him the money either way at that point.

And I think it’s probably intended as a commentary on the ultra wealthy. Like of course people with more money than most counties have no plans to leave anything for the next generation. They have achieved their high levels of success by being solely focused upon themselves and so are honestly incapable of considering others. They are solely interested in enjoying the life they are currently living and why strain themselves to fight and build something when they don’t have to?

But it also works so well as a supernatural legacy and ironic conclusion to Roderick’s deal: he agreed that none of his bloodline would outlive him, and so none of them built anything that would.

#the fall of the house of usher #spoilers #mike flanagan #tfothou #legacy #ultra wealthy

[system-of-a-feather]

Thoughts on ESDM

So one of the like... three or four main reasons I moved out to Colorado was to learn and try out ESDM - or Early Start Denver Model. For those that don't know, its a relatively new but highly regarded (albeit some traditional ABA fans dislike it apparently, go figure) due to its active incorperation of developmental and attachment based studies + having some of the most robust research

The thing that has me humoring it at all is that they really dont do any discrete trial training (DTT) or any dedicated "work time" and everything is based in pro-stim play therapy

I heard of it first from my time in university cause the university I went to actually had one of the largest labs participating in research for the treatmenr and I heard it actually from one of their autistic researchers which they do actively look to hire on the labs page

I ALSO ran it by a vibe check from what my therapist (autism specialist, hates ABA) to see what hes heard and thought of it and he hasn't had extensive access to it, but all hes heard and seen is positive stuff and had no outstanding concerns

And so as a hardcore traditional ABA hater who would rather die than do traditional ABA again in ANY form under even the "best clinic" - I was genuinely just curious to see what the hype is

I'm honestly a skeptic despite what I've heard, but I'm on day three of training and (honestly have been doing petty tests to see how dedicated they are to supporting neurodiversity by not only NOT masking actively just stating any reserves I have and dissing traditional ABA whenever I get the chance) so far... I hesitantly want to say I think its living up to the hype???

Tomorrow is when we talk about how we handle "challenging behavior" so I'm KIND of waiting for the second shoe to drop cause if it does at any point in training, it would be there.

But genuinely, compared to what I saw in ABA clinics and even the non-ABA special education (for kids with extra support academically, developmentally or emotionally) classrooms, the kids genuinely seem to be having a much better of a time and actually wanting to be here.

It'll probably be a few months of actually working here before I have a firm stancd about what I think about it but I figured Id document some thoughts and observations I had on the treatment as I didn't see much of anyone talking about it in any "hey I actually hate ABA but do acknowledge that some neurodivergent kids need early support that create a high demand for care that is hard to meet with the current structure of mental health care and availibility of therapists and so I would really like to genuinely see something not traumatizing that can help" cause I personally am hesitant to trust "research" on anything based on ABA cause "research" exists for ABA as well

Anyways Ill be making this a thread of journal-ish things.

#alter: fei #esdm #early start denver model #esdm journaling

[catindabag]

The fourth set of ✨Academy Photos✨ in my TBOSAS Crack!AU. Here’s PART 1, PART 2, & PART 3.

PS: A certain Mentor (Festus) secretly gave the Tributes a camera to share in order to quench their boredom while waiting for the final verdict that would change Panem forever. (AKA: The great trial to stop/revamp the Hunger Games and replace it with ✨Panemvision✨). Enjoy~.

Sabyn, Facet, and Velvereen pretending to enjoy Palmyra Monty’s infamous expired family pie before being rushed to Dennis Fling’s Black Market clinic again to recover. #barelysurvived #send #sorrows #prayers #foodpoisonedby #PalmyrafreakingMonty

Domitia Whimsiwick laughing at Festus Creed (at the back) because of his failure to buy booze and chocolates for the group. The convenience store clerk thought Creed was just 15 years old and almost got him arrested for illegally buying alcohol as a minor. #Festusfails #Felixhelpus #almostgotarrested #again

Velvereen, Facet, Dill, and Mizzen hiding at the back of the school kitchen while waiting for their Mentors to empty out the food pantry again. #atfancyschool #washungry #needthatheavenbread #withMizzenthegremlin

Bobbin (Corn Poppy) being forced by Coral and Wovey to go with Coryo and Sejanus to an underground dance competition, just because he can backflip and do somersaults for fun. #weneedcash #dancedancebaby #Snowjanus #masterplan #withBobbinCornPoppy

Bobbin (Corn Poppy) with a very happy Coryo Snow. They won the underground dance competition and got some extra cash for the Tributes. Also, a jealous Sejanus took the photo out of spite. Now Bobbin is on Plinth’s hit list for touching his sugar baby fiancé without permission. #wewonbaby #wehavecash #Snowjanus #masterplan #youbetterwatchout #BobbinCornPoppy #Coryoismine!

Clemensia Dovecote got caught reading a banned book that was once owned by Dean Casca Highbottom when he was still dating the ever gorgeous Crassus Xanthos Snow. #allaboutlove #Crasca4Ever #bannedbook #gotanotherdemerit #sorrynotsorry

Mizzen the gremlin and Brandy Sharp Candy trying to act normal and posing for their respective Districts while touring the old Capitol train station with their Mentors. Honestly, they just want food and souvenirs to bring back home. #choochoo #nomoreHungerGames #touringtheCapitol #withourMentors #PercyPrice&rice

Facet and Velvereen posing inside Livia’s gigantic walk-in closet. They were the only Tributes to be invited by Mama Cardew because of their ✨fashionista✨ status. #Bestlooking #Tributes #DistrictOneforthewin #sponsoredbyMamaCardew #wegotthebanksbaby

#tbosas #crack #crack post #crackship #coriolanus snow #the ballad of songbirds and snakes #ballad of songbirds and snakes #hunger games #the hunger games #suzanne collins #thg #thg fic #thg incorrect quotes #tbosas fic #tbosas incorrect quotes #crack treated seriously #lucy gray baird #sejanus plinth #president snow #snowjanus #snowplinth #coriolanus x sejanus #clemensia dovecote #Mizzen #dill #bobbin #festus creed #facet #venlvereen #coral

[paradise-world]

Fictional Ties | Zhang Hao ZB1

Summary : In a web of familial expectations, pretense, and unexpected feelings, Y/N and Zhanghao navigate the complexities of a fake relationship, only to discover the genuine connection that has been there all along.

