#randomized controlled trial

[dontmeantobepoliticalbut]

A new landmark study has found that access to gender-affirming healthcare significantly reduces rates of depression, gender dysphoria, and suicidality among transgender people.

While it’s no secret that providing gender-affirming care to transgender individuals who ask for it can greatly benefit their well-being, an increase in transphobic rhetoric and bans on gender-affirming healthcare has prompted thorough medical studies into the impact of such care.

Now, brand new research conducted in Melbourne, Australia, has found that allowing transgender people to access the care they’re after can reduce suicidality by a stunning 55%.

As part of the first-ever randomized controlled trial (RCT) on gender-affirming care, researchers took 64 transgender and gender-diverse adults who had been looking to start testosterone therapy and randomly split them into a treatment group and a control group.

While the treatment group was allowed to begin hormone therapy that week, the control group waited three months for their treatment to begin.

Before the study began, both groups were evaluated on depression, gender dysphoria, and suicidality. Three months later, the two groups were evaluated again.

RCTs for medical care can often be hard to conduct due to practical and ethical concerns. However, researchers of this study found a way to hold an RCT for this study by incorporating a shorter follow-up period. Rather than giving the control group a placebo drug, or no treatment at all, they were simply given a longer wait time.

The results showed a notable decrease in gender dysphoria, depression, and – most significantly – suicidality.

The group that received gender-affirming care right away saw a 55% reduction in suicidality compared to a 5% drop within the control group.

Depression scores in the treatment group decreased by half, while gender dysphoria rates also significantly decreased.

Breaking down their findings, researchers Brendan J. Nolan MBBS, Sav Zwickl, PhD, and Peter Locke wrote: “There was a statistically significant decrease in gender dysphoria in individuals with immediate [access to gender-affirming care] compared with delayed initiation of testosterone therapy.”

“A clinically significant decrease in depression and a decrease in suicidality also occurred with immediate testosterone therapy.”

“The findings of this trial suggest that testosterone therapy significantly decreases gender dysphoria, depression, and suicidality in transgender and gender-diverse individuals desiring testosterone therapy.”

Of course, this isn’t the first time that research has shown significant drops in depression and suicide rates among transgender individuals who receive gender-affirming care.

A 2022 medical study showed that young transgender people who have access to puberty blockers are 73% less at risk of suicide and report improved well-being.

But, as anti-trans activists advocate for further bans on gender-affirming care, one of the key arguments is that the evidence in support of the care isn’t up to scratch with GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) standards.

So research like this landmark RCT is so significant to the transgender community and its allies as the fight for their healthcare rights rumbles on.

[irispublishersgastroenterology]

28 Day Randomized Double-Blind Placebo Controlled Trial using Pre-Polymerized Cross-Linked Sucralfate Barrier (Esolgafate) for Erosive GERD

Abstract

Background: Treatment of erosive gastroesophageal reflux disease (eGERD) centers on control of acid pH using proton pump inhibitors (PPI), histamine 2 receptor antagonists (H2RA) and antacids (AA). However, the presence of bile and serine proteases in gastric refluxate, not addressed by PPI, H2RA or AA, is suspected to be associated with onset of Barrett’s esophagus and rise of esophageal adenocarcinoma. Pre-polymerized sucralfate barrier therapy (PPSBT) recognized first by US FDA as a medical device has enhanced bio adherence and blocks access of acid and non-acid irritants to the mucosa.

Aim: To evaluate the efficacy of mucosal protection by PPSBT for the treatment of erosive GERD.

Methods: In a 28 day statistically powered, multi-center randomized double-blind placebo controlled trial, 19 patients with eGERD were randomized to receive PPSBT or placebo. Antacids were available to each group for breakthrough pain. Treatment effect on erosions and eGERD symptoms (heartburn & reflux sensation) were evaluated. Adverse events were assessed.

Results: For patients taking PPSBT, 89% and 78% had relief of heartburn and reflux respectively compared to 25% and 12.5 % of those on placebo. Complete healing occurred in 89% taking PPSBT compared to 25% of those on placebo. No adverse events occurred.

