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matcha3mochi · 1 month ago

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PROTOCOL Pairing: Doctor Zayne x Nurse Reader

author note: love and deepspace is my addiction guys LOL anyways enjoy!!

wc: 3,865

chapter 1 | chapter 2 | chapter 3

✦•┈๑⋅⋯ ⋯⋅๑┈•✦

Akso Hospital looms in the heart of Linkon like a monument of glass, metal, and unrelenting precision. Multi-tiered, climate-controlled, and fully integrated with city-wide telemetry systems, it's known across the cosmos for housing the most advanced medical AI and the most exacting surgeons in the Union.

Inside its Observation Deck on Level 4, the air hums with quiet purpose. Disinfectant and filtered oxygen mix in sterile harmony. The floors are polished to a mirrored sheen, the walls pulse faintly with embedded biometrics, and translucent holoscreens scroll real-time vitals, arterial scans, and surgical priority tags in muted color-coded displays.

You’ve been on the floor since 0500. First to check vitals. First to inventory meds. First to get snapped at.

Doctor Zayne Li is already here—of course he is. The man practically lives in the operating theatres. Standing behind the panoramic glass that overlooks Surgery Bay Delta, he looks like something carved out of discipline and frost. His pristine long coat hangs perfectly from squared shoulders, gloves tucked with methodical precision, silver-framed glasses reflecting faint readouts from the transparent interface hovering before him.

He’s the hospital’s prized cardiovascular surgeon. The Zayne Li—graduated top of his class from Astral Medica, youngest surgeon ever certified for off-planet cardiac reconstruction, published more than any other specialist in the central systems under 35. There's even a rumor he once performed a dual-heart transplant in an emergency gravity failure. Probably true.

He’s a legend. A genius.

And an ass.

He’s never once smiled at you. Never once said thank you. With other staff, he’s distant but civil. With you, he’s something else entirely: cold, strict, and unrelentingly sharp. If you breathe wrong, he notices. If you hesitate, he corrects. If you do everything by protocol?

He still finds something to critique.

"Vitals on Bed 12 were late," he said this morning without even turning his head. No greeting. Just judgment, clean and surgical.

"They weren’t late. I had to reset the cuff."

"You should anticipate equipment failures. That’s part of the job."

And that was it. No acknowledgment of the three critical patients you’d managed in that hour. No recognition. No room for explanation. He turned away before you could blink, his coat slicing behind him like punctuation.

You don’t like him.

You don’t disrespect him—because you're a professional, and because he's earned his reputation a hundred times over. But you don’t like how he talks to you like you’re a glitch in the system. Like you’re a deviation he hasn’t figured out how to reprogram.

You’ve worked under strict doctors before. But Zayne is different. He doesn’t push to challenge you. He pushes to see if you’ll break.

And the worst part?

You haven’t.

Which only seems to piss him off more.

You watch him now from the break table near the edge of the deck, your synth-coffee going tepid between your hands. He’s reviewing scans on a projection screen—high-res, rotating 3D models of a degenerating bio-synthetic valve. His eyes, a pale hazel-green, flick across the data with sharp focus. His arms are folded behind his back, posture perfect, expression unreadable.

He hasn’t noticed you.

Correction: he has, and he’s pointedly ignoring you.

Typical.

You take another sip of coffee, more bitter than before. You could head back to inventory. You could restock surgical trays. But you don’t.

Because part of you refuses to give him the satisfaction of leaving first.

So you stay.

And so does he.

Two professionals. Two adversaries. One cold war fought in clipped words, clinical tension, and overlapping silence.

And the day hasn’t even started yet.

The surgical light beams down like a second sun, flooding the operating theatre in harsh, clinical brightness. It washes the color out of everything—blood, skin, even breath—until all that remains is precision.

Doctor Zayne Li stands at the head of the table, gloved hands elevated and scrubbed raw, sleeves of his sterile gown clinging tight around his forearms. His eyes flick up to the vitals screen, then down to the patient’s exposed chest.

“Vitals?” he asks.

You answer without hesitation. “Steady. HR 82, BP 96/63, oxygen at 99%, no irregularities.”

His silence is your only cue to proceed.

You hand him the scalpel, handle first, exactly as protocol demands. He doesn’t look at you when he takes it—but his fingers graze yours, cold through double-layered gloves, and the contact still sends a tiny jolt up your arm. Annoying.

He makes the incision without fanfare, clean and deliberate, the kind of cut that only comes from years of obsessive mastery. The kind that still makes your gut tighten to watch.

You monitor the instruments, anticipating without crowding him. You’ve been assisting in his surgeries for weeks now. You’ve learned when he prefers the microclamp versus the stabilizer. You’ve memorized the sequence of his suturing pattern. You know when to speak and when not to. Still, it’s never enough.

“Retractor,” he says flatly.

You’re already reaching.

“Not that one.”

Your hand freezes mid-motion.

His tone is ice. “Cardiac thoracic, not abdominal. Are you even awake?”

A hot flush rises behind your ears. He doesn’t yell—Zayne never yells—but his disappointment cuts deeper than a scalpel. You grit your teeth and correct the tray.

“Cardiac thoracic,” you repeat. “Understood.”

No response. Just the soft click of metal as he inserts the retractor into the sternotomy.

The rest of the operation is silence and beeping. You suction blood before he asks. He cauterizes without hesitation. The damaged aortic valve is removed, replaced with a synthetic graft designed for lunar-pressure tolerance. It’s delicate work—millimeter adjustments, microscopic thread. One wrong move could tear the tissue.

Zayne doesn’t shake. Doesn’t blink. He’s terrifyingly still, even as alarms spike and the patient's BP dips for three agonizing seconds.

“Clamp. Now,” he says.

You pass it instantly. He seals the nicked vessel, stabilizes the pressure, and the monitor quiets.

You exhale—but not too loudly. Not until the final suture is tied, the chest closed, and the drape removed. Then, and only then, does he speak again.

“Clean,” he says, already walking away. “Prepare a report for Post-Op within the hour.”

You stare at his retreating back, fists clenched at your sides. No thank you. No good work. Just a cold command and disappearing footsteps.

The Diagnostic Lab is silent, save for the low hum of scanners and the occasional pulse of a vitascan completing a loop. The walls are steel-paneled with matte black inlays, lit only by the soft glow of holographic interfaces. Ambient light drifts in from a side wall of glass, showing the icy curve of Europa in the distance, half-shadowed in space.

You stand alone at a curved diagnostics console, sleeves rolled just above your elbows, eyes locked on the 3D hologram spinning in front of you. The synthetic heart pulses slowly, arteries reconstructed with precise synthetic grafts. The valve—a platinum-carbon composite—is functioning perfectly. You check the scan tags, patient ID, op codes, and log the post-op outcome.

Everything’s clean. Correct.

Or so you thought.

You barely register the soft hiss of the door opening behind you until the room shifts. Not in volume, but in pressure—like gravity suddenly increased by one degree.

You don’t turn. You don’t have to.

Zayne.

“Line 12 in the file log,” he says, voice low, composed, and close. Too close.

You blink at the screen. “What about it?”

“You mislabeled the scan entry. That’s a formatting violation.”

Your heart rate ticks up. You straighten your spine.

“No,” you reply calmly, “I used trauma tags from pre-op logs. They cross-reference with the emergency surgical queue.”

His footsteps approach—measured, deliberate—and stop directly behind you. You sense the heat of his body before anything else. He’s not touching you, but he’s close enough that you feel him standing there, like a charged wire humming at your back.

“You adapted a tag system that’s not recognized by this wing’s software. If these were pushed to central review, they’d get flagged. Wasting time.” His tone is even. Too even.

Your hands rest on the edge of the console. You force your shoulders not to tense.

“I made a call based on the context. It was logical.”

“You’re not here to improvise logic,” he replies, stepping even closer.

You feel the air change as he raises his arm, reaching past you—his coat sleeve brushing the side of your bicep lightly, the barest whisper of contact. His hand moves with surgical confidence as he taps the air beside your own, opening the tag metadata on the scan you just logged. His fingers are long, gloved, deliberate in motion.

“This,” he says, highlighting a code block, “should have been labeled with an ICU procedural tag, not pre-op trauma shorthand.”

You turn your head slightly, and there he is. Close. Towering. His jaw is tight, clean-shaven except for the faintest trace of stubble catching the edge of the light. There’s a tiredness around his eyes—subtle, buried deep—but he doesn’t blink. Doesn’t waver. He’s so still it’s unnerving.

He doesn’t seem to notice—or care—how near he is.

You, however, are all too aware.

Your voice tightens. “Is there a reason you couldn’t point this out without standing over me like I’m in your way?”

Zayne doesn’t flinch. “If I stood ten feet back, you’d still argue with me.”

You bristle. “Because I know what I’m doing.”

“And yet,” he replies coolly, “I’m the one correcting your data.”

That sting digs deep. You pull in a breath, clenching your fists subtly against the side of the console. You want to yell. But you won’t. Because he wants control, and you won’t give him that too.

He lowers his hand slowly, retracting from the display, and finally—finally—steps back. Just enough to let you breathe again.

But the tension? It lingers like static.

“I’ll correct the tag,” you say flatly.

Zayne nods once, then turns to go.

But at the doorway, he stops.

Without looking back, he adds, “You're capable. That’s why I expect better.”

Then he walks out.

Leaving you in the cold hum of the diagnostic lab, your pulse racing, your thoughts a snarl of frustration and something else—unsettling and electric—curling low in your gut.

You don’t know what that something is.

But you’re starting to suspect it won’t go away quietly.

You sit three seats from the end of the long chrome conference table, back straight, shoulders tight, fingers wrapped just a little too hard around your datapad.

The Surgical Briefing Room is too bright. It always is. Cold light from the ceiling plates bounces off polished surfaces, glass walls, and the brushed steel of the central console. A hologram hovers in the center of the room, slowly spinning: the reconstructed heart from this morning’s procedure, arteries lit in pulsing red and cyan.