Genre : Fake Dating, Romantic Comedy, Drama, Contemporary Romance, Coming-of-Age, Slice of Life, Family Drama, Fem Reader

Warnings : N/A

Word Count : 4.8k

Notes : I KNOWWW I'm not finished the RIcky fic yet but if I'm being honest it's kinda feeling like a chore & I wrote a whole plan & story structure like last night so I couldn't help myself

In the wake of Y/N's triumphant completion of her bachelor's degree in dentistry, a sense of anticipation and familial expectations cast shadows upon her future. Hailing from a family of affluence and prestige, Y/N found herself standing at the threshold of a two-year clinical practice, the final leg of her journey to becoming an orthodontist. The air was thick with the weight of expectations, as her family, rooted in tradition, pressed for Y/N to settle down before immersing herself in the demanding world of orthodontics.

Amidst the quiet turmoil of Y/N's familial crossroads, a figure from her university days, Zhanghao, emerged as a steadfast companion. Having earned his legal degree and aspiring to carve a path in corporate law, Zhanghao found himself in the anticipation-laden limbo before embarking on his practical legal training. As life beckoned them towards uncharted territories, the bond between Y/N and Zhanghao would face new trials, testing the delicate balance between personal aspirations and societal expectations.

The agreement to catch up had been long overdue, the culmination of their individual journeys post-graduation. Y/N, having successfully completed her dentistry degree and venturing into the realm of clinical practice, agreed to meet Zhanghao, her close friend since their university days. As the sun dipped below the horizon, they found themselves at the familiar entrance of the local coffee shop, a nostalgic spot that bore witness to countless conversations during their academic years.

The bell above the door chimed softly as Y/N and Zhanghao stepped into the warmth of the coffee shop. The aroma of freshly ground coffee beans filled the air, triggering memories of late-night study sessions and laughter echoing within these walls. It was a place that held the essence of their shared past. The barista greeted them with a knowing smile, acknowledging the familiarity that exuded from the duo. They chose a corner table, the same one they occupied during countless university meet-ups, and settled into the plush chairs.

As Y/N ordered her favorite latte, the ambiance of the coffee shop transformed into a sanctuary for catching up. The whir of the espresso machine and the murmur of conversations formed a backdrop as the two friends began to unravel the threads of their daily lives. The aroma of freshly brewed coffee wafted through the air, enhancing the atmosphere of nostalgia that enveloped them.

"How's your family been?" Zhanghao inquired, his eyes reflecting genuine interest. Y/N, sipping her latte, felt a nervous flutter in her chest. She paused for a moment before responding, "Well, they're pressuring me to settle down, but you know me—I'm not really ready for a serious relationship." The vulnerability in her voice resonated in the air, setting the tone for a candid conversation. "It's my Dad's birthday soon, though, so he'll be expecting a lot since it's been a while since I've seen them," Y/N added, the weight of familial expectations evident in her words.

There was a momentary silence, a shared understanding lingering between them. Zhanghao, sensing Y/N's unease, broke the quietude with an unexpected proposal. "I can be your fake boyfriend if you want," he suggested, a genuine smile playing on his lips. Y/N, surprised by the offer, looked at him questioningly. "Really? You would do that for me?" she asked, the sincerity of her inquiry hanging in the air. "If it appeases your family, then sure," Zhanghao replied, his smile unwavering. The exchange concluded with a handshake, sealing a pact that would weave their lives into a fabricated dance of companionship for the sake of familial expectations.

After the candid catch-up at the coffee shop the previous day, Y/N and Zhanghao wasted no time. They both hurriedly retreated to their homes, filled with a sense of anticipation and the practicality of packing for the imminent trip. As the sun dipped below the horizon, the echo of shared laughter lingered in their minds, blending seamlessly with the tasks at hand.

The next morning, a gentle knock on Y/N's door heralded the beginning of a new chapter. Zhanghao, punctual and ready for the journey, stood at her doorstep just as the first rays of sunrise painted the sky in hues of pink and gold. Y/N greeted him with a smile, her large black duffel bag slung casually around her arm. Zhanghao's eyes met hers, and with a gesture of chivalry, he offered, "Let me take that for you." Y/N willingly surrendered the weight of her bag, and Zhanghao effortlessly carried it to the trunk of his car. With her front door securely locked, Y/N joined Zhanghao in the passenger seat, marking the beginning of a road trip that held the promise of familial expectations and uncharted territories.

As the engine hummed to life, Zhanghao typed the address of the hotel into the GPS, a beacon guiding them towards their destination. The quiet hum of the highway accompanied Y/N as she began to unravel the details of the trip. "So my Dad's a CEO of this technology company," she explained, her words weaving a narrative of corporate grandeur. "Once we arrive at the hotel, we have to explore the city with my family." Zhanghao chuckled, the familiarity of their conversation putting them at ease. "What does that have to do with your Dad being a CEO?" he teased as the scenery unfurled beyond the car windows. "Tonight, we're having a big dinner at this fancy restaurant with his associates, four of his close friends, and more people from my family," Y/N continued, painting a picture of an opulent evening. "Doesn't sound too complex," Zhanghao remarked, steering the conversation into the realm of simplicity. "Well, they're gonna be asking a lot of questions," she added, a hint of nervousness in her voice. "Fine by me," Zhanghao shrugged, the easygoing nature of their banter settling any lingering apprehensions.

And so, they continued to drive down the open road, a journey that held not only the promise of a familial charade but also the unspoken nuances of companionship and discovery. The hum of the highway became a backdrop for the unfolding chapters of their shared adventure.

After three hours of traversing scenic landscapes and winding roads, Y/N and Zhanghao finally arrived at the lavish hotel that would serve as their home during this unexpected escapade. The grand edifice stood before them, radiating opulence under the golden hues of the setting sun.