Conclusions: Enhanced mucosal protection by PPSBT demonstrates effective symptom control and erosion healing in patients with eGERD. Acid-indifferent cytoprotection from acid, bile and serine proteases by PPSBT may be a useful adjunct in management of eGERD, and a return to the past for the future.

Read More About This Article : https://irispublishers.com/ajgh/fulltext/28-day-randomized-double-blind.ID.000528.php

Read More Iris Publishers Google Scholar Article: https://scholar.google.com/citations?view_op=view_citation&hl=en&user=Wws4PocAAAAJ&cstart=20&pagesize=80&citation_for_view=Wws4PocAAAAJ:YOwf2qJgpHMC

[hezuart]

What do you think is wrong with Belos as a villain?

His plan is ridiculously long and convoluted, and we don't really get clear motivations behind his actions. On top of it all, he was so pissed off with his brother for falling love with a witch. Instead of blaming the witch or feeling hurt over his brother's choice, he went an even weirder route of cloning his own brother to manipulate, lie, then kill the clones in cold blood for several generations... for no good reason.

[religion-is-a-mental-illness]

[lostconsultants]

Measuring Change: Methods and Best Practices for Accurate Results

Measuring change is crucial in many fields, including business, science, education, and personal growth. It helps track progress, identify areas of improvement, and make informed decisions. However, measuring change is not always straightforward, and it involves several factors that can impact the accuracy of the results. In this blog post, we will explore common methods for measuring change,…

[neonatalresearch]

How should we pasteurize donor breast milk?

The standard method of pasteurization of donor breast milk, and I believe the only method approved by HMBANA (the human milk banking association of north america), is similar to what Louis Pasteur himself came up with a couple of centuries ago (in about 1865). I’m not sure why its called Holder pasteurization, it may be because the temperature is “held” at 62.5 degrees for 30 minutes, or maybe…

[impriindia]

Randomized Control Trials (RCTs) - IMPRI Impact And Policy Research Institute

Session ReportAasthaba Jadeja An online International Winter School Program on “Impact Evaluation in Practice” is a five-day  immersive online hands-on certificate training course organized by IMPRI Impact and Policy Research Institute, New Delhi. The day 2 of the program started with a session on “Randomised Control Trials(RCTs)” by Ms. Vasanthi Subramonia Pillai and Mr. Ankit…

[islamiceconomicsproject]

Do Islamic Microfinance Institutions Affect the Socio-economic Development of the Beneficiaries

Paper Title: Do Islamic Microfinance Institutions Affect the Socio-economic Development of the Beneficiaries? The Evidence from Turkey Author:        Salih Ülev, Fatih Savaşan, Mücahit Özdemir Publisher:    International Journal of Ethics and Systems, Vol. 39(2), 286 – 31.  This paper aims to investigate the effect of Islamic microfinance on poor households through the case of the IKSAR Qard…

[chinesegreenteagoldentriangle]

Explore the potential benefits of long-term tea consumption for cardiovascular disease

Cardiovascular disease is a leading cause of death worldwide, and tea is one of the most widely consumed beverages and a primary source of caffeine for adults. The habit of drinking tea originated in China thousands of years ago, but has since spread worldwide. Evidence from observational and randomized controlled studies suggests that green tea has many potential benefits in reducing the risk of cardiovascular disease. These benefits include reducing the risk of major cardiovascular events, lowering blood pressure, reducing low-density lipoprotein cholesterol (LDL-C) levels, and aiding in weight loss.

At the same time, the physiological mechanisms by which tea confers cardiovascular benefits are being elucidated. Studies have found that tea polyphenols, particularly catechins, are the primary components responsible for the cardiovascular protective effects of tea. Clinical evidence shows that tea consumption can lower the risk of coronary heart disease, heart failure, arrhythmias, stroke, cardiovascular disease, and all-cause mortality. In population-based studies, higher tea intake, especially of green tea, is associated with increased survival-related cardiovascular benefits.