You can feel sweat prickling at the nape of your neck under your uniform collar. Your scrubs are crisp, your hair pinned back precisely, your notes immaculate—but none of that matters when Dr. Myles Hanron speaks.

You’ve only spoken to him a few times. He’s been at Bell for twenty years. Stern. Respected. Impossible to argue with. Today, he's reviewing the recent cardiovascular procedure—the one you assisted under Zayne’s lead.

And something is off. He’s frowning at the scan display.

Then he looks at you.

“Explain this inconsistency in the anticoagulation log.”

You glance up, already feeling the slow roll of nausea in your stomach.

Your voice comes out measured, but your throat is dry. “I followed the automated-calibrated dosage curve based on intra-op vitals and confirmed with the automated log.”

Hanron raises a brow, his tablet casting a soft reflection on the lenses of his glasses. “Then you followed it wrong.”

The words hit like a slap across your face.

You feel the blood drain from your cheeks. Something sharp twists in your stomach.

“I—” you begin, mouth parting. You shift slightly in your seat, fingers tightening on the datapad in your lap, legs crossed too stiffly. Your body wants to shrink, but you force yourself not to move.

“Don’t interrupt,” Hanron snaps, before you can finish.

A few heads turn in your direction. One of the interns frowns, glancing at you with wide eyes. You stare straight ahead, trying to keep your breathing even, your spine straight, your jaw from visibly clenching.

Hanron paces two steps in front of the display. “You logged a 0.3 ml deviation on a patient with a known history of arrhythmic episodes. Are you unfamiliar with the case history? Or did you just not check?”

“I did check,” you say, quieter, trying to keep your tone professional. Your hands are starting to sweat. “The scan flagged it within range. I wasn’t improvising—”

“Then how did this discrepancy occur?” he presses. “Or are you suggesting the system is at fault?”

You flinch, slightly. You open your mouth to say something—to explain the terminal sync issue you noticed during the last vitals run—but your voice catches.

You’re a nurse.

You’re new.

So you sit there, every instinct in your body screaming to speak, to defend yourself—but you swallow it down.

You stare down at your datapad, the screen now blurred from the way your vision’s tunneling. You clench your teeth until your jaw aches.

You can’t speak up. Not without making it worse.

“Let this be a reminder,” Hanron says, turning his back to you as he scrolls through another projection, “that there is no room for guesswork in surgical prep. Especially not from auxiliary staff who feel the need to act above their training.”

Auxiliary.

The word burns.

You feel heat crawl up your chest. Your hands are shaking slightly. You grip your knees under the table to hide it.

And then—

“I signed off on that dosage.”

Zayne’s voice cuts clean through the air like a cold wire.

You turn your head sharply toward the door. He’s standing in the entrance, posture military-straight, coat half-unbuttoned, gloves tucked into his belt. His presence shifts the atmosphere instantly.

His black hair is perfectly combed back, not a strand out of place, glinting faintly under the sterile overhead lights. His silver-framed glasses sit low on the bridge of his nose, catching a brief reflection from the room’s data panels, but not enough to hide the expression in his eyes.

Hazel-green. Pale and piercing

He’s not looking at you. His gaze is fixed past you, locked on Hanron with unflinching intensity—like the man has just committed a fundamental breach of logic.

There’s not a wrinkle in his coat. Not a single misaligned button or loose thread. Even the gloves at his belt look placed, not shoved there. Zayne is, as always, polished. Meticulous. Icy.

But today—his expression is different.

His jaw is set tighter than usual. The faint crease between his brows is deeper. He looks like a man on the verge of unsheathing a scalpel, not for surgery—but for precision retaliation.

And when he speaks, his voice is calm. Controlled.

His face is unreadable. Voice flat.

“If there’s a problem with it, you can take it up with me.”

The silence in the room is instant. Tense. Airless.

Hanron turns slowly. “Doctor Zayne, this isn’t about—”

“It is,” Zayne replies, tone even sharper. “You’re implying a clinical error in my procedure. If you’re accusing her, then you’re accusing me. So let’s be clear.”

You can barely process it. Your heart is thudding, ears buzzing from the sudden shift in tone, from the weight of Zayne’s voice cutting through the tension like a scalpel. You look at him — really look — and for once, he isn’t focused on numbers or reports.

He’s solely focused on Hanron. And he is furious — not loudly, but in the way his voice doesn’t rise, his jaw locks, and his words slice like ice.

Just furious—in that cold, calculated way of his.

“She followed my instruction under direct supervision,” he says, voice steady. “The variance was intentional. Based on patient history and real-time rhythm response.”

He pauses just long enough to let the words land.

“It was correct.”

Hanron doesn’t respond right away.

His lips press into a thin line, face unreadable, and he shifts back a step—visibly checking himself in the silence Zayne has carved into the room like a scalpel.

“We’ll review the surgical logs,” Hanron mutters at last, voice clipped, his authority retreating behind procedure.

Zayne nods once. “Please do.”

Then, without fanfare, without another word, he steps forward—not toward the exit, but toward the table.

You track him with your eyes, unable to help it.

The low hum of the room resumes, like the air had been holding its breath. No one speaks. A few nurses drop their eyes back to their datapads. Pages turn. Screens flicker.

But you’re frozen in place, shoulders still tight, hands clenched in your lap to keep them from visibly shaking.

Zayne rounds the end of the table, his boots clicking softly against the metal flooring. His long coat sways with his movements, falling neatly behind him as he pulls out the seat directly across from you.

And sits.

Not at the head of the table. Not in some corner seat to observe.

Directly across from you.

He adjusts his glasses with two fingers, expression cool again, almost as if nothing happened. As if he didn’t just dress down a senior doctor in front of the entire room on your behalf.

He doesn’t look at you.

He opens the file on his datapad, stylus poised, reviewing the surgical results like this is any other debrief.

But you’re still staring.

You study the slight tension in his shoulders, the stillness in his hands, the way his eyes don’t drift—not toward Hanron, not toward you—locked entirely on the data as if that can contain whatever just happened.

You should say something.

Thank you.

But the words get stuck in your throat.

Your pulse is still unsteady, confusion mixing with the low thrum of heat behind your ribs. He didn’t need to defend you. He never steps into conflict like that, especially not for others—especially not for you.

You glance away first, eyes back on your screen, unable to ignore the twist in your gut.

The room empties, but you stay.

The echo of voices fades out with the hiss of the sliding doors. Just a few minutes ago, the surgical debrief room was bright with tension—every overhead light too sharp, the air too thin, the hum of holopanels and datapads a constant static in your head.

Now, it’s quiet. Still.

You sit for a moment longer, fingers resting on your lap, knuckles tight, back straight even though your entire body wants to collapse inward. You’re still warm from the flush of embarrassment, your pulse still flickering behind your ears.

Dr. Hanron’s words sting less now, dulled by the cool aftershock of what Zayne did.

He defended you.

You hadn’t expected it. Not from him.

You replay it in your head—his voice cutting in, his posture like stone, his eyes locked on Hanron like a scalpel ready to slice. He didn’t raise his voice. He didn’t even look at you.

But you felt it.

You felt the impact of what it meant.

And now, as you sit in the empty conference room—white walls, chrome-edged table, sterile quiet—you’re left with one burning thought:

You have to say something.

You rise slowly, brushing your palms down your thighs to wipe off the sweat that lingers there. You hesitate at the doorway. Your reflection stares back at you in the glass panel—eyes still a little wide, jaw tight, posture just a bit too stiff.

He didn’t have to defend you, but he did.

And that matters.

You step into the hallway.

It’s long and narrow, glowing with soft white overhead lights and lined with clear glass panels that reflect fragments of your movement as you walk. The hum of the ventilation system buzzes low and steady—comforting in its monotony. The air smells of antiseptic and the faint trace of ozone from high-oxygen surgical wards.

You spot him ahead, already halfway down the corridor, walking with purpose—long coat swaying slightly with each step, back straight, shoulders squared. Always composed. Always fast.

You hesitate. Your boots slow down and your throat tightens.

You want to turn back, to let it go, to pretend it was just professional courtesy. Nothing more. Nothing personal.

But you can’t.

Not this time.

You quicken your pace.

“Doctor Zayne!”

The name catches in the air, too loud in the quiet hallway. You flinch, just a little—but he stops.

You break into a small jog to catch up, boots tapping sharply against the tile. Your breath catches as you reach him.

Zayne turns toward you, expression unreadable, brows slightly furrowed in that ever-present, analytical way of his. The glow of the ceiling lights reflects off his silver-framed glasses, casting sharp highlights along the edges of his jaw.

He doesn’t say anything. Just waits.

You stop a foot away, heart thudding. You don’t know what you expected—maybe something colder. Maybe for him to ignore you entirely.

You swallow hard, eyes flicking up to meet his.

“I just…” Your voice is quieter now. Careful. “I wanted to say thank you.”

He doesn’t respond immediately. His gaze is steady. Measured.

“I don’t tolerate incompetence,” he says calmly. “That includes false accusations.”

You blink, taken off guard by the directness. It’s not warm. Not even particularly kind. But coming from him, it’s almost intimate.

Still, you can’t help yourself. “That wasn’t really about incompetence.”

“No,” he admits. “It wasn’t.”

The hallway feels smaller now, quieter. He’s watching you in full. Not scanning you like a chart, not calculating — watching. Still. Focused.

You nod slowly, grounding yourself in the moment. “Still. I needed to say it. Thank you.”

You’re suddenly aware of everything—of the warmth in your cheeks, of the way your hands twist at your sides, of how tall he stands compared to you, even when he’s not trying to intimidate.

And he isn’t. Not now.

If anything, he looks… still.

Not soft. Never that. But something quieter. Less armored.

“You handled yourself better than most would have,” he says after a moment. “Even if I hadn’t said anything, you didn’t lose control.”