The exterior of the hotel was a testament to luxury, its facades gleaming in the sunlight. "This is not what I expected at all," Zhanghao commented, his eyes scanning the architectural elegance of the building as he unloaded their luggage. "I told you, CEO Father," Y/N chuckled, a playful glint in her eyes, setting the tone for the indulgent experience awaiting them inside. The two embarked on their journey through the polished entrance, stepping into a world where every surface seemed to shimmer with affluence.

Once inside, they found themselves immersed in an ambiance of pure luxury. The intricately designed interior boasted ornate furnishings, gleaming marble floors, and an aura of extravagance. Y/N and Zhanghao approached the reception desk, where the attentive staff ensured their seamless check-in process. After securing a room on the sixth floor, they stepped into the elevator, a cocoon of silence enveloping them.

"Is this overwhelming for you?" Y/N inquired, her eyes reflecting concern as the elevator ascended. "Nope, not really," Zhanghao nonchalantly shrugged, a calm demeanor masking any potential apprehension. The silence lingered briefly before Y/N broke it with a genuine expression of gratitude. "I'm grateful that you came with me," she confessed, a smile gracing her lips. "It's no worries at all," Zhanghao grinned, offering comfort through a reassuring rub on her shoulder.

Upon reaching their designated floor, they traversed wide, fancy hallways adorned with artistic touches, eventually arriving at their room. As the door swung open, natural light poured in, casting a warm glow on every inch of the meticulously arranged space. "I'd love to stay in here for an hour at least," Y/N remarked, appreciating the serenity of their temporary haven. Zhanghao, with a gentle smile, reminded her of their impending plans. "Well, we have to get ready to go to the city," he said, marking the beginning of the next chapter in their venture. With that, they both immersed themselves in the task of transforming their appearances to meet the standards set by Y/N's esteemed family.

To create a lasting impression right from the start, Y/N and Zhanghao meticulously coordinated their attire, both opting for a timeless theme of black and white. Just a couple of steps away from the designated meet-up point, they paused, a shared anticipation hanging in the air. Not yet approaching, they deliberated on the perfect entrance. "What shall we do?" Zhanghao asked, seeking guidance for their grand debut. "What are your boundaries?" Y/N questioned in return. "Nothing really," he shrugged. With an unspoken agreement, she began to wrap her hands around his arm, a gesture of unity as they approached her family, adorned with smiles that concealed any underlying nerves.

As they neared the family, the Ahns greeted them with pleased looks on their faces, the synchronized elegance of Y/N and Zhanghao not going unnoticed. A series of prim and proper greetings ensued as the family exchanged pleasantries. Y/N's mother, after releasing a warm hug, addressed Y/N, "You've never told me about your boyfriend, Y/N." Y/N turned to Zhanghao, already looking at her. With a small hand gesture, she beckoned him closer. "Zhanghao, meet my mother," Y/N introduced, initiating a handshake. "Hello Mrs. Ahn, my name is Zhanghao," he grinned politely. "It's really great to meet you," she smiled back, the warmth of acceptance evident in her gaze.

The entire family embarked on a journey through the city, exploring different landmarks and important buildings. "This city is so beautiful," Y/N commented, her eyes sparkling with amazement. "I know," Zhanghao replied shortly, the unspoken connection between them apparent. They exchanged smiles, a silent understanding that spoke volumes in the midst of the bustling cityscape.

After a leisurely stroll, they decided to venture into a small, albeit pricey, restaurant. "They sell the best Kobe Beef here!" Y/N's brother exclaimed with enthusiasm. "Your family seems very fond of this place," Zhanghao whispered to Y/N. "Mainly my brother, but my sister never really cared," she shrugged. Seated at the restaurant, they indulged in high-quality meals featuring juicy beef. Amidst the flavorful bites, the family continued to socialize, sharing laughter, stories, and creating an atmosphere of warmth that transcended the boundaries of familial expectations.

As they returned to the sanctuary of their hotel room, the air was filled with a comfortable fullness from the delightful dinner. "You did very well to impress them," Y/N complimented, her voice carrying a note of approval. "I hope we were believable at least," Zhanghao smiled, a sense of satisfaction evident in his expression. "I'm sure we were," she reassured, confidence radiating from her. The successful charade had set a positive tone for the evening.

Transitioning from their casual attire, they delved into the realm of elegance. Y/N, with practiced grace, began to curl her hair, while Zhanghao, ever the debonair companion, parted his hair near the middle, revealing a sophisticated look. "You suit this hairstyle a lot," Y/N complimented his appearance, her eyes appreciating the transformation. "I'll keep that in mind when seeing your family," Zhanghao smiled, returning the favor. "But I'm the one that complimented you…?" Y/N looked confused. "Well then, this is the only time you'll see it," he teased before receiving a playful slap on the shoulder. "You're so mean to me!" she complained, the banter echoing through the room.

With their attire carefully selected, they adorned themselves with accessories that added a glimmer to their appearance. "Y/N!" Zhanghao called. "What's up!" she asked. "Can you help me put on my tie?" Y/N left the bathroom and approached Zhanghao. As she fixed his tie with little distance between them, she asked, "Do you not know how to put on a tie?" "This is the first time I'm wearing one," he commented. Looking up at him, Y/N met his piercing gaze. With one final knot, she finished, saying, "There you go." Zhanghao checked himself out in the mirror, teasingly asking, "Would you say I look handsome enough for your family?" "Whatever, let's go!" Y/N jokingly rolled her eyes, and together, they stepped foot outside of their hotel room.

Once again, they walked down the halls, the click of Y/N's heels resonating one step at a time as she walked beside Zhanghao, their coordinated elegance setting the stage for the next act in their charade.

The restaurant exuded an air of exclusivity, its highly polished interior complemented by black-tinted windows that added a touch of mystery. The group was sizable, comprising nine members of the Ahn family, including Y/N's dad, ten of his associates, four close friends from high school, and the three partners of his children, among whom Zhanghao found his place. The entourage of 26 individuals made a grand entrance, the prestigious family name uttered by Y/N's dad opening the doors to the large and luxurious restaurant.