Cardiovascular disease is the leading cause of death worldwide, with approximately 4 million deaths attributed to it in 2017, accounting for one-quarter of all deaths. In China, coronary heart disease and stroke have become the leading causes of death. Therefore, the challenge of how to prevent cardiovascular disease through daily diet is urgent. The idea of drinking tea for health benefits has been circulating in society for a long time, and studies have been conducted in countries such as the United States and Japan, indicating that moderate tea consumption can lower the incidence of cardiovascular disease and overall mortality. However, due to cultural and lifestyle differences and disease spectra, this conclusion cannot be directly extrapolated to the Chinese population.

Tea, especially green tea, is a rich source of flavonoids, including catechins, epicatechins, and epigallocatechin gallate. Mechanistic studies have shown that these biologically active compounds can alleviate oxidative stress, relieve inflammation, and enhance endothelial and myocardial cells. Observational studies and randomized controlled trials have also shown that these biologically active compounds can alleviate risk factors for coronary heart disease, including hypertension and dyslipidemia. In contrast, the tea polyphenols in black tea are oxidized into pigments and inactivated during the fermentation process, resulting in weaker associations with health benefits.

[circeyoru]

Darkest Confession = Requested

[Human!Alastor x Serial Killer Enthusiast!Reader]

Everyone have that one thing that really really sets them apart from the group, right? Some can be way too addicted with coffee that they don’t sleep much cause of it, or some can be so obsessed with ducks that they have a whole collection of it (ahem Lucifer ahem anyways…). Either way, usually it’s harmless

No, not you

You were no police officer or detective, or any career related to crime. You were someone simple working from place to place, always moving. Yet you found yourself engrossed with the art of killing. No, you don’t kill yourself. But you love to read about the people that do, specifically, serial killers

To just have the urge to kill and do it then deal with the consequences. It was like the most extreme of goal making. The thing with serial killers is that they mostly pick random people off the streets and kill for whatever reason they have. One can’t link the killings back to the killer because there was none! Oh, how you eat those stories up like a bedtime story

You somewhat study serial killers and their killings, feeling drawn to them enough that you’d move from place to place. It was your drive and your calling. One you keep quite deep down, you’d let this side of you out from time to time, but you had to control it since some might think you deserve the straight jacket or put in a hospital, or just label you as mental

Close friends and your family knew this side of you and said one day you’d be in deep waters for this interest of yours. They had advised you to stop and just push it away, find something else to think. Maybe a romantic partner that you can settle down with?

Hell no! (like Charlie to Val)

You follow serial killer stories from place to place. As sad that it was to know it after the killings were brought to light because of the slow news outlet, you take what you can. You’d mostly maybe catch a glimpse of the killer, behind bars or during trials

There was a few close calls. You recall yourself impersonating a reporter to interview the killer and your interest in them got them to talk, but you had to left before someone caught on you weren’t a reporter. Another time, a writer hired a helper to talk with a killer on trial, you wrote so much notes that the writer wanted you long term

Still no, you left to follow more serial killers when you could

You heard of a serial killer at large. In New Orleans, City in Louisiana. You heard it over the radio from a rising host that took over the hearts of the people, even outside of his hometown. He detailed the killings, even claiming to have seen a few of the bodies alongside the police so he could offer a clearer picture to the listeners of the horrors the killer can do and wasn’t afraid to show off

A serial killer still free and in society. While the other listeners in the cafe shivered and whispers to each other to be cautious or relief that the killer wasn’t in their town or city, you were planning your next travel

Next stop the New Orleans, hunting ground of the Bayou Serial Killer

Settling down was easy since you had been so custom to it. Like always, you wandered a bit, get the feel of the place and its people, the vibe of the city so you can fit in. Then you visited the place where the bodies were found, information provided by the local newspaper and the radio talkshows

You didn’t know then. That someone was following you after a few of your visits to the body dumping grounds. You certainly didn’t know that chance encounter with the radio host was staged

“I’d like coffee, black!” You heard the familiar voice ring. You didn’t have to look up to know the customers and staff members of the cafe all drawn to the man that ordered at the counter. You rolled your eyes. It was the famous radio host, Alastor, he started frequenting this cafe only recently (when you showed up in town) and would take his morning coffee here before he goes live

If only he was a serial killer or someone close to one… You remember the first time seeing him when he entered the cafe. You wanted to approach him, but he was always eyed by the people that put him on a pestasole. You learned to stay clear of people like that because, there were always some fans crazier than the other. Take yourself as an example, with your obsession and addiction to killers