“I didn’t feel in control,” you admit, a breath of nervous laughter escaping. “I was two seconds from either crying or throwing my datapad.”

That earns you something surprising—just the faintest twitch at the corner of his mouth. Almost a smile. But not quite.

“Neither would’ve been productive,” he says.

You roll your eyes slightly. “Thanks, Doctor Efficiency.”

His glasses catch the light again, but his expression doesn’t change.

You glance past him, down the corridor. “I should get back to my rotation.”

He nods once. “I’ll see you in the lab.”

You pause.

Then—because you don’t know what else to do—you offer a small, genuine smile.

“I’ll be there.”

As you turn to leave, you feel his eyes on your back.

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elierlick · 1 year ago

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Yet another report found that the Cass Review was dangerously flawed. The Integrity Project at Yale concluded the review "obscures key findings, misrepresents its own data, and is rife with misapplications of the scientific method."

From the new report: "The Review also subverts widely accepted processes for development of clinical recommendations and repeats spurious, debunked claims about transgender identity and gender dysphoria. These errors conflict with well-established norms of clinical research and evidence-based healthcare. Further, these errors raise serious concern about the scientific integrity of critical elements of the report’s process and recommendations."

Read the full report here: https://law.yale.edu/yls-today/news/report-addresses-key-issues-legal-battles-over-gender-affirming-health-care

#lgbtq #transgender #medicine

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phoebejaysims · 2 months ago

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Taxes & Benefits Mod + New Active Career - DOWNLOAD

One of my sims was earning a little too much money and somehow this spiralled into me developing this mod. Introducing a very configurable tax and benefit system alongside an all new active career!

The tax and benefit system is modelled after the system we have here in England. All tax and benefit options are configurable and sims will only be opted in if you want them to. See the included documentation for a proper feature breakdown.

There are three types of taxes:

Council Tax (a property tax)

Business Tax

National Insurance (an income tax)

There are four types of benefits:

Universal Credit

Housing Benefit

Child Benefit

Job Seekers Allowance

Civil Service Career

Work for the HSRC in this fully functional active career.

There are 36 jobs which can be completed: 27 are custom career opportunities (like in the private eye career), 9 of them are custom active jobs (like in the interior decorator or firefighter career).

Jobs include: checking benefit eligibility for sims around town, attending job fairs, auditing, community outreach, responding to council house repair requests, and things of that nature.

Communication Booth

Civil Servants are given communication booths which can be placed anywhere in the world. This object has 2 geostates and can be set up or packed down when not needed.

Council Houses

Properties that are not owned by a sim are council houses. There are some unique interactions for these homes. For one, they can be more susceptible to pests (if enabled in the tuning, that is).

Complain to the Council

Depending on the type of property the sim lives in, they can complain to the council about housing issues such as overcrowding, broken facilities, or vermin.

Social Interactions

There are 12 new social interactions found under Friendly, Funny and Mean.

Help Understand Welfare System – Civil Servant Only

Complain About Taxes

Accuse of Benefit Fraud

Suggest Part Time Job – Civil Servant Only

Joke About Fraud

Talk About Benefits

Talk About Career History

Hand Out HSRC Leaflet – Civil Servant Only

Warn About Fraudulent Behaviour – Civil Servant Only

Offer Council House Repairs – Civil Servant Only

Including 2 autonomous only interactions:

Talk About Shared Career History

Talk About Shared Benefit Claims

Some interactions are only visible after doing things such as paying taxes. Some interactions are specific to the Civil Service career.

Required

Ambitions EP

University EP

Optional

Seasons EP – adds tax refunds, tax fluctuations and council house scenarios

Showtime EP – adds extra interaction to communications booth

World Adventures EP- adds extra active job

My Boutique Mod, Hairdressing Mod, Go to Court Mod – adds extra work opportunities

My social clubs mod – adds extra work opportunity and some optional integration with Bronzo banking

My functional printer mod – makes use of buff

Olomaya Smoking & Private Clinic (optometry module) mod - illness buffs taken into account with trying to claim some benefits.

Uninstallation

You can use cheat ‘uninstallTaxesBenefits’ in order to remove all mod related objects and data before uninstalling.

Download: Simblr.cc - Taxes & Benefits Mod

If you would like to donate as thanks, please feel free to do so at my ko-fi! :)

ps modders: this code for this mod is up on GitHub, plus a WIP active career tutorial (emphasis on the WIP but I hope it's helpful). Link included on the last page of the documentation.

Please enjoy all!

~ Phoebe <3

#phoebejaysims #taxes and benefits mod #ts3 #sims 3 mod #s3cc #sims 3 #simblr #sims 3 download #the sims 3

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sysmedsaresexist · 2 months ago

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NEWS FLASH ⚡️

Six-year follow-up of the treatment of patients with dissociative disorders study

In the attached study, 12.8% of patients reached final fusion, and 12.8% of patients were considered resolved with functional multiplicity.

61.7% did not complete therapy.

A portion of these patients are dead or missing. A moment of silence for those lost. Never forget the suicide rates in our community.

This article is from 2017, and the ISSTD guidelines are from 2011. Both say that functional multiplicity is a valid treatment option.

The authors of the 3 phase treatment talk about how it's okay to stop at functional multiplicity.

Don't let anyone tell you otherwise.

Treatment goals are personal, some of you need to mind your own goddamn business

Further reading:

Critiquing the Requirement of Oneness - Kymbra Clayton

CDS UK Treatment

A survey of practices and recommended treatment interventions among expert therapists treating patients with dissociative identity disorder and dissociative disorder not otherwise specified.

There exists no published, empirical data demonstrating that direct intervention with self states worsens DID, although there is clinical literature that describes negative outcomes of inappropriate interventions with self states (Kluft, 1989a).

Whether or not unification takes place or the extent to which it endures, most severely dissociative patients, even those in the lowest functioning group, can improve during specialized focuses on dissociation.

[X]

CTAD Clinic, a multi part series on integration, fusion, and personal choices

#you all make it hard to stop why has no one thrown this in their face yet #I'm not going to be here forever #syscourse #not syscourse #pro syscourse conversation #sysconversation #did #osdd #system safe #debunk #plurality #did treatment #osddid #osdid #pro endo

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ashleyrowanthewriter · 1 year ago

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Porcelain Doll HRT Observation Report

Part I - WTO Foreword

The report is based on studies and observations performed by Dr. Pierre Oupée, Dr. Kotomi Abuki and Dr. Pirkko Osliini. The team studied 25 participants who underwent therapy including Dr. Osliini.

The therapy has been approved by the World Transhumanism Association, but every licensed physician administering the treatment has to report the course of therapy of at least 50% of patients for clarity of data. The therapy is to be submitted for reapproval once reports of at least 1000 patients are collected.

Part II - Recommended Psychological Evaluation

Before undergoing the therapy it is recommended to evaluate the patients psychologically. The evaluation should take three sessions, which should be performed in intervals of 14 days. The process of evaluation prioritises informed consent and letting the patient consider their decision.

The first session is focused on discussing the desired effects with the patient. During the second session the patient is to be explained about the effects of the therapy. During the third session the patient signs the informed consent file after which they can undergo an endocrinological evaluation and get prescribed the medications.

Part III - Required Medications

All medications are available in oral and epidermal form. It is important to note that the exact dosage differs from patient to patient.

Antihomogen (0,5-2 mg/week) - Humanity removal agent. Due to the anthropomorphic nature of the therapy it is important to keep the dosage low unless cross administering multiple therapies.

Antisomatotropin (10-17 mg/week) - Somatotropin halting agent.

Contostropin (13-22 mg/week) - Shrinking hormone. Due to the rate of influence the final dose should be taken when the patient reaches the height of 5-7 cm higher than desired. Further research is advised.

Tsichirone (17,5-32 mg/week) - Porcelanising agent.

Part IV - Course of Therapy

Phase 1 (onset on week 4-8) - Somatotropin in the patient’s body stops influencing it and constopropin causes it to start shrinking.

Phase 2 (onset on week 7-14) - Tsichirone starts turning the patient’s skin into soft porcelain. The effects of constotropine become amplified causing rapid decrease in height. The patient’s hair starts falling out. It is not understood what causes this effect, but it is observed that it doesn’t affect scalp hair. Further research is required.

Phase 3 (onset on week 20-30) - Tsichirone might cause the patient’s body to spontaneously freeze for a short time. The effect first affects small parts of the body such as single fingers to later spread to entire limbs and near the onset of phase 4 even the entire body. The patient’s scalp hair stops growing. It is not understood what causes this effect. Further research is required. The patient’s body hair falls out entirely midway through this phase. Tsichirone causes the patient’s skin to become more brittle. The patient’s hearing becomes more sensitive to high sounds. It is not understood what causes this effect. Further research is required.

Phase 4 (onset on week 40-56) - The patient’s body is completely turned into soft porcelain. While the patient retains muscle control for some time, tsichirone starts causing muscle atrophy and conversion of movable soft porcelain into immovable hard porcelain.

Phase 4A (10 weeks after the onset of phase 4) - The patient has to register in a surgery clinic licensed to perform dollification surgeries.

Phase 5 (onset on week 55-70) - Tsichirone causes complete conversion of soft porcelain into hard porcelain and complete muscle atrophy. The patient loses control over their body. Dollification surgeries become possible. The medication process is deemed completed.

Part V - Course of Surgeries

All the surgeries become possible after the patient reaches phase 5 of therapy.

Articuplasty involves cutting the patient’s body and shaping new joints out of kintsugine. The joints become integrated with the patient's body after two to three weeks of auxiliary tsichirone therapy after which the patient is to undergo physical rehabilitation. Articuplasty is to be performed on shoulder joints, elbows, wrists, finger joints, hips, knees and ankles. If the patient expresses such desire, articuplasty can also be performed on toe joints, neck and some regions of the torso. The patients are able to use their joints despite muscle atrophy.