Arriving at a private room with a grand table, the middle seat reserved for Y/N's father, Y/N and Zhanghao found themselves seated next to each other, not too far away from her father. Warm welcomes were extended by Y/N's grandparents, aunt, and uncle, enveloping Zhanghao in a generous embrace. "How did you two meet?" Y/N's grandmother sweetly asked, her eyes filled with curiosity. "We met the moment we entered the same university together," Y/N replied, narrating their genuine story. "How did you two get together?" Her grandfather inquired. "I took her to a local coffee shop nearby, ordered her the same latte she always orders, and asked the big question." Zhanghao answered, and a shared smile passed between them as their eyes met.

As the evening progressed, orders were placed, with Y/N opting for pasta and Zhanghao choosing risotto, both adorned with white truffles. The table was set for a feast of flavors.

Once the meals were served, Y/N's father took the floor. "I'd just like to welcome today, my youngest daughter's boyfriend, who I had just met today." Applause followed as Zhanghao graciously bowed. "So, child, tell me, what are your plans for the future?" Y/N's father inquired, bringing a moment of thoughtful silence before Y/N responded. "Since I'm starting my clinical practice for 2 years and studying orthodontics after that, while Zhanghao is soon to start his practical legal training to begin his journey to become a corporate lawyer, I'd say we're both focusing on ourselves, our stability, and security with our careers and finance." Y/N smiled, but her father's reaction was less enthusiastic. "That's alright, just expected a bit more from you, though, Y/N," he commented, casting a shadow of disappointment over her. She stared at the ground, feeling displeased.

"We would like to get married, though, find a home to permanently stay at, and build a family," Zhanghao spoke up, breaking the silence. Y/N looked up, and her father's grin widened. "After everything else, though, of course," Zhanghao added. Y/N's dad, now pleased, announced to everyone, "That's more like it, everyone!" The room filled with applause, smiles, and nods, celebrating the future plans of Y/N and Zhanghao's relationship.

After indulging in flavorful food and high-quality drinks, Y/N and Zhanghao returned to their hotel room, the echoes of the celebratory dinner still lingering in the air.

In the hushed ambiance of their private space, a storm brewed within Y/N. Panic consumed her as she grappled with the weight of the plans laid out at the dinner table. "It's just so much! Imagine all those hopes and expectations for us." Y/N's voice trembled, her chest constricting, breathing becoming a struggle. The room seemed to spin as she paced hurriedly, a cascade of worries and fears pouring out in a torrent. Her eyes welled with tears, and her mouth felt dry as she verbalized the overwhelming thoughts racing through her mind.

Witnessing Y/N's distress, Zhanghao approached her, gently holding her by her exposed shoulders. "Y/N, it's okay," he reassured, his voice a soothing balm. Drawing her into a soft hug, he whispered, "I'm sorry," as Y/N quietly began to sob. "I only said that because I saw how sad you were at your Dad's disapproval," he explained, tears mirroring Y/N's falling from his eyes. "We can always fake break up, okay? You can make it completely my fault and make me seem horrible so it doesn't have a bad image on you." As he let go of her and looked into her eyes, he added, "You don't have anything to worry about, okay? I'm always here for you anyway." A warm smile accompanied his reassurance as he gently wiped away her tears with his thumb. "Thank you, Zhanghao, for everything," Y/N grinned, small tears still escaping from her eyes.

"This is gonna sound really weird," Zhanghao began, his voice carrying a gentleness. "But do you want me to hold you tonight, maybe? I just don't want you to sleep in this state." He asked gently. "No, it's fine. Thank you for making me feel better, though," she smiled. As they began to get ready for bed, going through their night routines, they eventually found themselves in the same bed, a pillow placed between them.

As the sun dawned on the next day, signaling the conclusion of their trip, the Ahn family decided to spend their remaining moments at a popular amusement park before heading home.

"I'm scared," Y/N whispered to Zhanghao as they stood in line for the roller coaster. "It's okay, it's just a roller coaster," Zhanghao reassured. Once on the ride, Y/N's screams echoed louder than Zhanghao's laughter, the twists, turns, and drops inducing a mix of fear and exhilaration.

The roller coaster adventure behind them, the family moved on to the towering and colorful Ferris ring car. Anticipation mingled with trepidation as Y/N, feeling uneasy, looked at Zhanghao. "Hold onto my hand if you get scared," he offered with a comforting smile. As they took their seats and the ride began, Y/N gripped Zhanghao's hand tightly. Their eyes met, and in that moment, a strange warmth enveloped Y/N, her heart racing uncontrollably as reality blurred with the spinning motion of the ride.

After trying out various rides, the family decided it was time to refuel. The image of Y/N and Zhanghao holding hands lingered in her mind as they sat down to eat. Zhanghao noticed her distant gaze, and he inquired, "What are you ordering?" "Just a corndog and coke, please," she replied. The shared ferris ring car moment played on repeat in her thoughts, leaving her questioning if Zhanghao was more than just a friend.

A face painting booth caught their attention, and everyone in the family wanted to get their faces painted. Y/N opted for a simple rose on her cheek, and the artist took extra care with the details. Zhanghao approached with a raccoon on his cheek, admiring Y/N's choice. The artist finished the rose, and Y/N marveled at the mirror, finding herself adorned with a beautifully shaded flower. The family then ventured to find accessories, with Zhanghao selecting a rose headband for Y/N. "To match with your cheek," he smiled as they admired her reflection. Y/N, determined to reciprocate, browsed through the limited selection for Zhanghao. Unable to find a raccoon headband, she suggested, "Do you just wanna match?" Zhanghao nodded, and they both snapped mirror selfies with their matching rose headbands before embarking on more rides at the park. The day at the amusement park became a vibrant chapter in their shared adventure, filled with laughter, shared moments, and the blossoming of something more than friendship.