“May I join you, my dear fellow?” Your eyes quickly scanned the place. Why was it so full today? You didn’t say anything and just gestured to the empty seat opposite to you in your booth. Great, now you had to go to work early because you wanted to avoid him. Wait

“Are you writing your script now?” You blinked at the notepad Alastor started to scribble over, you couldn’t just start by asking ‘are you writing your script on the serial killer? Can I see, please?’. Your keen eyes caught the words ‘serial killer’ and ‘bodies’

Alastor chuckled and said he was merely reorganizing his thoughts so he could envision his radio host as smoothly as possible for the listeners. You blink ‘for the listeners’, again with that. But does he really put others first behind himself? Somehow you didn’t think so

Of course his notes got you to put your attention on him. Alastor had to internally grin. He noticed a new face in town after some time. Then he noticed you going to his dumping grounds. He had thought you were a new detective or police to hunt him down by looking over new evidence. He thought he was right when he saw you noting down the surroundings even with the absence of the body

You were followed carefully to check if you had family and/or friends that would make a fuss of your disappearance. When you had none, he thought you were an easy target. But you weren’t a detective nor a police. Imagine his surprise when he only found you returning home. Never once had you went to the police with that notepad of yours

Odd

So he followed some more. It then that he noticed you had a spark in your eyes whenever serial killers or their killings were mentioned. While other would shiver with the sight of fear in their eyes, you had interest and excitement. So odd, but he didn’t dislike it. It fueled his interest in you

He tried striking conversations with you, but you were so plain and common, one he can brush off as a local polite individual. You fitted in with the commonality that quickly and easily. Though his concern was your disinterest and ignorance to him, he once let his assistant to play a pre-recorded show to see your reactions to his killings reported

There it was. You and that spark of yours with that notepad and pen, writing so furiously like you were possessed. You were more expressive and childish even, swaying from side to side, tapping your feet, drumming your fingers. It was like he witnessed your true self. He confirmed it when the topic changed and like a switch, you were that mundane self of yours

It was all so fasincinating to him and he had to talk to the real you. So he staged this meeting. He was right on the money, you would start off with someone common, then poke at your interest, wanting him to start the topic so you’d be involved. Slowly and with time though, you’d just talk outright with him

It was routine for him, meeting you before his show at that cafe and in their secluded booth you basically marked your own when it was in the morning. He’s review his notes with you and then talk about the (his) killings with you, the newest discoveries, the clues that detectives and polices missed, all that juicy details you’d like

Another problem came. You saw him as a friend. He saw you as a romantic interest

To you, it was rare that you could connect this much with someone. No one back home, not even your closest family members and frends, would indulge with you in this interest of yours. No matter how much you spoke your thoughts on serial killers and their killings, Alastor didn’t push you away and even ask questions on your thoughts. You cared so much for him, as a friend, but he wasn’t your interest

To him, you were now one of his reason to kill more. That bloodlust was on par with the spark you’d have in your eyes when he struck again. Some poor victim died and you only focused on him, the killer! He once compared you to his friend Mimzy, she knew and helped his killings, but she didn’t give him the same joy and bubbly emotions he’d have when talking to you about his kills. It wasn’t the same. So were you the one? The one to his cold dark heart.

And he confessed. More than just his feelings

“My dearest darling, I would be so honoured if you’d agree to allow me the once-in-a-lifetime opportunity to officially court you.”

“No.” There was no hesitation in your voice, nor was there a pause. “Sorry, Alastor, I just considered myself married to serial killers. Or at least, this one in your town. I love them no matter what. So I can’t accept your feelings. But I hope we can continue being fr—”

Alastor held onto you, it was just a stroke of luck that this place was the secluded forest he was familiar with. He kneeled down on one knee and kissed your knuckles, his eyes staring straight at you with that crazed look in his eyes and that murderous grin he only let his victims see, “Allow me to reintroduce myself. My name is Alastor, the Bayou Serial Killer.”