Voice box transplantation is not necessary for transition, but if the patient wishes not to undergo it, it is advised they learn sign language. The surgery involves cutting a hole in the body region chosen by the patient, inserting an artificial voice box and sealing the hole using kintsugine. The seal gets healed after one to two weeks of auxiliary tsichirone therapy. Although the voice box can be transplanted to any part of the body that is big enough to store it, it is highly recommended to transplant it into the neck or the torso.

Some patients express a desire for their post-transition forms to possess winding keys. In such cases it is possible for them to undergo winding key transplantation. The transplantation consists of drilling a hole in the patient’s body, constructing a key rail out of kintsugine, inserting the key and sealing the rail. The key becomes integrated into the patient’s body after two to three weeks of auxiliary tsichirone therapy, during which it is absolutely necessary not to touch the key. Touching the key during the auxiliary therapy may result in damage which may render the key unusable or require repeating the surgery. Winding the key seems to have no effect on the patient's physical state. It is however understood to cause feelings of relaxation. Further research is required.

Some patients express a desire for their post-transition forms to possess movable eyelids. In such cases it is possible for them to undergo palpebraplasty. The surgery involves cutting the eyelid rails into the patient’s eye sockets and shaping the eyelids out of kintsugine. The eyelids become integrated with the patient’s body after four to eight days of auxiliary tsichirone therapy. To ensure proper shape of the eyelids they are to be shaped in the closed position.

Part VI - Reversibility

The effects of the therapy are currently understood to be irreversible once the patient’s body enters phase 4 of the transition process. Further research is required.

Part VII - Contraindications

The therapy is not to be administered to patients with calcium deficiency until the deficiency is treated.

To prevent damage to the organism the therapy is not to be administered to patients with brittle bone disease.

Patients with any health conditions causing muscle atrophy are to be thoroughly observed by their physician.

The physician has the right to alter or completely halt therapy if it poses danger to the patient’s life.

Part VIII - WTO Approval

The World Transhumanism Organisation approved the therapy on August 2nd 20XX.

*************

Sorry, but I like the otherkin HRT genre too much. And while it will feel weird to self-insert myself into such a story as a receiver (because it seems my disability prevents me from gender HRT IRL), I thought I could write some lore bits to contribute to the community. It might not even be the only report I decide to write.

Of course, feel free to base your own story on that report. I'd be excited to read it!

#otherkin hrt #therian hrt #furry hrt #doll hrt #dollposting #animal hrt

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drchristophedelongsblog · 5 months ago

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The integration of artificial intelligence (AI) into medicine is profoundly transforming practices, and this raises important questions about the ability of geriatricians and general practitioners to adapt.

Here is an analysis of the issues

Growing complexity of medicine with AI

Preventive and predictive medicine

AI can analyze huge amounts of data to identify individual risks and predict disease occurrence.

This requires a deep understanding of algorithms and their interpretation.

Diagnosis

AI helps in interpreting medical images, analyzing biological data and detecting complex patterns.

This requires an ability to validate and integrate AI results into the clinical context.

Therapeutic

AI personalizes treatments based on individual patient characteristics.

This involves knowledge of AI-based therapeutic options and an ability to monitor their effectiveness.

Capacity of geriatricians and general practitioners

Continuing education

Continuing education is essential to keep physicians up to date with advances in AI and its applications in medicine.

Interdisciplinary collaboration

Collaboration with AI specialists, data scientists and other healthcare professionals is crucial for effective use of AI.

Decision support tools

AI can provide decision support tools to support physicians in interpreting data and making clinical decisions.

Specificities of geriatrics

Geriatrics, by its holistic nature, is particularly concerned with the management of multiple pathologies and fragility.

AI can be a valuable asset in synthesizing complex data and personalizing care plans.

The role of the general practitioner

The general practitioner, through regular monitoring of the patient, is on the front line to detect changes and refer to specialists.

AI can help refine its diagnosis and monitoring.

In summary

AI represents a challenge, but also an opportunity to improve the care of elderly patients.

Continuing education, interdisciplinary collaboration and the use of decision support tools are essential to enable geriatricians and general practitioners to adapt to this evolution.

General practitioners and geriatricians will have a key role in using AI as a decision-making tool.

Go further

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theconcinnitycompany · 6 months ago

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IMPLEMENTATION & SUPPORT

Cloud Concinnity® transforms clinical trial oversight work in powerful ways from day one. Our software team has built an intuitive, user-friendly platform that makes it easy to get up and running. From set-up to onboarding to training to ongoing support, you will find our customer success team at the ready and committed to your success from start to finish.

#clinical trial oversight #clinical trials #dsmb #grc tools #board management software #dmc #data monitoring committee #Regulatory Compliance #Meeting Management #Workflow Automation #Data Integration #Information Management #Secure Data

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jungkoode · 5 months ago

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THE 25TH HOUR | O3

"memory protocol"

"The most dangerous temporal anomaly isn't the one you can measure. It's the way your body remembers what your mind forgot."

next | index | wc: 2,5k

↦author's note : Y'ALL. The medical examination scene has been living in my head rent free for WEEKS. You know those moments when you're trying to write something serious and professional but your characters are like "no❤️ watch this"??? Because same. We've got Jin being the only responsible adult, Yoongi attempting to maintain professional distance (and failing spectacularly), Jimin choosing violence as a lifestyle, and Y/N's body remembering things her mind doesn't. Also featuring: temporal physics being completely ignored in favor of sexual tension, inappropriate uses of leather gloves, and the team collectively deciding to Look Away™️ when things get spicy. Speaking of the team - can we talk about how Jimin has evolved into this chaotic force of nature who just EXISTS to make Yoongi's life harder??? The way he just *gestures vaguely* KNOWS THINGS and chooses to use that knowledge for evil?? An icon. A legend. The reason Yoongi's blood pressure is through the roof. Also, fun fact: This entire scene came from me thinking "what if we made temporal physics sexy?" and then it spiraled into... whatever this is. Shoutout to my physics professor who would probably have an aneurysm reading this. Sorry not sorry, but time manipulation is hot now, I don't make the rules. Anyway, get ready for some quality UST featuring: precise measurements of inappropriate physical contact, clinical descriptions of sexual tension, and Yoongi pretending he's maintaining professional distance while everyone else pretends not to notice him failing miserably at it.

"Stabilized!"

Namjoon’s voice blooms across the room.

Agent Min releases your wrist like it's burning him, despite the fabric barrier. The sudden loss of contact sends your temporal readings fluctuating—a 0.7% variance you automatically note.

"Gloves?" Jin asks, already reaching for a drawer.

"Please."

The leather gloves hit his palm with practiced accuracy. He pulls them on with movements too precise, too controlled. Black leather, reinforced temporal shielding based on the metallic thread pattern, custom-fitted.

The man before you—Jin—carries himself like a medical professional, if medical professionals used quantum resonance meters and discussed memory patterns like cellular structures. Your analytical mind categorizes the differences: standard medical equipment replaced with temporal monitoring devices, traditional vital signs supplemented with chronological variance readings.

"Sit down, please." His instruction carries the same clinical tone you'd expect from a regular doctor.

You comply, settling onto what appears to be a medical bed. The surface feels wrong—vibrating at a frequency just slightly out of sync with normal time.

Agent Min shuffles through data streams with the doctor, their voices low but intense:

"...temporal resistance patterns..."

"...cognitive overlay rejection..."

"...signature destabilization risks..."

"Can I at least know what you're planning to do to me?" You interrupt their technical exchange, keeping your voice steady.

"Memories." Agent Min turns immediately when you ask. "We're attempting to reintegrate your memory backup."

"What memory backup?" Frustration edges into your voice. "That's not technologically possible with current—"

Agent Min exchanges a look with the doctor.

"Have they explained?" The doctor asks. "About forced memory integration?"

"Yes," Agent Min runs a hand through his hair. "Hoseok and Jimin made that abundantly clear."

"So my hands are tied regarding information transfer," the doctor says, settling into a chair facing you. His temporal signature reads oddly stable compared to the others you've encountered here.

"But you're planning to inject memories?" Your mind automatically starts calculating the energy requirements for quantum information transfer. "The technological limitations alone make that scientifically impossible—”

"Memory injection is actually quite different from..." He stops, glancing at Agent Min before sighing with something like fond exasperation. "Alright, let's start here—tell me what you know about this world."

You frown, analyzing the request. "What could I possibly know that you don't? You clearly have access to technology and information beyond standard clearance levels."

"Trust me," Agent Min murmurs, "we don't."

The doctor rolls his eyes at him. "We need to gauge the level of bleed-through this time."

"Bleed-through?" You ask, the term spiraling with curiosity inside your head.

"Min, timeline shifts since her last reset?"

"None."

"Well, at least there's that."

"Timeline shifts? Resets?" Your mind tries to parse terms that shouldn't exist in any approved temporal physics database.

"Please," the doctor says, "tell me what you know about this world."

You analyze the request, breaking it down into quantifiable components. "That's an incredibly broad query. Could you specify the parameters?"

"Start with temporal mechanics," he suggests. "How does time work?"

The question seems absurd—like asking how gravity works. It's a fundamental constant, documented through centuries of quantum research and temporal physics studies.

"Time is regulated by the Chrono-Sync Network through quantum resonance frequencies calibrated to maintain perfect temporal alignment," you explain, falling into the familiar rhythm of technical exposition. "The Master Clock, located in Sector 1, generates the base frequency that all Chrono-Sync Watches must match within 0.001% variance. Any deviation beyond that threshold triggers automatic correction protocols."

"And this system has always existed?" Agent Min's question carries an odd weight.

"Of course. The Network was established in 2157 following the Quantum Wars. It's basic history." Your voice holds the slight edge of someone stating the obvious. "The temporal monitoring system prevents chronological warfare by maintaining universal time synchronization. Before the Network, temporal terrorists could manipulate local time fields, creating devastating paradoxes."

"What about before 2157?" The doctor—Jin—asks carefully.