After a day filled with laughter and shared moments at the amusement park, the time came for Y/N and Zhanghao to pack up their bags and return to the realities awaiting them.

"Do you think we were successful?" Zhanghao questioned as they began their journey back. "Definitely," Y/N chuckled, her heart fluttering at the thought. "My dad loves you, and my mum made very nice comments about you, so we were definitely successful." Their smiles mirrored the contentment they felt, the shared success of their faux relationship adding an unexpected layer to their friendship.

As they drove, Y/N found herself admiring the tall trees and the vibrant hues of the sky as the sun began its descent, casting a warm glow over the landscape.

After another three hours on the road, they arrived at Y/N's house. "I'll help you with your things," Zhanghao offered. The two walked up to her door, and as Y/N opened it, Zhanghao placed her belongings on the ground. Gratitude filled Y/N's expression as she said, "I can't thank you enough for this." "Well, I care for you a lot, so of course, I'd help," Zhanghao giggled before pulling her into a warm hug. "I'll see you, Zhanghao!" she grinned. "On our next adventure!" he replied, returning her smile before hopping into his car and driving off. The echoes of their shared escapade lingered in Y/N's mind as she entered her home, grateful for the unexpected turns their journey had taken.

Chapter 10: Practices

In the unfolding chapters of their individual journeys, Y/N and Zhanghao delved into the intricate realms of their chosen careers. Y/N, now immersed in the bustling atmosphere of her dental clinical practice, found herself navigating through the daily tapestry of oral healthcare.

The scent of antiseptic lingered in the air as Y/N moved seamlessly through her responsibilities. Engaging in the artistry of dental procedures, she meticulously performed cleanings, her nimble fingers expertly navigating the contours of each tooth. With precision and care, she executed fillings, infusing renewed vitality into deteriorating enamel. Extractions, while a somber task, became a necessary skill in her repertoire, handled with both gentleness and efficiency.

Dental examinations became a routine, a meticulous inspection of oral landscapes. Y/N's keen eyes scanned for signs of decay, misalignment, or potential issues, each diagnosis a puzzle to solve. As she interacted with patients, she honed her ability to communicate complex dental findings in a way that was both understandable and comforting.

One day, curiosity led Y/N to the orthodontic realm, an area she aspired to explore further. Standing beside one of her seasoned colleagues, she observed the delicate artistry of creating and fitting dental appliances. The metallic gleam of braces adorned the workspace, and Y/N absorbed every nuance, expressing her desire to specialize in orthodontics.

Beyond the technical skills, Y/N embraced her role as an educator. Patient interaction extended beyond the chair, as she imparted valuable knowledge about oral hygiene practices. Her counseling extended beyond the clinical setting, empowering individuals to cultivate habits that would contribute to a lifetime of dental wellness.

In the symphony of dental care, Y/N found her rhythm. Each day brought new challenges and triumphs, as she honed her craft within the clinical confines. As Zhanghao embarked on his own journey in practice legal training, their parallel pursuits carved distinct paths toward professional fulfillment. The separate beats of their careers played on, harmonizing the melody of their individual growth.

Nearly two weeks had passed since Y/N and Zhanghao delved into their respective careers. While occasional texts maintained a connection between them, their focus was primarily on navigating the challenges of their professional lives.

On a Friday evening, the familiar knock echoed through Y/N's doorway. Zhanghao stood on the other side, and Y/N welcomed him into her home with a warm smile.

Seated comfortably on her couch, the atmosphere shifted as Zhanghao began to open up. "I might need your help," he confessed, revealing the source of his stress – the upcoming Legal Awards Gala. "I'm expected to attend, since my mentor who is an experienced lawyer invited me," he explained.

Curiosity piqued, Y/N inquired, "What's wrong with that?" Zhanghao looked up, gauging her reaction. "He said that I should bring a date," he emphasized, and Y/N's eyes lit up with enthusiasm. "Of course!" she exclaimed, wrapping him in a hug. "Are you sure? I don't want to make you feel forced," Zhanghao questioned, concerned. Y/N assured him with a smile, "No, of course not. When is it?"

"Tomorrow night," Zhanghao replied. The room filled with laughter as they both shared a moment of light-heartedness. "As long as you pick me up, we'll be all good," Y/N playfully added, sealing the deal with a shared sense of excitement.

The night of the Legal Awards Gala had arrived, and Y/N meticulously styled herself in a sophisticated black dress paired with a chic blazer. As she stepped outside, she found Zhanghao waiting for her, looking dapper in a well-fitted suit and tie.

"You learned how to do it yourself, I see?" Y/N teased, observing his refined appearance. "I had to learn for the whole legal training thing," he chuckled, revealing the practical side of his attire.

They entered the car, and as they began to drive, the night sky welcomed them with a breathtaking display of stars. Y/N, feeling the festive spirit, suggested, "What should our entrance be?"

Zhanghao pondered for a moment before proposing, "Our famous arm hold?"

"Let's go with that," Y/N agreed, anticipating the subtle theatrical touch they would bring to the event.

Upon their arrival, the venue unfolded before them – another grand hotel setting the stage for the Legal Awards Gala.

Y/N elegantly wrapped her hands around Zhanghao's arm as the two made their entrance into the hotel. Escorted to the venue, they found themselves in a breathtakingly luxurious ballroom adorned with glittering chandeliers. The air was filled with an air of sophistication, and the attendees, donned in opulent attire, hinted at the grandeur of the Legal Awards Gala.

A distinguished man approached them and warmly shook Zhanghao's hand. "Y/N, meet my mentor Ryu Chanwoo," Zhanghao introduced. As Ryu Chanwoo extended his hand to Y/N, she greeted him with a warm smile. "Nice to meet you, I'm Ahn Y/N." Ryu Chanwoo chuckled, "I've heard your family name many times thanks to your father. I'm proud of you for bringing a very prestigious date, Zhanghao; this will definitely help with your professional image."