Note: I had SO MUCH FUN writing for this. Thank you for suggesting this, Any~ (I’ll just call all the anonymous asks this from now on). I would tag the person but this is anonymous request (╯︿╰)

Requests are open, but keep in mind of what I wrote in the Masterlist. I’ll ultimately decide whether or not to write for them. Thanks!

Circe Y.

MASTERLIST

[mrsdarkandyandere7]

❤ Yandere Lawyer ❤

▶ This is a yandere/dark work and it may contain triggering content so please READ THE WARNINGS before. Do not read if minor.

More at Masterlist

Female reader

WARNINGS: Obsession; Misogyny; slight Power Abuse.

This idea credit goes to @d-lioncourt cause she's the one that motivated me for this idea. Hope you like this :)

--

◾ Yandere! Lawyer who works in the top law firm of the country. He’s cold, determinate and calculative. Always thinking 10 steps ahead of everyone, carefully considering all possibilities and creating extensive back-up plans. 

His job relies on his capacities and he always aims for the top. If he’s not recognized as the best lawyer available, then he doesn’t even know what he’s been doing so far. 

◾ Yandere! Lawyer who doesn't care about how things are done as long as he wins the case in the end. Who said lawyers are saints?

He may be an advocate of the law but that doesn’t mean he doesn’t bend it to his will, finding sneaky gaps to reach his goal: win. 

Isn’t that what makes him such a requested lawyer? Isn’t that what causes every big corporate company to try to sign him up, to offer several millions for him to represent them in court? Because everyone knows that he wins.

No matter what happens during the trials or how badly the opposite side tries, he wins. It’s an irrefutable truth and anyone that tries to contradict it is a complete and utter fool. 

◾ Yandere! Lawyer who is upset enough when he’s informed that he’s gonna have to take a Pro Bono case for a random civilian. It’s frustrating to spend his precious time and expensive resources on a worthless someone.

It’s stupid and he'd immediately refuse it if it wasn’t for the strict order he receives from the higher ups.  

◾ Yandere! Lawyer who rattles you up, insisting on long sessions so he can know your side of the story.

His questions feel like accusations and you hate spending long hours answering him. Makes you feel like you’ve actually committed a crime of sorts when the reality is none of that. 

He knows you’re bothered by the way he pays attention to each of your words, taking mental notes of every minuscule detail so he can bring it up later.

He’s highly aware of how unnerving he can get and it’s fun to see you get so quiet and shy over it. 

He loves it when people get intimidated by him and it’s particularly pleasant when a pretty thing like yourself gets too timid to spare him a few words. 

◾ Yandere! Lawyer who drags the case much longer than it needs to. He could definitely end it in a blink of eyes, it would be so easy for him. A piece of cake. 

But he doesn’t. 

It’s exciting to see you on court, a helpless expression covering your whole face and your eyes at the verge of tears as your future lays on his hands.  

So pathetically weak. You can’t even defend yourself, you need him to do that for you. To defend your honor, to protect you. 

◾ Yandere! Lawyer who makes sure you know that despite it being a Pro Bono case, you owe him. He wants you to know that he’s winning this case for you, wasting his valuable time just to save your pathetic ass from those embezzlement charges. 

That he’s the one saving you from going to prison - despite the very evident fact that you have such a weak personality that it’s practically impossible that you’d steal money from your boss. 

◾ Yandere! Lawyer who takes every chance to hurt your feelings with snide remarks.

You look prettier when you cry, something so enticing about those shiny diamond-like tears that glow in your eyes and the miserable way you furiously blink to keep them at bay - to which you fail. 

You’re crying because of him. That’s enough to make him buzz with a twisted sense of possession and control. He holds that much power over you. 

◾ Yandere! Lawyer whose mind wanders over the tempting fantasies of returning home to you. You’d do a submissive girlfriend, he’s so sure of that. If he gave you a nasty slap and a few harsh words, you’d bend to his will so fast - like a obedient girlfriend should. 

It would be so easy to control your life.

Order you to move in with him. Command you to become his stay-at-home girlfriend. Push you to cut off friends and family until only he remains. 

Those misogynistic ideas keep him thinking about you longer than he should. 