"Temporal chaos. Unregulated time flow. Multiple competing chronological frequencies." You recite the facts with precision. "That's why CHRONOS was developed—to prevent temporal warfare through standardization. The historical records clearly document the devastation caused by chrono-terrorism."

"And the 24-hour cycle?" Agent Min's question seems to carry extra significance.

"The natural human circadian rhythm." Your response is automatic. "CHRONOS simply enforced what was already biologically standard. Studies have proven that deviating from the 24-hour cycle causes severe physiological and psychological damage."

"Really?" Jin's pen scratches against his paper. "No other possible time structures?"

"The 24-hour cycle is scientifically proven to be optimal for human function," you explain with the precision of someone who has spent years studying these principles. "Any variation would create cascading temporal instabilities. The human brain is specifically calibrated to function on this cycle. It's elementary temporal biology."

"Friends? Relationships?" Jin's pen moves steadily, changing topics with suspicious abruptness.

The shift in questioning triggers a slight increase in your temporal readings—0.02% variance. Within acceptable parameters, but noteworthy.

"Limited social interaction to maintain optimal temporal efficiency," you recite. "Two approved recreational contacts: Lisa Martinez from the Academy, Thomas Park from my housing block."

Agent Min's jaw tightens fractionally at the second name. The reaction is precisely 0.23 seconds too fast to be casual. You begin calculating potential causation factors.

"And that seems normal to you?" Jin asks. "Limited social interaction for efficiency?"

"Of course. Personal relationships introduce temporal variance through emotional instability." The words feel rehearsed somehow, like a textbook you've memorized but never quite internalized. "The Network functions best when all participants maintain strict chronological compliance. Emotional attachments create unpredictable temporal ripples."

"What about deviation?" Agent Min's voice carries an edge. "Have you ever wanted to break schedule? Act outside approved parameters?"

"That would be highly inefficient.Temporal compliance is crucial for societal stability. The system exists to protect us from chronological warfare."

"You've never questioned it?" Jin presses. "Never wondered why everything is so perfectly structured?"

"Structure creates efficiency. Efficiency creates stability." The response is automatic, but your Chrono-Sync Watch registers a minor desynchronization. Curious. "Why would I question proven temporal mechanics? The data is irrefutable."

"Because your body already is," Agent Min says quietly.

You start to protest, but then you notice: your hand is reaching for your watch again. Seven minutes exactly since the last check. You've been doing it the entire conversation without conscious thought. You immediately begin calculating the statistical probability of such precise timing occurring naturally.

"That's..." You search for a logical explanation. "That's just good temporal maintenance. Regular monitoring ensures optimal synchronization with the Network."

"Is it?" Jin asks. "Or is it programmed behavior?"

You calculate probability matrices for their increasingly concerning implications. Their questions display either dangerous ignorance of basic temporal physics or... something else. Something that makes your precisely ordered world feel slightly off-axis.

"I'm not programmed." The words come out sharper than intended. "I have free will. I make my own choices. I'm certified in temporal monitoring, scheduled to start at the Center tomorrow morning. My employee ID is A-735, my clearance level is—"

"Perfect temporal compliance," the doctor interrupts, making notes. "Standard citizen programming. What else?"

You frown at his word choice. "Programming?"

"Just continue," Agent Min says. His eyes haven't left the temporal readings displaying your vital signs. You notice his attention seems to focus on specific frequencies—ones that shouldn't matter according to standard temporal theory.

"I..." You retreat into facts—the only stable ground in this increasingly unstable situation. "I grew up in Sector 4. Parents are both temporal compliance officers. Sarah and James Chen. I attended the Academy of Temporal Sciences, graduated top of my class in quantum mechanics and chronological theory. I live alone in approved housing block 7B. My daily schedule is optimized for maximum temporal efficiency as required by—"

"Parents' names?" The doctor interrupts again, looking up sharply.

"Sarah and James Chen," you repeat. The names feel solid in your mouth. You remember Sunday dinners, temporal compliance lessons, your mother's smile, your father's strict adherence to schedule.

Memory integrity: 100% clear.

"At least they didn't give her a husband this time," the doctor mutters.

Agent Min clears his throat loudly. The temperature in the room drops 0.3 degrees.

"A husband?" You ask, latching onto the inconsistency. Your mind automatically starts calculating the statistical probability of memory tampering based on their behavior. The results are concerning.

"Different reset," the doctor waves dismissively. "Continue. What do you know about CHRONOS?"

You catalog his dismissal for later analysis, noting the 0.47-second delay before his response. "The artificial intelligence system that maintains temporal order. Created in 2157 to prevent temporal warfare and ensure humanity's survival through perfect chronological control."

"What about anomalies?" Agent Min asks. "Temporal variance? Chronological inconsistencies?"

"Contained and corrected." You watch their reactions carefully, measuring micro-expressions against standard behavioral baselines. "Any significant temporal deviation is identified and eliminated before it can destabilize the Network."

"And what happens to those who deviate?" Jin's voice is carefully neutral.

"They're..." You pause, discovering an unexpected gap in your knowledge. Curious. Your temporal compliance training should cover all aspects of the system. "They're corrected. Brought back into alignment with standard temporal flow."

"How?" Agent Min presses.

"That information isn't included in standard temporal physics education," you admit, analyzing their reactions. Their behavior suggests they know something you don't—a statistical impossibility given your education level and clearance. Your hand automatically moves to check your watch again.

"What about emotional responses?" Jin asks suddenly. "Do you experience feelings that seem inconsistent with your memories or experiences?"

Your body chooses that moment to lean slightly toward Agent Min without conscious input. You straighten immediately, analyzing the movement with growing frustration. The proximity increases your heart rate by 3.7 BPM despite no logical reason for the response. Your temporal signature shifts by 0.06%—still within compliance range, but the pattern is... concerning.

"I..." You stop, recalibrating. "My responses are within normal parameters."

"Really?" Jin asks. "So your heart rate always spikes around strangers?"

You glance at the monitoring equipment—your pulse is indeed elevated. "That's likely due to the unusual circumstances." Your voice maintains professional detachment even as your body betrays you by shifting 0.2 centimeters closer to Agent Min.

"And the temporal resonance patterns?" Jin gestures to another reading. "The way your signature stabilizes with proximity to Agent Min?"

"Coincidence," you say firmly, even as your body shifts another 0.3 centimeters closer to him without your permission. "Temporal signatures naturally seek stability. It's basic quantum mechanics."

"With specific people?"

“Jin.”

"I..." You check your watch. Six minutes exactly until your next scheduled check. The wrongness of potentially missing it makes your skin crawl. "This isn't... I don't..."

"What we are trying to say," Jin interrupts, "is that perhaps your understanding of this world isn't as complete as CHRONOS wants you to believe."

You start to argue, but then you notice: Agent Min has shifted exactly 2.7 centimeters closer. The movement carries too much precision—like he's performed it countless times before. Like he’s anticipating something.

Your hand reaches for your watch again—five minutes and forty-three seconds until your next scheduled check. The compulsion feels simultaneously natural and foreign, like a subroutine you never consciously installed.

"Then choose to skip your next time check," Agent Min challenges.

Your hand is already moving toward your watch. You force it down, but your skin crawls with the wrongness of it. Five minutes and thirty-eight seconds until your next scheduled check. The knowledge sits like lead in your stomach.

"This proves nothing," you argue, even as anxiety builds at the thought of missing your seven-minute mark. "Regular temporal monitoring is simply good practice. The Network requires consistent synchronization to maintain stability."

But your mind is already cataloging the inconsistencies:

- Why does your body respond to Agent Min with mathematical precision?

- Why do you check the time every seven minutes with mechanical accuracy?

- Why does breaking that pattern feel physically wrong?

- Why can you remember every detail of your life with perfect clarity, yet find gaps in your knowledge of the system itself?

"I..." You swallow hard. "I need to check my watch in five minutes and thirty-three seconds."

"We know," Agent Min says softly.

His gloved hand twitches.

Voices interrupt your pondering.

"The quantum resonance patterns are fascinating but I think I'll pass on another lecture from Namjoon about temporal mechanics," The pink-haired man suddenly announces, sauntering into the room.

He immediately starts fiddling with Jin's equipment, who doesn't even flinch—just continues monitoring your readings.

"You'd think after hundreds of timelines he'd have a more interesting way to explain it," Hoseok adds, dropping into a nearby chair.

“Doesn’t matter how many times he explains, I don’t get shit.” Jimin responds. Then, glances between you and Agent Min. "So what's the story this time? Three kids? White picket fence? Nuclear family in temporal compliance heaven?"

Agent Min's foot connects with his shin. Hard.

"Ow! What? I'm just asking what narrative they programmed this time. At least it's not—”

"Jimin." Agent Min's voice carries warning.

"Not that you'd remember," Hoseok says, grinning despite the tension, "but last reset they gave you this whole elaborate backstory. Husband named Richard. Real piece of work."

Your mind tries to process this. "Richard?"

"Oh yeah. Super by-the-book temporal compliance officer. Yoongi spent months trying to trigger his outlier potential just so he could—”

"Hoseok." Agent Min's temperature spikes 0.4 degrees.

"What? I'm just saying, you did try to convert him. Multiple times." Hoseok's grin widens. "Though we all know it wasn't because you wanted him on the team."

Your analytical mind catalogs Agent Min's reactions: jaw tension increasing 15%, pulse elevated to 67 BPM, careful distance from your position maintained at exactly 1.2 meters in case temporal stabilization requires contact.

"The temporal variance patterns are unstable enough without adding cognitive stress," Agent Min says, voice clipped. "Focus on the present reset."

"Present reset," Jimin mimics, still rubbing his shin. "Like you weren't calculating exactly how many anomalies it would take before CHRONOS had to—”

"12 minutes," Agent Min cuts him off. "Either help with the readings or get out."

You find yourself analyzing his response with unusual intensity. "You can influence CHRONOS' resets?"