After Zhanghao expressed gratitude to his mentor, Ryu Chanwoo mingled with others. Y/N, amused by the revelation about her father's reputation, chuckled, "I didn't know people knew my Dad that much." Zhanghao replied, "Well, you're helping me a lot right now." The two shared a laugh before engaging in conversations with senior partners from renowned law firms. Topics ranged from industry trends to legal strategies and potential collaborations.

As the night progressed, they took their seats at a table, joining the company of others. Socializing continued over the elegant dinner, creating an atmosphere of camaraderie among legal professionals. In the latter part of the gala, Y/N and Zhanghao witnessed numerous individuals receiving awards for their outstanding achievements in the field of law. Although Y/N had limited knowledge of the legal intricacies, she graciously smiled and clapped throughout the evening.

The night air was filled with a sense of accomplishment as Zhanghao drove Y/N home after the Legal Awards Gala. However, as Y/N prepared to exit the car, Zhanghao's sudden request halted her movements. "Wait," he said, his gaze piercing hers, prompting her to sit back down.

With a look of genuine confusion, Y/N awaited his words. "Why are we just faking all the time?" he asked, causing her to furrow her brows. As he continued, Zhanghao revealed, "Y/N, we've been friends throughout all of uni." A sense of realization flickered across her face. "Are you saying what I think you're trying to say?" she questioned, searching his eyes for confirmation. "Yes, I am, Y/N," he replied.

A silent pause lingered before he opened up about the feelings he had harbored. "I felt something on your father's birthday trip, or maybe even during uni," he confessed. "I know we've only been fake dating twice, and it's been nearly two weeks. But throughout our adventures, we said we only needed each other for different things. What if we just needed each other, in general?" he asked, a genuine look in his eyes.

Y/N's heart raced as she contemplated his words. "What if I want you to want me instead of being something you need?" she questioned. Zhanghao's response was clear, "I think it's very obvious from what I'm saying right now that I want you." With that, they leaned in for a kiss, a culmination of unspoken emotions. Zhanghao gently held her face, and Y/N placed her hands behind his head. Their hearts raced, and the kiss was now a testament to their newfound connection.

As they reluctantly let go, Zhanghao bid her goodnight, "Goodnight, Y/N," he said, a smile playing on his lips. "Goodnight, Zhanghao," she grinned, stepping into her house with the certainty that she was now more than just a fake girlfriend. New beginnings awaited them both.

notes : i hope you enjoyed!! i know this is pretty short but i hope you enjoyed reading it as much as i enjoyed writing it! this was supposed to be after the ricky fic & another project but i genuinely just couldn't help myself.

#paradise-world #zerobaseone #zb1 #zerose #zerobaseone oneshot #zerobaseone zhanghao #zb1 oneshot #zb1 oneshots #zb1 x reader #zb1 imagines #zb1 zhanghao #kpopidol #kpop #boysplanet #boys planet #oneshot #oneshots #imagine #imagines #zhanghao x reader #zerobaseone imagine #zerobaseone oneshots #zerobaseone x reader #zb1 fluff #zb1 scenarios #zerobaseone fluff #zerobaseone scenarios #kpop writing #zhanghao oneshot #zhanghao imagines

[aspiretechsoft]

#clinical research training in pune #sas clinical trials programming in pune #clinical sas certification course in pune

[thatsonemorbidcorvid]

“If the practice stopped, top-level women’s sport as we know it might cease to exist.”

Full text below cut

My wife and I are lifelong runners. It’s the sport we fell in love with, and ended up excelling at—during our wedding, every speaker from the preacher to the best man mentioned some variation of “Can you imagine how fast their future kids are going to be?” My wife, Hillary, is by far the more accomplished athlete. I made the NCAA championship; she was an All-American. I had dreams of qualifying for the Olympic trials; she actually did it. By many measures, she’s simply better. But not by all of them.

We both got our start in middle school. When Hillary was in seventh grade, she ran a 5:42 mile. At the same age, my best was virtually identical at 5:40. If we had lined up for a race, there would have been a close dash to the finish line. Fast-forward to ninth grade, and we were both ranked among the top freshman runners in Texas. But a clear difference had emerged: Her time had steadily decreased to 5:13, while mine had shot all the way down to 4:22. At the end of our collegiate running careers, the massive gulf remained: She ran 4:43 and I ran 4:01. I didn’t train more, care more, or possess more grit. She surpasses me on all of those things. I just had an inherent advantage: my biology.

It’s no secret that sports-performance differences between sexes are a flashpoint in an American culture war that goes beyond athletics into ideology and identity. I’m not here to tackle the tough and important questions of sport and sex, such as how to include trans athletes and people who have differences of sexual development in a sporting world that is mostly divided along binary lines. What I am here to address is one of the simplest debates. Over the past few years, some cultural commentators and sociologists have minimized the impact of sex-based biological differences on sporting performance. Some claim that men’s biological advantages in speed, strength, or endurance are scientifically debatable. (This magazine recently published such arguments in an article about youth sports.)

Here is what the facts say. Sport for women is generally undervalued and under-resourced in America, and this can affect women’s performance levels. Coed sports at recreational and youth standards—played as part of living a good life, not to develop elite athletes—can be both fun and competitive. But at the highest, rarefied levels of many professional sports, men and women appear to have different performance ceilings.

The research is clear: The difference in my wife’s and my athletic progression is not unusual. With young kids, the best boys tend to be only a hair better than the best girls. We can see this in age-group records: The boys’ and girls’ records for the 9-to-10-year-old 100-meter-sprint are nearly identical (12.73 versus 12.85). But in the 15-to-16-year-old records, the gap has gone from a crack to a gulf (10.51 versus 11.34).

A study by Mike Joyner and his colleagues at the Mayo Clinic found the same trend when analyzing the top 100 freestyle-swimming times of boys and girls from ages 5 to 18. Before the age of 10, both sexes are remarkably similar in performance, with the best young girls actually tending to swim faster than the best boys. But after 10, the boys get ahead. By 17, the average difference is 8.4 percent. Researchers found the same trend when evaluating more than 400,000 ordinary kids in the P.E.-class shuttle run: similar speeds early on, but an ever-widening gap starting at about age 10.