◾ Yandere! Lawyer who isn’t afraid to act upon his wishes and so he does. After a triumphing win on court, he leaves.

Storms off without even looking at you and you don’t even have the chance to thank him, but you forget about that quickly. 

You have more pressing issues to focus on, such as rebuilding your life all again. Celebrate your win. Find a new job. Move on with your life the best as you can. 

Your peace lasts exactly one week. And then everything comes down in rubbles.

Because then he comes to retrieve his payment. 

[acwellness]

Randomized Controlled Trials of Beans

Randomized Controlled Trials of Beans

Do legumes—beans, chickpeas, split peas, and lentils—work only to prevent disease, or can they help treat and reverse it as well? Legumes—all kinds of beans, chickpeas, split peas, and lentils—are “an excellent source of many essential nutrients, including vitamins, minerals, fibers, antioxidants, and other bioactive compounds,” and not just an excellent source, but they are perhaps the single…

[bet-on-me-13]

Ellie worked undercover at Cadmus

So, Ellie has grown up and become an Adult living on her own by now.

She is doing her best to make the most out of her life. She went to school, graduated from College, and even got a Job.

She grew up in a Lab, and learned quite a bit about Genetic Engineering over the course of her life both before and after escaping (Both from Vlad, and from Danny during that Point in time where they were trying to permanently stabilize her).

So, when she gets an offer to join a new start-up Company called Cadmus, she jumped at the opportunity to use her Knowledge to help others. (She was told it was a Research Company that used Genetic Engineering to make medicines)

It wasn't until she had already signed the NDA that she figured out that this was an Illegal Cloning Lab.

Thankfully, she was immune to the Mind Control that they had tried to use on all of the Scientists to make them okay with all of the illegal shit, but she still had to play the part so she could help the poor clones who would be created in this project.

She went Undercover for years. Any time a Clone was deemed a "Failure", she would try her best to save them. She did manage to save a few, sending them to Danny so he could help them find a home, but unfortunately she couldn't save them all.

After a few years, the other scientists began to stress out. The K-Series had been a total failure so far, and none of the Clones had even come close to being Viable. Even the most successful one, identified as Match, couldn't come close to being called an actual success.

So, they went a different route. If Kryptonian DNA didn't want to be Cloned, then maybe they could splice it with some other DNA and force it to work with them?

The Scientists began splicing Human DNA into the Genome, running trials to see if it would be Viable at all before even attempting to create a Full Clone. And they did find some success, preliminary tests showed that Human DNA was uniquely adaptable when it came to splicing, and theoretically it could be used to make a Fully Viable Clone!

When Luthor heard of this, he deemed that nobody aside from himself was worthy of being the "Father", and gave his own DNA to the Scientists to use for the Experiment.

Ellie was put in charge of transporting the DNA to the Lab, but in a random accident (we both know it wasn't, Clockwork), she ends up dropping the Sample. In a rush, she just puts some of her own Blood into the Vial and gives it to the Scientists working on the Gene Splicing Project. (She was panicking, ok?! Nobody would be able to work in a lab like this without getting a little bit of anxiety, and she hadn't gotten a wink of sleep in days at that point!)

They are thrilled! They don't know why, but Mr Luthor's DNA was so much better at Splicing than any other Human DNA they had ever tested before. He was certainly right about his own DNA being the beat suited for the Job!

Ellie meanwhile is having a bit of a meltdown. She can't believe she just gave them some of her DNA! And they already used it to make a Fetus! She's a mother now! She never wanted to be a Mom!

But she guesses that none of that matters anymore. She's has a son now, and she needs to get him out of there. But how to do it? As the only successful K-Series Clone, he was under the most heavily guarded security imaginable, so there was absolutely no way she would ever be able to sneak him out of there. Even if she used her powers, the Security was primed to scan for any and all foreign energy signatures, even Ecto Energy.

So for now, she was stuck. She couldn't break him out, and she also couldn't just leave the Company and let them abuse all those poor clones like that! She just needed to wait for the right opportunity to get her son out of there, even if it meant that she would have to stay behind.

It wasn't until a team of errant Sidekicks broke into the Lab a few years later, that she had a way out for her son.