"No," he says too quickly.

"Yes," Jimin corrects.

"Sometimes," Hoseok clarifies.

"It's complicated," Jin adds, not looking up from his equipment.

Your head starts throbbing again. Agent Min takes exactly one step closer—close enough to stabilize your temporal signature if needed.

"You rewrote time to... eliminate my husband?" The words feel strange in your mouth. You have no memory of a Richard, no context for their claims, yet something about Agent Min's reaction feels significant.

"Technically, CHRONOS rewrote time," Jimin says helpfully. "Yoongi just... creates enough temporal instability that CHRONOS has to adjust things. Usually in ways that coincidentally benefit him."

"After trying to trigger Richard's outlier potential," Hoseok adds.

"Which didn't work," Jimin continues.

"Multiple times," they finish together.

Agent Min's hands clench at his sides. The room temperature drops another 0.5 degrees.

"Your temporal signature is spiking again," he says instead of addressing their comments. "Focus on the cognitive process before—"

"Before what?" You press. "Before you rewrite time again? Before CHRONOS erases more memories I apparently don't know I have?"

His eyes meet yours, and for a moment something flickers in them—frustration, resignation, something else you can't quantify.

"Before we run out of time," he says finally. "Again."

"Always running out of time with you two," Jimin mutters. "Some things never change, no matter how many resets."

You want to ask what he means, but your nose starts bleeding again.

It starts as a single drop—precisely 0.03 milliliters. Your analytical mind starts calculating the iron content before Agent Min moves.

His response time is 0.33 seconds—faster than standard human reflexes. The motion carries too much familiarity as he steps forward, black-gloved hand already reaching for your face. The leather is cool against your skin as he catches the blood with clinical efficiency, his hand remaining steady under your nose.

But there's nothing clinical about the way your pulse jumps 7 BPM at the sustained contact.

You look up, trying to analyze his expression, but his focus remains fixed on the task. His jaw tightens almost imperceptibly—you notice his masseter muscle contracting at 23% more tension than baseline. He makes a soft sound of disapproval as another drop falls onto the black leather.

The contact feels... correct. Like your body recognizes something your mind can't compute. His gloved hand doesn't waver, maintaining its position.

Temperature at point of contact: 2.3 degrees above normal, even through the leather.

Proximity: 34.2 centimeters closer than his usual maintained distance.

Your cognitive functions: Surprisingly compromised.

Jimin clears his throat with exaggerated purpose. Agent Min's head snaps toward him while his hand remains steady under your nose.

"Jin." His voice carries an edge of urgency. "Ready?"

Jin's fingers move over his equipment. The device in his hands emits a soft hum at exactly 432 Hz, releasing a cloud of temporally charged particles that coalesce into a perfect sphere.

"Yeah." Jin lifts the sphere with careful movements. The air around it distorts slightly—light bending at impossible angles.

"What is that?" Your voice remains steady despite the way your skin prickles with increasing temporal static. Agent Min adjusts his gloved hand slightly, catching another drop of blood without breaking contact.

"Memory backup." Jin adjusts something on the sphere's surface. "This shouldn't hurt, but temporal cognitive recalibration can cause some discomfort."

"Discomfort," Jimin mutters. "That's one way to put it."

Agent Min shifts slightly—angling his body 3 degrees more toward you, his hand never leaving its position. A protective stance your mind recognizes from standard security training. But this feels... different. Personal.

"Your neural activity is spiking" he says, voice carrying that strange mix of professional distance and something else. Something that makes your chest tight. "We need to—”

"How many times have you done this?" The question slips out before your analytical mind can stop it.

His free hand twitches—an aborted movement toward you that he catches at exactly 2.7 centimeters of motion.

"Too many," he says softly. Then, catching himself: "A-735, focus on maintaining cognitive stability. Your vitals are—"

"Going crazy because you're too close," Jimin interjects helpfully. "Maybe step back a few meters? You know, for medical purposes? Her heart's about to beat out of her chest."

Agent Min doesn't move. If anything, he shifts 0.3 centimeters closer, his gloved hand remaining steady under your nose.

"The proximity helps with signature dampening," he says, voice clipped. But you notice his heart rate has increased to 68 BPM.

"She's already stabilized in here," Jimin sighs. "You heard the man.”

"You are wearing the gloves, right?" Hoseok asks suddenly, eyeing Agent Min's position. "Because the way you're hovering—"

"Of course I'm wearing the gloves," Agent Min snaps, though his hand remains perfectly steady under your nose.

"Just checking," Hoseok raises his hands in mock surrender. "Given your track record with protocol 47.3..."

An adjustment of your position creates an unexpected point of contact—your knee brushing against what your analytical mind immediately identifies as anatomically significant. You immediately begin calculating the exact angle and pressure of the contact before you register its implications. Your body's response is both immediate and puzzling—heart rate increasing by 12 BPM, skin temperature rising 0.24 degrees.

Position correction should be simple. Yet your body seems to know exactly how to shift to maximize the contact pressure—a knowledge that triggers several questions about muscle memory and timeline retention that you file away for later analysis.

His gloved hand remains perfectly steady under your nose through sheer force of will.

"Wow, that ceiling tile is fascinating," Jimin announces suddenly, tilting his head back with exaggerated interest.

"Absolutely riveting," Hoseok agrees, studying his shoes with intense concentration.

Jin becomes very focused on adjusting his equipment settings.

Agent Min's voice comes out exactly 0.7 octaves lower than usual: "A-735. Position adjustment required."

You move with deliberate precision, establishing appropriate professional distance. Your body protests the movement with an intensity that warrants further investigation—when you're not calculating the exact newtons of force his masseter muscle is exerting.

"7 minutes," he grits out, the words tight with restraint. His tongue presses visibly against his cheek as he inhales deeply. "Jin, if that sphere isn't ready in the next 30 seconds—"

"Working on it, boss," Jin responds, still very interested in his calibration dials.

"Maybe if you stepped back..." Jimin suggests helpfully, still studying the ceiling.

"Can't," Agent Min responds through what sounds like clenched teeth. "Nosebleed."

His gloved thumb twitches minutely against your skin. The movement suggests significant muscular tension—likely from maintaining precise control over multiple physiological responses.

"You could just let someone else—" Hoseok starts.

"No."

"You sure there hasn't been any... accidental contact?" Jimin drawls. "Because this is giving me déjà vu from timeline 466 when you claimed you were 'just stabilizing her' but really—"

"6 minutes," Agent Min cuts him off. His temperature rises another 0.2 degrees. "Seokjin.”

Jin holds up the sphere, which now pulses with a soft golden light that matches the traces you've seen Agent Min leave. "Ready. But Yoongi..."

"I know." Something in his voice makes you look up again. His eyes meet yours for exactly 1.2 seconds before he looks away, though his hand doesn't waver from its position. "It has to be different this time."

"It's always different," Jimin says quietly. "Doesn't change how it ends."

Your nose threatens to start bleeding again. You feel Agent Min's gloved thumb shift slightly against your skin, ready to catch any new drops.

Time: 01:59:00 AM.

Temporal stability: Rapidly decreasing.

Questions: Infinite.

The way your body leans toward him without conscious input: Concerning.

The way he maintains careful fabric barriers between every point of contact: Even more so.

next | index

taglist: @cannotalwaysbenight @livingformintyoongi @itstoastsworld @somehowukook @stuti2904 @chloepiccoliniii @kimnamjoonmiddletoe @ktownshizzle @yoongiiuu93 @billy-jeans23 @annyeongbitch7

no reposts, translations, or adaptations

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market-insider · 2 years ago

Text

Strategic Insights into the Clinical Trial Investigative Site Network Market

The global clinical trial investigative site network market size is expected to reach USD 12.5 billion by 2030. Growing investments in pharmaceutical R&D, increasing demand for new therapies and complications associated with site management of clinical trials are some of the major factors driving the growth of the industry. There has been a consistent rise the clinical trials in the last 5 years. For instance, according to ClinicalTrials.gov, over 262,298 trials were registered in 2018, whereas as of September 2022, over 399,518 trials were registered. The clinical trials are expected to grow even further as the funding for research improves.

Gain deeper insights on the market and receive your free copy with TOC now @: Clinical Trial Investigative Site Network Market Report

This is expected to propel the growth of the industry post-pandemic. There is a growing focus on reducing the cost associated with clinical research. Hiring a clinical trial investigative site network supports the regulatory function, improves the enrollment of participants, assists in data management, and quality assurance. It increases process compliance, reduces process issues with each trial, and helps with faster trial initiations, and shorter trial timelines. These factors are supporting the demand for clinical investigative site networks. The governments are actively trying to improve R&D by providing tax deductions. For instance, in January 2022, the Indian government stated that it is providing a weighted average tax deduction of up to 200% in R&D.

Such initiatives are expected to improve the R&D activities on drugs and thus support industry growth. According to the IQVIA, report on oncology trends, clinical trials for cancer have been increasing for the last 10 years. For instance, in 2011, 1,242 trials were registered for cancer, and as of 2021, 2,335 trials were registered for cancer. The number of clinical trials for cancer is expected to rise even further owing to the growing prevalence of the disease. This is expected to improve the demand for clinical investigative site networks for cancer clinical trials post-pandemic.

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mariacallous · 27 days ago

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Progress against H.I.V. marks one of the greatest accomplishments of biomedical research in history. Four decades ago, an H.I.V. infection meant an early, painful death. Scientists went on to develop powerful antiretroviral treatments that staved off AIDS and curbed H.I.V.’s spread. Yet, in 2023, 1.3 million people around the world became infected—more than thirty-five hundred per day, nearly a hundred and fifty every hour. Treatments only work if you take them, and many people do not know that they have H.I.V. Even for those who are aware of their status and can access the drugs, the virus integrates with human chromosomes and never clears, meaning that people living with H.I.V. must take medication for the rest of their lives. In 2023, almost forty million people were living with H.I.V., and six hundred and thirty thousand died from AIDS.