The reason for this is simple: puberty. The overwhelming driver for the sudden jump in male performance seems to be the surge, at this specific time of an athlete’s life, in the steroid hormone testosterone. This hormone influences muscle size and strength as well as the amount of oxygen-carrying red blood cells in our body. A large analysis on running, jumping, and swimming found that the rise in testosterone during puberty in males coincided with a steep improvement in performance. When puberty occurs, girls, on average, continue steadily improving their sporting performance into their teens. But boys get a rapid shift upward in their trajectory.

When looking at elite runners—whether sprinting 100 meters or racing many miles—once athletes hit physical maturity, the best men have anywhere from a 9 to a 12 percent advantage over the best women. A significant gap can be seen in cycling, swimming, speed skating, high-jumping, and a variety of other athletic feats. The gap is even larger in sports that depend highly on strength. For example, when looking at elite weight lifters in the same weight class, the performance gap is about 24 to 30 percent.

It’s important to note a few caveats. First, most of the best research is on sports that are easily quantifiable. For example, there’s no way to directly compare the skill levels of elite tennis players to measure for tiny performance differences unless they play one another. What we know is that the less a sport relies on speed, power, or endurance, and the more it relies on skill, the smaller the gap is. In sports like shooting and archery, the difference between men and women is negligible at best. Second, the performance gap of course doesn’t mean that all men will triumph over all women all the time. My comparatively unathletic brother would get beaten by thousands of women in a mile-long race. And if my wife showed up to a local turkey trot, she’d likely decimate all the men. Third, because there is significant overlap between males and females in performance, female outliers can shine, particularly in niche sports with a small number of competitors (e.g., ultrarunning).

But at the top of the top of the athletic world, in widely played sports with elite coaching, the gap between the sexes seems almost insurmountable. Take the queen of track and field, Allyson Felix. The 11-time Olympic medalist’s best 400-meter time ever is 49.26. In just the 2022 season, that would have put her 689th on the boys’ high-school performance list.

None of this is meant to disparage the phenomenal women athletes at the top of their game. But if we stopped dividing sport by sex, elite women’s sport as we know it could cease to exist. We might miss out on Megan Rapinoe at the World Cup or the spectacle of Sydney McLaughlin effortlessly gliding over hurdle after hurdle. Acknowledging the performance differential should encourage us to do everything possible to make sure female athletes can keep competing at these levels.

But how do we know that the gap between the sexes isn’t sociological, like we’ve seen in fields such as math, where research suggests that social factors explain much of the gender gap in average performance? The history of sport is rife with sexism that has held back women. Take, for example, the 1928 Olympics, where Knute Rockne, the famed Notre Dame football coach (and newspaper columnist), reported in The Pittsburgh Press that after the 800-meter final, five women collapsed and that “it was not a very edifying spectacle to see a group of fine girls running themselves into a state of exhaustion.” Following public outcry, the 800-meter was removed from the Olympics for 32 years. But the reports were false—women weren’t collapsing left and right. The top-three women actually broke the former women’s world record that day.

Women today still face inequality in sport. Many professional sports have a significant pay gap, limiting the ability of women to focus solely on it as a career. Media attention for women’s sport is severely lacking, with 95 percent of sports TV coverage in 2019 going to men, according to a USC/Purdue University study. In some colleges, a significant difference in funding and severe lack of female coaches—who act as both a role model and an advocate for women’s sport—can impact participation rates. Yet even in sports where sexist sociological barriers have been lowered, a performance gap can persist.

Women were barred from major marathons for much of the 20th century. The Boston Marathon, for example, didn’t allow women to compete until 1971. At that point, the women’s unofficial world record was about 2 hours and 45 minutes. At the same time, the men’s record stood at 2:08:34. That’s a massive 30 percent performance gap. By the summer of 1984, when women were finally able to run the marathon in the Olympics, they’d massively cut into the men’s lead, leaving only a 11 percent gap. These kinds of gains bred a sense of optimism. “We’re nearer and nearer the men now,” said the second-place female finisher of the 1983 Boston Marathon. But the trend faltered. In the nearly four decades since then, women have kept improving, but the current gap still stands at 10.7 percent.

Every sport is different. Some are still like 1970s marathoning—the chasm between men and women is caused in large part by discrimination. Those gaps need shrinking. But the same trajectory we saw in the marathon occurs in most women’s sports that remove sexist barriers. For example, a 2010 study traced the progression of male and female performance across the prior decades in 38 athletic events in five different sports: swimming, cycling, speed skating, weight lifting, and track and field. It found that the gender gap had been fairly stable for more than two decades, and concluded, “After a significant narrowing of gender gaps, women and men now evolve in parallel, in the same direction.”

The upside of acknowledging that sex differences in performance exist is that we can discuss the vital, knotty debates that emerge from this biology. For example, would creating more coed sporting opportunities before, say, age 10, keep girls in sport longer? How should schools and clubs handle a young female athlete who wants to play football even though there’s no girls’ team? Should we get rid of sex-based divisions in sports like shooting, where the performance gap is minimal? We certainly need to figure out better answers for trans athletes and people like Caster Semenya, who, because she has differences of sexual development, is allowed to compete in the 5K but not the 800-meter race.

To solve these questions, we need to first accept the premise that puberty can create unequal sporting ability. Doing so doesn’t mean that we stop fighting inequality or dismiss tricky edge cases. It actually should free us from arguing over what should be a noncontroversial claim. We can then shift our focus to making sure women have the space, resources, and opportunities to show their talents. We can acknowledge that though I might have run faster at my peak, my wife’s performance and achievements are undoubtedly more impressive. We can stop judging female athletes against their male counterparts and enjoy their athleticism on its own accord.

Steve Magness is a performance coach and sports scientist. He is the author of Do Hard Things: Why We Get Resilience Wrong and the Surprising Science of Real Toughness.