[ddarker-dreams]

random yan chrollo blurb because i can't stop thinking about him even if i try . 🙏

“Are you sure?”

“I’m sure.”

“… Are you still sure?”

“I’m still sure.”

“Swear to me.” 

“I swear.”

“That wasn’t sincere enough… swear… swear on the Troupe. In the name of their, uh, honor, or whatever.”

“Honor?” The word sounds humorous coming from Chrollo’s lips. “Very well. I swear on the honor of the Phantom Troupe that I won’t go back on my word.” 

You sit across from a formidable opponent. Fate has decreed this your lot, so you’ve taken what has been forcibly thrust upon you and sworn to crush it. However, at this stage, you’ve modified your parameters to be more realistic. The new, somewhat more obtainable goal is to leave a dent. Or a scratch, perhaps. 

For this dream to be realized, risks must be taken. The risk in this case is a willingness to interact with a man named Chrollo Lucilfer. His is a species defined by its tenacity. Through trial and error, you’ve concluded that typical avenues of escape aren’t in the cards. Nothing concerning the life you lead now is ordinary, so creativity and a solid vision are paramount. 

Your adversary sits leaning forward, his elbow on the table, forearm extending upward, and palm open. He observes you with the degree of amusement he always does, content in waiting for you to make the first move. 

You take a deep breath. Oxygen floods your being and blood circulates in full force. Every system in your body is primed and ready, there’ll be no better window, so you take it, springing into action. 

Contact is made with his outstretched palm. You steady your footwork for better balance, then pull, demanding everything your muscles can deliver and then some. This immense exertion of force is the culmination of your efforts. Hours of scheming by the window, exercising self-control not to pour salt on his strawberries so he’d be more affable to your requests, running mental calculations and simulations… 

… Alas, it’s not enough. 

You pitched a pseudo arm wrestling competition where you could use any means necessary to make him budge. You didn’t dare stipulate that you successfully pull his arm down, your hubris doesn’t extend that far; but the slightest movement on his part would spell your victory. A victory that’d have him fulfill any request your overactive imagination could conjure up. These terms and conditions were smoothed out in a verbal binding contract. 

His countenance is the same as it would be if he were flipping through a book or pulling his phone from his pocket — entirely casual. He isn’t even straining himself to maintain this stalemate. It’s possible that his physical strength is simply beyond your understanding, as is that parapsychological phenomena he refers to as Nen. 

“What,” you heave, disbelief coloring your tone, “Is your body made out of?” 

“Oxygen, hydrogen, nitrogen—” 

“It was rhetorical, Mr. Alchemist,” you cut him off. 

He simply shrugs and smiles. Somehow, his arm still hasn’t moved an inch throughout that exchange. The thought of this metric gives you pause. An idea is sown and imbued with life in the span of a few seconds. 

“Ah, that’s the expression you get before you say something endearing,” he comments, almost dreamily. 

You ignore him and straighten up, ready to argue over technicalities like your life depends on it. Seeing that you’ve abandoned your previous scheme, he relaxes back into the chair. 

“I have a case. How do we know your arm didn’t move… an atom to the side?” 

Chrollo tilts his head. “An atom?” 

“Yes. If an inch is a unit of measurement, there has to be something smaller. So maybe your arm didn’t move an inch, but it moved the width of an atom. Are you following me?” 

“...” 

You barely comprehend it. 

One second, you’re standing, the next, you’re sitting, with arms and a familiar cologne engulfing you. You can feel the low rumbling of his chest. He chuckles into your ear and secures you tighter against him upon sensing your instinct to struggle. Scowling, you cross your arms while he regains his composure. 

“Don’t be cross with me, dear,” he smooths out your shirt, as if it’d exonerate him of his transgressions. “I’m not laughing at you. You’re just… everything. Everything I need. I’m sorry. Please finish your point.” 

“Court’s adjourned.” 

“That’s a shame. When might it reopen?”

“Never, you’re sentenced to death. No appeals.”  

“I thought you opposed capital punishment?” 

“Each second that has passed since this conversation began has regressed my views by a decade each.” 

"I'll just have to hold onto you for the time being then."

All you can muster the strength to do is sigh.