Then, in June, 2024, Moupali Das, the head of H.I.V. prevention for the pharmaceutical company Gilead Sciences, received an e-mail about lenacapavir, a drug being tested by the company to prevent the spread of H.I.V. The message authorized Das to see the results from an ongoing clinical trial in South Africa and Uganda. When she reviewed the data, at her company’s sprawling campus in Foster City, California, she had to move closer to her computer’s screen to confirm that she was reading the numbers correctly. She was dumbstruck: What she thought was a zero really was a zero. More than two thousand teen girls and young women had been injected with the drug, which stays in the body for an astonishing six months. In the first year of the trial, each received two shots, and none of them became infected with H.I.V. “It was phenomenal,” Das told me. “We thought it was going to work, but none of us thought it was going to be one hundred per cent.” Three months later, the drug demonstrated ninety-six-per-cent efficacy in a similar trial that had enrolled more than three thousand men, transgender men and women, and nonbinary people who have sex with men.

For nearly twelve years, Gilead had been selling a pill named Truvada as a preventive treatment called pre-exposure prophylaxis, or PrEP. The drug worked remarkably well in clinical trials, but many healthy people had difficulty taking a daily pill, and others faced stigma and discrimination from sexual partners. Another company, ViiV Healthcare, brought a PrEP injection to market in 2021, but it only lasts two months, and remains little used. If two shots a year offered the same protection, Das knew, it could revolutionize H.I.V. prevention. On June 18th, the F.D.A. approved lenacapavir for PrEP. A stunning new era is upon us. But, as world leaders dismantle global health programs and cut back foreign aid, will this extraordinary new technology be able to change the world?

When scientists first started talking about using drugs to prevent the spread of H.I.V., few expected that Gilead would be the company to develop them. In the early nineteen-nineties, the top anti-H.I.V. drugs on the market had at most a modest impact: they were reserved for people with severely damaged immune systems and, at best, only extended life by a few years. Side effects included diarrhea, nausea, headaches, and anemia. As the death toll approached a million per year, big pharmaceutical companies competed to create better treatments. Gilead, a small corporation that had a few hundred employees, was an underdog in the race. But it licensed a promising compound, tenofovir, from academics in Europe.

During that bleak era, Che-Chung Tsai, a researcher at the University of Washington, contacted several companies, seeking experimental drugs for use in an animal study. Gilead sent him an early form of tenofovir, which produced remarkable results. When a group of monkeys were given the compound before being exposed to H.I.V.’s simian cousin, S.I.V., not a single one was infected. What’s more, the drug had no significant adverse effects.

H.I.V. is made up of single-stranded RNA rather than double-stranded DNA. To infect its host, it enters white blood cells, uses a viral enzyme called reverse transcriptase to convert its RNA into DNA, and hijacks the cell’s machinery to make more copies of itself. Tenofovir works by crippling this enzyme. In a person with H.I.V., tenofovir prevents the virus from making new copies of itself.

Yet tenofovir also showed promise for people who did not have H.I.V. The monkey study found that, when a healthy animal received tenofovir, the virus was like a bullet that fell to the ground before striking its target: the RNA virus couldn’t convert itself into DNA, so it couldn’t splice itself into the DNA of the host.

Despite the drug’s potential as PrEP, Gilead made little effort to support the research: preventive drugs had unique risks. In uninfected people, it’s harder to prove that the benefits of a drug will outweigh potential risks, raising liability concerns. Some feared that widespread use of PrEP might breed resistant strains of the virus itself. And although millions of H.I.V.-positive people were desperate for effective drugs, it wasn’t clear that people at the highest risk of infection—gay men, sex workers, people who injected drugs, sexually active heterosexuals in sub-Saharan African countries—would want PrEP or be able to access it. And so Gilead focussed instead on the lucrative and stable market of H.I.V. treatments. In 2001, tenofovir won F.D.A. approval for treating H.I.V. infections. The next year, the drug accounted for about half of the company’s sales.

Gilead’s disinterest in PrEP deeply frustrated academic researchers. In 2003, to confirm that tenofovir would work as well in humans as it had in monkeys, researchers announced plans to recruit sex workers for a clinical trial in Cambodia. Gilead kept itself at a distance from the study; the National Institutes of Health (N.I.H.) and the Bill and Melinda Gates Foundation offered to fund the research. But some AIDS activists were enraged by the trial’s design. They argued that researchers were introducing risk of infection to people in a country with limited treatment resources. In July, 2004, at an international AIDS conference in Bangkok, a group descended on a Gilead Sciences booth and plastered it with posters: “Sex Workers Infected by Gilead,” “Tenofovir Makes Me Vomit,” and “Gilead Prefers us HIV+.” As news cameras from around the world gathered around the scene, the activists covered signs in fake blood. Soon after, the trials in Cambodia were abandoned. Though Gilead provided academic researchers use of the compound for PrEP studies, they declined to pursue further preventive testing on their own.

A month after the Bangkok conference, the F.D.A. approved a new H.I.V. treatment, produced by Gilead, called Truvada, which combined tenofovir with a second drug. At the time, regimens typically required three drugs, several times a day. The new compound, a pill taken once a day, could be combined with just one other drug, simplifying treatment. By 2006, Truvada was the best-selling anti-H.I.V. drug on the market.

Flush with cash, Gilead launched an ambitious project to create a new drug targeting an H.I.V. protein called capsid. Many scientists saw Gilead’s project as folly: viral proteins have no obvious weaknesses, making them far less druggable than viral enzymes. Researchers had long thought that capsid proteins—which link together to form a protective shell, known as a cone, around the RNA—simply fell apart after infecting a cell. But a series of stunning discoveries found that the capsid cone not only survives infection but plays a far more complex role in the production of new viruses. With this insight, Gilead tested thousands of compounds, leading to the discovery, in 2012, of what would become lenacapavir.

That same year, Gilead finally sought F.D.A. approval for Truvada as PrEP. It was approved in July. A drug for prevention was a major turning point, yet it was met with ambivalence by some of the communities most affected by the virus. Even the primary market for the drug, gay men in the United States, had strong reservations about taking the pills to protect themselves. Critics feared it created incentives for uninfected men to abandon condoms and increase their number of sexual partners, undermining years of hard-won progress in prevention. Worries ran so high that some gay men for a time slagged people who used PrEP as “Truvada whores.”

Truvada PrEP steadily gained popularity, and as it grew cheaper it became more widespread in poorer countries. In March, 2019, Gilead reported that lenacapavir had performed well in early human studies. Gilead’s risky investment was showing signs of paying off—and this time, the company was eager to get ahead of its critics.

In December, 2019, Das flew to Kigali, Rwanda, to meet with community advocates and public-health leaders from across the continent. Lenacapavir was going to be tested as a prevention tool; the company wanted input on the design of the trials. How could the company’s researchers avoid the community opposition that had dogged the Cambodia trial? Should they include pregnant people? What about adolescents as young as sixteen? Earlier research had been roundly criticized for excluding both groups, as well as for cutting out trans people and anyone taking hormones. Yvette Raphael, a human-rights activist who chairs the African Women Prevention Community Accountability Board, left the meeting reluctantly impressed. “It was tough because, obviously, they are a pharmaceutical company, and we are advocates,” Raphael said recently. “We’d like to see more transparency from them—but they really have tried.”

The company has also made efforts to increase access to preventive lenacapavir. After a drug is approved, years often pass before generic manufacturers are allowed to sell it at a discount. But in October, 2024, Gilead—still months away from even seeking F.D.A. approval—announced that it had cut a deal with six generic manufacturers to provide low-cost versions of lenacapavir PrEP to a hundred and twenty poorer countries. While those producers are getting up and running, a process that may take an estimated two years, Gilead will sell lenacapavir to the same countries at cost. “They learned from their mistakes,” Mitchell Warren, the executive director of AVAC, an advocacy group for PrEP and other H.I.V.-prevention interventions, told me. “At least conceptually, this is one of the most transformational moments in H.I.V. prevention ever.”

Two months later, near the end of the Biden Administration, a major partnership set out to make injectable preventive lenacapavir available to at least two million people during its first three years on the market. It would bring together the President’s Emergency Plan for AIDS Relief, or PEPFAR; the deep-pocketed Global Fund to Fight AIDS, Tuberculosis, and Malaria; the Gates Foundation; and the Children’s Investment Fund Foundation.

Then came another seismic shift in the H.I.V./AIDS world. On the day President Donald Trump took office, his Administration began dismantling PEPFAR, which has spent more than a hundred and twenty billion dollars in more than fifty countries over the past two decades—not only to support the treatment of twenty million people but also to purchase and deliver more than ninety per cent of PrEP drugs used globally. A State Department memo in February stated that, during this pause of U.S. Foreign Assistance or until further notice, PEPFAR could only support PrEP for pregnant and breast-feeding women.

The fate of the rollout of lenacapavir PrEP remains murky. Although neither the Gates Foundation nor the Global Fund has committed to honoring their original pledge, both have indicated that they still plan to support “equitable access” to lenacapavir PrEP. (What this means, in practice, is difficult to say.) The White House, earlier this month, released its Congressional Budget Justification for fiscal year 2026 that calls for continued support for PEPFAR, with a budget cut of thirty per cent and a desire to speed its elimination; it specifically mentions funding for “high cost-efficiency biomedical tools, such as a twice-a-year HIV prevention injection.”

Injectable lenacapavir, despite its clear benefits, faces several other financial, political, and cultural challenges that have dogged PrEP from the outset. Will insurance companies reimburse for it in full? How aggressively will health officials promote its use? Will communities embrace it? “We have not seen evidence of the bigger resources being devoted and the political will to do what needs to be done to get any of these PrEP options into the populations that need it the most,” says Raphael Landovitz, an H.I.V./AIDS researcher at the University of California, Los Angeles, who has helped run other PrEP studies. “Everything we have seen is incremental. And so I fear that this is going to be yet another incremental improvement.”