 

[the-cat-and-the-birdie]

GOTHPOOL - Milo Mason Earth 138 - Hobie's Deadpool

Milo is a street kid through and through. He's been one all his life. All six years, that is. All six he can remember. He met Hobie at 13, when they both were just hungry kids living on the street and squatting in flats, and when they were hungry, they'd count out pence until they had something to share.

Now, they're both heros and roomies! (Although Hobie agrees with neither)

Hobie helped Milo transition, helping him steal his T shots when they were younger

Constantly mentions once being taller than Hobie

Has no pupils. If you ask, he'll act like he doesn't know what you're talking about. (There is no known explanation for this)

At 17 him and Hobie lost contact, with Milo going into a clinical trial with the promises of money and mental help.

Instead he got his healing factor

Him and Hobie reunited through 'Hero Work' - with Gothpool meeting Spider-punk

Only for Milo to immediately go 'No fucking way!! Talk again!! Hobie?? Hobie, m8 is that you? You sound just like this bloke-'

And Hobie had to be like 'Can you...not keep saying my name out loud.'

He thinks he lives at the houseboat, keeps breaking in and eating Hobie's heinz beans

Endless supply of witty and worn t-shirts

Loves Hobie and wants to kiss him on the mouth but in a loving platonic way. Enjoys picking Hobie up

Used to be vocals for the band in 138 (he can actually sing. unlike Hobie)

Hobie gave Milo his first T shot at 14.

Him and Diane do not get along well. She says Milo freaks her out. Milo doesn't know why she's so jumpy around gunpowder and lit matches - like calm down what kinda Spider-woman are you??

Clueless about politics, though Hobie tries his best to teach him. It's hard for Milo to grasp, and really easy for him to get frustrated, but he genuinely wants to learn. So Hobie is extra patient with him.

Even so, Gothpool is a CRAZY asset to have in battle. He may not know about systemic oppression but he knows that a bat to the forehead will knock a cop out cold

Mainly self-trained but highly skilled in fire-arms. Fights every battle like he's in a street fight outside a bar and he's ready for blood

His favorite food is a cheese toasty with marinara sauce and a root beer float

Also he's allergic to cats. He says he isn't but he is.

Uhhhh yeah, that's all really. I realized I never posted Milo so I figured I get around to it lol

I LOVE HIM. I LOVE HIM IM SO NORMAL BUT ALSO I LOVE HIM AND HOBIE

#I REALLY WANTED TO GIVE HIM 2D GORILLAZ EYES YOU KNOW WHO I MEAN #I have no idea if i ship them or not but they love each other in a not platonic not romantic secret third typa way #spidersona #spidersonas #hobie brown #deadpool #spiderpunk #spider punk #wade wilson #milo mason #atsv #across the spiderverse #across the spider verse #hobie brown x oc #hobie x oc

[dresden-syndrome]

please, how would the stomach ache + nausea/vomiting whump trope work in your OC's universe?

Whumping in EESU: Nausea, vomiting and stomach ache

(+ purposefully spoiled food for @witchy-shortcake!)

The classic: stomach ache and nausea as a side effect of medicine or chemicals forcibly given to a lab rat whumpee for clinical trials.

Whumpee with a horrible stomach ache surrounded by calm and unaffected ASR doctors, crying for help and begging for pain relief they know they won't get.

Caretaker doctor having to explain to the lab rat whumpee they really can't give them any meds or treatment since it'd very visibly mess with the study results and they'll be suspected of messing it up.

Whumpee having to throw up in a room full of doctors/researchers, not allowed to let it out alone in the cell or bathroom.

That uncomfortable nauseous feeling when a whumpee has a tube inserted down their mouth or nose.

Lab rat whumpee being fed meals containing tested meds or chemicals.

Class 3 whumpee being fed meals containing tested meds or chemicals then having to go back to work afterwards, gradually starting to feel weak and nauseous and not knowing why.

Bonus points if after a while the labor camp guards find them on the ground, curled up with hands around their stomach.

Whumpee coming to the camp hospital with a stomach ache and getting told they're still fit to work and they have to be back.

Whumpee becoming nauseous from even a sight of food - whether because of an illness or from numerous experiences of getting sick after eating.

Detained whumpee being fed spoiled food as a method of pressure (bonus points if the interrogators taunt them with fresh nutritious meals and/or promise to share them in exchange for needed information).

Interrogated whumpee in an already nauseous state tortured with flashing lights. (Bonus points if the interrogators are aware of their ill-feeling and they're making it worse deliberately).

"Personal property" whumpee given spoiled food as a punishment.

Whumpee having a terrible hangover the morning after their owner forced them to drink.

Whumpee is in hiding; when they fall ill with a stomach virus or food poisoning they have to avoid hospitals at all cost and only rely on their caretaker companions.

Whumpee feeling nauseous during or after torture, usually from beatings to the head or stomach.

Sick whumpee brought to the medical office with the sterile hospital smells so strong it makes their nausea even worse.

Whumpee is thrown to their cell after an interrogation; too hurt and dizzy to stand up, they vomit and pass out.

Whumpee becoming nauseous from anxiety or fear when entering their boss's office. Or a room where State Security officers wait for them to make a warning. Or an interrogation room. Or the ASR lab.

"Deep reeducation" technique tests where the researchers purposefully induce pain and nausea in their whumpee when showing them the enemy countries' ideology and propaganda.

Motion sickness. Especially when transported to detention, labor camp or a class 4 designation facility in a tiny dark cell of the van or train.

Caretaker going out for medicine to relieve their whumpee's nausea or stomach pain. What could go wrong? There may be martial law time and they don't have a permission for going out past curfew. There may be a riot or protest action on the streets and they're risking being taken as one of the suspected offenders. They may be a class 2-3 offender living in a labor commune where getting proper medication can be quite a trouble.

#whump #whump community #whumpblr #historical whump #totalitarian whump #military whump #lab whump #med whump #pet whump #sick whump #sickfic whump #interrogation whump #whump ideas #whump prompts #whump prompt list #sickfic prompts #emeto prompt #tw vomit #emeto tw #emeto