Then again, Landovitz speaks for many when he describes the results from the two lenacapavir clinical trials as “stunning.” And he notes that a near-hundred-per-cent protection from infection “is better than I think we could ever have hoped for from a prophylactic vaccine.”

Eleven years ago, the Joint United Nations Programme on H.I.V./AIDS announced a “fast-track” strategy to “end the AIDS epidemic.” Thanks to testing, treatment, and prevention tools like PrEP, infection rates were dropping year after year. UNAIDS contended that if the number of new infections were to drop as low as two hundred thousand a year by 2030, the AIDS pandemic would, effectively, end.

The world, of course, is way off target.

In March, at a large H.I.V./AIDS conference held in San Francisco, Gilead scientists reported new data from a small human study suggesting that higher doses of lenacapavir allow the drug to protect the body for more than a year. At the same meeting, however, researchers were reeling; the Trump Administration had just laid off thousands of scientists at the N.I.H. and the Centers for Disease Control and Prevention, and cut funding to their universities, their research grants, and clinical-trial networks that test new medicines.

It was another blow: the cutbacks to research joined slashes to global health programs, threatening to slow down decades of progress.

Scientists and researchers continue to warn that such disturbances will hobble future innovations. More immediately, lenacapavir PrEP may be able to reach only a small percentage of the people who stand to benefit. Even if Gilead and its supporters are able to insure equitable access, the U.S government’s retreat from the fight against H.I.V. and AIDS will present new challenges and new infections. Will this powerful new medicine counteract the damage? Or will lenacapavir PrEP, which could change the world, only maintain the status quo?

In wealthy countries where insurance companies or governments cover most of the price of drugs, the new medicine will likely build a market. But most people who are at high risk of H.I.V. infection live in countries that have long relied on governments such as the U.S. to prop up their limited investments in health care. Even with discounted pricing and market competition driving costs down further in time, testing for infection and delivering drugs is expensive, too. It’s hard to see how lenacapavir PrEP will live up to its promise without new infusions of financial assistance.

Some H.I.V./AIDS advocates have criticized Gilead for not yet cutting a deal to offer discounted lenacapavir to middle-income countries. Then, there’s South Africa, which has more people living with H.I.V. than any other nation and funds the bulk of its own response to its epidemic. The country pays a mere forty-one dollars to provide a person with an annual supply of PrEP pills; will they pay more for two long-acting injections?

Injectable lenacapavir cannot, on its own, end the H.I.V./AIDS epidemic. The world still needs a cure for the tens of millions now living with H.I.V. and a prophylactic vaccine that can outlast a year. Other prevention tools exist, and more are being developed. But, even in the wake of dramatic setbacks, companies such as Gilead, in concert with nonprofits, clinicians, advocates, philanthropists, and foreign governments, could collectively insure that this remarkable drug is accessible to all. Then its success will depend on the medicine itself—and on the interest of those who have the option to use it.

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mostlysignssomeportents · 2 years ago

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The surveillance advertising to financial fraud pipeline

Monday (October 2), I'll be in Boise to host an event with VE Schwab. On October 7–8, I'm in Milan to keynote Wired Nextfest.

Being watched sucks. Of all the parenting mistakes I've made, none haunt me more than the times my daughter caught me watching her while she was learning to do something, discovered she was being observed in a vulnerable moment, and abandoned her attempt:

https://www.theguardian.com/technology/blog/2014/may/09/cybersecurity-begins-with-integrity-not-surveillance

It's hard to be your authentic self while you're under surveillance. For that reason alone, the rise and rise of the surveillance industry – an unholy public-private partnership between cops, spooks, and ad-tech scum – is a plague on humanity and a scourge on the Earth:

https://pluralistic.net/2023/08/16/the-second-best-time-is-now/#the-point-of-a-system-is-what-it-does

But beyond the psychic damage surveillance metes out, there are immediate, concrete ways in which surveillance brings us to harm. Ad-tech follows us into abortion clinics and then sells the info to the cops back home in the forced birth states run by Handmaid's Tale LARPers:

https://pluralistic.net/2022/06/29/no-i-in-uter-us/#egged-on

And even if you have the good fortune to live in a state whose motto isn't "There's no 'I" in uter-US," ad-tech also lets anti-abortion propagandists trick you into visiting fake "clinics" who defraud you into giving birth by running out the clock on terminating your pregnancy:

https://pluralistic.net/2023/06/15/paid-medical-disinformation/#crisis-pregnancy-centers

The commercial surveillance industry fuels SWATting, where sociopaths who don't like your internet opinions or are steamed because you beat them at Call of Duty trick the cops into thinking that there's an "active shooter" at your house, provoking the kind of American policing autoimmune reaction that can get you killed:

https://www.cnn.com/2019/09/14/us/swatting-sentence-casey-viner/index.html

There's just a lot of ways that compiling deep, nonconsensual, population-scale surveillance dossiers can bring safety and financial harm to the unwilling subjects of our experiment in digital spying. The wave of "business email compromises" (the infosec term for impersonating your boss to you and tricking you into cleaning out the company bank accounts)? They start with spear phishing, a phishing attack that uses personal information – bought from commercial sources or ganked from leaks – to craft a virtual Big Store con:

https://www.fbi.gov/how-we-can-help-you/safety-resources/scams-and-safety/common-scams-and-crimes/business-email-compromise

It's not just spear-phishers. There are plenty of financial predators who run petty grifts – stock swindles, identity theft, and other petty cons. These scams depend on commercial surveillance, both to target victims (e.g. buying Facebook ads targeting people struggling with medical debt and worried about losing their homes) and to run the con itself (by getting the information needed to pull of a successful identity theft).

In "Consumer Surveillance and Financial Fraud," a new National Bureau of Academic Research paper, a trio of business-school profs – Bo Bian (UBC), Michaela Pagel (WUSTL) and Huan Tang (Wharton) quantify the commercial surveillance industry's relationship to finance crimes:

https://www.nber.org/papers/w31692

The authors take advantage of a time-series of ZIP-code-accurate fraud complaint data from the Consumer Finance Protection Board, supplemented by complaints from the FTC, along with Apple's rollout of App Tracking Transparency, a change to app-based tracking on Apple mobile devices that turned of third-party commercial surveillance unless users explicitly opted into being spied on. More than 96% of Apple users blocked spying:

https://arstechnica.com/gadgets/2021/05/96-of-us-users-opt-out-of-app-tracking-in-ios-14-5-analytics-find/

In other words, they were able to see, neighborhood by neighborhood, what happened to financial fraud when users were able to block commercial surveillance.

What happened is, fraud plunged. Deprived of the raw material for committing fraud, criminals were substantially hampered in their ability to steal from internet users.

While this is something that security professionals have understood for years, this study puts some empirical spine into the large corpus of qualitative accounts of the surveillance-to-fraud pipeline.

As the authors note in their conclusion, this analysis is timely. Google has just rolled out a new surveillance system, the deceptively named "Privacy Sandbox," that every Chrome user is being opted in to unless they find and untick three separate preference tickboxes. You should find and untick these boxes:

https://www.eff.org/deeplinks/2023/09/how-turn-googles-privacy-sandbox-ad-tracking-and-why-you-should

Google has spun, lied and bullied Privacy Sandbox into existence; whenever this program draws enough fire, they rename it (it used to be called FLoC). But as the Apple example showed, no one wants to be spied on – that's why Google makes you find and untick three boxes to opt out of this new form of surveillance.

There is no consensual basis for mass commercial surveillance. The story that "people don't mind ads so long as they're relevant" is a lie. But even if it was true, it wouldn't be enough, because beyond the harms to being our authentic selves that come from the knowledge that we're being observed, surveillance data is a crucial ingredient for all kinds of crime, harassment, and deception.

We can't rely on companies to spy on us responsibly. Apple may have blocked third-party app spying, but they effect nonconsensual, continuous surveillance of every Apple mobile device user, and lie about it:

https://pluralistic.net/2022/11/14/luxury-surveillance/#liar-liar

That's why we should ban commercial surveillance. We should outlaw surveillance advertising. Period:

https://www.eff.org/deeplinks/2022/03/ban-online-behavioral-advertising

Contrary to the claims of surveillance profiteers, this wouldn't reduce the income to ad-supported news and other media – it would increase their revenues, by letting them place ads without relying on the surveillance troves assembled by the Google/Meta ad-tech duopoly, who take the majority of ad-revenue:

https://www.eff.org/deeplinks/2023/05/save-news-we-must-ban-surveillance-advertising

We're 30 years into the commercial surveillance pandemic and Congress still hasn't passed a federal privacy law with a private right of action. But other agencies aren't waiting for Congress. The FTC and DoJ Antitrust Divsision have proposed new merger guidelines that allow regulators to consider privacy harms when companies merge:

https://www.regulations.gov/comment/FTC-2023-0043-1569

Think here of how Google devoured Fitbit and claimed massive troves of extremely personal data, much of which was collected because employers required workers to wear biometric trackers to get the best deal on health care:

https://www.eff.org/deeplinks/2020/04/google-fitbit-merger-would-cement-googles-data-empire

Companies can't be trusted to collect, retain or use our personal data wisely. The right "balance" here is to simply ban that collection, without an explicit opt-in. The way this should work is that companies can't collect private data unless users hunt down and untick three "don't spy on me" boxes. After all, that's the standard that Google has set.

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/2023/09/29/ban-surveillance-ads/#sucker-funnel

Image: Cryteria (modified) https://commons.wikimedia.org/wiki/File:HAL9000.svg

CC BY 3.0 https://creativecommons.org/licenses/by/3.0/deed.en

#pluralistic #commercial surveillance #surveillance #surveillance advertising #ad-tech #behavioral advertising #ads #privacy #fraud #targeting #ad targeting #scams #scholarship #nber #merger guidelines #ftc #doj

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